Does ObamaCare really depend on the young?

Health Law’s Success Rests on the Young” is the headline on a front page Wall Street Journal article today. The Journal’s Op/Ed pages have been hopelessly reactionary for decades, but it’s only recently that the news section has started to become polluted with bias.

The article makes it seem as though ObamaCare’s survival depends on 20-something’s signing up for health insurance to pay for all the old, sick people out there. The article also points to Portland, OR to demonstrate that subsidies for those with low incomes will be lower than expected and thus will discourage people from signing up. The implication is that young adults won’t sign up for health insurance because it will be cheaper to pay the penalty for violating the mandate than to buy insurance.

The article includes a balanced view if you look carefully, but t de-emphasizes a number of important points:

  • Penalties may be low at first, but they go up by a factor of 4x over the first three years starting in 2014. So even if it seems worthwhile to pay the penalty at first, that calculus will change over time
  • The reason subsidies are lower than expected is because some insurance companies are being more aggressive than expected in offering low-priced plans. Those low prices are available to all –whether they are eligible for subsidies or not– and I expect people to choose those inexpensive plans. Contrary to what critics expected/hoped for, prices on the exchanges will be aggressively low
  • The exchanges are only one of the ACA’s mechanisms for offering health insurance to young adults. Everyone can stay on their parents’ plan till age 26, small employers will receive subsidies for coverage, and Medicaid eligibility will be expanded. It’s a real stretch to assert that those who aren’t covered by any of these mechanisms are the key to the law’s success
July 25, 2013

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