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Wednesday, June 05, 2013

It doesn't have to add up to a lot of money for people to get upset at Big Government

by digby

As I listen to progressives explain why the people who will pay higher health care premiums should not be upset by it, I can't help but remember an event that took place here in California 10 years ago exactly:
California's vehicle license fees, which are based on the value of the car or truck, tripled Friday as state officials allowed a controversial provision of a law which had been gradually lowering them to kick in.

That provision sends the fees up to previous levels in times of state budget difficulties. California would face a possible budget deficit of as much as $38 billion by the end of the coming fiscal year if spending and revenue trends were to continue.

The increase could boost the annual fees by an average of about $130.

The trigger for the increase had been a political hot potato as Gov. Gray Davis and some other elected officials tried to find a way to increase the fees without opening themselves up to voter backlash.

But state Sen. Tom McClintock, an opponent of the fee increase, on Friday filed paperwork with the state attorney general to collect signatures on two measures to lower or eliminate the fee.
We know what happened. They ended up recalling Davis and we ended up with a full decade of completely dysfunctional government.

It's a different time now and health insurance benefits people directly while a vehicle licence fee does not. And yes, the private insurance market is much smaller than the number of people affected by the vehicle license fee. I draw the analogy simply to illustrate the fact that appealing to the common good will not work on everyone and that Republicans will find a way to turn this into a crisis, even though it will be just as stupid as that vehicle license fee brouhaha was. For the GOP the fact that premiums will go up for some people is very good politics.

I am not saying that Obamacare won't be a net improvement. Of course it will be -- it gets a lot of people insured who couldn't be insured before and over the long haul it will likely lower costs throughout the system. But if implementation means that some people will have to pay more, it's fair to assume that the Republicans will turn that into a full blown hissy fit --- and that many of the those affected are going to scream bloody murder. People are looking for reasons to be upset about it.

If everyone read Jonathan Cohn's piece in today's TNR, the majority of them would probably come away assured that they are getting a good deal and it's all worth it. But as I wrote earlier, the people who buy their own insurance on the private market know what they're paying for and being told they will have to pay more for insurance they already decided they couldn't afford is going to make at least some of them mad. Some of those who aren't currently insured will also feel they are being made to do something they had consciously decided not to do. So the idea that it's going to be a breezy, simple thing that everyone will gladly accept because it's the right thing to do and will help other people just seems naive to me. I feel as if this is going to be a political battle and the supporters of the ACA aren't really prepared for what's coming.

I could be wrong, obviously. It's absolutely true that the number of people who will have a plausible cause for complaint is quite small and maybe there won't be very many who object. But what does that have to do with what the Republicans are going to do with this? They are very clever at turning people into victims of Big Government.

You can see how they are looking at it from this tweet from Townhall editor Kevin Glass:

This article in Reason makes that point as well. I do remember there being discussion of rates going up but not as much as people are saying in that article. More importantly, I think that when the endless talk of lowering health care costs was raised s a primary motive for the reform, most people assumed it would lower their costs/premiums too. I'd be shocked if the average person who paid attention during the health care debate understood that health insurance premiums would likely go up for some people.

I was one who did, and I wrote about it, predicting some of this reaction back in 2009. I've always been willing to try to find ways to pay more because I do care about those uninsured people and I understand that everyone had to chip in in order to get more poor people cared for. I just can't see my right wing "business consultant" neighbor who already complains about government regulations being someone who feels the same way. Maybe I'm underestimating him. But I doubt it.

Here's a debate on this between Avik Roy and Ezra Klein on Chris Hayes show last night on this very subject.
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I think Ezra is over estimating the fact that because he responded to a CBO report and something from Evan Bayh that this constitutes a "debate" on the fact that premiums would obviously go up.  That's a very elite debate --- and I honestly don't believe that this was made apparent to the public by the administration or Democrats in general.  I listened very closely and what was mostly being discussed was cutting costs and covering more people.  Sure, it should have been obvious that the money would come from somewhere, but I don't think it was clear that some of it would be coming out of individuals' pockets in the form of higher premiums. I'd love to see some polling on this at the time.

I'm sympathetic to the idea that the ACA was a hugely complicated bill that was difficult to explain. I'm sure it's frustrating to those who were deeply immersed in the details to find out that people didn't get the basic premise.  But I think everyone should have been prepared for the fact that these sorts of changes would be used by the opposition to undermine support for the plan. And now that we see just how willing the Republicans are to block all the tweaking/improvements that everyone knew would be necessary, this attitude is going to be even more of a problem.