Jonathan Cohn of TNR rides to the rescue of ObamaCare's redistribution:
Republicans Are Right: Obamacare Is Redistribution
But here's how it really works
And his gist: most of the giovernment funding is in the form of higher taxes on high earners (the new Medicare tax), fees on the health services industry, and reduced payments to health providers. So relax, everyone, ObamaCare is socking it to the oppressors!
I know what you're thinking - what about the stories about higher premiums, higher deductibles, and smaller networks? If newly-cancelled enrollees pay a higher premium (with a higher deductible), that does not show up as either a Federal tax or expenditure, although it does subsidize those with pre-existing conditions.
And what about all the stories about the importance of the 'Young Invincibles' who are expected to overpay for insurance to subsidize the rest of us (and who, despite the individual mandate, may become the Young Invisibles at enrollment time)? That also occurs outside Cohn's framework of government expenditures and receipts, but it is clearly important, so how did he manage to ignore it?
Cohn ignores the elephant by pretending everyone else is, too. He opens by excerpting this from a recent discussion on Fox News:
Republicans and their allies are making a lot of different arguments about what Obamacare is doing to America. It’s hiking premiums! It’s making people lose their doctors! It’s destroying Medicare! But if you listen closely, you’ll discern a common theme—a message aimed squarely at the middle class: Obamacare is taking away your money or health insurance, and giving it to somebody else. "If you think about it, it's $250 billion a year in Medicaid expansion, in the subsidy structure, that's basically being paid for by people on Medicare, through Medicare cuts, and a lot of tax increases," James Capretta, a former Bush Administration official now at the Ethics & Public Policy Center, said on Fox News Sunday. "It is a massive, massive income redistribution."
So since Capretta was ostensibly talking taxes, Cohn talked taxes. But link followers will find that taxes were a bit of an afterthought in the redistribution portion of the discussion. The moderator's intro was crystal clear:
WALLACE: All right. And that brings me to the final point I want to discuss here, and that is this question of whether or not ObamaCare has massive income redistribution.
Neera [president of the Center for American Progress], is it not the case that younger, healthier people are going to pay more than they currently do -- you got to let me ask the question.
Gee, that was not about taxes. Eventually Capretta was bnrought into the discussion:
WALLACE: Jim, is that a better deal or -- final word, is it a better deal or not?
CAPRETTA: Much worse deal. People today, if they're young and healthy can get relatively inexpensive insurance in the open individual market.
You're right about income redistribution, though. If you think about it, it's $250 billion a year in Medicaid expansion, in the subsidy structure, that's basically being paid for by people on Medicare, through Medicare cuts, and a lot of tax increases.
If you want to know what the bill is really about, people in their most honest and candid moments will admit that it's basically taken $250 billion a year out of taxes and Medicare and moving it into the Medicaid expansion and the subsidy structure. This other premium subsidies are also occurring between young and the old. But it is a massive, massive income redistribution.
So Capretta supplemented the 'young v old' argument with the point that Medicare is being cut for all, including the non-wealthy, and taxes are going up.
In response, Cohn decided his better rhetorical ploy would be to ignore the main point being made by the redistribution critics and press on, hoping no one would notice. Or more likely, figuring that even if people noticed, at least the left would have some new talking points around which to rally (Ed Kilgore at the Washington Monthly plays along uncritically, as does Paul Waldman at TAP). That is, if "tax the rich" can be considered a new talking point.
SOOOO YESTERDAY... The NY Times covered the controversial redistributive nature of ObamaCare a few weeks back, before lefties realized that they needed to rally around the rebuttal of a strawman argument:
Don’t Dare Call the Health Law ‘Redistribution’
By JOHN HARWOOD
Hiding in plain sight behind that pledge — visible to health policy experts but not the general public — was the redistribution required to extend health coverage to those who had been either locked out or priced out of the market.
Now some of that redistribution has come clearly into view.
The law, for example, banned rate discrimination against women, which insurance companies called “gender rating” to account for their higher health costs. But that raised the relative burden borne by men. The law also limited how much more insurers can charge older Americans, who use more health care over all. But that raised the relative burden on younger people.
And the law required insurers to offer coverage to Americans with pre-existing conditions, which eased costs for less healthy people but raised prices for others who had been charged lower rates because of their good health.