Health insurance premiums are rising under Obamacare. This was totally predictable as a result of applying the Romneycare model of health care financing to states that lacked Massachusetts’s provisions of guaranteed issue, community rating, and Massachusetts’s preexisting high premiums. Massachusetts is where the Obama/Romney model of health insurance reform made the most sense, and even there, Romneycare is eating the state budget.
Obamacare is going to increase health care premiums. It is unpopular. The obvious answer is to repeal Obamacare right? Not so fast. Public opinion is complicated and people are risk averse. Obamacare isn’t going to be repealed until the start of 2017 at the absolute earliest. Repealing Obamacare will not bring back the pre-Obamacare world. By 2016, a lot fewer people will have employer-provided health insurance than in 2010. Premiums will be higher. Democrats will have a case that the higher premiums (which of course are the fault of the greedy mean insurance companies) make not repealing Obamacare a moral priority. What are you going to do with people whose employers no longer offer health insurance? What are you going to do with people who can only afford their current (2016) health insurance because of the Obamacare subsidies? What are you going to do with people with pre-existing conditions? What happens if I lose my job and can only get a series of part-time jobs that add up to forty hours a week but don’t offer health insurance? Absent these answers, a lot of people who tell polls that they disapprove or are neutral toward Obamacare might operate based on an attitude of “Maybe Obamacare isn’t good, but what are you going to do and anyway things could be worse.”
Republicans need both a negative and a positive message on Obamacare. Obamacare raised premiums, will cause millions to lose their employer-provided health insurance, discourage businesses hiring workers full-time, and raised taxes to boot. We need better health care policies. Congress can, in repealing Obamacare, make Indiana-style low cost HSA/catastrophic coverage health insurance plans legal in every state. We can offer tax credits to make it easier for workers whose employers to do not offer health insurance to buy their insurance without discouraging hiring. We can make health insurance available to those with pre-existing conditions much more cheaply than under Obamacare. Republicans will be able to say that we will save you money, help the uninsured, and encourage job growth. The best part is that replacing Obamacare with these kinds of laws would actually make health care policy better that the pre-Obamacare status quo. That’s what winning looks like.
And it wouldn’t just be good policy. It would also give Republicans something to say to younger voters. Younger voters are going to be hit especially hard by Obamacare, but they have to be convinced. Younger voters haven’t been socialized into the conservative narrative that government-run medicine is terrible. The standard center-right rhetoric they hear from the most prominent Republican spokesmen means nothing to younger voters. That shouldn’t be surprising and it doesn’t mean that younger voters are obtuse. Most of the 2012 Republican presidential candidates couldn’t make a coherent case against Obama/Romney-style health care policy to Republican primary voters ever mind non-Republican young people.
Obamacare is an opportunity if Republicans can just seize it. A Republican alternative health care policy would give younger people (and not just younger people) an easily comprehensible reason to vote Republican. Democratic health care policy makes you pay too much for health insurance and punishes you if you won’t pay the inflated prices. It makes it tougher for you to find full-time work. Vote Republican and you can get cheaper health insurance while still helping those with pre-existing conditions and offering a chance at health insurance to people whose employers don’t offer insurance while making it easier for you to find a job. Aren’t you glad you joined the Republicans?
