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Health care policy is too complicated for political sound bites

October 29, 2013, at 4:31 PM

President Obama created a major public relations headache for himself when he declared — repeatedly — over the last several years that people who like their health insurance plan would be able to keep it under the Affordable Care Act.

However, NBC News reported last night that millions of Americans will actually lose their existing insurance coverage and the White House knew this was coming.

The problem is that the health care system is much complicated and more nuanced than Obama's convenient sound bite. He probably shouldn't have said it. But problems the law may cause a small number of Americans are being blown up to make it look like they're affecting all Americans.

The reality is that those currently without health insurance or with pre-existing conditions will likely be better off under the law. Those currently with cheap catastrophic policies may be worse off if they cannot find a new policy. But the vast majority of Americans will notice no difference at all in their health insurance coverage.

Three policy wonks explain:

Jonathan Cohn: "ObamaCare is transforming one part of the existing health insurance market, in ways that will force some people to pay more than they do now. But that's only part of the story. Many other people, quite possibly the majority of people in that market, will pay less than they do now. And even those paying more will be getting more comprehensive, more secure insurance. If all of this sounds familiar, it should. Health policy experts spent much of the summer arguing about this very point — about the likelihood of both 'rate shock' and 'premium joy' and which effect matters more. The lesson of that debate (at least to me) was that journalists, politicians, and anybody else talking about this should really provide a full, nuanced picture — noting all the ways ObamaCare is affecting premiums and how that will play out for people in different situations. But that doesn't seem to be happening, except at places like Politifact. More typical is a recent study from the Heritage Foundation suggesting that most people will end up paying more. That report continues to reverberate throughout the right wing press, even though it left out half the facts."

Ezra Klein: "The conversation over these premiums has been confused to the point of being outright misleading. It's become common, for instance, for the Affordable Care Act's critics to compare sticker prices in the individual market to the prices in the exchanges now. Since it was routine before for a quarter of people to be turned away or quoted a higher price after revealing their health history, this isn't just comparing apples to oranges. It's comparing apples to oranges that many people couldn't even buy."

Greg Sargent: "Critics of the law are right to ask whether it is having an adverse impact on these millions of Americans. And the White House could have been clearer in laying the groundwork for this political argument: It wasn't sufficient to say people who like their plans will be able to keep it, which is narrowly untrue. But the GOP outrage about Americans supposedly 'losing' coverage is largely just more of the same old misdirection. It's a subset of a larger Republican refusal to have an actual debate about the law's tradeoffs — one in which the law's benefits for millions of Americans are also reckoned with in a serious way ... Only the law's downsides, and not the millions who stand to gain — many old, poor or sick — must be acknowledged.”

Our political system doesn't do justice to helping Americans understand the nuances of our health care system. And when the solution is as polarizing as ObamaCare, the added confusion only serves the interests of many politicians.

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