Obamacare: Does California prove it can work?

Last week, California revealed that the premiums insurers will charge customers through its exchange are “surprisingly low.”

“There’s an Obamacare shock coming,” said Paul Krugman in The New York Times. But the people who’ll be shocked are the conservatives who’ve been gleefully predicting that the president’s health-care reform law will be a disaster. The big question hanging over the law has been how much the uninsured will pay for coverage through state-run exchanges when the mandate kicks in next year. Last week, California—“the law’s most important test case”—revealed that the premiums insurers will charge customers through its exchange are “surprisingly low,” due to strong competition. A single person would pay only $276 a month for a “silver” plan with moderate coverage—or just $104 if his income qualifies him for government subsidies. A “bronze” plan, with the barest level of coverage, would cost a young person just $172 a month—before any subsidies. Of course, “not every state is going to have as happy an experience,” said Matthew Yglesias in Slate.com. Out of sheer spite, Republican-run states such as Texas, Florida, and Alabama are refusing to help implement the law, guaranteeing higher premiums and more chaos. But as the inevitable problems in Obamacare get ironed out over time, Americans will know that if they lose their jobs or their employers don’t provide health insurance, they’ll be able to buy coverage at affordable prices. “In concrete terms, this has all the hallmarks of a successful and popular initiative.”

Don’t bet on it, said Philip Klein in WashingtonExaminer.com. California’s health-insurance prices may seem low—but even without Obamacare, young, healthy people can buy bare-bones plans right now for under $200 a month. They can also choose to go without insurance at all—an option they lose under Obamacare. If young people refuse to comply with the mandate, and decide to pay the $95 per person penalty instead, it will bring about the “Obamacare Nightmare Scenario,” said Peter Suderman in Reason.com. Then most of the people signing up for coverage will be older and sicker—causing premiums to skyrocket, and reinforcing “public skepticism of the law as an unworkable burden.”

That’s certainly the Republicans’ hope, said Ezra Klein in The Washington Post. They’re so dedicated to Obamacare’s failure that they are blocking the tweaks any big law requires, and are actively trying to “make it as big a mess as possible,” on the assumption that voters will blame Democrats. But if blue states like California, Oregon, and Washington are running “working, near-universal” health-care systems by the end of next year, it will throw problems in Republican-run states into stark relief. Voters may well direct their anger not at Obamacare, but at the Republican governors and legislators who have “failed to implement a clearly workable law.”

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The reality is that no one still really has any idea whether Obamacare will work or not, said Robert Samuelson, also in the Post. The law’s “plumbing is still under construction,” with a majority of states yet to unveil their own exchanges, and the federal government still deciding how it will run exchanges in the 27 states where lawmakers have refused to set them up. Much uncertainty also remains for the people most affected by the law—the uninsured, small-business owners, part-time workers, and the self-employed. Will small companies fire workers or cut salaries to pay for insurance? Will millions of people choose to pay the fines rather than comply with the mandate? As 2014 draws near, all that remains shrouded in “the fog of Obamacare.”

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