Wednesday, August 31, 2016

Swinging for the Fences, Using a Balsa Bat

But to explain why they should have done something else, I should first explain why I think that what we’re seeing now was predictable. The answer is that long before the exchanges opened, many critics warned that its weak mandate – the fines for failing to participate are modest -- would result in rampant gaming of the system by people who signed up only when they got sick.

The weakness of the mandate, like other flaws in the law, was politically necessary because the law was already quite unpopular, and its supporters couldn’t afford to alienate a single other voter. So they passed what they could and hoped to fix it later. However, the unpopularity of the law meant that there was a strong risk that they wouldn’t be able to fix it later, and indeed that is where we now find ourselves.

I don’t mean to suggest that the law has been an utter failure by the standards of its architects. They have not achieved anything close to universal coverage, but they did manage to reduce the number of uninsured people by somewhere between a quarter and a third. However, I think that if they had been a little less stuck on the idea of attacking every problem at once, they might have passed a less ambitious plan that would nonetheless have expanded coverage substantially, with far fewer risks to either the system or the Democratic Party.

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