Obamacare supporters are taking a much-needed victory lap this morning over the news that the law will dramatically reduce individual market premiums in New York state.
That’s a political coup for Democrats, both because the headlines look nice and because they point to the reality that the law will make life better for thousands of people. New York’s a big state!
But as I’m sure others have already pointed out, New York’s also a unique state. And the health policy status quo there makes today’s news entirely predictable.
This is oversimplified, but New York law is essentially half-carrot, no stick. Anyone can buy health insurance on the individual there, but because there’s no mandate and related counterbalancing regulations, insurers charge most people a ton of money for it.
To switch metaphors, Obamacare will attach the missing legs to that stool, including subsidies, and therefore bring down insurance costs. In a very real sense, the news out of New York vindicates the consensus view that the mandate-subsidize-regulate policy only works if it includes a mandate, subsidies, and regulations. This vindication couldn’t be better-timed, as the House of Representative gears up to vote on legislation to delay the mandate for a year.
But because New York has sui generis insurance regulations, its consumers experience will also be unique. They already have part of Obamacare — they’re just about to get the other parts that make it all work together.
That means consumers there will have a different lived experience of the law than states that are starting from scratch. It’s no coincidence that of the biggest states in the union, the White House is focused on outcomes in California, Texas, and Florida. And if you’re looking for Obamacare news that can be generalized look to states like that. If they get it right in any one or all three of those states, the jig will be up for ACA saboteurs.
