Yesterday California rolled out is ACA Exchange, and it looks like a rousing success:
An estimated 5.3 million Californians will be eligible for coverage through Covered California, the state agency running the insurance marketplace. The lowest-income people will be referred to public safety net programs, while some 2.6 million middle-income residents will qualify for federal subsidies to help pay their premiums.
Covered California provided examples of what a 40-year-old would pay depending on income and where that person lives.
A San Francisco resident earning more than $46,000 a year will be able to choose among five plans with a monthly premium ranging from $221 to $501.
Meanwhile, a 40-year-old resident in Fresno who earns about $15,400 a year will be able to pick from four plans and will be eligible for federal subsidies. That person can expect to spend between $53 and $102 on premiums each month on a middle-of-the road plan.
In other words, the exchange has done what it promised to do: make insurance available at reasonable prices to uninsured Californians. This is, of course, a disaster for Republicans:
Based on the premiums that insurers have submitted for final regulatory approval, the majority of Californians buying coverage on the state's new insurance exchange will be paying less—in many cases, far less—than they would pay for equivalent coverage today. And while a minority will still end up writing bigger premium checks than they do now, even they won't be paying outrageous amounts. Meanwhile, all of these consumers will have access to the kind of comprehensive benefits that are frequently unavailable today, at any price, because of the way insurers try to avoid the old and the sick.
Obamacare critics have long warned, and Obamacare defenders have long feared, that insurers selling plans through the new exchanges would inevitably jack up premiums—if not to pad profits, than to adjust to the regulations that the new law imposes....
For some young, healthy people who now have skimpy, dirt cheap coverage, the new prices really will seem rather high by comparison. But experts think the number of people who fit that category will be small. That's one reason why, on Thursday, officials and consumer advocates were talking about a very different kind of sticker shock: Premium bids that were lower than expected. “For plan after plan, we’re getting the best-case scenarios,” said Peter Lee, executive director of Covered California.
The availble figures back up that verdict.
Krugman is gleeful:
[T]hink about the political dynamics. Because the Supreme Court decided to let states opt out of the Medicaid expansion, some states — notably Texas — will have a pretty dysfunctional version of Obamacare in 2014, although even those systems will provide significant benefits to many people. Still, the whole political calculus was supposed to be that Republicans in red states could point to the horrors of Obamacare and ride them to political victory. Instead, it looks as if we’re going to see blue-state residents reaping the benefits of a functional health care system, while red-state residents are denied many of those benefits, for what looks like no better reason than mean-spirited spite — because what’s going on is, indeed, mean-spirited spite.
Suddenly 2014 just got a lot more interesting. Politics on one side, policies on the other...which will win?