Tuesday, November 05, 2013

Dammit, take credit for the good!

Many of us who support the primary goal of the Affordable Care Act--to provide access to insurance for many more Americans--get frustrated by the inability or unwillingness of the administration to create a powerful narrative for the law.  A story earlier this week in the New York Times provides an unfortunate example.

The headline is a winner: Under Health Care Act, Millions Eligible for Free Policies.

The lede is more qualified:

Millions of people could qualify for federal subsidies that will pay the entire monthly cost of some health care plans being offered in the online marketplaces set up under President Obama’s health care law, a surprising figure that has not garnered much attention, in part because the zero-premium plans come with serious trade-offs. 

We can't blame the administration for the reporters' choice of words, but in the second paragraph they start to dig themselves into a hole:

Three independent estimates by Wall Street analysts and a consulting firm say up to seven million people could qualify for the plans, but federal officials and insurers are reluctant to push them too hard because they are concerned about encouraging people to sign up for something that might ultimately not fit their needs.  

What is this paternalism? We are reluctant to tell people about plans that can help them because the plans may not help them as much as plans they can't afford?

In contrast, the advocates understand that something important is being made available:

Supporters of the Affordable Care Act say that the availability of free-premium plans — as well as inexpensive policies that cover more — shows that it is achieving its goal of making health insurance widely available.

But then we get this "no comment" from the administration:

Officials at the Department of Health and Human Services would not comment on the McKinsey analysis, saying in a statement that the goal of the health law was to provide a range of options for people with differing needs and budgets.

In a unattributed statement?   Luckily someone else is out there who is willing to be quoted:

The availability of zero-premium plans may make the deal especially enticing to the healthy young people the marketplace needs to succeed, said Mark V. Pauly, a professor of health care management at the University of Pennsylvania’s Wharton School. “This is such a good deal that you’d have to believe you were immortal not to really pick it up,” he said.

I wish the administration would likewise learn to claim victory on these matters.

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