[C]uts to Medicare Advantage are not bugs. They are features of the system. So are:
-The cuts to Medicare’s Hospital Fund
-The redistribution of wealth from the young to the old.
-The redistribution of wealth from rural communities to urban ones.
-The as yet unrealized (thanks to a presidential waiver) premium and deductible increases, as well as a narrowing of health networks, for people in the small group marketplace. These people will not be eligible for subsidies.
-The realized premium and deductible increases, as well as a narrowing of health networks, for people in the individual marketplace who did not get a subsidy (and for many who did as well).
-The impending increases in costs for large businesses and therefore their employees.
This gets to the heart of what is, at its core, the strongest argument against Obamacare. And it is a non-ideological one at that. It goes something like this:
Barack Obama and congressional Democrats wanted to expand health insurance coverage, but political constraints prevented them from creating a straightforward program like Medicare that spreads the burden evenly across society. What they did instead was create a series of implicit taxes upon certain, politically disadvantaged groups of people to pay for the coverage expansion for the politically advantaged groups. These implicit taxes are, in many respects, socially perverse. That is, they burden middle class people whom we as a society usually try not to burden. These people were burdened by Obamacare not because there was no way around it, but because Democrats wanted to grossly understate the true costs of the expansion. In other words, not only are these people losing, they are losing for purely political reasons.
Obama, Democrats in safe congressional districts, liberal opinionmakers, and their friends in the media have studiously avoided acknowledging these burdens. Indeed, Obama’s “apology” for lying about keeping your plan if you liked it was the very definition of grudging, and was only forced from him after the lie was plain for all to see.
But vulnerable Senate Democrats, who are compelled to keep an eye on what is happening on the ground in their states, know better.