Peter Suderman explains his problem with the Obama administration’s plan to offer accelerated implementation of state flexibility around the Affordable Care Act:
the supposed flexibility the opt-out provision gives the states to innovate is fairly limited. Theoretically, they can get out of the mandate. But to do so, they have to submit a proposal that is judged to cover the same number of people, for the same cost (or less), with the same benefit and coverage levels as mandated in the law. That will make it easier for states–like Sen. Bernie Sanders’ home state of Vermont–to experiment with, say, single payer at the state level. But the high bar for coverage set by ObamaCare means that proposals that would rely on higher levels of cost-sharing, on increased use of catastrophic insurance, on allowing consumers to choose what benefits they actually want to pay for are less likely to pass muster.
Brian Beutler translates: “so this opt-out plan is useless if what you want to do is provide crappy benefits to the people in your state.”
It strikes me, though, that this would be a productive direction for the debate to take. If you define the minimim benefits package more generally, you need higher taxes. Conversely, if you want to cut taxes for the rich, you need the non-rich to have stingier health care plans. This kind of debate—left wants high taxes to offer generous benefits, while the right wants stingier benefits to make lower taxes affordable—is very much “normal” politics and you never see an end of it. Here, suddenly, apocalyptic rhetoric about socialism and pulling the plug on grandma is gone. You just have a basic taxes vs spending, progressive vs regressive debate of the sort that exists on tons of other issues.