I would not be surprised at all if the health-reform bill, once implemented, will trigger some and perhaps quite a bit of migration from the employment-based health-insurance platform onto the individually-insured platform based on health insurance exchanges. The White House would be well advised to acknowledge that possibility and to defend it, as can easily be done.Indeed, if memory serves me accurately, Stuart Butler or John Goodman would not mourn the erision of the employment-based health insurance system either. Would they not favor a system of truly protable, individually purchased insurance policies in place of a system that tied individuals to particular jobs and offered ephemeral coverage? Why should small business be saddled with the problem of health insurance?
That’s right. Conservatives have been arguing for years that we should eliminate the tax subsidy for employer based insurance and give everyone the choice of purchasing insurance through the individual market. Sen. John McCain’s (R-AZ) campaign plan provided Americans with tax credits to purchase coverage on their own and some of the party’s brightest thinkers still believe that placing the individual in charge of his or her own health insurance plan is the way to go. If you don’t believe me, you should listen to Gov. Mitch Daniels’ (R-IN) solutions for reforming health care at yesterday’s AEI event.
The health care bill that Congress passed and the President signed would take small and gradual steps towards that direction (albeit with far greater regulation of the individual insurance product) without blowing up the employer health care system. After the first 10 years, the Congressional Budget Office estimates that “the number of people obtaining coverage through their employer would be about 3 million lower in 2019 under the legislation.” The Center of Medicare and Medicaid Services estimated that just 1.4 million would move out of employer coverage.
So what conservatives are criticizing is actually slow crawl towards their own ultimate goal. But rather than attacking the pace of reform, they’re characterizing the very idea of losing employer-based insurance as a failure in the new law. If that’s the case, then what does it say about their own health proposals?