If nothing else, the government shutdown and the simultaneous opening of the ACA exchanges has created the opportunity to discuss the issues with Republicans. Some observations below the crashing waves.
I pay for my own health insurance and I hope to save some money because of the exchange. Higher or lower, I will blog about my rates when I can actually get them arranged.
But I work with people that have employer provided health insurance and I am finding that there is a problem. They aren't learning the things we learn here.
1. They do not know what health insurance rates were like before. They may have heard, and they do make a contribution to their own health insurance, but they have never had to bear the full cost so they have never really internalized the true cost of health insurance.
2. They do not have to try to find health insurance for themselves on the exchanges, so they are not having good or bad experiences there themselves.
3. They are getting most of their "news" from Fox - need I say more?
Since about 70% of the population is covered by employer sponsored health insurance, this is the case for a lot of people. Presumably, about 70% of Republicans are going to only hear about it and never experience the exchanges etc. And this is a problem.
What is likely to save us from the disinformation they get from Fox is the fact that most of them do have friends and relatives that will benefit from the ACA and the exchanges. Hopefully some information will filter in that causes them to eventually realize the full extent of the lies they have been told.
And we need to be evangelists about this. Those of us with personal experiences to tell and from what we learn from each other here on DK need to interact with them. I did that yesterday, and here is my Reader's Digest condensed version of that encounter.
I got these quotes from a guy I work with - a decent guy but totally in the tank for Republicans:
"Yes, I heard about a guy that was paying $200 a month that is now having to pay $500 a month."
and:
"Everyone is having to pay 2 to 4 times as much as before."
I countered with the example here on DK about the republican couple that were "able to buy a far better plan than [their] current policy while saving at least $13,000 per year." My friend's take on that was that the truth is probably somewhere in between the extremes of Fox News on the one hand, and MSNBC on the other (already movement on his part).
I came back with the need to compare apples-to-apples and that the story I had told was an Apples to even better Apples story. I said that there are enormous differences between insurance policies, that some were crap, and that the ACA sets standards for minimum insurance levels. If companies were free to provide whatever level of insurance they wanted to, I asserted, then a mandate to provide it would be meaningless because they could just buy junk insurance for their employees.
He understood this because the teachers in this state have really crappy insurance provided to them that isn't worth anything. His wife is a school teacher and they obviously get their health insurance through his job instead. He said they have been put on notice that rates for the teachers are doubling this coming year with an additional 40% the next because of the ACA.
OK, I pointed out, it's the same thing for the guy who used to pay only $200 per month for junk insurance. Now that the ACA mandated minimums are in place, both the school teachers and that guy are now getting real insurance. Those comparisons are not apples-to-apples I pointed out.
I think he got that, but there was an even deeper discussion about how the subsidies work, and that was where I really got him. I explained that on the exchanges everyone could look to see what rates they could get and that they could quickly and easily compare rates from different companies for similar levels of coverage (I didn't go into all the details of metal levels etc. - he didn't need to know that). And then, I told him, they ask you for your estimate of your 2014 income and they determine how much you should be able to pay. Then, the government chips in (no discussion of tax implications etc. e.g. K.I.S.S.) an amount to help pay for the difference between what you can supposedly afford and what it will cost a person.
That got him mad again. "See, that's where we hate it," he countered. "People being dependent on the government."
Wait a minute, I implored him. Previously, these people had no insurance and effectively got health care for nothing because when they needed medical care they got it anyway. The government makes payments to hospitals for that (taxes for us) AND we pay for that through higher costs when we need health care ourselves and when we buy insurance. Now, I said, they - the poor - are going to be paying some of the cost of their health care. It may not be all of it, but they will be paying something. They (poorer people) are actually going to be paying more for health care now than they have in the past, but they are more than willing to do that, because they want to be responsible Americans like us. They don't want a hand out. But when they have a minimum wage job that only pays them a thousand dollars a month, how are they supposed to pay a $700 per month premium for health insurance? Maybe they only pay $100 per month under this plan, but it's $100 more per month toward their health care that we don't have to pay any more.
I think he got it. My parting shot was that in the next election he would be voting Democratic. He disagreed with my assessment.