The high-deductible plans in the Affordable Care Act
For obvious reasons, it’s very difficult for conservatives to admit that the Affordable Care Act includes a lot of the policy ideas they’ve been pushing for years. But as the Kaiser Family Foundation’s Drew Altman points out, the law includes very high-deductible plans that leave individuals with a lot of exposure to costs and thus incentive to save money — an approach that conservatives have been advocating for a long time — even thought it never gets credit for including that idea. And note that the table atop this post is for single coverage — the deductibles are twice as large for family plans. As Altman concludes:
A different way of looking at the ACA is that it represents a bargain between liberals and conservatives, although not one that was ever explicitly made. The left got 32 million people covered and reforms that eliminate the worst abuses in the health insurance system. And the right got a further push, beyond the momentum already underway in the market, towards just the kind of "skin in the game" insurance they have always believed will help control health care costs. It’s the big victory in health reform conservatives seem not to realize they have won.
The irony of the health-care reform law, which included a lot of ideas proposed during the Gang of Six’s negotiations even as it didn’t include any votes from the Republicans who were part of the Gang of Six, is that conservatives got a lot of their ideas into the bill, but did not themselves have to put any “skin in the game” to get them there.