In recent opeds for the Los Angeles Register and the Orange County Register, I explain how ObamaCare's requirement that insurers cover people with pre-existing conditions at the same price as healthy people dramatically reduces the risks associated with not having health insurance, and therefore creates a perverse incentive for people to drop their coverage and wait until they get sick to re-enroll. I expected most Americans would not know about this feature of ObamaCare, and that many of the law's supporters would not appreciate my drawing attention to it. I did not expect a Pulitzer Prize-winning journalist like Los Angeles Times columnist Michael Hiltzik to go to such great lengths to shoot the messenger. Hiltzik has devoted two columns to calling me "disreputable," "clueless," "obtuse," and "irresponsible," and my argument "lame," "dopy," "ghoulish," "asinine" and "blindingly obtuse." Well.
Pulitzer Prize-winning journalist Michael Hiltzik. Photo credit: Los Angeles Times.
Despite all the bluster, Hiltzik never actually disputes my central point. In an attempt to see if we really have a disagreement, I asked him, "True or false: ObamaCare makes it safer to drop one's health insurance than it was pre-ACA." He declined to answer directly, but his response lends support to my claim:
Cannon seems to be unaware that the goal of Obamacare is to make it easier to obtain health insurance, not easier or "safer" to drop it. The assumption underlying the ACA is that it's unsafe to not have health insurance…
My point flows tautologically from his: by making it easier to obtain health insurance when you need it, ObamaCare reduces the risk of not buying health insurance when you don't.
It's not that being uninsured now carries zero risk. Of course not. As Hiltzik notes, an uninsured person today can still get hit by a bus and be bankrupted by the ER bill. Or get cancer and be unable to obtain treatment until the following January, when she can enroll in an ObamaCare plan. But those risks were already there. ObamaCare has made the risk of being uninsured smaller than it was previously, because it drastically reduces the share of their medical bills that the uninsured will have to bear after January 1, and creates several new ways the uninsured can cover their medical bills between the onset of illness and that date.
It is reasonable to expect/worry that people will respond to the perverse incentives this creates. The risks associated with being uninsured were already small enough pre-ObamaCare that tens of millions of healthy people chose not to buy health insurance. When people learn that ObamaCare has reduced the expected cost of being uninsured, an even greater number of healthy people could make that choice. Yes, one goal of the ACA's authors and supporters was to encourage people to purchase health insurance. But the law's authors also created incentives that undermine that goal. It's not the first time they undermined their own handiwork.
Rather than confront this feature of the law, Hiltzik calls me names and distracts readers by falsely claiming that I "advise Americans not to sign up for ObamaCare." Not only is that false, the very idea of encouraging people not to purchase health insurance – even ObamaCare – is completely alien to me. When two colleagues with small children (!) told me they were dropping their health insurance because of ObamaCare, I cautioned them against it.
Where does Hiltzik see me advising people not to buy health insurance? "Maybe I misunderstood Cannon," he writes. "But it strikes me that by making the argument that [ObamaCare reduces the risks associated with dropping coverage] his words were indistinguishable from actually advising people to do so. Otherwise why make those claims?" Gee, just off the top of my head…maybe because it's true? Because people should know about these perverse incentives when making up their minds about this important policy issue? Because educating the public now could head off a disaster in which these perverse incentives destroy the health insurance markets that protect millions of Americans?
When you think about it, though, even the fact that Hiltzik misunderstood me corroborates my point. I was making bland observations about how ObamaCare has altered the risks associated with being uninsured. If simply describing those new incentives can be so easily mistaken for advocating that people follow them, then ObamaCare must have made not buying insurance significantly more attractive than it was before.
The name-calling and this one false accusation do not exhaust the ways Hiltzik misleads Los Angeles Times readers. He also tells them I somehow think "there's no downside to going without coverage" (obviously, false); that I am a "conservative" (libertarian, learn the difference); that I advise people to "commit fraud" (seriously?); and that I call myself an "expert" on health policy (I don't, because there's no such thing).
This is not the type of debate I enjoy. So I'll close with something I wrote in a follow-up piece for the Los Angeles Register: I wish Hiltzik got as upset with the people who created ObamaCare's dangerous incentives as he gets with people who draw attention to them.
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