The Wall Street Journal today reports on a fallback health care plan that's been floating around the Obama administration for weeks, but seems to have been rejected by President Obama. The plan would expand Medicaid, the Children's Health Insurance Plan, and require insurers to let people stay on their parents' insurance plan through age 26. Ross Douthat enthuses:
the more modest plan is instructive. Per the Journal, it would insure half as many people as the House and Senate bills — 15 million, all told — at a quarter of the cost. 15 million happens to be roughly the number of American citizens who don’t have insurance, aren’t already eligible for Medicaid or S-CHIP, and make less than 300 percent of the poverty line. Which suggests that you can do some of the most morally urgent work of health care reform without a mandate or price controls, and at a fraction of the current legislation’s price tag.
I appreciate Douthat's enthusiasm and good intentions, but he's simply mistaken here. He seems to believe that this "skinny bill" insures new people at half the per unit cost of the big bill because it would introduce some wondrous new efficiency. In fact, it's cheaper because most of the people it would cover are children and young adults, who are inexpensive to cover. In other words, this would do the least morally urgent work of health care reform. This would make it harder to eventually cover the worst-off victims of out broken system, because these young and healthy customers are the bait Democrats have dangled in front of insurers to get them to accept the new requirements to cover high medical risks.
Moreover, it would also do nothing to reform the insurance markets or to set up the delivery system reforms that health care wonks believe could have a transformational effect. Plus I doubt you could get it through Congress anyway -- it's not like you have a lot Republicans in favor of expanding Medicaid and S-CHIP or layering new regulations on the insurance industry.