When asked what makes the world work, any self-respecting right-wing Republican knows the politically correct answer: competition! (With at least one exclamation point.) It is the paramount principle and universal solvent perennially touted by the right to cure whatever ails us – in the abstract.
What they don’t seem to like so much, in reality, is the competitive impact of the Affordable Care Act, which is forcing health insurance companies into a contested marketplace – and seems to be driving down rates, state by state. The latest data arrived this week from New York, where insurance regulators announced that the new rates approved for 2014 will be 50 percent lower, on average, than current rates.
That stunning report follows similar news from California, where rates may drop by as much as 29 percent, as well as Oregon, Rhode Island, Vermont and several other states where the early indications show rates declining. Based on data compiled from 10 states and the District of Columbia, the Department of Health and Human Services says that 2014 premiums for mid-range (or “silver”) health care plans in those states will be nearly 20 percent lower on average than its own earlier estimates.
The reason is simple, as anyone familiar with the American health care marketplace knows. Most states until now have had no meaningful competition among insurance companies — and certainly nothing like the health insurance “exchanges” created by Obamacare to guide consumer choices.
In states that have actively promoted the exchanges, real competition is arising thanks to a marketplace that allows consumers to examine and understand choices, plans, and prices with ease. “That’s a very different dynamic for these companies, and it’s prodding them to be more aggressive and competitive in their pricing,” explains Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reform.
For those of us who preferred (and still favor) a single-payer system providing Medicare to everyone, the compromises of Obamacare always provoked doubts about efficiency and fairness. Many liberals supported the Affordable Care Act reluctantly as a bad deal that was acceptable only in lieu of no deal.