The NYT published a news piece today on the Affordable Care Act that accuses Republicans of “preparing to exploit every problem that arises” with Obamacare in the next midterm elections. The most telling part of the piece comes at the end. After heaping scorn on Republican opportunism, the author delves into what Obama will need to do to make the ACA work:
The stakes for the president are high. The ultimate success of the law, and in turn his domestic legacy, depends on how well the insurance marketplaces operate, and whether enough young Americans enroll for coverage [...]
He will especially urge healthy young adults, those up to 35 years old, and minorities — groups in which he has “a lot of cachet,” Mr. Pfeiffer said — to sign up starting Oct. 1 for the new exchanges. Beginning Jan. 1, most Americans must have insurance or pay fines.
Without the participation of that generally healthy young population, insurance premiums for everyone else would increase—threatening support for a law already short of it.
In short, the success of the ACA wholly depends on President Obama’s ability to persuade young people to voluntarily subsidize the old. If young people don’t agree to sign up for expensive plans full of benefits many of them don’t need, the oldsters won’t be able to afford the high cost of their plans.
This is exactly why we’ve been worried about the ACA from the beginning: It is founded on a huge generational transfer from young to middle-aged. This is an especially bad deal for younger generations, not least because the rapidly growing costs of health care (which the ACA doesn’t do enough to control) pretty much guarantee that they won’t be able to have the same kind of benefits as today’s middle aged by the time they reach their 50s.
The Democratic plan to make Obamacare work apparently boils down to a hope that the President can successfully abuse the trust that young people have placed in him by convincing them sign them up in large numbers for a bad deal.