The Conservative Case for the Affordable Care Act, Part III - Ezra Klein - The Washington Post

 

By Ezra Klein

Reihan Salam is tired of having to rebut the claim that the consistent thing for conservative supporters of subsidized-insurance exchanges for the over-65 set to do would be to support — or at least admit the potential viability of — subsidized exchanges for the under-65 set, which is a model better known as the Affordable Care Act.

But moving on from it is easier said than done. The policy Reihan is trying to defend — the Ryan-Rivlin bill (pdf) — appears to mimic the Affordable Care Act. One of its two namesakes, Alice Rivlin, believes that it mimics the Affordable Care Act and has said so on-the-record. Its other sponsor, Paul Ryan, says he disagrees, but he can’t explain why. When asked, he said, “how I would do exchanges are very different than how Alice wants to do exchanges.” He didn’t go into further detail. I subsequently asked Ryan’s staff if Ryan would like to do an interview explaining how his exchanges would differ. The request was declined. I then asked his staff if they could explain to me how Ryan’s exchanges differ. They didn’t respond.
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Health Care Opinion Leaders' Views on Congressional Priorities - The Commonwealth Fund

More than nine of 10 leaders in health care and health care policy believe the general direction set by the Affordable Care Act is appropriate, with nearly seven of 10 favoring implementing the law with little or no change, according to a Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey. A large majority of leaders support moving forward with each of the major elements of reform, including the individual mandate, state-based health insurance exchanges, and Medicaid expansion. Survey respondents believe payment approaches that encourage care coordination for patients with chronic diseases, establish greater alignment across public and private purchasers, and incentivize the use of evidence-based medicine will be effective in achieving a high performance health system. Eighty-one percent of leaders support expanding successful cost-containment pilots contained in the Affordable Care Act as part of a federal budget deficit reduction strategy.

Citation

K. Stremikis, S. Guterman, and K. Davis, Health Care Opinion Leaders’ Views on Congressional Priorities, The Commonwealth Fund, February 2011.

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