Consider this from Grace Marie Turner, commenting on a new study by the Urban Institute:
The number of uninsured people in the U.S. grew by 3.4 million between 2004 and 2006, a time of robust economic growth, largely due to a continued decline in employment-based health insurance. This is the key finding in the latest study by John Holahan of the Urban Institute entitled, "The U.S. Economy and Changes in Health Insurance Coverage, 2000-2006."
Not surprisingly, the declines were greatest among those with lower incomes.
It is worth remembering that every time the cost of health insurance rises by 1%, the number of people with health insurance declines by 200,000 to 300,000 people. During 2004-2006, employer health benefit costs rose by nearly 20%.
It is not surprising that those at the lower end of the income scale, whose wages are most sensitive to benefit cost pressures, are most likely to be impacted.
Is the answer going to be trying to force employers to provide health insurance, as both Sens. Clinton and Obama would do? Especially when the mandated coverage is going to be at least as rich as that provided to members of Congress?
Providing lower-income workers with meaningful subsidies to buy more affordable, portable coverage would seem a much more sound prescription for realistic reform.
To paraphrase the classic campaign line, "It’s the costs, stupid."
I’d add to that getting rid of unnecessary mandates, of course. Our progressive friends can dance around the issue of mandate costs all they like, but it looks like – according to this Urban Institute study – we could get significant re-uptake by the private sector of health insurance for employees if we could just lower the costs. Mandates are a good place to cut costs. And while we might argue about which mandated coverage items are "critical" or "essential", some clearly are not — some of which I have enumerated recently.
More importantly for progressives: it’s coming down to a choice between giving people some flexibility to their plans, or forcing coverage and allowing them to opt out altogether. I’d rather see more people with some insurance than fewer (richer) people with Cadillac plans. Something has got to be done and it ain’t socialized medicine.
(Update: Here’s an article on CNN about getting the young invincibles in with more flexible plans.)