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The State of Play

Jon Cohn gets some altitude and explains where we are in the grand sweep of health-care reform. Unsurprisingly, I agree with everything he says. Seriously. Everything. Sometimes I think he's copying my mind.

By Ezra Klein  |  August 3, 2009; 10:18 AM ET
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Interesting post.

A couple of thoughts:

--The interesting question is that the "Plan B" may have policy ramifications. Specifically, less generous subsidies for low-income will make an individual mandate either not possible or ineffectual (the "exceptions" to the mandate will be so broad that its not really meaningful), which in turn threatens the ability to pass regulation with some community rating. Or at least the latter part was the theory of those who supported Clinton, in the "mandate debate" of the primaries. And as I wrote then, the whole "we must have mandates in order to have community rating" was a red herring-- while theoretically true, the practical rate of free-riding wouldstill be sufficiently low to make this an annoyance, not a deal breaker. So I'm looking forward to being completely right on this score, Ezra. :) But on the political front, if a "Plan B" means that the insurance industry isn't going to get an increase in covered lives in exchange for their support, AND Obama's political strategy is to hang them out to dry, as was suggested in a number of articles this weekend, then Ignani et al may stop playing so nice.

-- Cohn had a line: "The opponents of health reform seemed disorganized and lost for most of this year, but now they have actual legislation to target--and they have found their footing." I find the non-specific "they" to be interesting. Because I certainly don't see an actual "they" doing a lot of opposition beyond Republicans doing pretty standard stuff for any legislation, nothing of the Harry and Louise sort has really been out there-- yet. To me, the dynamic has changed because of two specific reasons-- an increasingly skeptical MSM coupled with polls showing falling support among the public. The causes for the former seem pretty clear to me. Obama's whole rationale for reform is based on a whole lot of projections-- and for the most part, Obama's administration has been wrong on the macroeconomic projections related to employment and the stimulus funding has been predictably behind schedule. So the media has learned from the stimulus situation, where they were overly wowed with wonkish presentations from Romer, Summers and others, and are realizing, these guys are guessing more than they all realized. Which puts another $1 trillion spend that's "paid for" in a different light. More skepticism from the media leads to less support from the public. This seem to be a much larger part of the dynamic that a non-specific "they've found their footing."

Posted by: wisewon | August 3, 2009 11:10 AM | Report abuse

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