It is nice to see both Paul Krugman and Matt Yglesias openly admitting that the Affordable Care Act is about as right-wing any insurance coverage expansion “reform” could be. From Yglesias’s The Sensible Conservative Alternative To The Affordable Care Act Is The Affordable Care Act:
If you simply do what Ponnuru and Levin propose, every insurance company will be competing to make a product that’s attractive to young men with no chronic health problems and unappealing to everyone else. To turn this idea into an idea that actually works for people with medical needs you need to do three things. One, you need to prevent firms from turning customers away because of their health status or demographic characteristics. Two, you need some kind of regulatory definition of the minimum benefits that need to be offered in order to qualify as “health insurance” that’s eligible for the tax credit. And three, you need some kind of penalty for failing to enroll yourself in a plan to ensure the existence of a viable risk pool. What you need, in other words, is the Affordable Care Act and its regulate/subsidize/mandate tripod structure.
There are no more conservative alternatives — not unless you give up on the whole idea that everyone should have coverage. There are alternatives to the left — single-payer, VA-style government provision — but Obamacare is already as conservative as a plan to make health insurance more or less universal can be.
As Nancy Pelosi pointed out when it passed, the law was based on an old proposal from the Heritage Foundation and effectively identical to what AHIP, the for-profit insurance company lobby, ask for in 2008.
Of course, this is why some at FDL thought that the entire left wing of the Democratic Party unnecessarily endorsing what was a corporatist, right-wing bill while the party pretended it was actually progressive was such a tragedy. It undermines the entire concept of real progressive health care while shifting the debate further to the right.
This is especially a concern given that Klein sees ACA as a likely tool to eventually voucherize Medicare and Medicaid, and Yglesias has a similar impression, or at least sees ACA as reason to shrink Medicare and push more old people onto the private insurance exchanges.