“Vance\u2019s sunny rhetoric here disguises his plan\u2019s inegalitarian moral priorities.<\/p>\n\n\n\n
It is true that the young and healthy have different medical needs than the old and sick. And before the Affordable Care Act\u2019s regulations, the former could sometimes procure cheaper insurance tailored to their (currently) limited needs.<\/p>\n\n\n\n
But this came at a social cost. Insurers were able to offer cheap health coverage to those who barely needed it by screening out those with preexisting conditions. In Vance\u2019s terminology, they constructed low-risk pools: By only including people who were unlikely to require expensive treatments in their plans, they could profitably provide low-premium insurance to the young and well.<\/p>\n\n\n\n
Meanwhile, sick and\/or older Americans on the individual insurance market either went without coverage or were forced to pay dramatically higher premiums in order to cover the high cost of their care. Some state governments tried to defray this cost somewhat by subsidizing high-risk pools. But enrollees still paid much higher premiums<\/a> than the typical market rate, and their coverage often excluded the treatments they needed most.<\/p>\n\n\n\n The Affordable Care Act effectively forced the healthy to subsidize the sick. It required insurers to include those with preexisting conditions in their plans and cover all medically necessary procedures. To guarantee that insurers could still turn a profit and that coverage remained (at least somewhat) affordable for all, the government provided consumers with insurance subsidies.<\/p>\n\n\n\n The upshot of all this was that coverage became a little more expensive for some healthy people, while growing much cheaper for the old and seriously ill.”<\/p>\n\n\n\n …<\/p>\n\n\n\n “Vance\u2019s vision for health care policy helps clarify the character of the right\u2019s burgeoning \u201cpopulism.\u201d On trade and immigration, Vance\u2019s ideology may prize a nationalistic conception of the common good above free markets. But on most economic questions, its iconoclastic rhetoric belies its fealty to conservative orthodoxy \u2014 and thus, to \u201cthe ruling class<\/a>\u201d whom Vance loves to deride.<\/p>\n\n\n\n As Trump\u2019s running mate, Vance is campaigning on tax cuts for corporations<\/a> and the wealthy and deregulation for health insurers. The rest of Trump\u2019s economic agenda is rather hazy. But if his first term is any guide, it would also involve curtailing workers\u2019 collective bargaining rights<\/a>, reducing workplace safety standards<\/a>, and attempting to throw millions off of Medicaid<\/a>. Vance has not seen fit to criticize any aspect of this record.” <\/p>\n\n\n\n …<\/p>\n\n\n\n “For Vance, deregulating insurance markets at the expense of the vulnerable is not neoliberal or anti-populist. But arguing that politicians should not spread incendiary lies about immigrants is.”<\/p>\n\n\n\n