Dem chorus rising: Don't let them take your freedom

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For most of the post-January 6 era, the U.S. has seemed to be sleepwalking toward autocracy. 

Republicans swiftly fell in all but unanimously behind Trump's Big Lie that he won the 2020 election; red states passed a raft of voter suppression laws; Trump acolytes positioned themselves to seize control of election administration and machinery; pardoned Team Trump criminals and the RNC encouraged thousands to sign up as poll workers; and diehard election deniers won Republican primaries for secretary of state, attorney general and governor in key states.

Meanwhile, inflation dominated headlines, Biden's approval rating sank to record lows for a first- and second-year president, courts upheld Republican gerrymanders and struck down Democratic ones, off-year elections swung heavily toward Republicans, and Republicans led in generic Congressional polling.

Then came the riveting January 6 Commission hearings in June and July, with Republican officials laying bare Trump's criminality and pathology -- and smack in the middle of that timeline, the intense shock of the Supreme Court ruling in Dobbs, overturning Roe v. Wade. Democrats woke up -- some Democrats, anyway. Gavin Newsom laid down a keynote in a July 4 ad aimed at Floridians ("inviting "them to move to California): freedom is under attack in your state...don't let them take your freedom.

ACA 2.0 in California: an individual mandate without shame and a move toward all-payer in pharma

Yesterday California's new Governor, Gavin Newsom "announced a series of major, first-in-the-nation executive actions and budget proposals to lower prescription drug and health care costs for all California families and move California closer to the goal of health care for all."

A couple of quick thoughts about the package:

1. The ACA-related proposals are to raise the subsidy cap to 600% FPL while enriching current subsidies -- and to implement a state individual mandate. That pairing addresses the fatal flaw in the ACA individual mandate, which New Jersey's disappointing enrollment performance following passage of a state individual mandate illustrates: subsidies are too skimpy (if available at all) to make the coverage on offer seem like a good deal to many who are required to obtain it.

Try telling someone with an income of $30k that a silver plan with a deductible of $2,500 will cost them $200 a month, or that a bronze plan with a $3k deductible will cost, $137 a month.That was the deal on offer for a 40 year-old in most of Jersey in 2019; in most other states, the deductibles would have been higher, though the bronze premium would in many cases be lower. My duty as an ACA Certified Application Counselor has been light, but I've seen enough to know that that kind of result does not make many prospective enrollee happy* (the case is different at lower incomes -- say, $17-20k for an individual, where strong Cost Sharing Reduction is available).  The case is often much worse for those with incomes above the subsidy threshold. In many states, premiums had risen high enough by 2018 that many people in the 400-600% FPL  income range and above were exempt from the mandate.