The ACA's satisfied unsubsidized

Over at the Atlantic, in my off-xpostfactoid reporting debut, I have a story recounting the experiences of several people

whose family income disqualifies them for subsidies and who bought insurance on the individual market for 2014. All had family members with preexisting conditions, which means they benefited from the ACA's prohibition on basing price or eligibility on medical history. All had been paying above-market rates or faced limited choices because of a family member's medical history.

As the article points out, this is a very large subset of the U.S. population  - somewhere between 19 to 50 percent of individuals, according to an HHS report overviewing various studies -- and a larger proportion of households. Conversely, a large number of subsidy-ineligible buyers who were in the individual market for insurance in 2013 and do not have preexisting conditions have seen their premiums rise, as the article acknowledges at various points. I have recounted the experiences of two of them here.

I have been trying my hand at reporting -- getting information from people and writing it down in context -- since early February.  The resulting posts to date are listed below.

What if the (Republican) dog catches the Obamacar(e)?
Children, CHIP, Medicaid and the ACA
Switching from COBRA to the ACA exchanges
Healthcare.gov comes through in a complicated situation
HealthSherpa claims to shorten ACA signup process
COBRA or the ACA?

A companion list to The Atlantic's "50 Greatest Inventions"

The Atlantic has a panel-generated list of the 50 greatest inventions since the wheel, which is entertaining, and an accompanying James Fallows meditation on what the exercise can teach us about innovation's impact, value and future prospects, which is humane, urbane and deeply informed, as you'd expect from Fallows.

Fallows also provides a "taxonomy" of the 50 chosen items. I had read the listicle first, and when I came to the lead-in to the taxonomy, it immediately made me sense a category missing from the list:

One of our panelists, Leslie Berlin, a historian of business at Stanford, organized her nominations not as an overall list but grouped into functional categories. From our panelists’ nominations, a similar but slightly broader set of categories emerges. Here is my adaptation of Berlin’s useful scheme.

Fallows' categories are as follows: innovations that 1) expand the human intellect; 2) are integral to the infrastructure of the modern world; 3) enabled the industrial revolution; 4) extend life; 5) allow real-time communication out of voice range; 6) enhance transportation; 7) enable organizational breakthroughs (clocks, calendars, alphabetization); and 7) facilitate killing.

I shouldn't say that what I want to add was "missing" -- arguably it didn't belong. Let's call mine a companion list. But it occurred to me a while back that the U.S. Constitution was a kind of enabling technology of the modern world, and that makes me want to think more about what you might call social technologies, from those traceable to the dawn of recorded history to the present (excluding an earlier strata including language, worship and prayer, marriage and tribal organization). Here's a first pass at a list of key "inventions" of this kind. It's neither chronological nor ranked in order of "importance," but rather loosely grouped according to type: legal, political, economic, pedagogical.

My last best shot in defense of the ACA

[repost] I have a piece up at The Atlantic updating my case that the enemies of the ACA misrepresented the individual mandate in the Supreme Court, that the cadre of oppressed citizens they conjured up is a phantom, and that the law's creators worked under a self-imposed "limiting principle," doing their utmost to minimize the financial burden imposed by the mandate.

Below, a few posts that flesh various parts of the argument compressed in the Atlantic piece.  A full index of my posts on the ACA in the Supreme Court, along with outside sources relevant to my argument, is here.

Misrepresentation of the mandate in the Supreme Court: Why it still matters (5/10)

Three possible surprise rulings on the Affordable Care Act (6/15)
Attention, Justices Kennedy, Roberts et al: Read the young people's brief (5/5)  
The ACA offers catastrophic coverage: the AP notices  (4/10)
Marty Lederman concurs: the individual mandate could be trimmed, not killed (4/5)
Go tell the justices: the ACA has a catastrophic coverage option (3/31, updated 4/2)  

And, for the record, the 3/28 post by a healthcare attorney who picked up the plaintiffs' core card trick more or less in real time during oral argument: Ragbatz on the catastrophic coverage options in the ACA. 

The morality tale that may sink the ACA, cont.

I have a piece up at The Atlantic updating my case that the enemies of the ACA misrepresented the individual mandate in the Supreme Court, that the cadre of oppressed citizens they conjured up is a phantom, and that the law's creators worked under a self-imposed "limiting principle," doing their utmost to minimize the financial burden imposed by the mandate.

Below, a few posts that flesh various parts of the argument compressed in the Atlantic piece.  A full index of my posts on the ACA in the Supreme Court, along with outside sources relevant to my argument, is here.

Misrepresentation of the mandate in the Supreme Court: Why it still matters (5/10)

Three possible surprise rulings on the Affordable Care Act (6/15)
Attention, Justices Kennedy, Roberts et al: Read the young people's brief (5/5)  
The ACA offers catastrophic coverage: the AP notices  (4/10)
Marty Lederman concurs: the individual mandate could be trimmed, not killed (4/5)
Go tell the justices: the ACA has a catastrophic coverage option (3/31, updated 4/2)  

And, for the record, the 3/28 post by a healthcare attorney who picked up the plaintiffs' core card trick more or less in real time during oral argument: Ragbatz on the catastrophic coverage options in the ACA.  

The Atlantic's slough of despond

Some time ago, The Atlantic's James Fallows wrote a reasoned, detailed and agnostic-to-hopeful assessment of the perception that the United States might be entering its long-anticipated decline.  Fallows concluded that the country has ample economic and cultural resources; that its fatal flaw might be the clunky democratic machinery bequeathed by the too-hard-to-amend Constitution; but that we had muddled through that difficulty in the past and might continue to do so (my take here).

A grimmer collective assessment is implicit in this month's Atlantic's dystopian take on the standard "year in ideas" feature.  This dyspeptic compendium may not reflect decline -- it's just fourteen journalists' perceptions -- but it does bespeak contagious pessimism begat by an anemic recovery.

The 14 biggest ideas of the year can mostly be placed three categories: no change, trivial change, and malign change. Or, sliced another way: lack of progress, useless diversion, and loss. Some of the changes -- the Arab Spring, wave elections, the rise of large middle classes in Asia -- are presented as at least potential positives -- but with a good deal of ambivalence. And in fact, those "ideas" in the "no change" and "trivial change" categories are mostly pretty malign too. Let's have a look: