For the millions of Americans who are losing health plans they liked as a result of the Patient Protection and Affordable Care Act, the name of that law is a bitter joke. They do not feel protected, and they often find that the replacement coverage they are forced to buy costs a lot more.
But President Obama has a solution. "We have to make sure that they are not feeling as if they've been betrayed by an effort that is designed to help them," he told NBC News last week. The dishonesty and condescension packed into that sentence help explain why Obama's signature achievement has provoked anger instead of the gratitude he expected.
Here's an idea: If you don't want people to feel that you've betrayed them, don't betray them. Don't promise, dozens of times without qualification, that they will be able to keep their health plans if they like them when you know that is not true.
Here's another suggestion: When you are apologizing for misleading people, don't seek to minimize the significance of your deception. "We're talking about 5 percent of the population," Obama told NBC's Chuck Todd. "It only affects a small amount of the population."
Obama was referring to the 14 million Americans who obtain health insurance through individually purchased policies, which is hardly a small number. According to studies by the Manhattan Institute and the Heritage Foundation, the policies these people find in Obamacare's insurance exchanges typically will cost more than what they have now.
Obama nevertheless claimed "the majority of folks will end up being better off," thanks to the tax credits available through the exchanges. But White House spokesperson Jessica Santillo says most will not be eligible for those subsidies.
Nor is it true that Obamacare's mandates won't affect people who are insured under employer-based group plans, who represent about half the population. Already nearly two-thirds of those plans are not covered by the Affordable Care Act's grandfather clause because their terms have changed since the law took effect.
All told, McClatchy D.C. estimates, "as many as 52 million Americans could lose or have lost old insurance plans." That does not mean they will have no coverage, but they can expect to see benefit changes and rate increases due to Obamacare's minimum coverage requirements.
White House spokesman Jay Carney seemed to promise otherwise last week, claiming that if you are covered through work, "there is no change for you except for an increase in benefits that everyone receives as a result of the Affordable Care Act." If benefit increases cost nothing, why not give everyone the most generous insurance possible?
Enough of this bronze, silver, and gold nonsense. Platinum for everyone! This comical refusal to acknowledge the tradeoffs imposed by Obamacare makes it hard to have a serious discussion about whether those tradeoffs are justified.
"What we intended to do," Obama explained last week, "is to make sure that everybody is moving into better plans because they want 'em, as opposed to because they're forced into it." This formulation implies that if people resist the option Obama deems better, it's only because they fail to recognize his superior wisdom.
Yet when the government bans what Obama calls "subpar" health plans, policyholders have to pay more, often for benefits, such as maternity or mental health coverage, they do not need or want. Contrary to what Obama says, that mandate is not "designed to help them"; it is designed to help people who want the added benefits and can get them cheaper when others are forced to subsidize the cost.
Likewise, when the government decrees that insurers may not charge sick people higher rates, healthy people make up the difference. When it restricts the extent to which insurers can tie rates to age, premiums for young people rise.
In other words, there are winners and losers under Obamacare. But to hear the president talk, all of us are winners. We just don't realize it.