Feb 11, 2013 1:56 PM GMT
The passionate supporters are the youth, who voted for him by a margin of 60% to 36%, according to exit poll samples of people 29 and under. His enemies are the elderly: Mitt Romney won 56% of the votes from people 65 and over. And while one of ObamaCare's earliest provisions was a boon to the young, allowing them to stay on their parents' insurance through the age of 26, what follows may come as an unpleasant surprise to many of the president's supporters. The provisions required to make any sort of health insurance plan work — not just ObamaCare, but really any plan of its sort — require healthy young people to pay more in health insurance than they consume in services, while the elderly (saved by Sarah "Death Panels" Palin from any serious attempt to ration expensive and often futile end-of-life care) consume far more than they pay in. There is always a push and pull, however, and this year will be spent laying plans to shift the burden further toward the young.
State and federal officials and the health care industry are currently preparing to implement two specific ObamaCare provisions taking effect on January 1, 2014, acting on this politically perverse principle of shifting resources from your supporters to your opponents. The first is the individual mandate, which aims to force the young, childless, and healthy — "Young Invincibles," as they are said to think of themselves — to buy heath insurance, even if they think (and even perhaps make a rational, if risky, bet) that they don't need it.
The second is a lesser-known policy to limit the practices of charging different premiums to different ages, known as age-rating. Many states currently set a limit on this difference, often mandating that an old person shouldn't pay a premium more than five times a younger person's, even if she's expected to use more than five times as much health care. The ObamaCare provision kicking in next January 1 would reduce that ratio to three-to-one, essentially limiting what the elderly pay in part by forcing young people to carry a larger share of the total cost of national health care.