One of the first columns I did for And magazine was about conservatives objecting to “subsidizing” a woman’s sex life by having birth control covered in Obamacare insurance. Sean Hannity, for example, declared that as he’s not the one getting laid, there’s no reason he should pay for the birth control. My column pointed out that this is how insurance works: healthy people subsidize worse-off people. It would make just as much sense to argue that “I don’t smoke, why should I pay for the cancer treatment of people who do?” Or that policies shouldn’t cover prostate cancer, as women are never going to need that coverage. But of course that wouldn’t further the right-wing war on birth control and on women who have sex without consequences.
But now Sen. Paul Ryan has taken the leap: his latest argument against the ACA and the individual mandate is that “The people who are healthy pay for the people who are sick.” As LGM and ThinkProgress point out, that’s how all insurance works. Health insurance. Ryan’s Trumpcare plan. Car insurance. Home insurance. E&O insurance (which protects businesses against the financial consequences of “errors and omissions” they might make). It’s how companies stay solvent. If insurers don’t get enough money from healthy people (or people whose houses don’t burn down or cars don’t crash), they go out of business. The purpose of the individual mandate is to ensure that doesn’t happen. Otherwise healthy people could delay until they need insurance and then take out the policy.
What Ryan is doing, of course, is reworking this simple fact to a)single out Obamacare and its mandate as some uniquely awful program; b)imply Trumpcare will fix it (it won’t — as noted, this is just how insurance works) and c)phrase it language Republican audiences are used to, about how the takers and moochers (someone else) are living high off the money paid in by hardworking Americans (themselves). Charles Pierce points out it’s much the same process by which Ryan’s family stayed afloat after his father’s death thanks to Social Security whereas Pierce (and others) were paying money in (Of course that hasn’t stopped Ryan from condemning supposed moochers who rely on government assistance any more than Rep. Steve Fincher receiving millions in farm subsidies stops him from condemning people who receive food stamps.)
While several takes have been “Paul Ryan doesn’t understand insurance” I’m pretty sure he does — it’s just not in his interest to acknowledge the facts.