Cherry picking? What does this mean? "Part of the murkiness stems from the role of government subsidies. Federal subsidies under the health law will help lower-income consumers defray costs, but they are generally not included in insurers' premium projections. Many consumers will be getting more generous plans because of new requirements in the law. The effects of the law will vary widely, and insurers and other analysts agree that some consumers and small businesses will likely see premiums go down." the article uses the word "may" a lot which implies the "may not" outcome is more likely. The article also says it is medical costs unrelated to the healthcare law plays a major role in price projections.
Is it possible to have an honest debate?
Yes, it is possible to have an honest debate... if anyone wants to.
Any who has had health insurance through an employer for more than a year knows that, more often than not, your company switches health insurance plans regularly (usually annually) due to the fact that health insurance premiums go up
every year, regardless of any changes in the law. In recent years, many plans easily see a 10-20% increase. If the increase is higher than 10%, most companies will shop around for a better deal, hence the constant switch from year to year in health insurers...
What the paragraph you mentioned means is that:
a) Exactly what the government subsidies will be is currently unknown from the sounds of it. If it covers the whole premium, then it will make no difference in the insurers' premium projections, unless the insurers have somehow decided that the subsidies will not cover the whole cost of the premium. (I guess that means if the government says the insurance premium is $480/month, but we're going to cap our subsidized customer's premiums at $380/month and you just have to live with that, then the insurers will have to make up the difference elsewhere - like those of us who have health insurance through work. But, I do not know if this is the case.)
b) Many people who insure as individuals, not through a job, choose plans with less coverage because it is cheaper. ie. It is a lot cheaper to get a catastrophic care plan that covers only major medical emergencies, than it is to get a plan that covers a lot of basics like annual exams and tests. With the law going into effect and requiring that ALL plans cover a wide variety of basics, those who insure as individuals will be forced to get a better plan than their pared down plan (because the pared down plans will be dropped), hence, they will automatically have to pay more because they will be getting more/better coverage.
c) Premiums, theoretically, should (and, historically, have in other insurance industries e.g. auto insurance) go down with everyone being required to have insurance. With everyone in the pool, paying for the premiums, and getting care earlier, the premiums offset costs because more people pay into it, and the insurance will reduce costs because more people will get care in the early stages of illness (because they actually have health insurance) when it is cheaper to treat.
I would liken it to the requirement most (all???) states have to carry auto insurance. When individual states first started mandatory auto insurance for all drivers, there was a big hue and cry about how it would be more expensive because of this or that reason (as well as all the individual rights nonsense). As it turned out, and very quickly, I might add, when the mandatory insurance went into effect, auto insurance rates went down, and did so fairly dramatically and fairly quickly. Not to mention that insured drivers were not held liable for uninsured drivers' accidents... Everyone had a stake in paying for insurance and no-one was unfairly penalized for their own or someone else's accidents.
Although, I would point out that I do not find it unrealistic or punitive to charge a surcharge for people who engage in unhealthy behaviour. Just as with auto insurance, if you have an "at-fault" car accident, your insurance rate increases for a period of time until you again prove a record of good driving. Likewise, I see no reason why a reasonable fee (say 1-5%) shouldn't be assessed to people who smoke, drink excessively, are fat or engage in other unhealthy activities that increase the likelihood that they will become unhealthy and, hence, more expensive to treat. Similarly, there can be a reduction of fees for those who show a decrease in unhealthy activities, the same way auto insurance premiums are lowered after periods of demonstrated safe driving.
But, overall, what the insurers are quoting, more often than not in these articles is not only the increase due to the new laws, but also the regular annual increases
that happen every year. For example, if they started calculating in 2010 how much the increase for 2014 would be comparatively, they may very well be adding the annual increase for 2011 (10% ave.) plus the annual increase for 2012 (10% ave.) plus the annual increase for 2013 (10% ave.) plus the annual increase for 2014 (10% ave.) plus the increases due to the changes in the law in 2014 (10-20% ave.) and before long your looking at a 50-60% estimated increase from whenever they started calculating!!!
In reality, the average person who gets insurance through a small business job will probably see an increase about $15-25% in the first year - at least 10% of that being the normal average annual increase in premiums that happen every year. Those who get insurance on their own will probably see an increase of 40-50% in the first year because they will be forced to get better coverage than what they currently have (but will also be eligible for subsidies). Those who work for large companies will probably see little change, maybe a nominal increase of 5% or less because large companies get a better deal. I expect that after a year or 2 of the new laws in effect, insurance premiums will begin to drop as insurers will have to attempt to get more market share through better plan offerings in order to increase revenue - if everyone has insurance, the only way to get new customers is to steal them from other insurers...the only way to do that is offer a better product.