One of my favorite writers on health care policy is Michael F. Cannon of the libertarian Cato Institute. He has an article in Forbes magazine that I think is a good level-set for the Obamacare changes that are happening in 2014 and beyond.

He writes:

[…]President Obama announced, just days before the deadline for purchasing coverage with a January 1 effective date, that he would offer a categorical “hardship exemption” from the individual mandate to anyone who had their insurance cancelled due to ObamaCare.

[…]If these folks choose not to buy health insurance, they will not face a penalty. They will also have the option to buy, “if it is available in your area,” the lower-cost catastrophic coverage that ObamaCare otherwise offers only to people under age 30, or who receive the separate “unaffordability” exemption from the mandate.

The obvious purpose of this policy is to give political cover to Senate Democrats who must face the voters next year, and are no doubt afraid of attack ads like this one.

[…]Yet this exemption may not be of much value to those who qualify, and is likely to create more problems for ObamaCare supporters than it solves.

The people who qualify for this exemption don’t actually want it. They want health insurance. They had affordable coverage, until ObamaCare took it away from them, and that’s what they still want now. Sebelius boasts that ObamaCare’s catastrophic plans cost 20 percent less than other ObamaCare plans, but don’t confuse that with affordable coverage. The Manhattan Institute’s Avik Roy — who is now the opinion editor for the sprawling Forbes empire – notes that ObamaCare’s catastrophic plans can still cost twice as much as what was previously available on the individual market.

But even if they like their catastrophic plan, they can’t keep it. Sebelius has complete control over the duration of the exemptions, which she has described as a “temporary” step “to smooth [consumers’] transition” to enrollment in Exchange plans. So in a matter of months, Obama will violate his “if you like your health plan” pledge again by kicking these folks out of their catastrophic plans. They will get another cancellation letter tossing them into the Exchanges. Their premiums will surge again. They may lose their doctor again.

The exemption means insurers will suffer losses this year, and rates will be higher next year, for all ObamaCare plans.

The president argued before the Supreme Court that ObamaCare’s regulatory scheme cannot work with out the individual mandate. Yet he has now exempted millions of the very people he most needs to comply with it. This exemption siphons good risks out of the Exchanges and destabilizes the risk pools for both the standard ObamaCare plans and the catastrophic plans. Participating carriers set the rates for their Exchange plans with the expectation that these folks would be purchasing bronze, silver, gold, and platinum plans through the Exchanges. But the healthiest members of this now-exempt group are the most likely to go uninsured or purchase a catastrophic plan. So Obama’s blanket exemption makes those risk pools older and sicker.

This blanket exemption also destabilizes the risk pools for the catastrophic plans. It opens those pools to lots of people over age 30, who have higher health expenses than people under age 30, and whom the insurers were not expecting to buy catastrophic plans when they set those rates.

So the effect of this is going to be to raise rates temporarily, because the insurers companies are not getting the younger, healthy people they need to make the rates as low as they originally calculated. They are going to lose a ton of money because the Democrats are changing the rules at the last minute. They people who have coverage are going to be the ones who make all the claims, and the people who normally don’t make claims are now exempt, temporarily – until the 2014 elections. This is going to be a huge hit to the health insurance companies.

As I noted before, the Democrats are going to have to bail out the insurance companies in order to account for the losses. It’s actually in the Obamacare law already, as David Freddoso explained. But will the Democrats use money from their political party to pay for their mistakes? Hell no – they will borrow it from your children, which is what they are so good at doing. There is a cost for electing incompetent people, and it’s going to continue to rise until the fools are voted out.