Michael Cannon has noted that guaranteed renewal was a common feature of individual health insurance plans even before it was mandated by federal law, and it doesn’t raise premiums nearly as much as the ACA’s rules do. But that’s actually a demonstration of how guaranteed renewal doesn’t work: It’s not very expensive for health insurers to offer because few insureds actually figure out how to turn it into effective coverage for expensive health conditions they develop.

This is a key difference in how liberals and conservatives view the health insurance market. Conservatives see a market that is working so long as you’re responsible enough to keep yourself covered at all times so guaranteed renewal protects you from pre-existing condition exclusions. Liberals see a market that is stacked against people’s efforts to access such protections.

Given how few people are making the protections of the existing system work, liberals have the better of this argument. They’ve found a way to make insurance available to the chronically sick that will actually work for most of the public. But they haven’t been upfront about the fact that their fix will be paid for with higher premiums for lots of healthy people, including Rosner.