The second thing that might make such a plan politically viable is the continuing problems in the insurance exchanges. Until prices stabilize, we remain at risk of seeing the number of uninsured start to march back upward, as unsubsidized consumers start to drop their high-priced, high-deductible, narrow-network insurance. Those drops will be concentrated in people who don’t qualify for subsidies, and as mentioned in the paragraph above, those folks are more likely to vote than the beneficiaries.
Consider a reader who recently wrote to me. He’s seen premiums and deductibles spike to the point where he has to spend more than $25,000 in a year on healthcare to break even on his insurance. It now makes more financial sense for his family to carry heavy accident insurance, and bank on being able to get back into the exchanges next year if one of them gets cancer.
He’s still probably vulnerable if he or his wife has a bad heart attack, but given the odds, and the price of unsubsidized insurance in his state, I couldn’t really fault his choice. He’s not the only one who’s written me a letter like that, and those people would probably be very interested in a program that offered their family substantial subsidies for insurance — and interested in the politicians who promised one.