California, the novelist Wallace Stegner famously wrote, is like the rest of America, only more so—meaning that wherever the country is headed, the Golden State is probably there already. So the state’s ObamaCare advance planning deserves closer scrutiny, given that it mirrors the regulatory and ideological model that the White House favors for everyone else.
In a matter of days, California will set a precedent for the future of the U.S. individual and small-business insurance markets via ObamaCare’s “exchanges,” where people will purchase coverage at heavily subsidized rates. The exchanges don’t start up until 2014, but the states were given wide bureaucratic latitude in how they’re run, and Sacramento is using this flexibility to convert them into a pretext for imposing de facto price controls on the insurance industry.
Jerry Seib and Gerard Baker discuss the renewed furor over health care, including the war of worlds between House Minority Leader John Boehner and House Speaker Nancy Pelosi.
That may be what Democrats had in mind when they passed the bill, but it’s particularly unfortunate because in principle exchanges could be a useful reform. States could sponsor transparent, neutral clearinghouses that compare costs and benefits among plans, encouraging insurers to compete to offer the products that consumers find most valuable. An exchange could operate much like travel websites such as Expedia.com, and a good one along those lines started in Utah last year.
California looked further east for inspiration—to Massachusetts, which has the only other exchange in the country. Known as the connector, it’s the centerpiece of the ObamaCare beta test that Mitt Romney passed in 2006 and is now the power center of the state’s public utility-style insurance regulation. In the daisy chain of “expertise” that is the health policy world, California’s regulations were shaped by Jon Kingsdale, a devout White House ally who used to run the Massachusetts connector and is now a consultant.
