The Affordable Care Act's Marketplaces covering more Wisconsinites, and Republicans don't like it one bit.

With Republican politicians and their voters salivating over the thought of the Supreme Court taking away federally setup exchange tax credits, it’s important to point out who in Wisconsin is getting the benefit:

Post Crescent: In 2014, 91 percent of Wisconsin consumers who obtained a marketplace plan received aid, according to the U.S. Department of Health and Human Services. Even if clients are able to find manageable premiums, they're often stymied by high deductibles and co-pays. "That sometimes causes them not to obtain insurance, or to later drop it."

The high deductibles and copays, the ones Republicans hate so much now, is a product of the individual "free market" insurance system. It was setup this way to discourage people from overusing medical services. Surprise, the biggest backers of high copays and deductibles; those same angry Republicans. Health savings accounts are also meant to discourage access.  

jsonline-Guy Boulton: In a 2010 essay, Stephen Parente, a health economist at the University of Minnesota and a former adviser to Sen. John McCain's presidential campaign, noted the plans in the marketplaces overall also have high deductibles, which many health economists support because the deductibles encourage people to be better consumers of health care. "That's sort of the dirty little secret in the room," Parente said.

(Parente also said) that "the roots of the law lie far more with Republican market-based health reform solutions than the single-payer and Medicare-for-all national health insurance programs proposed by Democrats since the end of World War II." Parente said the law has similarities to McCain's proposal in his campaign, such as using refundable tax credits to enable people to buy their own health plans. "Last I checked, that's what this is" … believes the marketplaces could lead to more competition and more options in the insurance market over time.

The Affordable Care Act is based on Republican values, which are now suddenly being abandoned for something not yet defined by the party (hint: it looks a lot like the ACA...doh!).

The law ... partially relies on commercial health plans and enables people to shop online for a plan of their choice — all concepts championed by conservatives. It also puts an emphasis on personal responsibility, a conservative mantra, in requiring most people to buy plans with high deductibles as well as in requiring people to have health insurance. "The huge irony is that Democrats are trying essentially the Republican idea," said James Morone, a political science professor at Brown University who has written extensively about the politics of health care reform.

The law is not projected to increase the federal budget deficit … "This is not about spending," Morone said. "And anybody who thinks this is about spending just hasn't looked at the numbers and is just not going to understand what's going on."

The overreaction to the ACA is also kind of weird, because so few people get to use it:

The law affects a small piece of the health insurance market: the market for people who don't get health benefits from an employer. It is a market that many health economists consider dysfunctional. An estimated 19.4 million people get coverage through the so-called individual market. That includes roughly 180,000 people in Wisconsin, a state with a population of 5.7 million people.

In contrast, 156 million people were covered through an employer in 2012.

So what’s the big deal? I just posted a piece on that here.