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Burn Your Obamacare Card, Burn Yourself

By now, you may have heard of the campaign to undermine Obamacare that the conservative group FreedomWorks is running. If not, read Sarah Kliff's article on it in the Washington Post. The article will take you inside the "Obamacare resistance," as she calls it, where leaders are printing up fake Obamacare cards and urging young people to burn them in protest. The idea is to undermine the law: If only older and sicker people sign up for coverage in large numbers, then insurers will have to raise premiums, increasing costs for the govenrment and for those who buy without subsidies.

Of course, people who decline insurance available to them must pay a fine. That's the "individual mandate" about which you've heard so much. But the penalty is relatively small in the first year—either $95 or 1 percent of income, whichever is greater and up to the cost of a typical "bronze plan." As a result, officials at FreedomWorks figure that convincing young people to pay that may not be so difficult. "We’re trying to make it socially acceptable to skip the exchange and pay the fine," Dean Clancy, a vice president at FreedomWorks, tells Kliff. "Our goal is directly opposite that of the administration’s. Our mantra is, 'skip the exchange, pay the fine.'"

The article prompted Christopher Flavelle of Bloomberg to call up FreedomWorks, and ask what the group would tell somebody who opted to pay the penalty, rather than take insurance, and then ended up with some kind of medical crisis. Apparently a FreedomWorks official told Flavelle it wouldn't matter. Obamacare prohibits insurers from denying guaranteed issue, the official noted, so this hypothetical person who had declined coverage could simply sign up for insurance after getting sick. No harm done.

Lots of people seem to be under the same impression—that you can simply wait until you're sick and then sign up for coverage. That's not correct. Adrianna McIntyre, blogging at the Incidental Economist, explains why: 

Sure, there’s the penalty; everyone knows about that. But there’s also the limited open enrollment issue. That’s insurer-speak for “you can only sign up for exchange plans during certain months”; despite the rhetoric, people actually can’t just buy insurance whenever they fall ill. The initial enrollment period is extended, from October 2013 through March 2014. But in subsequent years, enrollment will only last from October to December. There are special exceptions, like losing employer-based coverage during an off month, but I double-checked the regs.“I accidentally burned my Obamacare card” didn’t make the cut.

Keep in mind that just one visit to the emergency room can easily generate bills that reach into five figures. All of which brings us back to the question Kevin Drum asked a week ago: Is FreedomWorks prepared to cover the medical bills for young people who take the group’s advice, turn down insurance, and end up with crippling medical debts?

Jonathan Cohn is a senior editor at the New Republic. Follow him on twitter @CitizenCohn