But much of the interview was dead serious, trying to tell viewers what they are up against. Stewart understood that letting states decide what the exact coverage could be within the ten coverage buckets the law requires—maternity, drug, mental health and so on—could leave people with good coverage or not-so-good coverage depending on where they live. He zoomed in on the often contentious relationship between the states and the feds over authority, and that led to a discussion of whether employers were likely to dump workers in the state shopping services, or the exchanges, and stop funding health insurance for them. Stewart asked several times whether employers would do that. It’s a good question, with opinions differing depending on who’s doing the opining. Stewart wanted Sebelius to opine. She was reluctant to say yes or no, but finally said no, reinforcing her PR message that the exchanges would would “stabilize” coverage for 180 million people with insurance from employers. In this discussion, a key point was missing, and one that Campaign Desk continues to point out. People who have employer coverage are generally stuck with that coverage even if they don’t like it and want to look for something cheaper or better. They cannot shop in the exchanges and receive a government subsidy to help pay for their policies unless their share of the premium exceeds 9.5 percent of their gross income. That’s a little-publicized part of the Affordable Care Act. Maybe The Daily Show can explore it later on.
Monday night’s takeaway, though, was not about the possibility employers might dump workers in the exchanges. It was that the secretary’s “flexibility” for the states might give them crappy, or shall we say less desirable, coverage if they live in the wrong state. As long as the coverage provides a minimum level of value, insurers have a lot of wiggle room to mix and match the premiums, the combinations of deductibles, number of doctor visits, and the coinsurance—the portion of the bill they will cover. Just imagine the choice and the headache someone will get figuring all that out. And just imagine the fun Stewart can have getting Sebelius to make all that clear.
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