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Fleeing From Health Insurance Isn’t the Same Thing as Losing It

“Republican healthcare bill imperiled with 22 million seen losing insurance,” reads a Reuters headline about the CBO assessment of the Senate healthcare bill.And, indeed, the CBO did say, “The Senate bill would increase the number of people who are uninsured by 22 million in 2026 relative to the number under current law.”

But the CBO never uses the word “lose”–a word that would imply that those people will be deprived of something they want. And that’s not what the CBO is saying. Instead, it notes:

CBO and JCT estimate that, in 2018, 15 million more people would be uninsured under this legislation than under current law—primarily because the penalty for not having insurance would be eliminated. The increase in the number of uninsured people relative to the number projected under current law would reach 19 million in 2020 and 22 million in 2026.

That is, in the absence of penalties coercing them to purchase health insurance that they don’t want, tens of millions of Americans will choose to go without. That’s a big difference for an allegedly free society whose political institutions can fairly be judged by the degree to which they leave people alone to make their own decisions. Those decisions may be wise, unwise, or a mix of the two. But the freedom to make that choice is what matters.

And if Americans choose not to purchase health coverage when they’re freed of coercion, they’re not losing coverage, they’re fleeing from it.

That’s not to say the Senate bill is a good one; it’s a dog’s breakfast that retains many of the distorting features of Obamacare without introducing the choice and free market reforms that could put health care back on an even footing.

But fleeing something you don’t want is a far cry from losing something you cherish.