The Affordable Care Act redistributes financial resources in many ways. First and foremost, it redistributes from the rich to the poor via the tax system. It also redistributes from people who are already receiving Medicare benefits to younger cohorts. In small ways, things like the medical devices tax redistribute from providers of cutting-edge health technology to purveyors of basic preventive treatment. And within the youth cohort, the mechanism of mandatory preventive coverage is to redistribute resources from men to women.
What’s why, as a humorous Jon Chait post notes, conservative examples of the dread “rate shock” always seem to feature a healthy 25-year-old man.
The underlying issue here, obviously, is that your typical twentysomething woman has more substantial health care needs than your typical twentysomething man. This broadly relates to the fact that women are biologically capable of becoming pregnant whereas men are not. And this in turn highlights some of the deep practical and conceptual linkages between the so-called “cultural” issues and the bread-and-butter economic issues. That’s because both the left and the right envision dealing with this issue through male-to-female cross-subsidies. The difference is that the left wants to provide those cross-subsidies via the welfare state, which will guarantee access to either birth control or prenatal care according to the woman’s preference. The right, by contrast, wants to provide those cross subsidies via marriage with single women who have sex (and their children) simply left to suffer pour encourager les autres. The “fusionist” alliance on the American right has always been grounded in this basic reality. Patriarchal family structures make it possible to get by without a generous welfare state, and an expansive welfare state tends to undermine women’s dependence on men.
Now an interesting question here is whether the healthy young men who are the ostensible victims of this Obamacare policy framework will actually care. Having been twentysomething relatively recently, I kind of doubt it. The social vision of cultural conservatives is not substantially more appealing to young men than to young women despite the narrow economics of it. It is true that gay men might have a deep objection to paying for heterosexual people’s birth control, but the GOP is working on other fronts to alienate that constituency. So I think you’re left with a complaint that will primarily resonate with the kind of cranky older men who made Sandra Fluke famous.
