I won’t repeat my ranting about the loss of real reform with the public option.  I think I’ve been over that ground enough.  The question is whether the bill is worth supporting with what’s left.  I’m not convinced, but Nate Silver makes a good case for its value to working families.  An excerpt:

Marcy is basically treating the $5,243 per year as though it’s a tax hike. That’s not what it is — at all. It’s a deeply discounted — albeit mandatory — service that they’re purchasing. And it’s saving them a lot of money: it either saves them a lot of money every year if they’re already buying insurance, or a lot of money on average if they’re not buying insurance.

And in either case, because of the caps in out-of-pocket expenditures — it also provides them with a lot more certainty in forecasting their income stream. It allows them to come up with a reasonable gameplan.

Frankly, unless they’re living in New York or the San Francisco Bay or some other place where the cost of housing is very high, the family that Marcy draws from — one which pays $1,600 per month for rent but does not buy health insurance for themselves or for their children — does not have a reasonable and responsible gameplan to begin with. If they can’t figure out how to squeeze out $430 per month in insurance premiums, what are they supposed to do in the status quo when somebody actually gets sick? You can object to the Senate’s health care bill on libertarian/paternalism grounds, but it will leave the overwhelming majority of low- and middle-income families better off.

It’s a bit patronizing to suggest to poor families that they ought to be able to come up with $430 per month in addition to the costs of life they’re already enduring.  Yeah, maybe someone will get sick, but with poverty it’s often really about the hear and now – the kids get hungry in the moment.

And without the price controls, what is even the guarantee of $430?  They’re mandating no exclusions for pre-existing conditions, but what in the bill ensures such people aren’t simply priced out?  That’s just as effectively prohibitive as an outright refusal.