We’re hearing an awful lot from and about those in the private health insurance market who are receiving policy cancellation letters with lots of heat but little light being shed on what is a serious issue. Much of the focus has been on President Obama’s repeated and misleading assertions that everyone would be able to keep their existing insurance plan and doctor. Perhaps mindful of the fact that, more often than not in America, nuance falls on deaf ears, he foolishly neglected to make a distinction between employer-provided insurance plans, which will be unchanged, and those purchased on the individual market which constitute about 6% of the insured overall.

Republicans who have been and continue to be unmoved by the plight of the uninsured are apoplectic in behalf of the people in this small segment of the insurance market who are losing their current insurance plans. This selective outrage is driven, of course, by their desperate desire to seize on anything that can help them destroy the Affordable Care Act.

The Washington Post’s Ezra Klein is one who has successfully put the issue in some perspective and his detailed analysis is a must read.

The individuals and families affected and whose plans fail to meet the requirements of the ACA, broadly fall into two categories. The first group has lousy insurance plans with features such as high deductibles, limited coverage and low caps on total expenditures by the insurance company, that ensure crushing out-of-pocket expenses in the event of a chronic or acute illness requiring serious and expensive treatment. The cancellation of these policies is an unequivocally good thing since such bare bones plans offer little security to the policy holders and cause higher costs to health providers and ultimately to the rest of us. The ACA will almost certainly provide much better, affordable plans once subsidies for those who qualify are factored. These people have little to complain about.

The second group, however, has a genuine beef. They are generally healthy, middle aged or older folks who have a decent insurance plan which, nevertheless, does not meet the ACA. Some of them, as highlighted in Klein’s story, have received cancellation letters and been unable to find a plan as good as the one they are losing at a comparable price either in the exchanges (assuming they’ve been able to check the federal website if they reside in a state without its own exchange) or from their current carriers. If they have a decent income they don’t qualify for subsidies.

Regrettable as their situation may be, it has to be kept in perspective. As Klein points out, these people have benefitted enormously from the ability of insurance companies to exclude others from coverage that had pre-existing conditions. By excluding these poor risks, insurance companies were able to offer more favorable plans to those who are now vexed by seeing them cancelled. A further consequence is that some of those who previously benefitted from the dysfunctional and rather pitiless individual health insurance market will likely pay more for less under the ACA, as appears to be the case for the individual mentioned at the beginning of Klein’s piece.

It is likely scant comfort for this group to know that many more people will gain health coverage previously denied them under the reformed private insurance market, and that others will get better, more comprehensive plans than they had before. Nevertheless, for the country as a whole and the cause of social justice, it’s a very worthwhile tradeoff.