In his latest Pulling it Together columnhttp://www.kff.org/pullingittogether/What-Conservatives-Won-In-Health-Reform.cfm, Kaiser Family Foundation (KFF) CEO Drew Altman argues that the Patient Protection and Affordable Care Act (PPACA) was a victory for Republican goals –even if that’s not apparent. KFF commissioned three actuarial consulting firms to estimate what patient deductible and co-insurance costs would be in health insurance policies due to be made available through the exchanges in 2014. (As an aside, KFF must be doing pretty well financially to hire 3 firms for the same task.) In any event, the firms showed that most of the plans would require out-of-pocket expenses for an individual in the range of several thousand dollars. Those numbers aren’t spelled out in PPACA but can be estimated from the way the law is crafted. According to Altman: A different way of looking at the ACA is that it represents a bargain between liberals and conservatives, although not one that was ever explicitly made. The left got 32 million people covered and reforms that eliminate the worst abuses in the health insurance system. And the right got a further push, beyond the momentum already underway in the market, towards just the kind of “skin in the game” insurance they have always believed will help control health care costs. It’s the big victory in health reform conservatives seem not to realize they have won.