This overblown controversy has also obscured the crux of what health care reform is trying to do, which is to guarantee that everyone can buy insurance without being turned away or charged exorbitant rates for pre-existing conditions and that everyone can receive benefits that really protect them against financial or medical disaster, not illusory benefits that prove inadequate when a crisis strikes.

Starting next year, all plans sold in this country will be required to provide 10 essential benefits, including some, like mental health and substance abuse treatment and maternity and newborn care, that are not now part of many policies. And premiums may well rise, in part because insurance companies must accept all applicants, not just the healthy.

Premiums are apt to come down for older patients and sicker patients with chronic illnesses. Premiums will likely go up for younger, healthier patients. Even so, analysts at the Kaiser Family Foundation believe that most people will actually pay less next year, because those with modest incomes will qualify for federal subsidies and many poor, uninsured people will be eligible for Medicaid.

Many higher-income people who won’t qualify for subsidies, however, will have to buy policies providing more benefits than they want. Maternity care for those who will not have children is one sore point. But that is one price of moving toward universal coverage with comprehensive benefits. And some of these higher-income people could suffer a catastrophic accident or illness that would previously have bankrupted them, but will now be paid for by insurance.

People under 30, who might balk at higher premiums, have another option. They can buy a catastrophic plan that provides all the essential benefits but keeps premiums low by making the beneficiaries bear a greater share of the cost. The hitch is that people who buy such plans are not eligible for federal subsidies, so many would probably be better off buying the cheapest plan available on the exchanges. Federal analysts estimated last week that, after subsidies, two-thirds of the uninsured young adults in 34 exchanges around the country could get coverage for less than $100 a month, and almost half could get it for less than $50 a month. That sounds like a bargain for comprehensive coverage.