Indeed, 11 million workers in small businesses are likely to pay more for health insurance under the Affordable Care Act, according to the report from Medicare’s chief actuary. An estimated 6 million workers will pay less, as the law’s market reforms restrict what insurers can charge to cover employees who are sick or older or are women facing higher costs related to pregnancy and childbirth.

The White House’s treatment exemplifies a problem President Obama has had since he began pitching his health-care law. He has avoided acknowledging the hard truth that changing the insurance rules means that some people will have to pay more. That elision has returned to haunt him, as it did this fall, when millions of policy cancellations fed nightmarish news cycles for Democrats.

This isn’t even change I can believe in.