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“Obamacare Opponents Still Await The Apocalypse”: Opponents Are As Wrong About Obamacare As Reagan Was About Medicare

A while back, progressive activists and politicians pushed for legislation to provide health insurance for a cohort of Americans who could not easily pay for their doctors’ visits and medications. Predictably, that effort was met with fierce resistance from conservatives, who didn’t seem concerned about those less-fortunate citizens who couldn’t afford medical care.

Conservatives denounced the plan as “socialized medicine” or a “communist takeover” of the American health care system. One notable conservative was especially alarmist, declaring that if the proposal passed Congress, “… you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free.”

No, that hysterical tirade didn’t come in response to the Affordable Care Act. Those words were spoken in 1961 by Ronald Reagan, who was crisscrossing the country to campaign against the adoption of Medicare. Yes, Medicare, which Congress passed in 1965 and is widely considered a resounding success.

Fast-forward a few decades. The same alarms were sounded more recently, as progressive activists and politicians pushed for legislation to provide inexpensive health insurance for those who couldn’t afford it. Actually, the denunciations of the Patient Protection and Affordable Care Act, usually called “Obamacare,” may have been even more hysterical.

As the law neared passage, I watched angry crowds gather near the White House — many holding vicious, racially charged signs lambasting the president — to chant about “socialism” and “communism.” Strangely, the most vehement criticisms came from Americans 65 and older, the very cohort that benefits from Medicare.

President Obama signed the Affordable Care Act in March 2010, so it has been the law of the land for five years. Given that, it’s possible to make a reasoned assessment of its strengths and weaknesses.

First off, let’s note that there has been no “socialist takeover” of American medicine. Obamacare uses private health insurance providers; the law merely sets requirements for health insurance plans and issues subsidies to patients who cannot afford to purchase policies.

As you might expect, the number of Americans with health insurance — and, therefore, with access to preventive medical care — has increased in the last five years. Before the law went into effect, there were 48 million uninsured Americans. Now, with 16 million people having signed up for Obamacare, that number has been cut by a third.

Furthermore, health insurance companies are no longer allowed to deny coverage to patients who are already sick or to set a “lifetime cap” on the amount of money a company will pay for medical care. Adult children, who might be in college or working at low-paying jobs without benefits, can stay on their parents’ policies until they are 26.

The Affordable Care Act may also have decreased the rate at which health care costs were escalating. Five years ago, medical care costs were skyrocketing, well beyond the rate of general inflation. Now, those costs are still going up — but at the lowest rate in 50 years. While economists aren’t certain that Obamacare’s cost-containment measures are responsible, many of them give the law credit.

To be sure, the Affordable Care Act has been no panacea. There are still 32 million Americans without health insurance. And, despite the president’s early pledge that people already insured could retain their policies, a tiny but vocal group lost their insurance because Obamacare deemed those policies inadequate. Many in that group ended up paying more for insurance, hardly a happy outcome.

But the worst failings of the Affordable Care Act are beyond its supporters’ control. Because of persistent, irrational Republican opposition, more than 20 states have refused to expand Medicaid — even though the feds would pay the lion’s share of costs. That means that millions of working-class Americans are not getting the health care they need. Furthermore, Obamacare’s unrelenting antagonists have mounted yet another challenge to the law before the U.S. Supreme Court.

It’s hard to fathom. The Affordable Care Act has failed to produce the apocalypse (remember “death panels”?) its fiercest critics predicted; instead, it has given millions of people access to decent health care. Its opponents are as wrong about Obamacare as Ronald Reagan was about Medicare.

 

By: Cynthia Tucker, Pulitzer Prize for Commentary in 2007; The National Memo, March 28, 2015

March 29, 2015 Posted by | Affordable Care Act, GOP, Uninsured | , , , , , , | Leave a comment

“Give Me Lipitor Or Give Me Death”: Last Call; Ted Cruz Signs Up For Obamacare

A day after announcing his White House bid – which included beating on the Affordable Care Act, his favorite punching bag – Sen. Ted Cruz, R-Texas, says he’s signing up for Obamacare.

Yes, you read that correctly: The man whose signature applause line is a promise to “repeal each and every word of Obamacare,” went on Healthcare.gov and got himself some benefits. Hypocrisy? Sure, but not in the way you might think.

Cruz had been covered through his wife’s employer, Goldman Sachs. If some insurance plans are Cadillacs, hers was a chauffeured, solid-gold Fleetwood, reportedly worth some $20,000 a year — around half of Texas’ median income. Heidi Cruz is taking a year or so of unpaid leave to help him on his campaign, though, so her health care coverage evaporates along with her likely very substantial  paycheck.

Now, the senator – or maybe an aide, or an intern or campaign volunteer or someone – will schlep to the computer, log on to Healthcare.gov and hunch down over the keyboard to do the Obamacare two-step to get coverage for the upcoming year.

Cruz says he had to get health coverage Obamacare, and he’s right: Sen. Chuck Grassley, R-Iowa, inserted an ACA amendment that requires all members of Congress to sign up through the federal exchange. That means Cruz has to if he wants health insurance, although, unlike a lot of Obamacare enrollees, his $174,000 annual Senate salary covers the premiums.

“Well, it is written in the law that members will be on the exchanges without subsidies just like millions of Americans so that’s – I think the same rules should apply to all of us,” Cruz told the Des Moines Register. “Members of Congress should not be exempt.”

Cruz has come up with his own Obamacare alternative, a plan which shifts a lot of control to the states — including ones like Texas, that opted out of Obamacare and all that federal money that went with it. If it were available, he probably would have signed up for Cruzcare instead.

Cruz: 2, Hypocrisy: Undecided. Still, let’s take a closer look.

If Cruz wanted to stand on no-Obamacare, no-way principle, however, perhaps he could opt out of government-sponsored health care entirely, just like the 6.3 million Texans who don’t have health insurance — in part because his state, and his party, decided to block it. That includes 1.2 million children just like Cruz’s two little girls who can’t get health care if they get sick.

That’s made Texas the state with the highest number of uninsured people, nearly twice the national average.

Further, if you squint, the changes the Cruz family are undergoing — loss of a job or a dramatic life change that reduces income — are the top reasons people lose health insurance, and among the reasons Obamacare exists in the first place. And if a parent or spouse gets sick without insurance, it can lead to some serious financial hardship.

It’s perhaps safe to say Cruz understands that intuitively, even if he probably would never say so explicitly. Which is probably why he signed up, and where the hypocrisy comes in.

Even though it exposes him to a modicum of ridicule, allegations of hypocrisy and getting the stink-eye from some of his die-hard supporters, Ted’s Excellent Obamacare Adventure speaks more loudly than his “repeal every word of Obamacare” applause line. When it came down to brass tacks and he lost his wife’s coverage, he opted-in.

He may be a fierce Obamacare critic, and he may agree with the decision to deny affordable health insurance to more than 6 million Texans who, one imagines, he assumes would rather have liberty than Lipitor. But when it becomes a personal matter involving his own family, his conservative ideals don’t necessarily apply.

 

By: Joseph P. Williams, Washington Whispers, U. S. News and World Report, march 24, 2015

March 25, 2015 Posted by | Affordable Care Act, Ted Cruz, Uninsured | , , , , , | Leave a comment

“GOP Critics In An Unenviable Position”: Conservatives Scramble To Downplay ACA News

Americans learned yesterday that the Affordable Care Act has extended health care coverage to 16.4 million people, slashing the nation’s uninsured rate by over a third, against the backdrop of related system-wide good news. This puts “Obamacare” critics in an unenviable position: trying to characterize a law that’s working as a horrible failure, all evidence to the contrary notwithstanding.

Sen. John Barrasso (R-Wyo.), who’s struggled in this area before despite being the Senate GOP’s point person on health care, gave it his best shot. “Millions of people have lost coverage they liked,” the far-right senator told the New York Times, repeating a dubious claim unsupported by the evidence. He added that extending coverage to millions through Medicaid expansion is “hardly worth celebrating.”

He didn’t say why, exactly, he finds it discouraging when low-income families receive coverage through Medicaid.

But the funnier reaction came by way of a Wall Street Journal piece.

Edmund Haislmaier, senior fellow at the Heritage Foundation, a conservative research group, said the report also doesn’t include essential information on how many people who signed up on exchanges were previously uninsured.

“It’s premature to say it’s ACA-related,” Mr. Haislmaier said.

The number of uninsured historically also has been closely aligned with the economy, with numbers rising during recessions and falling as conditions improve.

Oh my.

The economic argument is itself politically tricky for ACA detractors, because it leaves Republicans in a position of arguing, “Let’s not credit Obama’s health care policies for the good news; let’s instead credit Obama’s economic policies.”

But it’s the Heritage Foundation’s other argument that’s truly amazing. The Affordable Care Act was created in large part to expand Americans’ access to affordable medical care. Once the law was implemented, its provisions worked like a charm and uninsured rate dropped. If the Wall Street Journal quoted Edmund Haislmaier fairly, the Heritage argument seems to be that the success might just be a coincidence – the ACA set out to reduce the uninsured rate, the law was implemented, and the uninsured rate fell at its fastest rate in four decades, but it’s “premature” to say the progress and the law are related.

Jon Chait joked:

Right, I mean, who can really say? Yes, there has been a sudden and extremely sharp plunge in the uninsured rates among the populations eligible for coverage under Obamacare that begins at the exact time Obamacare took effect:

But that could be anything. Survey error. People being excited about Republicans winning the midterm. Sunspots. You never know. Probably not the sudden availability of a major new federal health-care law enrolling millions of people.

Perish the thought.

For context, it’s worth noting that the Heritage Foundation used to be one of the leading conservative think tanks in the nation, even sketching out a health-care-reform blueprint several years ago that resembles the “Obamacare” model now. In recent years, however, Heritage’s focus has shifted away from scholarship and towards political activism.

 

By: Steve Benen, The Maddow Blog, March 17, 2015

March 18, 2015 Posted by | Affordable Care Act, Conservatives, Uninsured | , , , , , , | Leave a comment

“Ebola And The 41 Million Uninsured Americans”: Political Failure’s That Have Left Americans More Vulnerable To Deadly Diseases

With the first diagnosed case of the deadly Ebola virus in the United States located in Dallas, Texans are understandably alarmed. The patient just died. Gov. Rick Perry has established a taskforce to address the Ebola threat.

Not a bad idea but still a feeble response coming from a governor who refused to expand Medicaid in his state, leaving millions of his people outside the health care system. About 6 million Texans are now walking around without health insurance. That’s almost 1 in 4 residents — the highest rate of uninsured in the country.

Of course, those without health coverage are least likely to have a relationship with a health care professional, someone they could contact about worrisome symptoms. And because vomiting and other signs of Ebola could indicate something far less serious, these mostly low-income people might put off going to a hospital until it’s too late.

But Perry was among the large group of so-called conservative governors deeming it was more important to stick it to President Obama than to broaden health coverage in their states. Not surprisingly, the sharpest drops in the rates of the uninsured are in states that went along with the expansion. The rates remain nearly unchanged in the 23 nonparticipating states.

There was always a humanitarian reason for supporting the Affordable Care Act. Now we are seeing the self-interested reasons, which have been missing in most of the Obamacare debate. Covering all is essential to public health. Even the rich don’t enjoy divine protection from deadly infectious diseases. That the federal government is covering nearly the entire cost of the Medicaid expansion makes the excuses for not joining the program especially ugly.

And this is not just about Ebola. The flu is a communicable disease that typically kills 30,000 Americans a year, mainly the very old, the very young and the frail. Universal coverage can help contain that, as well.

The Ebola scare has overshadowed another frightening virus that has been diagnosed in hundreds of children since August — and that has just claimed the life of a 4-year-old in New Jersey. Enterovirus-68 has been found in 48 states, with significant numbers reported in Colorado, Illinois and Missouri. This respiratory illness, which has been associated with partial paralysis, spreads the same way colds do, through saliva and other bodily fluids.

Controlling these diseases requires early quarantine of those infected, and how are you going to find people who would test positive if they don’t go to a medical facility? Politicians who irresponsibly passed up an opportunity to bring such health services to their people are currently grasping at useless proposals.

Louisiana Gov. Bobby Jindal thinks the answer is to “stop accepting flights from countries that are Ebola stricken.” But what about the two nurses in Madrid who tested positive for the virus after treating a Spanish priest? The priest and one of the nurses have already died of the disease.

Do we stop accepting flights from Spain, which has a pretty good health care system, of course covering everyone? Not unexpectedly, the Texas governor opposes the flight ban idea.

Jindal was inexplicably proud to decline $6 billion in federal money to expand Medicaid coverage in his state. Nearly 900,000 Louisianans currently lack health insurance.

“Expansion would result in 41 percent of Louisiana’s population being enrolled in Medicaid,” Jindal explained at the time. “We should measure success by reducing the number of people on public assistance.”

There are many ways of measuring success in a society, widespread health coverage being one. Instead, we see a political failure that has left Americans more vulnerable to a deadly disease than they had to be. It’s really something.

 

By: Froma Harrop, The National Memo, October 9, 2014

 

October 10, 2014 Posted by | Infectious Diseases, Medicaid Expansion, Uninsured | , , , , , , | Leave a comment

“The Same Reasonable-Sounding Lies”: What Won’t The GOP Do To Keep The Poor Uninsured?

When it comes to healthcare, Southwest Virginia is a desperate place. Many of the state’s poorest and sickest live in that pocket of coal country between US Route 19 and the Kentucky and Tennessee borders, where it’s so hard to see a doctor that a free mobile health clinic held each July at a county fairground draws hundreds. “Southwest Virginia is one of the worst places we go to,” said Stan Brock, the founder and president of Remote Area Medical, which runs that clinic and others throughout the country.

That corner of Virginia also encompasses the district of Phillip Puckett, who served as a Democratic state senator until Monday, when he suddenly resigned. His decision to step down appears to have been the result of a bribe offered by Republican colleagues bent on stopping the expansion of Medicaid. Puckett’s resignation gave Republicans the one seat they needed to take control of the Senate; it also put him in the running for a paid post on a state tobacco commission that is controlled by some of the very same Republicans. And it cleared the way for the chamber to appoint his daughter to a state judgeship.

By stepping down, Puckett effectively ended a months-long battle over the fate of the 400,000 Virginians who are too poor to buy insurance but don’t meet the state’s restrictive eligibility requirements for Medicaid. The state Senate had been on course to vote to expand the program under the Affordable Care Act, setting up a budget showdown with the Republican-controlled House. But with the GOP now in control of the Senate, both chambers are expected to pass a spending plan on Thursday that does not include the expansion.

The advocacy group ProgressVA called for an investigation of allegations of a quid pro quo between Puckett and Republicans, who deny they made any sort of deal. Puckett cited “recent issues that have developed in our family” as grounds for his resignation, and said he would withdraw his name from consideration for the job on the tobacco commission. Virginia Attorney General Mark R. Herring announced that he does not see an “investigative role” for his office.

The question of what prompted Puckett’s mid-term resignation is tantalizing, and potentially important, but it’s also beside the point. The true scandal is that hundreds of thousands of Virginians—including more than 20,000 of Puckett’s own constituents—will be denied health insurance.

The Medicaid showdown in Virginia was particularly heated because the legislature was so closely split. But Republicans all across the country have gone to insane lengths to keep millions uninsured, or to justify doing so. In Louisiana, for example, the state sued MoveOn.org for a billboard criticizing Governor Bobby Jindal’s opposition to the Medicaid expansion. Republicans in Utah are trying to embed work requirements into a private alternative to the expansion, a stipulation that would likely make the plan unworkable. In Arkansas, Republicans tried to roll back the Medicaid alternative that passed last year by refusing to reauthorize its funding. Although the program was finally re-approved, conservative lawmakers—who are steadily gaining ground in the Arkansas legislature—indicated that they’ll attack it again next year.

For years now Republicans have trotted out the same reasonable-sounding lies to fight the expansion, namely the myth that states can’t afford it. The real callousness that undergirds their ideological campaign was made clear this year, however, by a handful of state senators in Missouri, who gathered on the Senate floor to make it clear that there would be “no path” forward for the expansion. “Why is this somehow our problem?” one lawmaker asked. “It’s not happening,” said another. “Go find something else to do.”

There simply isn’t anything else that the millions of Americans who fall into the coverage gap can do to afford healthcare. Expanding Medicaid won’t fix all of the health problems in Southwest Virginia; a shortage of providers serving rural and low-income patients also challenges the region. But that’s no reason to deny insurance to people, particularly when the costs of doing so will be born almost entirely by the federal government, not the state. The persistence of myriad other issues to be dealt with is simply an indicator that people would be better served if lawmakers spent less time devising elaborate schemes to keep the poor uninsured and found something else to do, themselves.

 

By: Zoe Carpenter, The Nation, June 10, 2014

June 11, 2014 Posted by | Health Care, Uninsured | , , , , , , , , | 1 Comment

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