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“The Burdens Of A Contradictory Message”: Is The Republican Position, “We’d Prefer To Leave You Behind With Nothing”?

On the surface, the Republican strategy on health care is proving to be more effective than they probably could have hoped. After waging a three-year sabotage campaign, the rollout of the Affordable Care Act has gone poorly; Democrats are divided; President Obama’s poll numbers are falling; the media is in a frenzy; the website still doesn’t work; and no one seems to remember the time Republicans shut down the federal government – just last month.

If RNC officials had written a script, it would look something like this.

And in the short term, at least as far as the politics are concerned, it’s quite possible that nothing else will matter. But at some point, I wonder if the political world will pause to consider the Republican message with a little more depth.

A few weeks ago, Matt Miller raised an important point: “What conservative officials, pundits and advocates are screaming is closer to the following: How dare you totally screw up something that we think shouldn’t exist!” Indeed, as we talked about as oversight hearings got underway a few weeks ago, conservatives are complaining about the functionality of a website that they’d just as soon destroy. They’re furious Americans are struggling to sign up for benefits that Republicans don’t want them to have. They’re demanding better performance of a system they’ve spent years deliberately trying to gut, and have no intention of trying to help fix.

The contradiction was more acutely obvious yesterday, with the release of October enrollment numbers: 106,185 consumers signed up for health insurance through an exchange, another 396,261 Americans have gained coverage through Medicaid expansion, and another million consumers were deemed eligible for coverage but have not selected a plan. GOP lawmakers considered this hilarious, noting a variety of sports venues that hold more than 106,185 attendees.

And that’s fine. Indeed, it’s predictable. About 500,000 Americans signed up for health care coverage last month, but because that number was far below the Obama administration’s original projections for the exchange marketplaces, critics of “Obamacare” want to take this opportunity to strut and gloat.

But that was yesterday. Today, I’d love to hear some of those same critics answer a couple of simple questions. First, for those mocking October enrollment numbers, do you wish that number was bigger or smaller? Because at this point, the answer appears to be “both,” which doesn’t make any sense. The Republican line currently seems to be, “We’re outraged that the number was so small, and we wish the totals were zero.”

That plainly doesn’t make any sense.

Second, for the 106,185 Americans who signed up for coverage through an exchange, and the 396,261 Americans who are now insured under Medicaid, is the Republican position, “We’d prefer to leave you behind with nothing?” What about those who sign up for coverage in November? And December?

 

By: Steve Benen, The Maoow Blog, November 14, 2013

November 15, 2013 Posted by | Affordable Care Act, Obamacare, Republicans | , , , , , , | Leave a comment

“It’s My New Heart”: Dick Cheney, An Even Bigger Monster Than You Thought

You’ve probably heard that Dick Cheney agrees with Bill Clinton about letting people who are losing private insurance keep their old plans, as President Obama repeatedly seemed to promise they could. That’s not surprising: Cheney is a troll who maligns the president whenever he can, and piling on with Clinton is a special kind of fun. Yes, it’s outrageous that a man who has enjoyed many millions of dollars of taxpayer-funded medical care doesn’t give a damn about the uninsured in our society, but that’s Dick Cheney.

Still, I was a little startled to hear the former vice president express total indifference to questions about his heart donor in a revealing interview with Larry King (it airs Thursday night; here’s a clip). It’s a window into his utter entitlement and self-absorption, and he comes off as an even bigger monster than I’d thought. Most people would at least feign interest in the donor; Cheney can’t manage it.

When King asks if he knows the identity of the person whose heart keeps him alive, Cheney, who is promoting a book about his transplant experience, says no, and adds, “it hadn’t been a priority for me.” Then he goes on:

When I came out from under the anesthetic after the transplant, I was euphoric.  I’d had–I’d been given the gift of additional lives, additional years of life.  For the family of the donor, they’d just been [through] some terrible tragedy, they’d lost a family member.  Can’t tell why, obviously, when you don’t know the details, but the way I think of it from a psychological standpoint is that it’s my new heart, not someone else’s old heart. And I always thank the donor, generically thank donors for the gift that I’ve been given, but I don’t spend time wondering who had it, what they’d done, what kind of person.

“It’s my new heart, not someone else’s old heart.” Consider the complete self-centeredness of that statement, and the utter lack of empathy. I shouldn’t be surprised at that — war criminals and torture-promoters aren’t known for their empathy — but I was. Cheney’s so absorbed in his great good luck that he can’t help sharing: “My cardiologist told me at one point, ‘You know, Dick, the transplant is a spiritual experience, not just for the patient, but also for the team.’” What a generous guy, sharing that “spiritual experience” with his cardiology team! So: Cheney is happy to have a new heart, but doesn’t bother to “spend time wondering who had it, what they’d done, what kind of person.”

And his statement that it wasn’t a “priority” to learn about his heart donor revealingly echoes his explanation for getting five deferments from the Vietnam War: The notorious war hawk famously told the Washington Post: “I had other priorities in the ’60s than military service.” Now he has other priorities than learning about his heart donor.

It’s certainly not compulsory to find out about the person who died so that you could live – who gave what Cheney called “the gift of life itself.” There may be valid psychological reasons not to. I don’t judge that decision. But I can’t get over the coldness required to express complete indifference to knowing about that person, and their family’s suffering.

Or could it be compassion? For a lot of people, the tragedy of a family member dying would be compounded, not lessened, by learning that their heart went to Cheney. Nah, there’s neither compassion nor self-awareness in the way Cheney talks about receiving “the gift of life,” from American taxpayers or from his mystery heart donor.

 

By: Joan Walsh, Editor at Large, Salon, November 14, 2013

November 15, 2013 Posted by | Dick Cheney | , , , , , , | Leave a comment

“What A Shocker”: Obamacare Is Working Best In States That Aren’t Trying To Sabotage It

The disappointing Affordable Care Act (ACA) numbers the Department of Health and Human Services (HHS) released on Wednesday revealed that the law is working best in the states that are — shockingly — implementing the law as it was designed.

Of the 106,185 people who have completed an application for health insurance, nearly 75 percent came from 14 states and the District of Columbia that both set up their own exchanges and expanded Medicaid.

Unsurprisingly, California and New York combined for the bulk of the enrollments, 51,769. But the most promising news from the Golden State wasn’t even included in this report.

Peter Lee, the executive director of Covered California, reported Wednesday that as of Tuesday, 60,000 Californians had signed up for insurance. Signups have increased to a rate of almost 2,500 enrollees per day in November. At that pace, the state could be expected to enroll 402,500 people by March 31 but Lee says that he expects to hit a goal of 500,000 to 700,000 people by then, which means he expects the pace to pick up by at least 640 people a day to over 3,000 enrollees.

Lee’s optimism is linked to more than the enrollment numbers. It seems California’s consumers are happy with the state’s website.

“Overall, nearly 70 percent of consumers who completed the survey found the application process easy to complete, and 88 percent of customers visiting CoveredCA.com found the information needed to choose a health plan that was right for them,” Covered California reported in a statement released Wednesday, giving Republicans another reason to hope that California isn’t a bellwether for the rest of the nation.

Red Kentucky is the only state in the union that voted for Mitt Romney and set up its own exchange, thanks in large part to Democratic governor Steve Beshear. The state’s site signed up a total of 32,485 Kentuckians, with 5,586 enrolling in private plans, in its first month of operation. This reduces the state’s uninsured population —estimated at 640,000 — by just over 5 percent.

Of course, it’s not hard for the states to look impressive next to the federal number that is anemically low. And not all the states that set up their own exchanges have succeeded. Oregon’s marketplace is so flawed, they didn’t even have numbers to report for October.

Implementing health care reform was never supposed to be easy.

“It’s like fixing an airplane while it’s in flight, if there is something terribly wrong with the plane,” said Timothy Jost, a health law professor at Washington & Lee University and an expert on the ACA.

And that’s without the unprecedented campaign of sabotage the right has waged. But the obstruction that has threatened the law most has been the combination of a mostly unforced error — Healthcare.gov’s disastrous launch — and Republican states refusing to launch their own exchanges. While the right is thrilled they’ve assisted in this catastrophe, it was the ancillary result of another sabotage strategy that was either masterminded or enthusiastically encouraged by Michael Cannon.

Who?

“Cannon is a health care policy expert at the libertarian Cato Institute,” reports The New Republic‘s Alec MacGillis. “He is also an avowed opponent of the Affordable Care Act, and has for several years now been embarked on a legal crusade that, while a ways from triumphing, may have inadvertently played an outsized role in suppressing the number of states setting up their own exchanges, thereby greatly confounding the law’s implementation.”

Cannon believes he has found a loophole in the law that could end up undoing it in any state that didn’t set up an exchange. With that in mind, he helped successfully convince every state with a Republican governor to reject their right to build their own site.

By opting out, states made the success of the president’s signature legislative accomplishment dependent on one single portal that needed to reach its tentacles into three dozen complex insurance markets at one time.

That — it turns out — is a lot more complicated than the administration expected it to be.

The best state numbers show that the ACA can be implemented with participation rates that are in at least in the same ballpark as Massachusetts’ Romneycare or Medicare Part D.

Medicare Part D Romneycare implementation

And there were some other numbers in the HHS report that bode well for reform.

HHS reports that 26,876,527 different users accessed the site and 3,158,436 calls were made to its center. A total of 1,477,853 applications processed to the point of where eligibility could be determined. This shows that the demand for what the marketplace is offering definitely exists.

Clearly and undeniably, the fate of the law now depends most on one thing.

“The October report is clearly disappointing,” Timothy Jost wrote in his blog. ”But the really important reports will be the December report, which will tell us how many will be enrolled for coverage that begins in January, and the March report, which will tell us how many will be enrolled for 2014.  If healthcare.gov is up and running by December, there is every reason to believe those reports will be much more promising.”

 

By: Jason Sattler, The National Memo, November 14, 2013

November 15, 2013 Posted by | Affordable Care Act, Obamacare, Republicans | , , , , , , | Leave a comment

“Darrell Issa’s Credibility Collapses”: Feeding Bogus Stories To Unsuspecting Journalists

House Oversight Committee Chairman Darrell Issa (R-Calif.) has a favorite trick: his staff puts together a partial transcript of closed-door testimony, they edit it in a misleading way to advance a far-right narrative, and then they look for a news organization who’ll fall for the scam.

This week, the trick involved Henry Chao, HealthCare.gov’s chief project manager at the Centers for Medicare and Medicaid Services, and an alleged memo involving security risks. CBS News fell victim to Issa’s swindle, and as was first reported right here on Maddow Blog, the story was quickly proven fraudulent.

At an Oversight Committee hearing yesterday, Rep. Gerald Connolly (D-Va.) questioned Chao on this point directly, made clear that the CBS report was wrong, and saw Chao explain that his words had been “rearranged” by the partial transcript Issa released.

But wait, there’s more.

Issa also insisted this week that the White House directed the CMS to disable the so-called “anonymous shopper” function of the Affordable Care Act’s website in order to prevent “sticker shock.” How’d that work out?

Three weeks ago, Issa alleged that the White House ordered contractors to disable the “anonymous shopper” function that would allow people to compare plans. “The White House was telling them they needed these changes,” he told CBS News. Why? He told Fox News that the administration “buried the information about the high cost of Obamacare” so that consumers wouldn’t get “sticker shock.”

In testimony Wednesday, however, an administration IT expert testified that he ordered the “shopper” function disabled until defects could be repaired and that there had been no political interference.

“So when Chairman Issa stated on national television that the White House ordered you . . . to disable the shopper function in September for political reasons, to avoid consumer sticker shock, that’s not true, is it?” asked Rep. John Tierney (D-Mass.).

Issa immediately objected, but it was too late – Issa’s lie (which is to say, his latest in a series of lies) had been exposed. The Republican said Tierney was mischaracterizing his claims, so Tierney read Issa’s discredited arguments out loud. (See the video http://youtu.be/oNSQn2zVdSU.)

I’m sure Issa and his office will continue to feed bogus stories to unsuspecting journalists. I’m less sure why anyone would keep falling for the same nonsense from someone lacking all credibility.

 

By: Steve Benen, The Maddow Blog, November 14, 2013

November 15, 2013 Posted by | Darrell Issa, Journalists | , , , , , , , | 1 Comment

“Obamacare’s Critical Moment”: It’s Time For Nervous Democrats To Have A Gut Check

At times like this, with the Obama administration weathering yet another controversy regarding the stumbling beginnings of the Affordable Care Act, it’s useful to remind ourselves that this too shall pass. I’ve been plenty critical of how Healthcare.gov has been handled (see here, or here, or here), but eventually it will get fixed, at least to the point at which it works well enough. Likewise, the fears now being experienced by people with individual insurance policies will, by and large, turn out to be unfounded. There will be some who have to pay more than they’ve been paying, but in almost all cases they’ll be getting more too.

But there’s no doubt that this is an escalating problem for the administration. The person who got sold a cheap insurance policy on the individual market because the insurer was confident that either a) they probably wouldn’t get sick any time soon, or b) the policy was so stingy (whether the customer knew it or not) that the insurer wouldn’t have to pay anything even if they did, has now become the victim whom all agree must be made whole. We’re all talking endlessly about Obama’s “If you like your current plan, you can keep it” pledge, but the fact is that if you have one of these junk insurance plans, you only like it if you haven’t had to use it. But no matter—the people on these plans (and not, say, people who are finally getting Medicaid, because they’re poor so who cares) are now the only people that matter. Congress is obsessed with them, the news media is obsessed with them, and Something Must Be Done.

The administration is clearly spooked, and so are Democrats. But everyone needs to take a breath and ask themselves whether what they do in the next couple of weeks is something they’ll be able to live with in a year or five years or twenty years.

No one should be under the illusion that the Republican proposals to “fix” the problem of people on the individual market who want to keep their current plan—one of which could be voted on today in the House—are anything other than an effort to cripple the ACA. Not only would they allow insurers to continue selling junk policies, they would also allow the insurers to deny people coverage because of pre-existing conditions. In other words, the Republicans propose to restore the abysmal status quo ante that led to passage of the ACA in the first place. They’d also have the likely effect of jacking up premiums in the exchange marketplace by allowing the insurers to cherry-pick healthy young people for the now still-legal junk policies, leaving older and sicker people to migrate to the exchanges, where premiums will almost surely skyrocket a year from now once the damage becomes clear. As Igor Volsky puts it, “On the eve of implementing hard fought reforms, lawmakers are essentially considering re-segregating the health care market: healthy uninsured individuals without an offer of employer-sponsored coverage, Medicare or Medicaid will be lured away into subprime policies that include few consumer protections (and probably won’t be there for them should they fall ill); sicker people will find themselves in exchanges that resemble high-risk insurance pools, paying ever-more for coverage.” Any Democrat who votes for something like that should be ashamed of themselves.

There’s a Democratic proposal from Mary Landrieu that’s almost as bad. Meanwhile, House Democrats are threatening the White House that they’ll sign on with the Republican plan if the White House doesn’t come up with some other solution that will allow them to cover their asses. But there may be no way to let people who have junk insurance keep it without undermining the law as a whole. As Ezra Klein says, “Solving a political problem now at the case of worsening a policy problem 10 months from now isn’t a good trade.” And that’s putting it way too mildly. They could easily try to solve a political problem now and give themselves a much worse political problem ten months from now by making it impossible for the law to succeed. If that happens, the fact that they signed on to the measure that all but destroyed the law isn’t going to save them with the voters. Obamacare’s fate is every Democrat’s fate, whether they like it or not.

You can say that Obama made his bed by repeating that “If you like your insurance, you can keep it,” and now he has to sleep in it. I’d have two responses to that. First, plans that were in effect when the ACA passed in 2010 fall under a grandfather clause, so strictly speaking, if you liked the plan you had when the law was passed and you still have it, you can keep it, even if it doesn’t meet the new requirements. But since the individual market is volatile (people move in and out of it frequently) and only plans that haven’t been altered since then fall under the grandfather clause, that’s a small number of people.

But much more importantly, we shouldn’t make a terrible policy choice just because it’s the one that we think would line up most precisely with a rhetorical pledge Barack Obama made three years ago. Yes, he should have said, “If you like your plan you can keep it, so long as it’s a plan that gives real coverage and doesn’t leave you vulnerable to bankruptcy if you get sick or have an accident.” But he didn’t. And today, we should make the policy choice that does the most good for the most people.

It would be nice if you could make an enormous policy change without leaving a single American worse off. But that was never possible. There are millions who are going to benefit from the ACA—people who had no insurance who will now be able to get it for free or for a modest cost, people with pre-existing conditions who couldn’t get coverage but now can, and yes, people who thought they were covered but weren’t and now will be, even if they have to pay a little more. Screwing huge numbers of them over for the sake of a small number of people who have been sold a bill of goods by their insurance company and want to keep their junk plans would be unconscionable.

As Josh Marshall says, it’s time for nervous Democrats to have a gut check. Republicans are positively slobbering at the opportunity they think they have to destroy the ACA. After all that’s happened—after a generation of waiting for health reform, after all the effort it took to pass it, after the Supreme Court case and the election and everything else—are there Democrats who want to find themselves telling their grandchildren, “Well, I helped the Republicans subvert the ACA and deprive millions of Americans of health security, because I was afraid somebody might run an ad against me in my next election”?

My confidence that your average member of Congress in either party fully understands the policy implications of what they might be voting for hovers somewhere near zero. But they need to get up to speed, and then find their moral centers. This is among the most critical moments in the already long and tortured history of this law. They’d better not screw it up.

 

By: Paul Waldman, Contributing Editor, The American Prospect, November 14, 2013

November 15, 2013 Posted by | Democrats, Obamacare, Republicans | , , , , , , | Leave a comment

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