By: Jay Inslee, Steve Beshear and Dannel P. Malloy, Opinion Pages, The Washington Post, Published: November 17, 2013: Jay Inslee, a Democrat, is governor of Washington. Steve Beshear, a Democrat, is governor of Kentucky. Dannel P. Malloy, a Democrat, is governor of Connecticut.
“Such Noble Sentiments”: Why Republicans Suddenly Care, Deeply, About All Those Canceled Health Policies
Amid the current national uproar over the troubles of the Affordable Care Act, it is almost uplifting to hear the deep concern expressed by politicians, pundits, lobbyists, and corporate leaders over cancellation of existing health insurance policies. They empathize loudly with the millions of potential victims, whose plight infuriates these worthy observers. They fill hours of television and pages of print with expressions of outrage.
Suddenly everyone in Washington is intensely concerned about Americans who are losing their health insurance.
The outpouring of noble sentiment would be laudable — indeed, long overdue — if only there was any reason to believe these protestations are sincere. Sadly, the evidence points in the opposite direction, for a single obvious reason: Millions of people in this country have been losing health insurance for many years, resulting in untold thousands of serious illnesses, bankruptcies, and early deaths – but until insurance cancellations became a political embarrassment for Barack Obama, the usual right-wing reaction was silence. (Except for that awkward and revealing outburst during the Republican debates of 2012, when a live audience howled its approval for the “let him die” plan.)
For anybody who ever honestly cared about people losing their health coverage – for instance, President Obama or his Democratic predecessor Bill Clinton – the depressing statistical reality has long been plain. Every day of every year, thousands of people leave the rolls of the private insurance industry in this country, almost never voluntarily.
People often forfeit insurance after losing a job, which happened to millions during the Great Recession. At the recession’s height, when the Tea Party Republicans were fighting to kill Obamacare in the cradle, more than 44,000 people were losing their health coverage every week. In May 2009, the policy journal Health Affairs published a projection that nearly 7 million Americans would lose coverage by the end of 2010.
People also lose insurance because their insurance company doesn’t want to pay the cost of a grave illness (having gorged on costly premiums for years), which has happened to many thousands more. The most recent congressional report on the subject found that three major insurance companies had saved at least $300 million through “rescission” of policies held by 20,000 seriously ill clients, while their profits mounted.
Or people lose insurance because the cost rises and they can no longer afford it, which happens routinely to nearly half the population at some point during every decade. A report released by the Treasury four years ago found that “nearly half of non-elderly Americans” had lived without health coverage at some point between 1997 and 2006, a period of relative prosperity and high employment.
The consequence, as everybody ought to know by now, is that upward of 45 million Americans have gone without health insurance at any given moment since 2007. And the further consequence is that many of those uninsured – men, women, and children — go without needed health care, leading to untold suffering and premature deaths for as many as 45,000 annually, perhaps more.
But such dismal facts have never seemed to trouble the Republicans who are screaming so loudly now about the terrible toll of Obamacare. The perennial GOP attitude was set forth by neoconservative eminence Bill Kristol back in 1993, when the prime objective was to kill the nascent Clinton health plan. “There is no health care crisis,” Kristol famously declared, and for him — then a well-paid flack in the Murdoch empire — that was true enough.
After two decades of medical costs skyrocketing above inflation, threatening fiscal and economic ruin, while millions went without insurance, such smug right-wing complacency remains largely intact. The only “health care crisis” ever feared by Republicans like Kristol is the prospect that reform will help Americans – as Obamacare is already doing, despite their worst efforts.
Let’s hope that the president’s team swiftly solves the inherent problems of providing universal coverage through private insurers. It is certainly possible, if never optimal, as Massachusetts and other states seeking to advance that goal are already proving.
And meanwhile, let’s please have no illusions about this momentary flurry of concern on the right over insurance lost. It would disappear instantly and permanently — if only Obamacare could be repealed.
By: Joe Conason, Featured Post, The National Memo, November 15, 2013
“Can We Please Get A Grip?”: Having The Backbone To Set Minimum Standards For Health Insurance
Democrats are showing once again they have the backbones of banana slugs.
The Affordable Care Act was meant to hold insurers to a higher standards. So it stands to reason that some insurers will have to cancel their lousy sub-standard policies.
But spineless Democrats (including my old boss Bill Clinton) are caving in to the Republican-fueled outrage that the President “misled” Americans into thinking they could keep their old lousy policies — and are now urging the White House to forget the new standards and let people keep what they had before.
And some congressional Republicans are all too eager to join them, and allow insurers to offer whatever crap they were offering before — exposing families to more than $12,700 in out-of-pocket expenses, canceling policies of people who get seriously sick, failing to cover prescription drugs, and so on.
Can we please get a grip? Whenever industry standards are lifted — a higher minimum wage, safer workplaces, non-toxic foods and drugs, safer cars — people no longer have the “freedom” to contract for the sub-standard goods and services.
But that freedom is usually a mirage because big businesses have most of the power and average people don’t have much of a choice. This has been especially the case with health insurance, which is why minimum standards here are essential.
Yes, the President might have spelled this out a bit more clearly beforehand, explaining that 95 percent of us aren’t in the private insurance market to begin with and won’t be affected, and that most of the 2 percent who lose their lousy policies and have to take better and more expensive ones will be subsidized.
But right now the President needs all the political support he can muster to hold insurers’ feet to the fire. Democrats should stand firm for a change.
By: Robert Reich, The Robert Reich Blog, November 15, 2013
“How We Got Obamacare To Work”: We Urge Congress To Get Out Of The Way And Support Efforts To Make Health-Care Reform Work
In our states — Washington, Kentucky and Connecticut — the Affordable Care Act, or “Obamacare,” is working. Tens of thousands of our residents have enrolled in affordable health-care coverage. Many of them could not get insurance before the law was enacted.
People keep asking us why our states have been successful. Here’s a hint: It’s not about our Web sites.
Sure, having functioning Web sites for our health-care exchanges makes the job of meeting the enormous demand for affordable coverage much easier, but each of our state Web sites has had its share of technical glitches. As we have demonstrated on a near-daily basis, Web sites can continually be improved to meet consumers’ needs.
The Affordable Care Act has been successful in our states because our political and community leaders grasped the importance of expanding health-care coverage and have avoided the temptation to use health-care reform as a political football.
In Washington, the legislature authorized Medicaid expansion with overwhelmingly bipartisan votes in the House and Senate this summer because legislators understood that it could help create more than 10,000 jobs, save more than $300 million for the state in the first 18 months, and, most important, provide several hundred thousand uninsured Washingtonians with health coverage.
In Kentucky, two independent studies showed that the Bluegrass State couldn’t afford not to expand Medicaid. Expansion offered huge savings in the state budget and is expected to create 17,000 jobs.
In Connecticut, more than 50 percent of enrollment in the state exchange, Access Health CT, is for private health insurance. The Connecticut exchange has a customer satisfaction level of 96.5 percent, according to a survey of users in October, with more than 82 percent of enrollees either “extremely likely” or “very likely” to recommend the exchange to a colleague or friend.
In our states, elected leaders have decided to put people, not politics, first.
President Obama announced an administrative change last week that would allow insurance companies to continue offering existing plans to those who want to keep them. It is up to state insurance commissioners to determine how and whether this option works for their states, and individual states will come to different conclusions.
What we all agree with completely, though, is the president’s insistence that our country cannot go back to the dark days before health-care reform, when people were regularly dropped from coverage, and those with “bare bones” plans ended up in medical bankruptcy when serious illness struck, many times because their insurance didn’t cover much of anything.
Thanks to health-care reform and the robust exchanges in our states, people are getting better coverage at a better price.
One such person is Brad Camp, a small-business owner in Kingston, Wash., who received a cancellation notice in September from his insurance carrier. He went to the state exchange, the Washington Healthplanfinder, and for close to the same premium his family was paying before got upfront coverage for doctor’s office visits and prescription drug , vision and dental coverage. His family was able to keep the same insurance carrier and doctors and qualified for tax credits to help cover the cost.
Since Howard Stovall opened his sign and graphics business in Lexington, Ky., in 1998, he has paid half the cost of health insurance for his eight employees. With the help of Stovall’s longtime insurance agent and Kentucky’s health exchange, Kynect, Stovall’s employees are saving 5 percent to 40 percent each on new health insurance plans with better benefits. Stovall can afford to provide additional employee benefits, including full disability coverage and part of the cost of vision and dental plans, while still saving the business 50 percent compared with the old plans.
In Connecticut, Anne Masterson was able to reduce her monthly premiums from $965 to $313 for similar coverage, including a $145 tax credit. Masterson is able to use her annual premium savings of $8,000 to pay bills or save for retirement.
These sorts of stories could be happening in every state if politicians would quit rooting for failure and directly undermining implementation of the Affordable Care Act — and, instead, put their constituents first. Health reform is working for the people of Washington, Kentucky and Connecticut because elected leaders on both sides of the aisle came together to do what is right for their residents.
We urge Congress to get out of the way and to support efforts to make health-care reform work for everyone. We urge our fellow governors, most especially those in states that refused to expand Medicaid, to make health-care reform work for their people too.
“Nobody Died”: No, Obamacare’s Flaws Are Not Like Hurricane Katrina
It’s one thing for former George W. Bush flack and Sarah Palin staffer Nicolle Wallace to make a silly and self-serving link between the troubled rollout of President Obama’s Affordable Care Act and her boss’s handling of, wait for it, Hurricane Katrina. It’s another for the New York Times to pick up the cudgel and seriously make a comparison between the Affordable Care Act’s acknowledged problems and the deadly 2005 tragedy.
But that’s what the paper did Friday morning, with Michael D. Shear’s “Health Law Rollout’s Stumbles Draw Comparisons to Bush’s Hurricane Response.” Other media are using the Times piece to make the same comparison. ABC’s “Good Morning America” did a whole segment on it; as I write, the chyron on MSNBC asks “Obama’s Katrina?”
Shear put it this way:
The disastrous rollout of [Obama’s} health care law not only threatens the rest of his agenda but also raises questions about his competence in the same way that the Bush administration’s botched response to Hurricane Katrina undermined any semblance of Republican efficiency….
“The echoes to the fall of 2005 are really eerie,” said Peter D. Feaver, a top national security official in Mr. Bush’s second term. “Katrina, which is shorthand for bungled administration policy, matches to the rollout of the website.”
No, Mr. Feaver, Katrina isn’t shorthand for “bungled administration policy.” It’s an actual tragedy in which at least 1,800 people lost their lives. Thousands of others were left stranded without food or water in their flooded neighborhoods, on freeway viaducts, in hospitals and nursing homes, and in the televised hell-hole of the Superdome. A million people were displaced, some of them permanently. Whole neighborhoods remain unrestored eight years later. There was at least $123 million in destruction, twice as much as in Hurricane Sandy.
In the ACA holocaust, by comparison, an undetermined number of people may lose health insurance policies they like. Many more, perhaps millions, have been frustrated by a kludgy website. On the other hand, at least 100,000 have signed up for insurance through the exchanges and another 500,000 or so have been newly covered by Medicaid expansion.
Oh, and there have been zero deaths as a result of the ACA woes — unless you count the death of credibility among journalists and pundits who would make such a lame and cruel comparison.
In Katrina, a toxic mix of indifference to the plight of poor, black New Orleans residents and genuine colorblind incompetence made a natural disaster worse. Bush, you’ll recall, threw a birthday party for Sen. John McCain, and then flew over the ravaged Gulf region without stopping. When he did visit, he praised his lame FEMA director Michael Brown – whose job as a commissioner of the International Arabian Horse Association had been great training for running the nation’s disaster preparedness agency – with the iconic “Heckuva job, Brownie.”
Obama, by contrast, stepped forward when the website troubles emerged. “Nobody is madder than me about the fact that the website isn’t working as well as it should, which means it’s going to get fixed,” he told a crowd Oct. 21. It’s still not fixed, although it’s working better, and the president has continued to push his staff for answers and apologize for the rollout woes, last week in an interview with NBC’s Chuck Todd; last night in a press conference. “There were times I thought we got slapped around unjustly,” the president said. “This one is deserved. It’s on us.” There has been nothing close to a “Heckuva job, Brownie” moment.
Finally, in Hurricane Katrina, most of the victims were poor African-Americans. In the current ACA controversy, the vast majority of people losing their private insurance policies are young and middle-aged white men who aren’t affluent, but are doing well enough that they don’t qualify for federal subsidies. That makes the Katrina-ACA comparison particularly outrageous, especially for journalists.
All that will ultimately matter is whether and when the site gets fixed, and the turmoil in the individual market, where some people are losing policies they want to keep, subsides. We still don’t know if the president’s proposed “fix,” which should let at least some of those folks hold onto their existing insurance, is meaningful enough to quell the political panic among some Democrats and people losing insurance, yet limited enough that it doesn’t undermine the goal of getting a bigger pool of people into the individual market for ACA-approved health insurance plans (rather than the junk insurance that currently dominates the individual market).
It’s clearly a mess, with genuine political and public policy implications. It’s fine for shrill Republicans to call it Obama’s Katrina, or his Iraq, or his Iran Contra – when it comes to this president, they have no credibility and they have no shame; they’ll say anything. But for the media to pick up on the GOP narrative and sincerely compare the ACA rollout stumble to a national tragedy like Hurricane Katrina?
Someone might call it the media’s Katrina — if it was fair to use a tragedy in which thousands died as a metaphor for mere incompetence. So I’ll just call it incredibly lame.
By: Joan Walsh, Editor at Large, Salon, November 15, 2013
“Let’s Work The Problem People”: Houston, We’ve Had A Health Care Problem For A Long Time
One of my favorite scenes in a movie is Ed Harris playing NASA ace Gene Kranz at mission control when Apollo 13 was about to burn up. He walks into a room full of engineers and scientists responsible for the mission as they are arguing and screaming at one another. He slams his fist down, quiets the crowd and says, “Let’s work the problem, people.”
That is how I feel about the launch of Obamacare. Fix it. Solve it. Make it work.
The other famous quote from that movie was Tom Hanks as Commander Jim Lovell when he said, “Houston, we have a problem.” The actual quote from Lovell was, “Houston we’ve had a problem.” Now that seems more appropriate for the herculean task of solving America’s health care problems.
We’ve had a problem, all right, for generations. We’ve failed to tackle the critical issue of health care in our country ever since Teddy Roosevelt. How can we justify more than 45 million Americans without health insurance? How can we rationalize a system that charges women twice as much as men? How can we not strike back against a system that would deny people health insurance because they had a pre-existing condition or that kicked them off because they hit a cap or got sick?
How can we possibly not recognize “we’ve had a problem” when costs have risen from $1,000 per person in the United States in 1980 to more than $8,000 in 2010? Costs going up 15 to 20 percent a year and eating up one-sixth of our economy are not sustainable.
The Republicans don’t want to work the problem, they want to sweep it back under the rug. Their goal is to turn this into a political football they can kick around between now and November. Five hearings in three days, more votes to destroy the Affordable Care Act. Not one suggested “fix” coming out of the Republicans in the House of Representatives.
I suggest House Speaker John Boehner and Rep. Darrell Issa watch the scene from Apollo 13 where the scientists react to Ed Harris. They put everything on the table that they have to work with in the space capsule and figure out how to bring the astronauts back safely to earth. They worked the problem; it is time for all concerned to do the same on health care. Mend it, don’t end it.
By: Peter Fenn, U. S. News and World Report, November 15, @013
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