“Obamacare’s Real Promise”: If You Lose Your Health-Care Plan, You Can Get A New One
The furor over “if you like your plan, you can keep it” touches on a deep fear in American life: That your health-care insurance can be taken from you. That fear is so powerful because it happens so often: Almost everyone in the country can lose their health insurance at any time, for all kinds of reasons — and every year, millions do.
If you’re one of the 149 million people who get health insurance through your employer, you can lose your plan if you get fired, or if the H.R. department decides to change plans, or if you have to move to a branch in another state.
If you’re one of the 51 million people who get Medicaid, you could lose your plan because your income rises and you’re no longer eligible or because your state cut its Medicaid budget and made you ineligible. You could lose it because you moved from Minnesota, where childless adults making less than 75 percent of the poverty line are eligible, to Texas, where there’s no coverage for childless adults.
If you’re one of the 15 million Americans who buys insurance on the individual market, you could lose your plan because your insurer decides to stop offering it or decides to jack up the price by 35 percent. And that’s assuming you’re one of the lucky people who weren’t denied coverage based on preexisting conditions in the first place.
Then, of course, there are the 50 million people who don’t have a plan in the first place. The vast majority of them desperately want health-care coverage. But it turns out that just because you want a plan doesn’t mean you can get one.
Virtually the only people whose health coverage is reasonably safe are those on fee-for-service Medicare and some forms of veterans insurance. And even there, enrollees are only safe until the day policymakers decide to change premiums or benefit packages.
President Obama’s critics are right: Obamacare doesn’t guarantee that everyone who likes their health insurance can keep it. In some cases, Obamacare is the reason people will lose health insurance they liked.
What Obamacare comes pretty close to guaranteeing, though, is that everyone who needs health insurance, or who wants health insurance, can get it.
It guarantees that if you lose the plan you liked — perhaps because you were fired from your job, or because you left your job to start a new business, or because your income made you ineligible for Medicaid — you’ll have a choice of new plans you can purchase, you’ll know that no insurer can turn you away, and you’ll be able to get financial help if you need it. In states that accept the Medicaid expansion, it guarantees that anyone who makes less than 133 percent of poverty can get fully subsidized insurance.
Health insurance isn’t such a fraught topic in countries such as Canada and France because people don’t live in constant fear of losing their ability to get routine medical care. A decade from now, that will be true in the U.S., too. But it’s not true yet, and paradoxically, that’s one reason health reform is so difficult. The status quo has left people rightly fearful, and when people are afraid, change is even scarier.
By: Ezra Klein, Wonkblog, The Washington Post, December 8, 2013
“Lipstick On A Pig”: You Can Teach Republicans What They Shouldn’t Say, But That Won’t Change What They Believe
When someone asks you if a victim of rape should be compelled by the state to carry a resulting pregnancy to term, it is not a gaffe if you reply that this hypothetical almost never happens because women’s bodies have a way of preventing conception when they are under stress. It’s also not a gaffe to reply that, while it is certainly unfortunate that rape babies are occasionally produced, it’s all part of God’s plan and clearly God wants that baby to come into the world. These responses are not gaffes because they are actually honest responses that reflect what Todd Akin and Richard Mourdock, respectively, actually believe.
A gaffe should be understood as an event where you actually say something that you didn’t mean to say or where you are caught being misinformed about some issue. While Todd Akin was misinformed about how human reproduction actually works, it was still how he thought human reproduction works. Call that one a half-gaffe. You can teach politicians what they shouldn’t say, but that won’t change what they believe. That’s why the following will not work very well:
The National Republican Congressional Committee wants to make sure there are no Todd Akin-style gaffes next year, so it’s meeting with top aides of sitting Republicans to teach them what to say — or not to say — on the trail, especially when their boss is running against a woman.
Speaker John Boehner is serious, too. His own top aides met recently with Republican staff to discuss how lawmakers should talk to female constituents.
“Let me put it this way, some of these guys have a lot to learn,” said a Republican staffer who attended the session in Boehner’s office.
There have been “multiple sessions” with the NRCC where aides to incumbents were schooled in “messaging against women opponents,” one GOP aide said.
When Todd Akin said that women can’t get pregnant from “legitimate rape,” he was suggesting that any woman who does get pregnant must have consented to have sex in some way. That’s what he believes. When Richard Mourdock said that pregnancies that result from rape are a “gift from God” and “something that God intended to happen,” he was suggesting that women should be grateful for their very unwanted pregnancies. That is what he believes.
Perhaps both men could have been elected to the U.S. Senate if they had just been counseled to keep their mouths shut or to repeat some GOP-approved talking point instead of saying what they actually believe. Personally, I think the electorate was better able to make a choice in those elections because the candidates were honest.
Wouldn’t it be better to nominate people who don’t believe things that make women want to flee rather than “guys [that] have a lot to learn”?
The problem isn’t the messaging. The problem is “these guys.”
By: Martin Longman, Washington Monthly Political Animal, December 7, 2013
“A Nightmare For John Boehner”: Why Obamacare Could Help The Democrats In 2014
If some Republicans are sounding just a little bit desperate right now, I think I know why. “Obamacare is not just a broken website,” House Speaker John Boehner sputtered the other day in retreat as it emerged that the website is now working well. “This bill is fundamentally flawed.” He sure hopes he’s right about that—and by the way, Mister, it’s a law, not a bill. But I bet late at night, when he’s having that last smoke and thinking back over his day, he fears that he’s wrong and that the central Republican…“idea,” if you want to call it that, of the last three years—get rid of Obamacare—is going to look awfully stupid to a majority of Americans eight or 10 months from now.
If you haven’t gone to HealthCare.gov just for kicks, I certainly recommend now that you do. Pretend that you’re from a state that didn’t create an exchange, if you aren’t, because if you’re from a state with its own exchange, you’ll just be kicked to the state website, and what you want to test here is the federal one. So just choose a yahoo state that didn’t play ball, where the law was mocked as just so much socialism.
I just did, for the first time in weeks, an hour before scribbling these sentences. I was amazed. It was lightning fast. Explanations were clear and straightforward. Instead of bureaucratese, I encountered something I didn’t expect at all: plain English!
And here’s the key thing. It gave me loads of choices. I pretended to be a 35-year-old man from Kansas with a spouse and child. Without even having to enter my fake income, the site delivered me in a split second to a page with loads of plan options.
Choice. That’s what America’s about. As I heard Sen. Joe Manchin (D-WV) say on Alex Wagner’s show a couple of weeks ago, we’re a nation of shoppers. It’s what we do best. Alas, he is correct. That’s what we want. From TVs to smartphones to flavors of potato chip that have been stretched to include ketchup and dill pickle (who eats those?), we believe that endless options are our right.
How many options? An amazing 42, to be precise. Forty-two plans! That might be more than the number of available potato-chip flavors in America. I would have to think it will shock people, in a highly positive way, to see they have so many choices. And most of all, it will feel…American. Something that offers a person 42 options ain’t socialism, as Americans know in their bones.
The plans ranged from $70 a month, which would have covered only me, to $742 a month for the Rolls-Royce family version, with $0 deductible and $6,500 out-of-pocket. It was an astonishing menu. And take it from a guy who just moved house and has been on the phone and online interminably with private-sector service-providers, mostly but hardly limited to the cable/Internet/phone company: This looked easy. The interface was great, really user-friendly, really clear.
Now, most of these plans weren’t cheap. Health insurance isn’t cheap. For example, a middle-of-the-pack silver plan looked like this: $472 a month; a $7,500 family deductible; a $12,700 out-of-pocket maximum. Those aren’t cheap. But a $10 copay for a doctor’s visit, $75 to see a specialist, and just $15 for a generic prescription. That’s not bad at all.
So yes, Mr. Speaker, it’s more than a website. It’s a chance for people who’ve eschewed insurance for years to buy it and take their kids to a doctor and even to a specialist when needed. Individuals will have to decide for themselves whether that buys them $5,664 in peace of mind (that’s $472 times 12), but I suspect a lot of people will decide that it sure does.
And this is where Republicans, if they’re looking around the corner, might be freaking out. They are going to emphasize the horror stories going forward, and those stories will exist. The Democrats will emphasize the violin stories, and they will exist, too.
But in between the decontextualized disasters and the stories with Hollywood endings will be millions of people to whom nothing particularly dramatic, but something very positive indeed, will have happened. They got insurance, or decent insurance, for the first time in their lives. They went and got their first physical in years. They had that bad back checked out finally. They took their child to an eye doctor and got her glasses. That’s not dramatic enough for a television ad, but any parent will understand that a child going from struggling with reading to being able to read easily at school is plenty dramatic.
I’ve known for a long time the Republicans were on the wrong side of history here. Forty-something million uninsured in this impossibly rich country, and they don’t want to do a thing about it. And don’t fall for their “plans.” They’re unworkable. They’re unworkable because the Republicans aren’t willing to spend the money that experts all say is required to make plans workable. And they aren’t willing to spend the money because spending money acknowledges the existence of a common purpose in this nation, and they certainly can’t acknowledge a common purpose, unless it’s war.
So while I’ve known they were on the wrong side of history, I have feared they were on the right side of the politics. Well, I’m starting to think otherwise. No American who has 42 choices is going to feel like the jackboot of the state is stomping on his neck. And sometime next year, the people in the states that didn’t take Medicaid money are going to start noticing something else: that in a lot of cases, they’re going to be paying more for the same plan that a person in a participating state is paying. How’s that going to go down, Rick Perry?
Mr. Speaker, light up another one. It’s going to be a long night.
By: Michael Tomasky, The Daily Beast, December 5, 2013
“Yes, McDonald’s Can Do Better”: More Than Greed, Profitable Fast Food Companies Could Pay A Living Wage
When I was 18, I spent a year and change flipping burgers in one of those restaurants where customers eat from a tray balanced across their car windows. It was one of the three jobs I held at the time, affording a simple budget and enough left over to save up to go to college after a couple of years. I put in hard hours for my employer and it eventually worked out just fine for me. It also makes for a nice story, but one that is embarrassingly dated. The fast food industry in which I worked is not the fast food industry of America today—just ask the thousands of workers on the streets, standing up for same opportunity to get by and get ahead that built the American Dream.
For today’s fast food work force, erratic scheduling makes holding down more than one job impossible—you can’t commit to a second employer if you’re on call for the first. At the same time, low wages barely cover basic household needs, leaving millions of workers in poverty despite being employed, and making saving for the future impossible. And the 18-year-old serving your root beer float? Now she is 29, and likely to have been to college and have a family to support.
What else has changed since I was behind the counter? Oh yeah, fast food companies are making more money than ever.
In our report “A Higher Wage is Possible,” my co-author Amy Traub and I show how Wal-Mart could meet worker demands for a fair wage without passing costs onto consumers. Every year, Wal-Mart directs a portion of its profits to buying back its own public stock, consolidating ownership and increasing earnings per share. If they used that money to invest in their workforce instead, Wal-Mart could offer a raise of $5.83 per hour to all of its 825,000 low wage workers. In addition to pulling thousands of families out of poverty, Wal-Mart would see lower turnover and higher productivity and contribute to economic growth that benefits Wal-Mart, retail, and the economy overall.
Share repurchases have become an increasingly popular business strategy. Last year, McDonald’s Corp spent $2.6 billion on them. YUM! Brands Inc, which includes Taco Bell, KFC, and Pizza Hut, spent $965 million. But while the long term value of buying back shares accrue mainly to those executives whose compensation is tied to stock performance, using that money to invest in the workforce would have benefits that apply to all stakeholders—workers, customers, communities, and shareholders too.
A quick calculation shows that McDonald’s and Yum could give raises of $2 to $3 per hour to every U.S. worker at their restaurant locations using just the money they now spend buying back shares. Since the details of their corporate pay structures are not public record, that is a raise applied to even the workers already earning above the threshold of $15 demanded on the streets. If we broke out the low-wage workers, or added in the billions in additional money paid to dividends each year, that raise could go even higher—without costing customers a dime.
There are lots of good reasons why fast food employers should do better for their workforce. It’s a win-win situation for everyone with a stake in the economy—and that is everyone. Moreover, fast food can do better, by using the money now syphoned to the top to invest in their workers and grow the economy.
To people like me who made their way through jobs similar to those of the workers on the street yesterday, the cripplingly poor terms of employment in today’s fast food industry look like more than just greed. It looks like the end of opportunity and the exchange of performance on paper for the substance of the American Dream.
By: Catherine Ruetschlin, The American Prospect, December 6, 2013
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