“A Million Here, A Million There”: Millions Of People Have Health Insurance Thanks To Obamacare
The big number in the news this week was 1.1 million – the number of people who signed up for health insurance through Obamacare’s federal insurance marketplace this year. This is an important figure, especially given the fact that it stood at little more than 100,000 at the end of November.
Nevertheless, that 1.1 million figure dramatically understates what the Affordable Care Act has already accomplished. The number we should be talking about is at least 9 million and could be 14 million people who are currently getting coverage under the law.
How many people are currently covered through the law? Start with the 1.1 million who have gotten care through the federal website. If you layer on the number of enrollees who have gotten coverage through state-run exchanges that number tops 2.1 million, Secretary of Health and Human Services Kathleen Sebelius announced Tuesday. Then throw in the 3.9 million people who have gotten health coverage under Obamacare’s Medicaid expansion. Oh and don’t forget about the young adults under 26 who are still covered by their parents’ health insurance plans thanks to the Affordable Care Act. A year-and-a-half ago, the Department of Health and Human Services put the number at 3.1 million but an August study by the Commonwealth Fund, a private foundation that focuses on health policy research, estimated that the figure had reached 7.8 million. Total those numbers and you get a minimum of 9 million Americans covered through Obamacare and a maximum of nearly 14 million.
To borrow Everett Dirksen’s old adage: A million here, a million there, and pretty soon you’re talking about real coverage. This is why Wisconsin Sen. Ron Johnson told the New York Times last week that the Affordable Care Act is “no longer just a piece of paper that you can repeal and it goes away. … We have to deal with the people that are currently covered under Obamacare.”
To be sure there are provisos and qualifications. Obamacare critics will point out that some number of those insured are only replacing coverage they lost thanks to the law disqualifying their plans (of course that will require those same critics to acknowledge that very few of the people losing their health coverage are now bereft); and in the context of 50 million uninsured it’s only a start – but it is a start. And while I’m writing this in the waning hours of 2013, it doesn’t take a great feat of prognostication to know that the first days of 2014 may well bring another round of Obamacare horror stories as people find out that they don’t have coverage they thought they signed up for. The October website disaster’s effects are still being felt – the administration had been aiming for 3.3 million signups by now, for example, so the 2 million figure is well short.
The law’s well-publicized stumbles have certainly taken their toll in polls. Finally clear of its shutdown self-immolation, the GOP seems to be building its 2014 strategy around Obamacare’s flaws. “Ideally, we’d freeze things the way they are in amber until November,” a senior House Republican aide told Time’s Jay Newton-Small last month.
But putting aside for a moment the fact that 11 months is an age and a day in politics, there’s a fundamental flaw in this GOP calculus: Obamacare’s not the cutting issue they seem to think it is. Democratic pollsters Stan Greenberg, James Carville and Erica Seifert surveyed the 86 most competitive House districts and found that the country remains deeply divided on the Affordable Care Act. “Health care is not a wedge issue,” they concluded.
The right’s problem is that it fixates on approval-disapproval numbers without digging into them. So while a CNN/ORC poll conducted in mid-December found that 35 percent favor the law and 62 percent oppose it, only 43 percent oppose the law because it’s too liberal; if you add the 35 percent who favor the law to the 15 percent who dislike it because they wish it did more, the GOP 2014 game plan becomes more puzzling. An early December New York Times/CBS News poll tells the same story: 50 percent oppose the law while only 39 percent approve. But only 42 percent think the law goes too far while a total of 50 percent think it either doesn’t go far enough or is just right.
Those are the figures right now. But in February of last year, the Congressional Budget Office estimated that 7 million people would be covered this year through the exchanges. Is that figure realistic? The Washington Post’s Obamacare guru, Sarah Kliff, reported this week that the health research firm Avalere Health estimated what the pace of enrollments should look like, modeling it off of the 2006 Medicare drug program rollout. Their guess for Obamacare was 2.4 million people by the end of 2013, making the 7 million target plausible.
One factor which will help? The health insurance industry is going all-in on the law. As the Wall Street Journal reported last month, health insurers are fighting for these millions of new customers. The Journal suggested that insurers will spend $500 million on local TV ads in 2014. Here’s my favorite part of the article: “The ad campaigns are a major shift in strategy for health insurers, most of whom have never really had to market directly to consumers aggressively until now.” It’s the free-market flipside of Obama’s infamous promise: If you don’t like your insurer, you don’t have to keep it. A full fight for customers could help the law reach the 7 million mark – bringing the total number of people insured under it to nearly 20 million.
Is the GOP really going to spend the fall campaigning to take health care away from nearly 20 million people?
By: Robert Schlesinger, U. S. News and World Report, January 3, 2014
“Where Beliefs Diverge”: The Issue That Turns Republicans Against Israel
America’s right believes that Israel can do no wrong when it’s building settlements in the occupied territories or trying to prevent a nuclear deal with Iran. But when it comes to social policies, fundamentalists ignore that Israel is far more progressive than the United States.
A new governmental panel is suggesting that the Jewish state pay for all abortions for women aged 20-33. Currently, abortions for medical reasons and for girls under the age of 18 are subsidized by the government.
“Unlike in the United States, abortion has never figured in the country’s political campaigns,” The Times of Israel’s Lamar Berman notes. “In fact, Israel does not even have an active anti-abortion movement.”
The Hyde Amendment makes it illegal for Medicaid to fund any abortions, except in the cases of rape, incest or a threat to the life of the mother. Several Republican state legislatures have passed laws that will require women to purchase an additional waiver to cover abortion.
Israel has a single-payer health care system, which helps keep costs low, as Mitt Romney noted during his visit to the country in 2012.
Christians like to play up their connection to the religious traditions of the Holy Land. But abortion is an issue where beliefs diverge.
“That Jewish law does not consider the fetus to be a legal person goes to the heart of why so-called ‘personhood’ amendments—laws that would declare a fertilized egg to be a person with rights—and other attempts by lawmakers and activists to afford fetuses equal protection rights have a constitutional problem,” Sarah Posner notes. “They reflect a particular religious view, one that is not, as Christian-right activists like to say about their beliefs on reproduction, a ‘Judeo-Christian’ one.”
As the far right has moved even further to the right on abortion — passing more restrictions in the last three years than in the decade before — it also has intensified its embrace of the Jewish state. Haaretz’s Chemi Shalev pointed out in 2011 that if President Obama treated Israel the way Ronald Reagan — who placed an embargo on arms sales to the state — did, he would be impeached.
The growing influence of the Christian Coalition following Pat Robertson’s galvanizing 1988 presidential campaign has shifted power to the evangelicals of the Republican Party and given rise to policies based on Christian Dispensationalism, which argues the Jews must return to Israel for the second coming of Jesus Christ to occur. Some Christians go further and argue that the conversion of the “chosen people” is necessary to bring about the rapture. George W. Bush recently raised funds for a group that is actively engaged in converting Jews.
The drastic dissonance between American fundamentalists and Israeli health experts — who would prefer to fund all abortions for all women but didn’t propose this for budgetary reasons — suggests that the right is willing to ignore differences of opinion on reproductive rights… when they’re focused on bringing about the end of the world.
By: Jason Sattler, Featured Post, The National Memo, January 2, 2014
“Listening To The Founding Fathers”: Constitutionalism With An Anti-Government Ideology Is Historically And Philosophically Mistaken
A political backlash has commenced within the Republican Party against tea party and libertarian groups that have limited interest in securing Republican victories and majorities. Elected leaders, party officials and business groups have begun pushing back against self-destructive legislative strategies and unelectable primary candidates.
But the GOP’s political reaction often concedes a great deal of ideological ground to anti-government populism — what its advocates describe as “constitutionalism.” Our national recovery, in this view, depends on returning to the severely constrained governing vision of the Founding Fathers, as embodied in the Constitution. Many Republicans now seem to be saying: Yes, this is the conservative ideal, but it is just not practical to implement at the moment.
This cedes too much. In a new essay in National Affairs, “A Conservative Vision of Government,” Pete Wehner and I argue that the identification of constitutionalism with an anti-government ideology is not only politically toxic; it is historically and philosophically mistaken.
It is not enough to praise America’s Founders; it is necessary to listen to them. The Federalist Founders did not view government as a necessary evil. They referred to the “imbecility” of a weak federal government (in the form of the Articles of Confederation) compared to a relatively strong central government, which is what the Constitution actually created. Though they feared the concentration of too much power in one branch of government, they believed that good government was essential to promote what they called the “public good.”
And they assumed that the content of the public good would shift over time. “Constitutions of civil government,” argued Alexander Hamilton in Federalist No. 34, “are not to be framed upon a calculation of existing exigencies, but upon a combination of these with the probable exigencies of ages. . . . Nothing, therefore, can be more fallacious than to infer the extent of any power, proper to be lodged in the national government, from an estimate of its immediate necessities. There ought to be a CAPACITY to provide for future contingencies as they may happen.”
In the tradition of the Federalist Founders, Abraham Lincoln believed the federal government should be capable of adjusting to changing circumstances and active in pursuit of national purposes. In his “Fragment on Government,” Lincoln described a number of matters requiring the “combined action” of government, including “public roads and highways, public schools, charities, pauperism” and “providing for the helpless young and afflicted.”
Conservatives naturally want to be seen as defenders of the Constitution. But “constitutional conservatives” need to recognize what both the Federalist Founders and Lincoln actually envisioned for the republic they respectively created and preserved. Far from being constrained by the political and economic arrangements of an 18th-century coastal, agrarian republic, the Founders fully expected the United States to spread across a continent, undergo economic and social change and emerge as a global actor. And they purposely designed a constitutional system that could accommodate such ambitions.
This is not to argue that the Founders would be happy with the current size and role of government. But, after protecting a variety of essential civil liberties, they placed such matters mainly in the realm of democratic self-government. They made it procedurally difficult for majorities to prevail. But they placed few limits on the public policies that durable majorities might adopt in the future — leaving “a capacity to provide for future contingencies.”
In our time, durable majorities have endorsed the existence of Social Security and Medicare. These roles of government were not envisioned by the Founders. But they do not violate a principle of our system nor run counter to the prescient mind-set of the Founders. People are free to argue for and against such programs. But this debate can’t be trumped or short-circuited by simplistic and legalistic appeals to the Constitution as a purely limiting document.
The broad purposes of the modern state — promoting equal opportunity, providing for the poor and elderly — are valid within our constitutional order. But these roles are often carried out in antiquated, failing systems. The conservative challenge is to accept a commitment to the public good while providing a distinctly conservative vision of effective, modest, modern government.
But a shift in mind-set is first required among conservatives: thinking of government as a precious national institution in need of care and reform. This would honor the Founders. The real Founders.
By: Michael Gerson, Opinion Writer, The Washington Post, January 2, 2013
“He May Also Have Been A Spy”: Snowden Lied About China Contacts
Yesterday, the New York Times urged the Obama administration to offer Edward Snowden “a plea bargain or some form of clemency.” The paper called the former NSA contractor “a whistle-blower” for his exposure of “the vast scope” of the NSA’s “reach into the lives of hundreds of millions of people in the United States and around the globe.”
Perhaps Snowden is what the Times portrays him to be, a hero of sorts, yet the editors of the paper rushed to judgment. In their editorial they did not even raise the possibility that he passed along vital national security secrets to China. It is likely he did so.
“I have had no contact with the Chinese government,” Snowden wrote in a Q&A on the Guardian website while taking refuge in Hong Kong in June. “I only work with journalists.”
That’s far short of the truth. By the time he wrote those words in the online chat, Snowden, according to one of my sources in Hong Kong, had at least one “high-level contact” with Chinese officials there. Those officials suggested he give an interview to the South China Morning Post, the most prominent English-language newspaper in Hong Kong. This is significant because, as the Post noted, Snowden turned over to the paper documents that contained detailed technical information on the NSA’s methods. Included in these documents were Hong Kong and Chinese IP addresses that the NSA was surveilling. The disclosure of those addresses was not whistle-blowing; that was aiding China.
The Post, my source told me, had sent two reporters to interview Snowden. The paper did not give a byline to one of them, a Chinese national serving as the deputy to Editor Wang Xiangwei, who openly sits on a Communist Party organ in the Mainland. That reporter is suspected to have then supplied Snowden’s documents to Chinese agents. Beijing, it appears, was able to cover its tracks while obtaining information from the so-called whistle-blower.
Specifically, it appears that agents of China’s Ministry of State Security were in contact with Snowden during his stay in Hong Kong, a semi-autonomous part of China. “The Chinese already have everything Snowden had,” said an unnamed official to the Washington Free Beacon days after the leaker had left Hong Kong for Moscow. Representative Mike Rogers, chairman of the House Select Committee on Intelligence, said that Snowden probably went to Mainland China during his stay in Hong Kong, a suspicion shared by some in that city.
Moreover, evidence suggests that Beijing orchestrated Snowden’s flight from Hong Kong. Albert Ho, one of Snowden’s lawyers, believes Chinese authorities contacted him through an intermediary to pass a message that it was time for Snowden to leave the city. “I have reasons to believe that… those who wanted him to leave represented Beijing authorities,” he was quoted as saying.
We can only speculate as to the motives of the Chinese to frustrate Washington’s attempts to apprehend Snowden, but they did their best to make sure that American officials did not get the opportunity to interrogate Snowden. The last thing they wanted was for the U.S. to learn the extent of their penetration of the NSA and the FBI in Hawaii.
Some in the American intelligence community suspect Snowden was really a “drop box,” receiving information from NSA personnel working for China. In other words, he was used as a courier.
In any event, the Daily Beast’s Eli Lake reported in late June that the FBI was investigating whether Snowden obtained documents “from a leak inside the secret FISA court.” Similarly, Mike Rogers has suggested Snowden probably had an accomplice in the NSA giving him information.
Beijing may also have encouraged Snowden to leave Hawaii. One of my sources indicates that Chinese intelligence, either directly or through FBI personnel working for China, tipped Snowden off that NSA investigators were closing in on him.
At this point, allegations of Snowden’s shadowy involvement with Chinese intelligence in Hawaii remain unconfirmed, but the evidence suggests he lied about his dealings with Chinese officials during his stay in Hong Kong. That tells us he may have been more than just a “whistle-blower.”
Just because he raised critical issues that go to the core of our democracy does not mean Mr. Snowden is a hero. He may also have been a spy.
By: Gordon G. Chang, Author of The Coming Collapse of China; The Daily Beast, January 3, 2014
“The Fight Is History, Done, Finito”: The Affordable Care Act Is Here To Stay
Now that the fight over Obamacare is history, perhaps everyone can finally focus on making the program work the way it was designed. Or, preferably, better.
The fight is history, you realize. Done. Finito. Yesterday’s news.
Any existential threat to the Affordable Care Act (ACA) ended with the popping of champagne corks as the new year arrived. That was when an estimated 6 million uninsured Americans received coverage through expanded Medicaid eligibility or the federal and state health insurance exchanges. Obamacare is now a fait accompli; nobody is going to take this coverage away.
There may be more huffing, puffing and symbolic attempts at repeal by Republicans in Congress. There may be continued resistance and sabotage by Republican governors and GOP-controlled state legislatures. But the whole context has changed.
Now, officials in states that refused to participate in Medicaid expansion will have to explain why so many of their constituents — about 5 million nationwide — remain uninsured when they could have qualified for coverage. More than 1 million of these needlessly uninsured Americans live in Texas, which is targeted by Democrats as ripe for inroads because of its rapidly changing demographics. Will Gov. Rick Perry (R) be forced to reconsider his Obamacare rejectionism? Or will he ultimately be remembered for speeding the state’s transition from red to blue?
Performance of the federal insurance exchange Web site, HealthCare.gov, will continue to improve, if only because the initial flood of applicants is bound to subside. Meanwhile, insurance costs and benefits in states that refused to set up their own exchanges will be compared with those in states that did. There will be questions about how the new law is performing — but no one will be able to pretend it does not exist.
And we will surely hear more stories about individuals taking advantage of the law’s consumer benefits, especially the fact that preexisting conditions can no longer be used to deny coverage. This is life-changing for insurance seekers who suffer from chronic illnesses such as diabetes or who have survived cancer.
Opponents of the law can hardly advocate going back to a system in which those who really need insurance can’t get it. What they can do, and surely will, is make lots of noise by pretending that any problem with anyone’s health insurance is due to the Affordable Care Act. Before Obamacare, millions of Americans had their policies canceled by the insurance companies every year. Millions more had their premiums raised, their coverage reduced or both. Now when these things happen, critics will try to blame the new law.
Increasingly, though, the GOP will sound foolish and irrelevant if it continues to put all of its eggs in the “repeal and replace” basket. The problem is that the Affordable Care Act is a set of free-market reforms based on ideas developed in conservative think tanks. Republicans who want to repeal Obamacare would have to replace it with something suspiciously similar.
If Republicans in Congress would work with the administration to make technical corrections to the Affordable Care Act, they could claim a victory of sorts: Obama gave you this mess and we cleaned it up. But after demonizing the program — and the president — for so long, the party has painted itself into a corner.
Note to the GOP: “We refuse, under any circumstances, to make the law work better for the citizens we represent” is perhaps not the ideal campaign slogan for the midterm election.
The real problem with the ACA, and let’s be honest, is that it doesn’t go far enough. The decision to work within the existing framework of private, for-profit insurance companies meant building a tremendously complicated new system that still doesn’t quite get the job done: Even if all the states were fully participating, only about 30 million of the 48 million uninsured would be covered.
But Obamacare does establish the principle that health care is a right, not a privilege — and that this is true not just for children, the elderly and the poor but for all Americans.
Throughout the nation’s history, it has taken long, hard work to win universal recognition of what we consider our basic rights. Perhaps future legislation will expand and streamline the ACA reforms until everyone is covered. Or perhaps we’ll move toward a single-payer system, possibly by expanding Medicare and Medicaid until they meet in the middle.
I don’t know how we’ll get there, but we’re now on the road to universal health care. There’s no turning back.
By: Eugene Robinson, Opinion Writer, The Washington Post, January 3, 2014
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