“Republicans Can’t Win By Attacking Health Care In 2014”: We will Turn The Corner If Progressives Do Not Sit On The Sidelines
For me, the fact that Republicans keep using the Affordable Care Act – Obamacare – as a political football is a tragedy. Sure, the law has problems, but it is already saving lives and improving the health of millions of Americans.
Thankfully, it seems that Republicans who are counting on attacking the health reform system to get them into the end zone will be stopped short of the goal line based on numbers coming out of a March special election for a Florida House seat
For me, the Affordable Care Act comes down to people’s lives and health. Consider the story of a young man I met who told me that this new avenue to becoming insured had saved his life.
He had some symptoms that made him worry about his health. But he, like many Americans without insurance, ignored them, as he couldn’t afford to see the doctor. After the Affordable Care Act became law, he got coverage through his parents’ health insurance plan, and on visiting a doctor, found out he had stage 4 — that’s advanced — cancer. Fortunately, he got to the doctor in time to save his life.
That young man is far from alone. As of the end of February, some 11 million Americans have health coverage under the new law. Repealing it, as Republicans continue to insist, would take away coverage from each and every one of them.
In the Florida election, Republican David Jolly said “I’m fighting to repeal Obamacare, right away.” His opponent, Democrat Alex Sink, countered, “We can’t go back to insurance companies doing whatever they want. Instead of repealing the health care law, we need to keep what’s right and fix what’s wrong.”
The key part of Sink’s message was to remind voters why people wanted health care reform in the first place. As one of Sink’s TV ads said, “Jolly would go back to letting insurance companies deny coverage.”
That’s an effective reminder of the huge problems Americans have had for decades, when insurance companies could deny care because of a pre-existing condition, charge people higher rates because they were sick, and even charge women higher rates than men. The ACA ended all that.
The candidates in Florida pushed especially hard for the votes of seniors, which is not surprising given both Florida’s high senior population and the fact that seniors vote more frequently than other age groups.
In its ads for Jolly, The Republican Congressional Campaign repeated the same misleading charge that Republicans used successfully in 2010 to scare seniors against the ACA, that it cut $716 billion from Medicare. But unlike 2010, when Democrats did not respond to attacks on the ACA, Sink pushed back.
She reminded seniors that the ACA actually provides important new Medicare benefits, including closing the infamous prescription drug “donut hole.” Sink’s ads accurately said, “His [Jolly’s] plan would even force seniors to pay thousands more for prescription drugs.”
By Election Day, voters had a clear contrast between the positions of the candidates on the ACA. It was a close election, with Jolly winning by a small margin (48.4 percent to 46.5 percent) in a district with an 11-point Republican advantage, one that has been represented by the GOP for nearly 60 years.
But polling found that independent voters in the district supported the “keep and fix” position over the “repeal” position by a margin of 57 percent to 31 percent. Sink actually gained ground over Jolly during the election on the question of which candidate had a better position on the ACA.
I am very much looking forward to the time when Congress can start having real debates on how, as Sink said, “we can keep what’s right and fix what’s wrong” with the Affordable Care Act. However, it looks like it will take at least one more election, in 2014, to get us to that point.
We will turn the corner if progressives do not sit on the sidelines, but instead welcome the debate that Republicans insist on having about repealing the ACA.
That debate is an opportunity for people to be reminded in concrete terms that the new health care program, for all its shortcomings, is about providing every American with the peace of mind that comes with having health coverage.
By: Richard Kirsch, Senior Fellow at The Roosevelt Institute; Published in The National Memo, March 20, 2014
“Stripping Away The Rhetoric”: Rebuilding The American Dream, One Insurance Policy At A Time
The Republicans give lots of reasons for their opposition to the Affordable Care Act. Only two really matter.
One is politics. The other is money. More precisely, big-business money.
Like Social Security and Medicare, the expansion of health insurance coverage is making voters more predisposed to support the politicians that championed the law — and they’re all Democrats.
Meanwhile, the more Americans benefit from this new law, the more Republicans are being forced to modify and mellow their rejection of it.
Within a few years, it may become as politically suicidal to openly attack the Affordable Care Act as it would be to call for abolishing Medicare.
Of course, Republicans can’t say they oppose the reform law often called “Obamacare” because it boosts the Democratic Party’s prospects. So they say it violates states’ rights. They say it infringes on individual liberty. They say it hurts small businesses. They say it will cost Americans their jobs.
None of these charges is withstanding scrutiny.
The law was written with states in mind. That’s why states can build their own insurance exchanges. It doesn’t erode individual liberty. The Supreme Court said so. And while it will be some time before we know about the law’s full economic impact, the evidence so far suggests that it puts more money into the pockets of people who will spend it, according to a report by the Congressional Budget Office.
Wasn’t that the same report that said Obama’s expansion of health insurance coverage is killing jobs? Indeed, many news outlets reported exactly that. But that’s a misreading of the report.
The CBO found that some workers — mothers with small children, students, and those close to retirement — have voluntarily left the workplace, because they didn’t need a job to maintain access to quality health care anymore.
Once the Affordable Care Act began to take effect, these workers exercised their newfound economic freedom by choosing to quit. They’re now caring for their kids and grandchildren, focusing on their own education, simply opting to enjoy their golden years, or starting their own businesses.
That’s something to celebrate. The critique that the Affordable Care Act somehow reduces the incentive to work doesn’t stand up to scrutiny.
The voluntary exit of more than 2 million workers from the American labor force will benefit many people. These workers are free to follow their dreams. If they are providing care, they will ease our caregiving deficit. And other Americans seeking work may finally find a job.
At the same time, money saved on health care can be spent on things that small businesses sell. Yes, I know. Republicans claim higher wages are bad for small businesses, and because small businesses are the engine of the economy, Obama’s expansion of health insurance is a job-killer. That’s just wrong.
Wages aren’t the top concern of small businesses. Taxes and poor sales are. So with more money in more pockets, sales receipts should climb.
When you strip away the rhetoric and take a good hard look at what the Affordable Care Act actually does, it sure looks like the new law raises wages and increases workers’ bargaining power.
By: Jonathan Stoehr, Managing Editor, The Washington Spectator; The National Memo, March 17, 2014
“Forget The Conventional Wisdom”: What Florida Really Tells Us About Obamacare
Was it really Obamacare that sunk Sink? I mean of course Alex Sink, the Democratic Florida congressional candidate who lost to Republican David Jolly on Tuesday. After the results were announced, Washington’s conventional wisdom congealed immediately: This was all about Obamacare, and it’s going to doom the Democrats come November.
Not so fast, says Geoff Garin, the pollster who did Sink’s polling in the race. Garin argues in a memo he released the day of the voting that “the issue ultimately provided more of a lift than a drag to her campaign.” He followed up by telling me yesterday: “She would have done worse if she’d neglected to hit back and engage the issue.” There’s a lesson in there for Democrats as they march toward November.
Garin put two key questions to the district’s voters. The first paraphrased the criticisms of Sink on Obamacare: Sink supports this law that will take away $716 billion from Medicare, and that caused 300,000 Floridians to lose their coverage and 2,500 patients at a district cancer center to have to change doctors. The second paraphrased criticisms of Jolly’s health-care position: He wants to totally repeal the law instead of fix it, a position that would let insurers again discriminate against the already ill and charge women more than they charge men for coverage. Repeal would also cut expanded prescription-drug coverage for Medicare recipients.
Respondents were asked to say whether this information gave them “very major doubts” about the candidates, “fairly major” doubts, “just some” doubts, or “no real” doubts. Results: While 43 percent now entertained very major doubts about Sink, 50 percent said they had very major doubts about Jolly. And 35 percent had no real doubts about Sink while only 26 percent had no real doubts about Jolly.
If that polling is accurate, then “more lift than drag” is accurate and fair. Guy Molyneux, a partner of Garin’s who oversaw some Obamacare polling for a couple of unions in January, echoed the point that there are at least three things Democrats can say about the law and the Republicans’ repeal zeal that poll really well. People broadly understand, Molyneux told me, that the law protects against discrimination based on pre-existing conditions, and they approve of that strongly. They also know that insurers can no longer drop sick people on whim, and they like that. And they’re getting to know that the law prevents insurers from charging women more than men, and they like that, too; even men.
There’s one more thing that people don’t yet know very well, but the polling indicates that it could be a strong debating point, too: Under the law, insurers have to publicly justify any rate increases greater than 10 percent. This is called rate review, and it and the medical-loss ratio provisions of the law (explained here) are the two main planks that guard against willy-nilly rate hikes. A Heath and Human Services study from last September found that nearly 7 million citizens had saved more than $1 billion because of rate review, and moreover, that insurance companies were seeking increases of 10 percent far less frequently than before the law because of the added oversight.
Since everybody and his brother assumes that the Affordable Care Act is going to increase their rates, seems to me it’d be awfully useful for the Democrats to develop a sharp talking point or two explaining to people that the law actually helps prevent crazy premium increases.
This all makes the Obamacare story a lot more complicated than “disaster for Dems.” It just doesn’t have to be. Republicans know this, too. Why are they, or some of them, suddenly talking about replacing the law? Precisely to try to insulate themselves from the effective Democratic attack that they’d give carte blanche to insurance companies to go back to their old ways.
It’s worth dwelling on this for a paragraph—it’s important to understand. It was in the spring of 2010 that the GOP unveiled “repeal and replace.” They stuck with that through the election. Then, once they’d retaken the House, they dropped “replace” and went for “repeal” only. Now that a midterm election is coming again, though, they’re starting to put “replace” back in their rhetoric. But it’s as hollow this time as it was then. “Our challenge,” Molyneux told me, “is to show that there’s nothing behind the curtain there.”
Lord knows, the Democrats have more problems than health care staring them in the face for the fall. The turnout question is the biggest one, although they say they’re making efforts this time that have no precedent in a midterm election. And Obama’s bad approval numbers—worse still in many of the states with high-profile Senate contests—are a huge factor. “If Obama’s still at 41 percent in mid-October, we’re in a world of hurt,” Molyneux says. And finally, but far from least, the economy. An awful, awful number from this week’s NBC/Wall Street Journal poll: Fully 57 percent of those surveyed said they think we’re still in a recession.
So yeah, there’s a lot for Democrats to worry about. But in most of the contested states—not Louisiana, probably not Arkansas, but the others—they can make Obamacare a net wash if they can be clear about the implications of “repeal” and call out their GOP opponents on “replace.” And maybe as a bonus show they have some fight in them, and give those unmotivated young and Latino voters some good reasons to go to the polls.
By: Michael Tomasky, The Daily Beast, March 14, 2014
“At The Intersection Of Calendars And The ACA”: The Success Of The System Will Not Rise Or Fall Based On Monthly Tallies
The Affordable Care Act enrollment figures for February were released yesterday afternoon, and for the most part, the numbers looked pretty good for those hoping to see the U.S. system succeed.
But news consumers can be forgiven for thinking the opposite. The Hill ran this headline: “ObamaCare enrollments dip.” The Washington Post had a similar message: “Obamacare enrollment drops off in February.” The conservative Washington Examiner told readers: “Obamacare signups slow down in February.”
Sounds discouraging, doesn’t it? January’s enrollment totals were heartening, but if you just skimmed the headlines out of D.C., you’d think February represented a step backwards.
The months HHS has been using for tabulation don’t correspond precisely to the calendar, because of state reporting methods and where weekends fall. As it turns out, “February” is actually February 2 through March 1. That’s 28 days. “January” is actually December 29 through February 1. That’s 35 days. Plug in the numbers, and you’ll see the average daily enrollment for January was 32,744 and for February it was 33,673. As you can see in the graph, the pace actually increased a bit. Among the very few who noticed were Charles Gaba of ACASingups.net and Sy Mukherjee of ThinkProgress.
At a superficial level, the raw monthly totals offer a misleading picture. Someone sees 1.2 million sign-ups in January, followed by 943,000 in February. That looks like a drop.
Until we’re reminded that February is the shortest month.
Stepping back, it’s worth noting that these month-to-month totals are interesting, but their broader importance is limited. I always make a point to highlight the totals as a way of documenting ACA progress, and there’s a political salience as more Americans get invested – literally and figuratively – in the law’s future, but the success of the system will not rise or fall based on monthly tallies and the degree to which they meet preliminary projections.
As Rachel has noted on the show more than once, when a very similar system was established in Massachusetts eight years ago, officials worked under the assumption that enrollment would be slow at first and would then improve in time. In the very first month of the state’s open-enrollment period, a grand total of 123 residents of Massachusetts actually signed up.
And while that may sound like a disaster, no one much cared – in fact, no one even bothered to acknowledge the total at the time, and the figure was only dug up later.
The Affordable Care Act is following a similar trajectory. And since the Massachusetts system is working quite well, that’s probably a pretty good sign.
By most estimates, by the end of March, a little over 5 million consumers will have enrolled through exchange marketplaces, and a similar number will have gained coverage through Medicaid. That’s not quite what the CBO projected before the process began – whether the 7 million figure could have been reached if healthcare.gov worked from the outset we’ll never know – but it’s a perfectly fine number when it comes to sustainability.
Keep this in mind the next time you’re perusing the Beltway media’s headlines about the system’s progress.
By: Steve Benen, The Maddow Blog, March 12, 2014
“Stand By It, Support It, Argue For It”: Democrats Should Run On Obamacare, Not Run From It
Alex Sink should have won the special congressional election in Florida yesterday. She had more money, she had a better resume and profile, and she was certainly a good candidate.
Florida’s 13th congressional district is a very competitive district that President Obama carried in both 2008 and 2012. True, it had been in Republican hands for a long time, but it was a good chance for the Democrats to pick up an open seat.
So, what went wrong? Hard to tell, of course, from inside the beltway, but let me offer up one thought. Sink tried to straddle health care and got caught in the middle.
As we all know, the notion that “I was for it before I was sort-of against it” does not sit well with voters. Certainly one could argue that the “fix what is wrong” strategy could work in 2014 for Democrats. But my fear is that what the voters hear is “I don’t really like Obamacare much because it may be hurting me politically.”
It is my strong belief that Democrats need to argue vociferously for the benefits of Obamacare. They need to tout what it will do for the country, for average Americans, for those without health insurance, for the economy, for keeping health care costs under control. If candidates believe they can distance themselves politically, especially after they voted in favor of it, they are making a tragic mistake. Own it. Don’t shy away from the important impact it is having now and will have in the future.
Sure, each race is different, each race will have its own dynamics, each race will have its own issues and differences among candidates. But if Democrats are hopelessly divided on health care, even at odds with themselves, they will not be able to stop the Republicans from hammering them.
By emphasizing the “mend it, don’t end it” strategy rather than the “here’s what it will do for you” strategy, Democrats are playing defense. Sure, they can use the Bill Clinton line, “We’ll be fixing it this year, will fix it next year and we’ll fix it the year after that,” but stand by it, support it, argue for it. This is the way Social Security worked and Medicare too — they were constantly amended and changed — but the end result is that they are among the most effective and popular programs ever enacted.
Gov. Mitt Romney tried to straddle the auto bailout, Republicans try obfuscating on women’s issues and Kerry tried to argue both sides of his Iraq vote. It’s hard to make those plays work.
On Obamacare, Democrats should argue strongly for it. Over the next eight months, Democrats should point to the number of people signing up, the care that people are receiving, the improvements in delivery and cost, and, most importantly, what it will accomplish in the future. Once Obamacare is fully operational, fewer people will be bankrupted by health care expenses, our populace will be healthier and the overall impact on the nation will be similar to Social Security and Medicare.
In short, if Democrats start now and double down on the issue, they will fare better in November than if they run and hide.
By: Peter Fenn, U. S. News and World Report, March 12, 2014
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