“Health Care’s Resistors And Adapters”: Why The ‘Bette’ And ‘Boostra’ Stories Fall Apart
You’ll recall that Washington state Rep. Cathy McMorris Rodgers, in delivering one of the 17 GOP State of the Union responses, spoke of “Bette,” the Spokane woman whose premiums were going up under Obamacare by $700 a month. The state’s jackboot, according to McMorris-Rodgers, was planted right on Bette’s throat, and there was nothing she could do about it. Bette would “have no choice” but to pay the extra, socialistic freight. Awful, awful, awful.
But the Spokane newspaper tracked Bette down and got the whole story, which was that her insurer did indeed cancel Bette’s then-current plan, which didn’t meet all the new ACA coverage requirements. When she called, the insurer tried to steer her to a plan that cost around $500 a month more. However, Bette never went to the Washington state web site to check out all the options available to her. If she had, the LA Times reported, she’d have found that in fact many options were available to her, “and with a deductible far lower than the $10,000 she was paying under the old plan and broader coverage, though lacking a provision for four free doctor visits a year provided by her old plan.” But Bette just didn’t want to go on “that Obama web site at all.”
Now, the Detroit News has found another Bette. Julie Boonstra has cancer, and last month she starred in a Koch Brothers-funded ad for one of the Republican candidates for U.S. Senate. The ad claimed that Obamacare would make her medication so unaffordable that she might die. The News looked into the details of her new plan and found that she is going to save $1,200 a year. Here’s how the News summarizes the details:
Boonstra’s old plan cost $1,100 a month in premiums or $13,200 a year, she previously told The News. It didn’t include money she spent on co-pays, prescription drugs and other out-of-pocket expenses.
By contrast, the Blues’ plan premium costs $571 a month or $6,852 for the year. Since out-of-pocket costs are capped at $5,100, including deductibles, the maximum Boonstra would pay this year for all of her cancer treatment is $11,952.
Like Bette, Boonstra just isn’t buying it. It “can’t be true” and “I personally don’t believe that.” She’s the ex-wife of a former GOP county chairman who was named by the Republican governor to a seat on the state Court of Appeals, though she told the News she’s never been political.
Maybe not. And she does have cancer, so the point here is not to lay into her. The point is the way people’s views have been set in concrete because of all this hatred and all these lies coming from Republicans and groups like the Koch’s Americans for Prosperity.
Most people love the feeling of having their anger and suspicions confirmed. The chance to say “I knew it!” is rare enough in this world, and most people relish it. They relish it on some level even more than being wrong but ending up pleasantly surprised, at least in cases where for whatever reason they’ve developed some kind of emotional commitment to the outcome that confirms their worst fears.
So people were told: Obamacare is going to screw you over. Most people—conservatives, of course, but just general people with a default distrust of government—accepted this as logical. So they looked only for evidence that would support their being screwed over. Evidence to the contrary, even when it benefits them, is dismissed. Bette and Boonstra both do this. Bette wouldn’t even go look at the web site, where she’d have seen she had numerous options. Boonstra, told by newspaper reporters the objective facts of her situation, said she simply doesn’t believe it.
I wrote a piece a couple of months ago for which I went on the recently fixed up ACA web site, pretended to be a married, modest-income guy from Kansas, and found that I was offered a staggering 42 different plans, from very cheap (and really high deductible) ones to quite pricey ones, with lots of stops in between. Most people who bother to look will find the same thing.
But they have to look. The baseline question, as it so often is in politics these days, is about emotional resistance. How long will it take before people who get letters about changes to their insurance just go on the ACA web site and calmly shop around? Some smallish number does that now, but I daresay there are more Bettes and Boonstras. One big determinant of how Obamacare ends up playing in the elections this November will be how many resistors have become adapters.
Meanwhile, it’s comical, but also kind of sick, that the law’s opponents keep producing these lies and can’t find any real victims. I’m sure some are out there, but far, far more people will benefit from the fine print of this law, which is why these stories fall apart.
By: Michael Tomasky, The Daily Beast, March 11, 2014
“Surprise, Surprise”: The Real Numbers On ‘The Obamacare Effect’ Are In, Now Let The Crow Eating Begin
After years of negative speculation on the part of the opponents of Obamacare, hard data is finally coming in with respect to the anticipated negative side-effects of the law.
The results are guaranteed to both surprise and depress those who have built their narrative around the effort to destroy the Affordable Care Act.
Let’s begin with the meme threatening that healthcare reform will lead to a serious decline in full-time employment as employers reduce workforce hours to below 30 per week in the effort to avoid their responsibility to provide health benefits to their employees.
It turns out that there has, in fact, been no such rush to reduce work hours. Indeed, numbers released last week reveal that precisely the opposite is taking place.
According to the Bureau of Labor Statistics (BLS), the number of part-time workers in the United States has fallen by 300,000 since March of 2010 when the Affordable Care Act was passed into law. What’s more, in the past year alone—the time period in which the nation was approaching the start date for Obamacare—full-time employment grew by over 2 million while part-time employment declined by 230,000.
And it gets even more interesting.
Despite the cries of anguish over the coming destruction of private sector work opportunities at the hands of Obamacare, it turns out that the only significant ‘cutter’ of work hours turns out to be in the public sector where cops, teachers, prison guards and the like are experiencing cuts in work time as cities, states and universities seek to avoid the obligations of the health reform law.
Correct me if I am wrong, but is it not the very same folks who strenuously oppose Obamacare who are constantly screaming for smaller government? Are these not the same people who have, for as many years as I can recall, been carping about swollen government payrolls?
But the false narrative that has been peddled to make us believe that the private sector can’t wait to lower our hours of employment turns out not to be the only false note being played by anti-Obamacare forces.
For months now, we have been pounded with the story of the millions of Americans who have lost their non-group, individual health insurance policy due to cancellations forced by Obamacare.
Yet, a new study just out by Lisa Clemons-Cope and Nathaniel Anderson of the Urban Institute tells a very different story.
How many times have readers, along with television and radio audiences, read or heard me point out that few ever expected to hang onto their individual insurance policy for longer than a year or two following date of purchase? Long before there was Obamacare, it was always clear that when someone purchased an individual health instance policy, it was pretty much a given that they would either be moving on to an employer provided group plan when they get a job or that their policy would respond to the ordinary, pre-Obamacare changes that occurred from year to year and result in the consumer having to purchasing a new plan after a short period of time.
Indeed, it was this very reality that made it clear to those who follow the health insurance industry that Obama’s “If you like your policy you can keep your policy” proclamation was a near impossibility for those participating in the individual marketplace. This simply wasn’t the way the individual market worked.
The Urban Institute study bears this out, noting that “the non-group market has historically been highly volatile, with just 17 percent retaining coverage for more than two years.”
While Obamacare foes have been quick to jump on this statistic when it comes to condemning the President for uttering his promise that you could keep your insurance if you are happy with your policy, the same people have somehow managed to miss the reality that a huge percentage of those who received cancellation notices last year were going to get that notice even if the Affordable Care Act had never existed.
But that is not all that critics have been missing as they’ve sought to exploit the supposed high number of cancellations they claim are due to Obamacare.
To find out just how many people have really been put into an insurance fix, the Urban Institute’s Health Reform Monitoring Survey, in December of 2013, asked people between the ages of 18 and 64 the following question:
“Did you receive a notice in the past few months from a health insurance company saying that your policy is cancelled or will no longer be offered at the end of 2013?”
The following bar published in Health Affairs provides the results—
Note that the number of people who saw their policy cancelled because it did not meet the Obamacare minimum requirements was 18.6 percent—dangerously close to the 17 percent of individual policyholders who were losing their individual market policies pre-Obamacare.
Also note that the 18.6 percent equates to roughly 2.6 million people whose plans were cancelled as a result of Obamacare—a number well below the estimates of 5 million or considerably more being tossed about by Obamacare opposition.
So, what happens to these folks who saw their health insurance policy cancelled?
According to the Urban Institute researchers :
“While our sample size of those with non-group health insurance who report that their plan was cancelled due to ACA compliance is small (N=123), we estimate that over half of this population is likely to be eligible for coverage assistance, mostly through Marketplace subsidies. Consistent with these findings, other work by Urban Institute researchers estimated that slightly more than half of adults with pre-reform, nongroup coverage would be eligible for Marketplace subsidies or Medicaid.”
So what does this data tell us?
As a result of at least half of those cancelled being able to either enroll in a Medicaid program or receive subsidies on the healthcare exchanges, many—if not most—will now find health care coverage at a price lower than previously paid while greatly improving the quality of coverage.
Still, roughly one million people will have to replace their cancelled policy with something that may cost them more. This is not a good thing but it is far, far less dramatic than what we’ve been hearing. It is also a part of the expected upheaval that has always—and will always—result from the passage of reforms designed to benefit the greatest number of people. Traditionally, those who are disadvantaged in this way find that things are sorted out in amendments to the initial legislation, amendments that can only result when Republicans in Congress stop playing politics and begin the serious work of making the law better for Americans.
There is another problem noted in the study—
Because of the amount of focus placed on scaring the you-know-what out of people when it comes to the alleged dire effects of Obamacare rather than educating them, people remain in the dark as to what is available on the exchanges or via the state Medicaid programs.
Per the Urban Institute study—
“Yet making the best enrollment choice may be difficult for consumers. HRMS findings show that many people are not aware of the new state Marketplaces, few know whether their state is expanding Medicaid, and many lack the confidence to enroll, make choices, and pay their premiums.”
Once again, politics trumps policy and the critical needs of those our elected officials are sworn to serve.
I highly encourage everyone—whether friend or foe of healthcare reform—to take a look at the study cited above and the BLS statistics. While most all would agree that there are some repairs that need to be made to the Affordable Care Act, workable fixes designed to benefit the public and improve American healthcare cannot happen so long as politicians, pundits and special interests are devoted to lying about what Obamacare means and what it does not mean to the American public.
Facts matter—even when they screw up an effective disinformation campaign.
UPDATE: Monday, 12:15pm EST:
The news just keeps on coming.
The Gallup-Healthways Well-Being Index is out this morning and reveals that 15.9 percent of American adults are now uninsured, down from 17.1 percent for the last three months of 2013 and has shown improvements in every major demographic group with the exception of Hispanics who did not advance.
That translates roughly to 3 million to 4 million people getting coverage who did not have it before.
According to Gallup, the number of Americans who still do not have health insurance coverage is on track to reach the lowest quarterly number since 2008.
This is one statistic that is going to be tough for Obamacare critics to overcome.
By: Rick Ungar, Op-Ed Contributor, Forbes, March 10, 2014
“50th Time Is The Charm”: For House Republicans, The Affordable Care Act Is Not About Policy And Governing Isn’t Their Goal
Last week, after House Republicans announced an upcoming vote on undermining the Affordable Care Act, President Obama took some time to mock GOP lawmakers for their pointless hobby. “You know what they say: 50th time is the charm,” he joked at a DNC event. “Maybe when you hit your 50th repeal vote, you will win a prize. Maybe if you buy 50 repeal votes, you get one free. We get it. We understand. We get you don’t like it. I got it.”
But by all appearances, Republicans aren’t concerned about mockery. They’re proceeding today with their plan to go after the ACA’s individual mandate – again. By most counts, it will be the 50th time House Republicans have voted to gut some or all of the health care law since 2011, even though they fully realize their bill has no chance of being signed into law.
The House is set to vote Wednesday on a bill by Rep. Lynn Jenkins (R-KS) to effectively delay the individual mandate for one year by reducing the penalty in 2014 for not buying insurance from $95 to $0.
The Republican-led chamber passed a similar bill last July, capturing 22 Democratic votes. Now that it’s an election year, it’s plausible that a significant number of Democrats will defect, given the unpopularity of the individual mandate and the likelihood that Senate Democrats will throw the bill in the garbage once it arrives.
House Republicans are under no illusions about the legislation’s prospects, but governing isn’t the goal. This is about an election-year stunt intended to help GOP lawmakers feel better, maybe motivate the base a bit, and create the basis for some new attack ads against Democrats.
Whether or not one approves of this waste of time, it remains a ridiculous display.
For one thing, the effort itself would be a substantive disaster if the bill actually became law. Clearly the GOP is in its post-policy phase, so real-world implications are no longer considered before bills receive votes, but the Center on Budget and Policy Priorities published an analysis yesterday and found that the House’s proposal would increase the number of Americans without insurance and lead to higher health care premiums in the individual market. How do Republican leaders respond to revelations like these? They don’t – this isn’t about policy, so the implications are deemed irrelevant.
For another, this is quite a bit of effort over a policy Republicans supported up until a few years ago – the mandate used to be a key feature of GOP health care plans.
House Republicans could be using their time wisely right now. Maybe they could work on real legislation; maybe they could present their “Obamacare” alternative they’ve been promising for years.
But that just doesn’t seem to interest them. Americans are instead stuck watching their House of Representatives spin its wheels, picking up self-satisfying “message” bills.
By: Steve Benen, The Maddow Blog, March 5, 2014
“Promises, Promises”: The Elusive Policy That’s Always On The Horizon
In 2009, as Democrats advanced the Affordable Care Act, congressional Republicans promised to produce an alternative plan to prove to the public that the GOP approach was superior. It sounded very nice.
But Republicans, working in secret, missed their own deadline. Then they missed another. Eventually, GOP lawmakers threw together a half-hearted package, which was a bit of a joke. As Matt Yglesias noted at the time, the Republican approach to reform sought to create a system that “works better for people who don’t need health care services, and much worse for people who actually are sick or who become sick in the future. It’s basically a health un-insurance policy.” The CBO found that the plan would leave “about 52 million” Americans without access to basic medical care.
Four-and-a-half years later, we find ourselves in a surprisingly similar situation. For reasons they sometimes struggle to explain, congressional Republicans still hate “Obamacare,” and just as importantly, are still working in secret on an alternative reform plan that will prove their superior policymaking skills. One of these days, they keep saying. Just you watch. It’ll be **awesome.
Except, of course, the elusive policy is always just out of reach. It sits at the horizon, but it never draws closer.
Suddenly, a House vote on a Republican alternative to Obamacare seems less likely.
Speaker John Boehner (R-Ohio) declined to commit to an alternative measure coming up for a vote this year but said GOP leadership is going to “continue to having conversations with our members” about items like tax reform and replacing President Barack Obama’s signature domestic legislation.
And what about the recent promises from House Republican leaders that they will present an ACA alternative – and vote on it – sometime in 2014? “We’re going to continue to go through a lot of ideas,” Boehner said yesterday, using the most non-committal language possible.
By any fair standard, this is quickly becoming a rather ignominious fiasco.
Jon Chait published a gem this week, highlighting the recent Republican rhetoric.
* On Jan. 30, House Majority Leader Eric Cantor (R-VA.) vowed, “This year, we will rally around an alternative to ObamaCare and pass it on the floor of the House.”
* On Feb. 21, Cantor said Republicans are working “to finalize our Obamacare replacement plan.”
* On Feb. 24, Cantor’s office said it’s prepared to “begin” working on the party’s alternative.
* On Feb. 27, Boehner said he’s prepared to “have conversations” with Republicans about what might be in an alternative policy.
Notice the pattern? Over the course of four weeks, we’ve gone from a guaranteed vote on an alternative to descending assurances about whether an alternative will ever even exist. Chait explained:
Lots of people treat the Republican Party’s inability to unify around an alternative health-care plan, four years after the passage of the Affordable Care Act, as some kind of homework assignment they keep procrastinating on. But the problem isn’t that Cantor and Boehner and Ryan would rather lay around on the sofa drinking beer and playing video games than write their health-care plan already.
It’s that there’s no plan out there that is both ideologically acceptable to conservatives and politically defensible.
Quite right. Republicans could present an alternative policy that they love, but it’ll quickly be torn to shreds, make the party look foolish, and make clear that the GOP is not to be trusted with health care policy. Indeed, it would very likely scare the American mainstream to be reminded what Republicans would do if the power over the system were in their hands.
On other hand, Republicans could present a half-way credible policy, but it would have to require some regulations and public investments, which necessarily means the party’s base would find it abhorrent.
And so we get … nothing. Years of promises later, the GOP can’t meet its own commitment to the public, not because Republicans are lazy, but because it’s a post-policy party.
They sure are great at complaining, though, aren’t they?
By: Steve Benen, The Maddow Blog, February 28, 2014
“Show Me The Medicaid Money”: Buckle Up Republicans, Obamacare Is Here To Stay
Somewhat quietly, Obamacare enrollment hit 4 million this week. Now, it’s certainly true—as critics have noted—that enrollees aren’t the same thing as people who will continue to stay with their plan for a full year. If an enrollee encounters an unexpected expense of replacing a head gasket or something like that, he might skip a payment. But even so, 4 million’s a more-than-respectable number.
Also rather quietly this week, a new tracking poll from the Kaiser Family Foundation showed support for repeal of Obamacare down to 31 percent. As Jay Bookman noted in the Atlanta Journal-Constitution, overall the poll wasn’t something the president would exactly brag about, but it did represent noticeable change, especially among independents, 57 percent of whom now support the law.
That 31 percent number made me sit up straight for one reason. The percent of Americans who identify themselves as conservative is, lately, about 38 percent, says Gallup. So 31 percent is getting down there. And consider this: As of mid-December 2013, the percentage of Americans who favored repeal was 52.3 percent in a Real Clear Politics average of numerous polls. The Affordable Care Act may not be as popular as Twelve Years a Slave, but it’s not The Lone Ranger anymore either.
I would think there’s a direct correlation between these two sets of facts, no? The more people go to the web site and see that they can get insurance at a decent price (in most cases), the more they tell their co-workers and neighbors that doing so wasn’t the horror show they expected. The more people learn about some of the law’s benefits, the more opposition to it softens.
There are still a few more things the American people need to learn about the law, though, and it’s up to the Democrats to tell them, and I’m going to bang on about this until I see some action. As I wrote Wednesday, Governor Rick Perry has said no to $9 billion in free money. Texas is the largest state in the union that hasn’t accepted the Medicaid expansion money, so that’s the biggest figure, but the figures are significant in relation to the population and budget in every single state.
These figures are from a Commonwealth Foundation report from three months ago. Florida is saying no to $9.6 billion, Georgia to $4.9 billion, North Carolina to $5.7 billion. Wisconsin is passing on $1.75 billion, Virginia on $2.15 billion, and Pennsylvania on $5.5 billion (although Pennsylvania is considering the opt-in). And this report’s figure for Texas is actually $9.6 billion.
You know how states clamor for federal highway money? Well, as Commonwealth points out, in every one of these cases, the Medicaid money is more—at least double, typically, and sometimes far more—than what these states get in highway money. And yet they say they don’t want it. They say that over time, they’re going to be on the hook for vast expenditures they can’t afford, or they fret publicly that Washington might change the formula. They’re both bogus arguments.
The federal government is paying 100 percent of states’ expansion costs through 2016 and no less than 90 percent thereafter on a permanent basis. It’s a sweet deal. But okay, what about that (up to) 10 percent that states are going to have to start paying? Ten percent doesn’t sound like a lot, but in dollar terms, isn’t that real money?
The answer is, not really, in most cases. This gets complicated and involves a category of spending by the states for something called “uncompensated care,” which is just what it sounds like—health care provided for free to poor people. State and local governments typically pitch in now on uncompensated care. But as the Center on Budget and Policy Priorities explains in a 2012 report: “The Medicaid expansion will reduce state and local government costs for uncompensated care and other services they provide to the uninsured, which will offset at least some—and in a number of states, possibly all or more than all—of the modest increase in state Medicaid costs.” Overall, the health-care consulting firm The Lewin Group estimates a minimal increase in states’ spending obligations, around 1 or 2 percent, depending on the state.
As for the argument that some GOP governors make that they fear Washington might change the formula…well, that’s straight from Orwell or Kafka. That is: Barack Obama isn’t going to change any formula. President Hillary Clinton wouldn’t be changing any formula. A Democratically controlled Congress won’t be changing any formulas. Only Republican presidents and congresses would do that. In other words, these Republican governors are saying—yeah, the deal looks fine now, but my party might take over, and then I’d be really screwed!
The ACA is here to stay. It’s not going to be struck down. It’s not going to be repealed. That would require a Republican president and 60 GOP senators and a solid GOP House majority, and the odds are strongly against the emergence of such a confluence. It’s going to exist. And inevitably, it’s going to grow. And more and more people are going to get used to it and learn to live with it. And over time, the people in states like Texas and Georgia and Wisconsin are going to see that people in nearby states that took the money are in fact pretty happy with their situations.
It’s only a matter of time before these resistant governors and state legislatures start caving. Democrats have it in their power to help hasten that timetable by making this an issue. They have to have the courage not to wilt or get the vapors whenever a right-winger invokes the evil gummint or the hated Kenyan. Democrats say they’ve waited decades for this moment. Well, it’s here. Now’s not the time to run away from the fight.
By: Michael Tomasky, The Daily Beast, February 28, 2014
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 