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.
“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
“Everyone Just Chill Out”: Memo To Democratic Chicken Littles, The Sky Is Not Falling
Ah, now this is what politics is supposed to be like: Ruthless Republicans, gleeful at the prospect that they might increase the net total of human suffering. Timorous Democrats, panicking at the first hint of political difficulty and rushing to assemble a circular firing squad. And the news media bringing out the “Dems In Disarray!” headlines they keep in storage for just this purpose.
The problems of the last couple weeks “could threaten Democratic priorities for years,” says Ron Brownstein. It’s just like Hurricane Katrina, says The New York Times (minus the 1,500 dead people, I guess they mean, though they don’t say so). “On the broader question of whether Obama can rebuild an effective presidency after this debacle,” says Dana Milbank, “it’s starting to look as if it may be game over.” Ruth Marcus also declares this presidency all but dead: “Can he recover? I’m sorry to say: I’m not at all confident.”
Oh please. Everyone just chill out.
It’s incredible how often reporters and pundits proclaim that what’s happening this week is the most important political development in years, and the balance of political advantage today will remain just as it is indefinitely into the future. Then a few weeks or months later things change, and they forget about what they said before, declaring once again that today’s situation is how things will be forevermore. Not long ago, people were saying that the fact that Obama couldn’t get a congressional vote authorizing a bombing campaign in Syria had crippled his presidency. Then the Republicans shut down the government, and people were saying they wouldn’t win another election in our lifetimes. That’s just in the last few months. And now people are saying that Obama’s second term, which has three years left to go, is an unrecoverable disaster.
So let’s try to see things from a less panicky perspective. The rollout has been a mess, but it’s important to remember that this period is all a preparation for the actual implementation of the law. Nothing that’s happening now is permanent. People have gotten cancellation notices, but no one has lost their coverage. The website sucked when it debuted, it sucks slightly less now, but there’s still lots of time for people to sign up for plans that take effect next year. And if things aren’t working properly by December, they’ll probably extend the open enrollment period to a point at which everything’s working. That’s a hassle, sure. But you can’t call the Affordable Care Act a failure until it takes effect and does or does not achieve its goals. That would be like calling your team’s season a failure because they lost a couple of pre-season games.
A few Democrats will probably vote today for the Republican bill that purports to address the problem of cancellations but it’s an attempt to gut the entire ACA. That’s because they’re cowards and fools, who think that they can protect themselves from a momentary political headwind by rushing into the Republicans’ arms. And you know what will happen? Nothing. You can just add this vote to the 47 prior ones repealing the law; it’ll have the same impact. It won’t ever get to the Senate, and even if it did it wouldn’t ever be signed by the President. It isn’t even worth paying attention to.
Here’s what’s going to happen. The administrative fix Obama announced yesterday will temporarily staunch the political bleeding. But it will have very little effect on the actual insurance market, which is a good thing. In some states, insurance commissioners won’t let the insurance companies continue to sell the junk plans we’ve been talking about. In others, insurers won’t want to go back and re-offer the plans they cancelled. Some of the people with the junk plans will end up keeping them, but most of them will end up going to the exchanges. Many will find that they can get subsidies, or even without them find an affordable plan. Some may find that they’re paying more for a plan that offers real insurance. Those in the latter group will grumble, but it won’t be front-page news anymore, because the media are extraordinarily fickle, and they’ve already told that story.
Over the next year, the rest of the law will be implemented. There may be problems here and there, but overall it will probably go reasonably well. There will be plenty of things Democrats can point to in order to convince people that it was a good idea, like the fact that now nobody can be denied coverage because of a pre-existing condition, or the fact that millions of people who couldn’t afford coverage or were denied before now have it. There will also be things Republicans will say to try to convince people it was a terrible idea, like the fact that premiums didn’t plummet, and health care is still expensive, and Obamacare didn’t give every little girl a pony.
And what else will happen in the next year? Other things. The economy may get worse, or it may get better. There may be a foreign crisis. Controversies we can’t yet anticipate will emerge, explode, then disappear. A young singer may move her posterior about in a suggestive manner, causing a nation to drop everything and talk about nothing else for a week. We might start talking about immigration reform again. There’s going to be another budget battle. In other words, all sorts of things could affect the next election, and the election after that.
So yes, this is a difficult period for President Obama, and for the Affordable Care Act. But everyone needs to take a deep breath and remember that things will change. They always do.
By: Paul Waldman, Contributing Editor, The American Prospect, November 15, 2015
“The Burdens Of A Contradictory Message”: Is The Republican Position, “We’d Prefer To Leave You Behind With Nothing”?
On the surface, the Republican strategy on health care is proving to be more effective than they probably could have hoped. After waging a three-year sabotage campaign, the rollout of the Affordable Care Act has gone poorly; Democrats are divided; President Obama’s poll numbers are falling; the media is in a frenzy; the website still doesn’t work; and no one seems to remember the time Republicans shut down the federal government – just last month.
If RNC officials had written a script, it would look something like this.
And in the short term, at least as far as the politics are concerned, it’s quite possible that nothing else will matter. But at some point, I wonder if the political world will pause to consider the Republican message with a little more depth.
A few weeks ago, Matt Miller raised an important point: “What conservative officials, pundits and advocates are screaming is closer to the following: How dare you totally screw up something that we think shouldn’t exist!” Indeed, as we talked about as oversight hearings got underway a few weeks ago, conservatives are complaining about the functionality of a website that they’d just as soon destroy. They’re furious Americans are struggling to sign up for benefits that Republicans don’t want them to have. They’re demanding better performance of a system they’ve spent years deliberately trying to gut, and have no intention of trying to help fix.
The contradiction was more acutely obvious yesterday, with the release of October enrollment numbers: 106,185 consumers signed up for health insurance through an exchange, another 396,261 Americans have gained coverage through Medicaid expansion, and another million consumers were deemed eligible for coverage but have not selected a plan. GOP lawmakers considered this hilarious, noting a variety of sports venues that hold more than 106,185 attendees.
And that’s fine. Indeed, it’s predictable. About 500,000 Americans signed up for health care coverage last month, but because that number was far below the Obama administration’s original projections for the exchange marketplaces, critics of “Obamacare” want to take this opportunity to strut and gloat.
But that was yesterday. Today, I’d love to hear some of those same critics answer a couple of simple questions. First, for those mocking October enrollment numbers, do you wish that number was bigger or smaller? Because at this point, the answer appears to be “both,” which doesn’t make any sense. The Republican line currently seems to be, “We’re outraged that the number was so small, and we wish the totals were zero.”
That plainly doesn’t make any sense.
Second, for the 106,185 Americans who signed up for coverage through an exchange, and the 396,261 Americans who are now insured under Medicaid, is the Republican position, “We’d prefer to leave you behind with nothing?” What about those who sign up for coverage in November? And December?
By: Steve Benen, The Maoow Blog, November 14, 2013