“ACA Enrollment Tops 6 Million”: The Imminent Implosion Of The Affordable Care Act Has Been Cancelled
The expectation all along was that health care enrollment through the Affordable Care Act would spike shortly before the March 31 deadline. As of this afternoon, those expectations are very much in line with reality.
More than 6 million people have signed up for health insurance on the new exchanges, a number that signals a tremendous last-minute surge, the White House said Thursday.
President Barack Obama told volunteers and navigators helping sign people up that 1.5 million people visited HealthCare.gov on Wednesday – the highest-traffic day yet. Officials have said they logged more than a million visits each day so far this week.
Remember, this total only refers to consumers who’ve signed up for private coverage through exchange marketplaces. It doesn’t include Americans who’ve gained coverage through Medicaid expansion. For that matter, clearing the 6-million milestone is an important threshold, but there’s still time remaining in the open-enrollment period and it’s not unrealistic to think we’ll see 6.2 million by next week.
“We are seeing near-record numbers of consumers coming to check out their options and enroll in coverage. Yesterday alone, we had 1.5 million visits to HealthCare.gov and took more than 430,000 calls at our 24/7 call center,” said Marilyn Tavenner, head of the Centers for Medicare and Medicaid Services.
As of March 1 – not quite four weeks ago – 4.2 million Americans had enrolled through exchanges, suggesting we’ve seen nearly two million consumers sign up in less than a month.
It’s easy to forget, but this seemed like a pipe dream last fall. In October, the first month of the open-enrollment period, just 106,185 consumers signed up for insurance through an exchange – causing Republicans to not only celebrate, but to openly mock the system by noting a variety of sports venues that hold more than 106,185 attendees.
It was obviously proof, we were told at the time, that the Affordable Care Act itself was “hurtling toward failure.”
Oops.
The enrollment totals must seem literally unbelievable to Republicans, who managed to convince one another that the ACA is not only catastrophically flawed, but on an inevitable road towards imploding.
Indeed, as Paul Krugman noted earlier today, “[P]eople in the GOP are still working with a completely wrong narrative — namely, that Obamacare is failing, and that these are desperate ploys to save a sinking ship. The reality is quite different: enrollments have clearly surged in the final month…. How will the GOP respond when the numbers come in?”
I don’t know the answer to that question, but I suspect it’ll have something to do with Benghazi.
To reiterate a point from early February, those who say they hate “Obamacare” won’t want to hear this, but the imminent implosion of the Affordable Care Act has been cancelled.
What’s more, this is less of a comeback story than a story of normalcy and effective governance. There was a fair amount of panic in November – remember the pieces that predicted “Obamacare may destroy all of liberalism forever”? – but there were plenty of voices counseling patience. There were problems, but they were surmountable. There were elements that were broken, but they could be fixed.
The recent progress, in other words, isn’t some remarkable fluke the White House achieved through a Hail Mary pass. Rather, what we’re seeing now is progress many of us expected to see all along.
By: Steve Benen, The Maddow Blog, March 27, 2014
“Just Die Already!”: GOP Would Bar Poor From Health Care Altogether
During a Republican primary debate in the last presidential election cycle, there was a dispiriting moment in which Tea Party audience members cheered at the idea that a comatose uninsured American — unable to afford health insurance — would be left to die. That infamous outburst, among others, has prompted GOP bigwigs to try to cut back on primary season debates, hoping to limit appearances that might expose the party’s baser impulses.
But that mean-spirited and contemptuous attitude toward the sick is alive and well in the Grand Old Party, as its maniacal (and futile) resistance to Obamacare has made clear. Now, one Republican politician is pushing that callousness to new lows: He wants to bar the uninsured from hospital emergency rooms.
Last week, Georgia Gov. Nathan Deal criticized a decades-old federal law that requires all hospitals that receive Medicare funds and have emergency facilities — and that’s most — to treat any patient who walks in needing care, regardless of his ability to pay. “It came as a result of bad facts,” Deal said, according to The Atlanta Journal-Constitution. “And we have a saying that bad facts make bad law.”
Deal says that many people use emergency rooms unnecessarily, and those patients inflate health care costs. He is factually correct. But there are other facts that undercut his arguments and reveal his hypocrisy.
First off, Deal is among those red-state Republicans who have vociferously opposed the Affordable Care Act, which makes health insurance available to hundreds of thousands of people who couldn’t otherwise afford it. If more people had health insurance policies that paid for doctors’ visits, fewer would use emergency rooms for routine complaints.
Second, Deal, like many Republican governors, has refused the Medicaid expansion made possible by Obamacare, even though the federal government would pick up 100 percent of the cost for the first three years and 90 percent until the year 2022. That expansion is the best chance many Georgians without means have for getting health insurance.
So, to sum up, Deal hates Obamacare and refuses its Medicaid expansion, which would keep the working poor out of emergency rooms. In addition, he wants to deny them access to emergency rooms unless they can pay. Really, governor? Don’t you insist that your values are “pro-life”?
It’s no wonder that GOP strategists shuddered when audience members responded so cruelly during the CNN/Tea Party Express debate in September 2011. It portrays the party as pitiless — a reputation unlikely to attract a majority of voters.
Quiet as it’s kept, most Americans support keeping Obamacare, despite the relentless pounding it has taken from Republicans. (And despite a website rollout that was infuriatingly incompetent.) A new poll by the Kaiser Family Foundation found that 56 percent of Americans favor keeping it in place, while just 31 percent want to repeal it. (Twelve percent want to replace it with a GOP plan.)
That’s likely because most voters, no matter their reservations about Obamacare, know that the Republican Party has no good solution for the millions of Americans who work every day but still don’t earn enough money to buy a health care plan. Americans have struggled with the nation’s dysfunctional health care “system,” and they know it’s overdue for an overhaul.
Meanwhile, as the midterm elections draw closer, the GOP struggles to come up with a plan that pretends to overhaul the health care system. Looking to avoid being painted as mere obstructions, House Republican honchos are working to draw their caucus together behind a bill that would replace Obamacare with a workable alternative.
But the most sincere plan so far — one offered by Sens. Richard Burr (R-NC), Tom Coburn (R-OK) and Orrin Hatch (R-UT) — would probably offer policies too skimpy to do any good once a policyholder gets sick.
Besides, even that replacement idea seems unlikely to draw broad support among the far-right Tea Partiers, who believe that allowing the uninsured poor to die is the appropriate government response to the health care crisis.
That’s a hulking bit of hypocrisy for a party that advertises itself as “pro-life.” Deal’s latest proposal is one more reminder of how little that label means.
By: Cynthia Tucker, The National Memo, March 1, 2014
“Health Care Horror Hooey”: Eliciting Human Sympathy For Purely Imaginary Victims
Remember the “death tax”? The estate tax is quite literally a millionaire’s tax — a tax that affects only a tiny minority of the population, and is mostly paid by a handful of very wealthy heirs. Nonetheless, right-wingers have successfully convinced many voters that the tax is a cruel burden on ordinary Americans — that all across the nation small businesses and family farms are being broken up to pay crushing estate tax liabilities.
You might think that such heart-wrenching cases are actually quite rare, but you’d be wrong: they aren’t rare; they’re nonexistent. In particular, nobody has ever come up with a real modern example of a family farm sold to meet estate taxes. The whole “death tax” campaign has rested on eliciting human sympathy for purely imaginary victims.
And now they’re trying a similar campaign against health reform.
I’m not sure whether conservatives realize yet that their Plan A on health reform — wait for Obamacare’s inevitable collapse, and reap the political rewards — isn’t working. But it isn’t. Enrollments have recovered strongly from the law’s disastrous start-up; in California, which had a working website from the beginning, enrollment has already exceeded first-year projections. The mix of people signed up so far is older than planners had hoped, but not enough so to cause big premium hikes, let alone the often-predicted “death spiral.”
And conservatives don’t really have a Plan B — in their world, nobody even dares mention the possibility that health reform might actually prove workable. Still, you can already see some on the right groping toward a new strategy, one that relies on highlighting examples of the terrible harm Obamacare does. There’s only one problem: they haven’t managed to come up with any real examples. Consider several recent ventures on the right:
■ In the official G.O.P. response to the State of the Union address, Representative Cathy McMorris Rodgers alluded to the case of “Bette in Spokane,” who supposedly lost her good health insurance coverage and was forced to pay nearly $700 more a month in premiums. Local reporters located the real Bette, and found that the story was completely misleading: her original policy provided very little protection, and she could get a much better plan for much less than the claimed cost.
■ In Louisiana, the AstroTurf (fake grass-roots) group Americans for Prosperity — the group appears to be largely financed and controlled by the Koch brothers and other wealthy donors — has been running ads targeting Senator Mary Landrieu. In these ads, we see what appear to be ordinary Louisiana residents receiving notices telling them that their insurance policies have been canceled because of Obamacare. But the people in the ads are, in fact, paid actors, and the scenes they play aren’t re-enactments of real events — they’re “emblematic,” says a spokesman for the group.
■ In Michigan, Americans for Prosperity is running an ad that does feature a real person. But is she telling a real story? In the ad, Julia Boonstra, who is suffering from leukemia, declares that her insurance has been canceled, that the new policy will have unaffordable out-of-pocket costs, and that “If I do not receive my medication, I will die.” But Glenn Kessler of The Washington Post tried to check the facts, and learned that thanks to lower premiums she will almost surely save nearly as much if not more than she will be paying in higher out-of-pocket costs. A spokesman for Americans for Prosperity responded to questions about the numbers with bluster and double-talk — this is about “a real person suffering from blood cancer, not some neat and tidy White House PowerPoint.”
Even supporters of health reform are somewhat surprised by the right’s apparent inability to come up with real cases of hardship. Surely there must be some people somewhere actually being hurt by a reform that affects millions of Americans. Why can’t the right find these people and exploit them?
The most likely answer is that the true losers from Obamacare generally aren’t very sympathetic. For the most part, they’re either very affluent people affected by the special taxes that help finance reform, or at least moderately well-off young men in very good health who can no longer buy cheap, minimalist plans. Neither group would play well in tear-jerker ads.
No, what the right wants are struggling average Americans, preferably women, facing financial devastation from health reform. So those are the tales they’re telling, even though they haven’t been able to come up with any real examples.
Hey, I have a suggestion: Why not have ads in which actors play Americans who have both lost their insurance thanks to Obamacare and lost the family farm to the death tax? I mean, once you’re just making stuff up, anything goes.
By: Paul Krugman, Op-Ed Columnist, The New York Times, February 23, 2014
“The Importance Of Having Health Insurance”: The 2014 Factor No One Is Talking About — Seniors Are Turning On The GOP
Congressional Republicans have passed a budget, raised the debt limit and punted on immigration reform with one goal in mind. They want to make the 2014 midterm elections about Obamacare.
The party seems to be so confident of this strategy that it doesn’t appear to have any “Plan B,” as The Washington Post‘s Greg Sargent continually points out.
While going all-in on the Affordable Care Act makes sense inside the right-wing mindset, where the law is one Fox News interview from disappearing to wherever Mitt Romney was supposed to go, seniors — America’s most reliable voters — may end up leading a backlash against a post-government-shutdown Republican Party that is even less popular now than when George W. Bush left office.
Undoubtably, the poll numbers for the president’s health law remain low months after HealthCare.gov’s bungled rollout — even though it has helped lead the country to the lowest uninsured rate in five years.
But since the 2010 election, after which real, live Americans began gaining health insurance coverage due to the Affordable Care Act, has there been even one election that has been swayed by Obamacare?
Having been the godfather of the law didn’t cost Mitt Romney the 2012 GOP primary. Having signed the bill into law didn’t cost President Obama his re-election. It didn’t stop Democrats from picking up seats in the Senate and the House. Since 2012, Governor Chris Christie (R-NJ) was re-elected after accepting Medicaid expansion and Terry McAuliffe won Virginia’s governorship with a jobs plan centered upon expanding Medicaid.
In Florida, Democrat Alex Sink narrowly leads Republican David Jolly in a special election to replace Rep. Bill Young (R-FL), who passed away late last year. As Jolly attacks Sink on Obamacare, Sink defends the most popular part of the law — the ban on insurers considering pre-existing conditions — and attacks Jolly on Medicare.
Republicans exploited seniors’ fears of Medicare cuts in 2010 — then voted for the same cuts when they took the House. They also went a step further by proposing a plan to radically remake the single-payer system that provides health coverage to every American 65 or older.
Jolly, a lobbyist, has never officially endorsed or voted for the plan created by Rep. Paul Ryan (R-WI) to turn Medicare into a voucher system. However, nearly every sitting Republican member of the House has.
Ryan’s plan and opposition to Obamacare earned him boos when he spoke at the AARP convention as Mitt Romney’s running mate in 2012. And it was certainly part of the reason he was barely visible in the last few weeks of the campaign.
And since the 2012 election, Republicans’ standing with seniors has only deteriorated.
“In 2010, seniors voted for Republicans by a 21-point margin (38 percent to 59 percent),” Democracy Corps’ Erica Siefert noted in her post “Why Seniors Are Turning Against The GOP,” published months before the government shutdown.
In the latest McClatchy-Marist National Poll, the GOP only had a 4-point margin over Democrats.
The same poll found that 58 percent of adults 45-59 and 54 percent of those 60 and older had an unfavorable view of the president. However, 73 percent of adults 45-59 and 74 percent of those 60 and older also reported an unfavorable view of Republicans in Congress.
Democrats recognize that Obamacare may be a liability and are circulating talking points that call attention to the fact that “65 percent of voters agree with the statement ‘we’ve wasted too much time talking about Obamacare and we have other problems to deal with.’” This aligns with polls that show again and again that most people would rather keep and fix the law than repeal it completely.
But it’s quite possible that the GOP’s stand on Medicare could ultimately be more harmful to their prospects than Obamacare is for Democrats.
Any Republican who sticks with repeal can be charged with wanting to raise prescription drug prices for seniors. Along with eliminating the closing of the Medicare drug “donut hole,” repeal also would erase subsidies that are potentially helping millions of older Americans afford care.
“I just cried, I was so relieved,” said 58-year-old Maureen Grey after using her new plan — purchased with the help of Obamacare subsidies — to visit a doctor.
Adults aged 55-64 make up 31 percent of the new enrollees in the health care marketplaces set up by the law. A new Associated Press report notes that workers nearing retirement have been hardest hit by the Great Recession and are in the most desperate need of what the law offers:
Aging boomers are more likely to be in debt as they enter retirement than were previous generations, with many having purchased more expensive homes with smaller down payments, said economist Olivia Mitchell of University of Pennsylvania’s Wharton School. One in five has unpaid medical bills and 17 percent are underwater with their home values. Fourteen percent are uninsured.
As of December, 46 percent of older jobseekers were among the long-term unemployed compared with less than 25 percent before the recession.
And those financial setbacks happened just as their health care needs became more acute. Americans in their mid-50s to mid-60s are more likely to be diagnosed with diabetes than other age groups, younger or older, accounting for 3 in 10 of the adult diabetes diagnoses in the United States each year. And every year after age 50, the rate of cancer diagnosis climbs.
For many of these Americans, the Medicare guarantee isn’t some distant, theoretical promise. It’s a necessity.
And with Obamacare bridging the gap until retirement, Republicans may find that their decision to make the 2014 election about health care will be as ill-advised as shutting down the government to defund it.
By: Jason Sattler, The National Memo, February 18, 2014
“Ideology Versus Pragmatism”: Republicans Consider Stripping Health Insurance From Tens Of Thousands Of Arkansans
In Arkansas, approximately 83,000 low-income residents are in danger of losing their health insurance as early as July 1.
In 2013, Arkansas’ Republican-controlled legislature devised an alternative plan to expand Medicaid while still protecting the state’s poorest residents and hospitals. Through the plan, commonly referred to as the “private option,” Arkansas distributes federal funds — provided under the Affordable Care Act — to eligible recipients, who then use the funds to buy private health insurance plans. Proponents note that the plan offers private coverage to residents who would otherwise be unable to obtain it.
As The Washington Post reports, Governor Mike Beebe (R) welcomed the plan, saying it would save taxpayers nearly $90 million this year. The Obama administration later approved the plan, adding two necessary conditions: that cost-sharing and recipients’ benefits remain the same as the traditional Medicaid program, and that the total costs of the private plan do not exceed those of implementing traditional Medicaid expansion.
Over the past year, the private option has become so popular that variations of it are now being adopted in several states, like Pennsylvania and Utah.
“In crafting the ‘private option,’ Arkansas has provided a pathway for other states. They truly are trailblazers,” Deborah Bachrach, a partner with consulting firm Manatt Health, told the Post.
In recent weeks, however, Republicans have threatened to jump ship on the plan, jeopardizing the program that offers protection to tens of thousands of Arkansans.
With the state’s May primaries quickly approaching, Republican lawmakers facing more conservative challengers are feeling the pressure to vote against a renewal of the program’s financing.
“You’ve got a very small minority of people who can derail this,” explains Governor Beebe, who says that the sudden lack of support has to do with “ideology versus pragmatism.”
“If we lose one or two votes, it’s critical,” he added.
Considering that Arkansas requires 75 percent of the members of both houses to pass appropriations measures, “one or two” GOP votes are certainly critical to the program’s future. And in recent weeks, two Republican state senators have voiced their opposition to extending the private plan.
Senator Missy Irvin, who voted for the program last year, announced she would no longer support it, citing a decision made by Arkansas Blue Cross and Blue Shield – Arkansas’ dominant health insurance company – to cut reimbursement rates by 15 percent to specialists who participate in its federally run online insurance exchange plans. Irvin might have had another motive, however; she is currently facing a primary challenge from Tea Party candidate Phil Grace, who pointed to Irvin’s support for the private option as one of the main reasons he chose to run.
The argument against the plan made by Grace and other conservatives like him is rather vague, but it still has the power to sway other GOP votes.
“Right now, Washington is broken and trillions of dollars in debt. We can’t count on D.C. to keep promises for any funding and Arkansas certainly can’t foot the bill. The only way to deal with D.C.’s issues is for states to band together and push back,” Grace says.
Grace’s opposition to the private program – which has been echoed by other conservatives running in 2014 — steers clear of the GOP’s typical “big government” arguments, leaving it seeming rather arbitrary.
State Senator John Cooper, another Tea Party favorite, also says that he will not vote to reauthorize the plan’s funding — which is not a surprise, since he won the state’s special election by running against the program. Cooper argues that it will not save Arkansas money in the long term, despite reports to the contrary.
If Republicans vote against the private option – a vote that come could as early as next week – the implications for the state’s poor residents are burdensome and great. Before the private option existed, Arkansas had one of the most restrictive Medicaid programs in the nation, which made it especially difficult for struggling individuals and families to obtain coverage.
By: Elissa Gomez, The National Memo, February 11, 2014
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