“Fostering Public Ignorance”: Health Care Reform Drives Republicans Stark Raving Mad
If insanity is defined as doing the same thing over and over and expecting a different result, it’s tempting to observe that congressional Republicans have gone stark, raving mad. My own GOP congressman, Rep. Tim Griffin, recently delivered himself of an opinion column boasting about having “voted more than 30 times to repeal all or parts of Obamacare.”
Only in politics does somebody expect praise for sheer futility.
Characteristically, Griffin’s column began by misrepresenting Senator Max Baucus. No, the retiring Montana Democrat didn’t call Obamacare a “train wreck.” In context, Baucus was complaining about Congress’s refusal to adequately fund programs helping people understand the law. With so much disinformation out there, he feared that public ignorance would lead to citizens initially missing out on its benefits.
But then fostering public ignorance is the whole GOP game plan at this point. Having been defeated in the House and Senate, failing to have Obamacare declared unconstitutional by the Supreme Court, and being rejected by voters in the 2012 presidential election, disinformation and sabotage are all they’ve got left.
In that spirit, Griffin quoted The Washington Examiner, one of those tycoon-funded right-wing propaganda publications reporting that “cost estimates from 17 of the nation’s largest insurance companies indicate that health insurance premiums will grow an average of 100 percent under Obamacare, and that some will soar more than 400 percent.”
Yeah, well the results are starting to come in. In California and New York, the nation’s two most populous states that have set up health care exchanges, premiums have dropped sharply below Congressional Budget Office projections.
According to the New York Times, “State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower.”
Similar savings have been achieved in California. They can be expected anywhere that large numbers of Americans can be persuaded to buy into the program and quit playing health care roulette.
But then that’s how insurance works—auto insurance, life insurance homeowners’ insurance, all insurance. By spreading the risk, you lower the cost to individual customers.
That’s the basic insight that led Benjamin Franklin to found the Philadelphia Contribution for Insurance Against Loss by Fire back in 1752. The more people purchase private health insurance through Obamacare, the lower their premiums and the lower the eventual cost to taxpayers.
Not to mention the enormous gain in personal freedom to individuals who can no longer be denied coverage due to “pre-existing conditions,” bankrupted by unexpected medical conditions, or forced to keep a job they dislike for fear of losing health insurance. Under Obamacare they can take it with them.
A certain kind of Republican, however, still doesn’t get it. Here’s GOP patriarch Ronald Reagan in 1961 inveighing against the dangers of “socialized medicine.” Unless Americans rejected it, he predicted, “one of these days you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.”
And what was Reagan talking about? Medicare. Should it be enacted, he warned, the plan to provide for Grandma’s medical bills would lead to government seizure of all doctors’ offices and hospitals. An all-powerful state would dictate where Americans would live and what their jobs would be.
Of course the Gipper was only an actor, reading a tycoon-approved script. After he became president he vowed to protect Medicare, already one of the most popular and successful government programs in U.S. history—along with Social Security, another threat to freedom as the scripted Reagan saw it.
Some still do. A local Republican politician of my acquaintance once suggested that if I liked Obamacare so much I should leave the country. I responded that as the losing party, maybe he should emigrate.
And good luck finding a country without universal health insurance and with indoor plumbing.
It’s true that with Red State politicians dragging their feet and Republican congressmen whose offices routinely assist constituents to work out Medicare and Social Security problems telling reporters they’ll refuse to help with Obamacare, the short-term rollout could be bumpy.
Over time, however, the Republican right is setting itself up for epic failure. Partisan passions aside, people want and need reliable health insurance. Doctors, hospitals and pharmaceutical companies need it as well.
This too: never mind the politicians. Health insurance companies are going to market Obamacare bigtime. Since the law mandates that 80 percent of premiums must be spent on benefits, the only way the insurance industry can enhance profits is by finding more customers.
It’s the American way.
By: Gene Lyons, The National Memo, July 24, 2013
“Political Skullduggery”: Indiana Fudges Truth On Health Exchange Rates To Make Obamacare Look Bad
Sometimes, the political urge simply overwhelms anything resembling common sense and appropriate behavior.
Witness the latest example of political skullduggery playing out in the great State of Indiana where GOP Governor Mike Pence has found it necessary to take extreme liberties with the reporting of the state’s healthcare exchange data—all to justify his anti-Obamacare political positioning.
Anyone paying attention to data projecting what a health insurance policy will likely cost on the newly formed individual policy insurance exchanges could hardly miss the headlines late last week announcing that premiums for health insurance policies stood to rise to an average monthly price of $570—a 72 percent increase over current rates in Indiana.
Of course, if this data is correct, it would be quite a blow to Indiana residents at the hand of the dreaded Obamacare.
At first glance—the only glance the Indiana officials intend for you to see—this is certainly disturbing news. Even those willing to accept the projections and claims made by the President during last week’s health care address—where he referred to the ‘good news’ in California, Oregon, Washington and, particularly, New York—would have to come to the understanding that there may, indeed, be states where the law is going to badly hurt consumers.
Fortunately, there are those whose job it is to dig below the surface of that ‘first glance’ to discover the truth of any situation—and, in this situation, we learn that Indiana has sought to play cute in its efforts to present a grim picture of the healthcare reform law, even when the data reveals otherwise.
You see, while the states that have already released their projections have based their price expectations on what insurance company filings suggest will be the cost of a ‘Silver’ plan (the second least expensive option to be offered on the exchanges), Indiana decided to publish their projections based on a calculation that took all the levels of plans to be offered—ranging from the less expensive Bronze and Silver plan to the most expensive Gold and Platinum plans—and averaged them all together to come up with their projected rates.
As Sy Mukherjee points out, “That’s like saying the average cost of a car in an Indiana dealership is $100,000 because it sells $20,000 Fords, $60,000 BMWs, and $220,000 Lamborghinis — technically true, but highly misleading.”
Exactly.
What possible benefit can there be to taking an average of costs ranging from most expensive to least expensive when we know full well that the overwhelming majority of those living in Indiana—and, for that matter, everywhere else—will purchase the policies in the lower cost ranges?
How do we know this?
We know this because we have the evidence of buying patterns provided by the State of Massachusetts, a state that has been utilizing this system for quite some time now.
As Sarah Kliff at the Washington Post reports—
“In Massachusetts, 8 percent of enrollees bought a gold plan. Eighty-four percent chose bronze or silver. At least one carrier in Indiana seems to agree with this distribution. In state rate filings, Physicians Health Plan of Indiana estimates that 45 percent of its enrollees will pick bronze and 38 percent take up silver. It is expected that the average mix of Individual Market will be more toward less rich benefit plans and credit should be given for the associated reduction in induced utilization,” the company wrote in its filing. In other words, the average plan cost isn’t a great estimation of what the average person will pay.”
Ms. Kliff also did a little digging to discover that the actual prices for Bronze and Silver plans in Indiana are going to be far below the $512 a month estimate provided by the state’s government.
“Anthem’s rate filing includes projections for health insurance costs in their bronze plans. A 47-year-old male who does not smoke would be charged, on average, $307 per month. Sample plans from another plan, MDWise, predict a 47-year-old man will be charged $294 and $391 for a bronze and silver plan, respectively.”
While you may find the actual rates of the policies to be made available on the Indiana individual exchange to be good news or bad— depending on what you currently pay for health coverage—one would at least hope that the state would want to put out an honest analysis.
“Victory For The Middle Class”: On Obamacare’s Third Birthday, There Are Already Reasons To Be Grateful
On March 23, 2010, Obamacare — formally known as the Patient Protection and Affordable Care Act — was signed into law by President Obama.
Three years later, the bulk of the first serious attempt at near-universal health care has not yet taken effect. Health marketplaces are still being formed, states are still deciding if they’ll take Medicaid expansion and the subsidies that will help tens of millions of Americans afford health care won’t roll out until January 1, 2014.
Implementing Obamacare won’t be easy, as even some of the biggest fans of the program admit. Expanding Medicare to cover all Americans would have to be an even simpler solution but a complete political impossibility — given that Joe Lieberman (I-CT), whose vote was necessary to pass the law, single-handedly vetoed a provision that would allow 55- to 64-year-olds to buy into Medicare. It’s a compromise solution that uses unpopular provisions — like the individual mandate — to achieve extremely popular results — ending lifetime limits and banning insurance companies from dropping patients once they become sick.
There will be plenty of time to debate the efficacy of Obamacare — especially with insurance companies enjoying record profits threatening to raise rates in order to justify changes to the law.
But right now we should celebrate the greatest victory for the middle class since Medicare and Medicaid. At its heart, Obamacare is a program that asks the rich and corporations to pay a little more to help working Americans get insurance they can count on, thus lowering the cost of health care for everyone. We already pay for each other’s health coverage, but just in the dumbest possible way — emergency rooms.
Here are five reasons to be grateful for Obamacare, which is already making life better for the middle class.
Obamacare Frees Workers And Entrepreneurs
One of the most popular aspects of Obamacare is that beginning in 2014, insurance companies will no longer be able to deny people coverage because of pre-existing conditions. Because insurance companies had been able to do this, many people avoided going to the doctor for fear of being diagnosed with a disease or condition that would brand them for the rest of their lives. Some stayed in jobs they didn’t want and others didn’t take the leap to start a new business for fear of not being able to get coverage. These changes especially free women — who by federal law can no longer be charged more for care because of their gender — to pursue new opportunities.
Insurance Companies Pay You Back
Insurance companies are required for the first time to prove that they’re spending between 80 and 85 percent of premiums, depending on the size of the company, on actual health care. If companies don’t spend that amount on coverage, they have to return that money to their customers — $1.2 billion was returned in 2012 to self-employed Americans whose insurers didn’t hit the proper ratio.
Millions Of Young People Already Covered
An estimated six million college students are already taking advantage of Obamacare’s provision that lets them stay on their parents’ insurance until the age of 26. This has led to a record drop in uninsured young people, allowing them to go back to school or pursue graduate degrees without taking on as much student loan debt.
Seniors Spend Less On Drugs
One of the most immediate benefits of Obamacare was the closing of the Medicare D prescription drug “donut hole,” which requires seniors to pay for the coverage gap between their deductible and yearly limit, at which point the plan covers all medication — $6.1 billion in drug coverage has already been distributed to seniors, which leads to the irony that Republicans ran and won in 2010 on saying that Obamacare cuts Medicare when, in fact, benefits for seniors have only increased. All the savings come from reforming the way providers are paid.
The Red States Get To Pay The Blue States Back
When the Supreme Court ruled that the mandate in Obamacare was Constitutional, it also gave states the chance to opt out of the Medicaid expansion that will provide free public health care for those not already on Medicaid, but who earn up to 133 percent of the poverty level. The states that are turning down the expansion, unfortunately, are some of those that need it the most. All of the states that have rejected the federal extra funding — which begins at 100 percent of the cost of the expansion and goes down to 90 percent — are states that generally vote Republican.
You probably know that most red states take in more federal money than they contribute, as Republican policies encourage growth of programs like food stamps. Though Republican governors can reject the benefits of Medicaid expansion, their richest citizens and corporations will still have to pay the taxes. As a result, they won’t be such “takers.”
Unfortunately, the working poor of red states — who earn too much to be on basic Medicaid — will suffer without the health insurance they need. Those on Medicare and Medicaid will likely see fewer doctors who want to accept clients from these programs, as Medicaid expansion was supposed to make up for the cut in reimbursement rates that begins in 2014. And all residents will not enjoy the slowdown in the growth of health care costs that will come from shrinking the number of the uninsured.
For red state governors, it’s a chance to fulfill the prophecies of doom Republicans made when Obamacare passed. But for residents of blue states, it’s a chance to make America’s health care system more equitable, with red states finally paying closer to their fair share.
By: Jason Sattler, The National Memo, March 22, 2013; Photo: The Advisory Board Company
“Warmed Over Pablum”: Marco Rubio’s Lies About Healthcare Reform
Marco Rubio’s rebuttal to the State of the Union address was remarkable for being unremarkable—it contained much of the same warmed-over pablum we heard from the stage in Tampa Bay at the Republican National Convention six months ago. President Obama “believes [the government] the cause of our problems” and that “More government isn’t going to help you get ahead. It’s going to hold you back.” There was even a Solyndra reference.
But the most interesting and substantive part of Rubio’s speech was the attack he leveled against healthcare reform. The Affordable Care Act will be implemented over the next—wait, sorry. I’m incredibly thirsty. I need some water before I finish this post.
Okay, back. In any case, as the ACA is implemented over the next few years, Republicans must continue to launch rhetorical bombs at it, because a negative public perception of the law would create cover for Republican governors to deny Medicaid expansion in their state, and might also blunt “Obamacare” as a powerful Democratic talking point in 2014 and 2016.
So here’s what Rubio said about the ACA:
[M]any government programs that claim to help the middle class, often end up hurting them instead.
For example, Obamacare was supposed to help middle-class Americans afford health insurance. But now, some people are losing the health insurance they were happy with. And because Obamacare created expensive requirements for companies with more than fifty employees, now many of these businesses aren’t hiring. Not only that; they’re being forced to lay people off and switch from full-time employees to part-time workers.
Rubio is explicitly trying to scare people into thinking they’re about to either lose their health insurance or get fired because of Obamacare. But none of this is true.
Let’s start with the first claim: that “some people are losing the health insurance they were happy with.” Rubio is eliding the fact that in the final telling, ACA is projected to insure 30 million Americans who otherwise don’t have health insurance. It’s not immediately clear who Rubio thinks is losing their policies, because after all, insurance companies can no longer just drop people from coverage because of pre-existing conditions.
Rubio goes on to say that “because Obamacare created expensive requirements for companies with more than 50 employees, now many of these businesses aren’t hiring” and others are switching from full-time to part-time workers because of the ACA. But that’s just not the case.
A study this summer from the Midwest Business Group on Health found that “there is little indication that employers plan to drop healthcare coverage.” The “expensive requirements” Rubio alludes to will be about 2.3 percent, according to one international consulting firm, and other studies show that healthcare reform might ultimately help small businesses because of the subsidies they receive and the fact they are offering a more attractive compensation package for employees. That’s what happened in Massachussets under Romneycare.
Sure, some right-wing business titans who run places like Applebee’s and Denny’s may say they’re going to cut back hours because of the dread of Obamacare, but they are the exceptions to the rule. Moreover, their actions are just one small part of a disturbing trend of large companies shifting healthcare costs onto low-wage workers—as would be any employer who cuts his full-time employees to part-time so he is not responsible for increased coverage requirements under the ACA.
And this gets to the real problem with Rubio’s speech. His case here is that Obamacare is hurting middle-class Americans—but then he specifically describes companies who would cut workers’ hours so they aren’t entitled to health insurance. It’s these vicissitudes of the free market that the ACA was trying to address, like when insurance companies drop people from coverage because they once took heartburn pills. Rubio’s larger case—his whole case in this speech—is that the government is hurtful, not harmful. But he was simply unable to prove it.
By: George Zornick, The Nation, February 13, 2013
“Setting The Stage”: What The Health Law Will Bring In 2013
Most of the really big changes made by the 2010 health law don’t start for another year. That includes things like a ban on restricting pre-existing conditions, and required insurance coverage for most Americans. But Jan. 1, 2013, will nevertheless mark some major changes.
One of those changes that will affect everyone with private health insurance actually took effect last September. But most people won’t see it until they renew or apply for new health insurance. It’s called a summary of benefits and coverage. The idea is to help people actually understand what’s in their insurance policies.
“One of the big complaints of people in polls or focus groups is that they just … don’t understand either the coverage or the price,” said Jay Angoff, a former official at the U.S. Department of Health and Human Services who worked on implementing the health law.
But with the new document, he says, “there’s a standard format that allows people to compare benefits to make apples-to-apples comparisons, not just on price, but on benefits.”
Health plans will also have to provide consumers a glossary of insurance terms if they ask for it.
“It’s still harder than some people would want,” Angoff says. “It’s still a complicated area. But I think HHS has really done a very good job in making it as simple and as meaningful as possible.”
Later in 2013 will also bring a key launch date for the law, says Angoff: “Oct. 1, 2013, is when open enrollment begins.”
That’s when people can start signing up for their 2014 coverage through the new health exchanges, or marketplaces, that the states and federal government are creating. Angoff, who used to head the office that’s in charge of building those exchanges, says he’s confident that things will happen on time.
“HHS has met all statutory deadlines on this until this point, and I have confidence that HHS will continue to meet those deadlines,” he said.
But the majority of what happens on Jan. 1 is to pay for the changes in 2014. In other words, tax increases and cuts in tax deductions. For example, starting next year, people will only be able to put $2,500 pre-tax into Flexible Spending Accounts that they use to pay for items insurance doesn’t cover.
“For example if they buy eyeglasses, if they pay copays on drug benefits or to their physician, they can submit those claims and be reimbursed from the pretax dollars,” said Marilyn Moon of the American Institutes for Research.
Moon says that while the change may hurt some people with very high out-of-pocket spending not covered by insurance, lawmakers decided this was a fair way to raise some of the money needed to pay for the rest of the law.
“This is a benefit that largely accrues to higher-income individuals who can afford to set aside a certain amount of money every year, to pay towards their health care spending,” she said.
There’s another tax change coming next year for the wealthy. Individuals earning more than $200,000 a year and couples earning more than $250,000 will see a nearly 1 percentage point increase in their Medicare payroll tax. They’ll also have to pay a 3.8 percent Medicare tax on their non-wage income. Moon says that represents a big change.
“The payroll tax usually applies only to wages, and now this law will extend it to investment income as well,” she said.
Those who take deductions for medical expenses on their income taxes will also see a change starting in 2013. Right now, expenses in excess of 7.5 percent of adjusted gross income are deductible. That’s going up to 10 percent for all except the elderly.
It will affect some people who spend a lot on medical care, says Moon. But the new law should also reduce the number of people with those very large bills, “because if everyone has health insurance, many fewer people should have to pay large amounts out-of-pocket on health care. Ten percent will not affect very many people, one would hope, when they get better insurance coverage.”
Finally, there’s a key change made by the health law for 2013 that will affect only the poor. Starting Jan. 1, state Medicaid programs will be required to reimburse doctors who provide primary care at Medicare rates, which are substantially higher. The idea is to get more doctors into the Medicaid program, which will itself expand in 2014.
The Medicaid increase, however, is only for two years.
By:Julie Rovner, NPR, January 1, 2013
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 