“You Need To Look At Your Facts”: A Novel Idea That Continuously Escapes Republicans
As regular viewers have no doubt noticed, “All in with Chris Hayes,” which airs just before “The Rachel Maddow Show” weeknights on msnbc, is consistently an exceptionally informative program. And while every night features lively and engaged discussions, there was one segment in particular this week that stood out as unique.
Chris talked – or at least tried to talk – to Jennifer Stefano, the Pennsylvania state director of the Koch-financed Americans for Prosperity, ostensibly about health care reform, though as viewers quickly realized, the guest was quite a bit more animated than the voices that usually appear on “All In.”
The segment apparently generated quite a bit of conversation soon after, with reform supporters and opponents “arguing over which side got schooled.” I don’t much care who was “schooled,” but because I’ve been interested in AFP messaging, it seemed worthwhile to do what our pal Ari Melber did last night: fact check Jennifer Stefano’s claims.
The AFP official claimed, for example, that as a result of the Affordable Care Act, “we really are having our choices removed from us as mothers.” Is that true?
Probably not. I say “probably” because Stefano didn’t specify what “choices” she thinks are being “removed,” and it’s tough to fact-check vague assertions, but there’s nothing in the reform law intended to take mothers’ choices away. On the contrary, parents seem to have far more health care options now than before the reform law was passed.
She added, “This law has made 7 million people lose their insurance.” Is that true?
There’s no evidence to support the claim. Estimates vary as to exactly how many consumers received cancelation notices, but (a) even the most conservative Republicans in Congress don’t put the total at 7 million; (b) millions lost their insurance routine under the old system, so the point is rather dubious; and (c) it’s misleading to suggest consumers “lost their insurance,” since most of these Americans really just made a transition from one plan to a different plan.
Stefano then argued, “For the people who have actually signed up on the exchange … only 14 percent of them are actually people without coverage.” Is this true?
No, it’s not. In fact, the conservative activist appeared to be citing a study that concedes it “did not break down their results for people who specifically purchased insurance through Obamacare.”
She also argued that Medicaid expansion would apply to “people making $94,000 a year.” Chris referred to this as “a math train wreck.” Who’s right?
Well, not Stefano.
Finally, Stefano argued, “Here’s what I want, stick to the facts…. Stick to the facts, talk about facts.”
That sounds like a great idea.
By: Steve Benen, The Maddow Blog, March 28, 2014
“Reality Is Starting To Set In”: Is The “Mend It” Period Of The Affordable Care Act’s Evolution Beginning?
All of a sudden, people in Washington seem to want to fix the Affordable Care Act. And regardless of their motivations, that should be—well, maybe “celebrated” is too strong a word, but we can see it as a necessary and positive development. Is it possible that the arguments about whether the ACA was a good idea or should have been passed in the first place are actually going to fade away, and we can get down to the businesses of strengthening the parts of it that are working and fixing the parts that aren’t? It might be so.
Sure, cretinous congressional candidates will continue to display their seriousness by pumping paper copies of the law with bullets, probably for years to come. But with this year’s open enrollment period coming to an end in a few days, a particular reality is starting to set in, namely that, however you feel about the law, millions of Americans have now gotten health insurance because of it. Repealing it would mean taking that insurance away. So let’s look at what people whose political fortunes are dependent on some measure of anti-ACA grandstanding are doing.
First, a group of centrist Democrats, mostly from conservative states, offered a plan to make some changes to the ACA, some of which are more meaningful and reasonable than others. Yes, they’re doing it because they want to give themselves some political cover. But that’s OK. Meanwhile, some Republicans are, for the umpteenth time, crafting a package of things they claim will “replace” the ACA. Of course it’s the same few things they’ve always advocated—make it impossible for people to sue for medical malpractice (AKA “tort reform”), let people buy insurance across state lines, encourage health savings accounts. Nobody who has thought about health care for five minutes thinks those “reforms” would do anything to address real health care challenges, but more importantly, they wouldn’t prevent the massive upheaval that would occur if you repealed the ACA. And that’s a reality that will become increasingly clear: the disruption of taking away the ACA now would be even greater than the disruption the law brought about in the first place.
So if Republicans took over the Senate, there would be a brief period of kabuki, in which they would attempt to pass their reform package, then President Obama would say, “This is a joke” and veto if it passed. Then they’d have to decide if they actually wanted to address their specific complaints about the ACA. And yes, we have to start from the assumption that everything conservatives say about the Affordable Care Act is offered in bad faith (sorry, conservatives, but you’ve earned it). That doesn’t mean, however, that they can’t prove that assumption wrong at some later date.
Democrats should respond by welcoming a more particular debate about the ACA, starting from the presumption that it’s law now and millions of people are dependent on it, so the question is what needs adjustment. Republicans can no longer just shout “This law sucks, because freedom!” It’s too late for that.
And some context is in order. Before the law was even passed, many of its advocates were careful to note that no matter how much care went into its design, adjustments were going to be required as it was implemented. That’s how things always go with complicated laws: conditions change, certain features don’t work the way they were supposed to, and unforeseen challenges emerge. Revising existing legislation is a substantial part of lawmaking, and always has been. For instance, when Social Security was created in 1935, it was written to exclude agricultural and domestic workers, which included most blacks in the South (there’s some debate about whether this was actually done in order to secure the support of Southern segregationists). That didn’t change until the 1950s. Survivor benefits for spouses and children were also added later. Cost of living adjustments were added later. In other words, the most successful and popular social program in American history required a lot of changes and alterations as it evolved, and no one ever expected that the ACA would be any different.
There are going to be changes to the ACA in the coming years, just as there should be. The trick now will be making sure the right changes are made.
By: Paul Waldman, Contributing Editor, The American Prospect, March 28, 2014
“Showing Why The Law Is Working”: The Koch Brothers Are Accidentally Advertising The Benefits Of Obamacare
Some new advertisements attacking the Affordable Care Act actually show why the law is working.
The ads are running in Colorado and Louisiana, two states where incumbent Democratic senators face difficult reelection fights. They come from Americans for Prosperity, the conservative organization backed by the Koch Brothers. And in the spots, a woman makes some fairly sweeping claims about how Obamacare is hurting average Americans: “Millions of people have lost their health insurance, millions of people can’t see their own doctors, and millions are paying more and getting less.”
The statements leave out critical context, as Politifact has observed. But the interesting thing about the ads is their style. The narrator isn’t claiming these things happened to her or, for that matter, to any particular person. It’s all very broad and unspecific.
That’s a change and it’s probably because so few “Obama-scare” stories have held up to media scrutiny. Remember “Bette in Spokane”? House Republicans claimed she had to pay twice as much for her new coverage. Reporter David Wasson, a local reporter with the Spokesman-Review, tracked her down and determined that Bette could actually save money if she bought Obamacare coverage on Washington state’s online marketplace. Then there was Whitney Johnson, a 26-year-old with multiple sclerosis, who claimed that she’d have to pay $1,000 a month for her new insurance in Texas. That didn’t sit quite right with journalist and policy expert Maggie Mahar. Mahar dug into the details and, in an article for healthinsurance.org, revealed that Johnson had actually found coverage for about $350 a month—what Johnson had been paying previously. Maybe the best-known story is the one of Julie Boonstra, a Michigan cancer patient who said that her new insurance policy was “unaffordable.” A series of reporters, first at the Washington Post and then at the Detroit News, determined that Boonstra is probably saving money because of Obamacare—all while keeping the physicians who provide her cancer care.
The conservatives’ struggle to find more airtight stories might seem mystifying, given that there’s no shortage of people with real and serious complaints about the Affordable Care Act. Quite a few Americans, probably numbering in the low millions, lost their old policies and are now paying more for replacements—usually because the old plans lacked benefits like maternity and mental health or because insurers can no longer avoid the sickest and most expensive beneficiaries. You’ve read about some of those people in these pages. These people are not happy and it’s easy to see why: The president and his allies promised that everybody who liked their olds plans could keep them. But, as Los Angeles Times columnist Michael Hiltzik has observed, these stories inevitably have a lot of nuance. These are people who, almost by definition, are healthy enough to have gotten cheap insurance before or make enough money that they don’t qualify for the Affordable Care Act’s insurance discounts. That makes their tales less dramatic.
A better subject for future conservative advertisements might be people with serious, even life-threatening diseases who need access to very specific specialists or hospitals—and are now having difficulty, because their new plans have very narrow networks of providers. But even these stories have mitigating circumstances that media attention would reveal. Most of these people can find their way to comparable, albeit different, doctors and hospitals—and at least some can keep the old ones if they’re able and willing to pay more for it. Also, this kind of thing was a problem long before Obamacare came along. And that’s not to mention the fact that, previously, many of these people lived in fear of losing their insurance altogether.
In short, these stories may generate sympathy but they are rarely the stuff of tragedy. And that’s because of the protections Obamacare provides—which is to say, the very things that Koch-funded right-wingers want to gut.
After all, it’s Obamacare that sets a minimum standard for insurance, so that all policies include comprehensive benefits and set limits on out-of-pocket spending. It’s Obamacare that puts coverage within financial reach of many more people than before, by offering those subsidies and then, for some people, reducing out-of-pocket expenses even more. In the old days, it wasn’t so hard to find tear-jerker anecdotes: People without insurance or with inadequate insurance were filing for bankruptcy, losing their homes, and missing out on essential medicine. Now those stories are less common and, for the most part, they are among people who had these same problems previously. Telling the stories of these people would be a rationale for expanding the Affordable Care Act, not repealing it.
At some point, conservatives will find some tragic stories that are real. It’s a big country, and a complex law, and there are bound to be a few people for whom the new changes work out really badly. But there are also good news stories—lots of them. And while those stories inevitably have complications of their own, some are pretty dramatic. Democrats may not have figured out the politics of Obamacare. But it looks increasingly like they got the policy right.
By: Jonathan Cohn, The New Republic, March 21, 2014
“The Real Truth About ObamaCare”: Conservatives Need To Help Fix It, Or Face Their Worst Nightmare!
Despite the worst roll-out conceivable, the Affordable Care Act seems to be working. With less than two weeks remaining before the March 31 deadline for coverage this year, five million people have already signed up. After decades of rising percentages of Americans’ lacking health insurance, the uninsured rate has dropped to its lowest levels since 2008.
Meanwhile, the rise in health care costs has slowed drastically. No one knows exactly why, but the new law may well be contributing to this slowdown by reducing Medicare overpayments to medical providers and private insurers, and creating incentives for hospitals and doctors to improve quality of care.
But a lot about the Affordable Care Act needs fixing — especially the widespread misinformation that continues to surround it. For example, a majority of business owners with fewer than 50 workers still think they’re required to offer insurance or pay a penalty. In fact, the law applies only to businesses with 50 or more employees who work more than 30 hours a week. And many companies with fewer than 25 workers still don’t realize that if they offer plans they can qualify for subsidies in the form of tax credits.
Many individuals remain confused and frightened. Forty-one percent of Americans who are still uninsured say they plan to remain that way. They believe it will be cheaper to pay a penalty than buy insurance. Many of these people are unaware of the subsidies available to them. Sign-ups have been particularly disappointing among Hispanics.
Some of this confusion has been deliberately sown by outside groups that, in the wake of the Supreme Court’s “Citizens United” decision, have been free to spend large amounts of money to undermine the law. For example, Gov. Rick Scott, Republican of Florida, told Fox News that the Affordable Care Act was “the biggest job killer ever,” citing a Florida company with 20 employees that expected to go out of business because it couldn’t afford coverage.
None of this is beyond repair, though. As more Americans sign up and see the benefits, others will take note and do the same.
The biggest problem on the horizon that may be beyond repair — because it reflects a core feature of the law — is the public’s understandable reluctance to be forced to buy insurance from private, for-profit insurers that aren’t under enough competitive pressure to keep premiums low.
But even here, remedies could evolve. States might use their state-run exchanges to funnel so many applicants to a single, low-cost insurer that the insurer becomes, in effect, a single payer. Vermont is already moving in this direction. In this way, the Affordable Care Act could become a back door to a single-payer system — every conservative’s worst nightmare.
By: Robert Reich, The Robert Reich Blog, March 22, 2014
“More Stuff Made Up About Obamacare”: A Nasty Ideological And Racial Undertone To Bobby Jindal’s Latest Campaign
It’s been obvious from the beginning that a big part of the GOP strategy for demonizing Obamacare has been to convince existing beneficiaries of federal health programs that ACA coverage would come out of their hides. Thus the constant efforts to convince Medicare enrollees that ACA was financed by “Medicare cuts” (not at all true with the exception of the reductions in super-subsidies offered to the Bush-era conservative pet rock of Medicare Advantage policies offered through private insurers). There’s also a nasty ideological and even racial undertone to this campaign aimed at white middle-class retirees who view their Medicare benefits as earned (via both payroll tax contributions and a lifetime of work), as opposed to the “welfare” being offered to those people supported by Medicaid or Obamacare.
But leave it to Bobby Jindal to come up with a line of attack that pits existing Medicaid beneficiaries against those who would qualify for coverage if, over his dead body, the ACA’s Medicaid expansion were to be enacted in Louisiana. TPM’s Dylan Scott has the story:
Engaged in all-out war with the liberal group MoveOn.org over a pro-Obamacare billboard, Louisiana Gov. Bobby Jindal (R) has accused the organization — and liberals in general — of endorsing discrimination against the disabled through their support of the federal health care reform law and its Medicaid expansion.
“Liberal groups like MoveOn.org won’t say one word about caring for individuals with disabilities, or how Obamacare prioritizes coverage of childless adults ahead of the most vulnerable,” Jindal wrote in an op-ed in the Shreveport Times last Thursday. “They just want to intimidate states into accepting Obamacare’s massive new spending programs.”
What does Bobby mean by “prioritizing” coverage of childless adults? Simply that expanded coverage comes with a higher federal match rate than is available for traditional Medicaid (not high enough, of course, to convince ideologically motivated Republicans, especially in the South, to execute an expansion that in many cases would represent a fiscal windfall for state governments while significantly reducing the ranks of the uninsured).
How, exactly, does that hurt people with disabilities, or others currently qualifying for Medicaid? The short answer is that it doesn’t, as Scott explains with some help from experts:
[T]here are a few huge problems with Jindal’s rationale, which effectively undermine the whole line of attack. First, some disabled people could actually qualify for health coverage under the Medicaid expansion, according to MaryBeth Musumeci, associate director of the Kaiser Commission on Medicaid and the Uninsured.
“People with disabilities can be within the new expansion group,” she said. “The ACA provides the opportunity for some people with disabilities to qualify for Medicaid who never qualified before. Their incomes, while still low, could have been above the very, very low limits states had set or they may not have been eligible at all if they fell into the category of single, childless adults. So it creates an expanded opportunity for people with disabilities to gain coverage.”
Second, Obamacare should have no policy bearing on the traditional Medicaid program. Federal funding for the traditionally eligible population remains exactly the same, and the states retain the same flexibility to manage their programs as existed prior to the law. The ACA brings a new population into the program, but there is no policy reason that it would lead to “discrimination” — as Jindal calls it — or any other detrimental effects for disabled people enrolled in the traditional program.
“I think that’s right,” Musumeci said when asked by TPM if the Obamacare’s Medicaid expansion should have no effect on traditional Medicaid. “What the Medicaid expansion essentially does is it creates a new eligibility category. Like any other time Congress has expanded eligibility of the program, it is adding statutory authority to cover this new group of people.”
“But it’s built into the same underlying Medicaid program. States still have all of the flexibility that they previously had in terms of how they structure their care delivery system, their benefits packages, and all of those things.”
It would be interesting to know how well people with disabilities, and other current Medicaid beneficiaries, would fare in Louisiana if the national Republican “reform” of Medicaid, a block grant that reduced federal funding over time, were to be enacted. Let’s hope we don’t find out. But in the meantime, the “prioritization” argument against the Medicaid expansion is just another effort to frighten one group of safety net beneficiaries they have a stake in excluding others. It’s exactly what we’ve come to expect from self-styled conservative Christian warriors like Bobby Jindal.
By: Ed Kilgore, Contributing Writer, Washington Monthly Politica Animal, March 20, 2014
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