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“ACA Plays ‘Remarkable’ Role In Cancer Detection”: A Striking Picture Of Increased Early-Stage Diagnoses Among Young Women

As the Affordable Care Act has taken root, there’s been quite a bit of anecdotal evidence pointing to people whose lives were saved – quite literally – by the law’s existence. But at this point, we’re also able to measure the ACA’s efficacy beyond just the anecdotes.

The New York Times reported on a substantial increase in the number of young women who’ve been diagnosed with early-stage cervical cancer, and there doesn’t seem to be much of a mystery to explain the trend. Because “Obamacare” covers young adults before their 26th birthday, the percentage of uninsured 19- to 25-year-olds has plummeted.

You can probably guess what that means: more young women are able to see a doctor, more doctors are able to do cancer screenings, and more exams are detecting cancer at early stages. From the Times’ report:

Researchers from the American Cancer Society wanted to examine whether the expansion of health insurance among young American women was leading to more early-stage diagnoses. Early diagnosis improves the prospects for survival because treatment is more effective and the chance of remission is higher. It also bolsters women’s chances for preserving their fertility during treatment. And women with health insurance are far more likely to get a screening that can identify cancer early.

Researchers used the National Cancer Data Base, a hospital-based registry of about 70 percent of all cancer cases in the United States. They compared diagnoses for women ages 21 to 25 who had cervical cancer with those for women ages 26 to 34, before and after the health law provision began in 2010.

The results painted a striking picture of increased early-stage diagnoses among the younger group, with no meaningful change in the older group.

One of the researchers, Dr. Ahmedin Jemal, said the effect of the Affordable Care Act is hard to miss, leading to results he described as “very remarkable.”

For the ACA’s proponents, it’s additional evidence to suggest the law is literally a life-saver, and for the ACA’s opponents, it’s another challenge in explaining why the law must be destroyed in its entirety, regardless of the consequences.

 

By: Steve Benen, The Maddow Blog, November 25, 2015

November 28, 2015 Posted by | Affordable Care Act, Cancer Screenings, Obamacare, Women's Health | , , , , | Leave a comment

“Health Reform Lives!”: The Reality Is That Obamacare Is An Imperfect System, But It’s Workable — And It’s Working

To the right’s dismay, scare tactics — remember death panels? — and spurious legal challenges failed to protect the nation from the scourge of guaranteed health coverage. Still, Obamacare’s opponents insisted that it would implode in a “death spiral” of low enrollment and rising costs.

I mention all of this to give you some perspective on recent developments that mark a break in the string of positive surprises. Yes, Obamacare has hit a few rough patches lately. But they’re much less significant than a lot of the reporting, let alone the right-wing reaction, would have you believe. Health reform is still a huge success story.

Obamacare seeks to cover the uninsured through two channels. Lower-income Americans are covered via a federally-funded expansion of Medicaid, which was supposed to be nationwide but has been rejected in many Republican-controlled states. Everyone else has access to policies sold by private insurers who cannot discriminate based on medical history; these policies are supposed to be made affordable by subsidies that depend on your income.

Nobody ever expected Obamacare to cover all the uninsured. In fact, Congressional Budget Office projections made in 2013 suggested that about 10 percent of nonelderly U.S. residents would remain uncovered: some because they are undocumented immigrants, some because of the gap created by red-state Medicaid rejection and some because they would fall through the cracks of a complicated system. But the law was nonetheless projected to produce a sharp reduction in the number of Americans without insurance, and it has, especially in states like California that have tried to make it work.

Meanwhile, both insurance premiums and the cost of subsidies designed to make them affordable came in far below expectations in both 2014 and 2015.

Sooner or later, of course, there were bound to be some negative surprises. And we’re now, finally, getting a bit of bad, or at least not-great, news about health reform.

First, premiums are going up for next year, because insurers are finding that their risk pool is somewhat sicker and hence more expensive than they expected. There’s a lot of variation across states, but the average increase will be around 11 percent. That’s a slight disappointment, but it’s not shocking, given both the good news of the previous two years and the long-term tendency of insurance premiums to rise 5-10 percent a year.

Second, some Americans who bought low-cost insurance plans have been unpleasantly surprised by high deductibles. This is a real issue, but it shouldn’t be exaggerated. All allowed plans cover preventive services without a deductible, and many plans cover other health services as well. Furthermore, additional financial aid is available to lower-income families to help cover such gaps. Some people may not know about these mitigating factors — that’s the problem with a fairly complex system — but awareness should improve over time.

Finally, UnitedHealth Group made a splash by announcing that it is losing money on the policies it sells on the Obamacare exchanges, and is considering withdrawing from the market after next year. There were some puzzling things about the announcement, leading to speculation about ulterior motives, but the main thing to realize is that UnitedHealth, while a huge provider of employment-based insurance, is actually a fairly small player in this market, and that other players are sounding much more positive.

Oh, and official projections now say that fewer people will enroll in those exchanges than previously predicted. But the main reason is that surprisingly few employers are dropping coverage; overall projections for the number of uninsured Americans still look pretty good.

So where does that leave us? Without question, the run of unexpectedly good news for Obamacare has come to an end, as all such runs must. And look, we’re talking about a brand-new system in which everyone is still learning how to function. There were bound to be some bobbles along the way.

But are we looking at the beginnings of a death spiral? Some people are indeed saying that, but as far as I can tell, they’re all people who have been predicting disaster every step of the way, and will still be predicting imminent collapse a decade from now.

The reality is that Obamacare is an imperfect system, but it’s workable — and it’s working.

 

By: Paul Krugman, Op-Ed Columnist, The New York Times, November 23, 2015

November 24, 2015 Posted by | Affordable Care Act, Health Reform, Obamacare | , , , , , , | 1 Comment

“Romney Wants Credit For Obamacare”: Mitt, ‘Without Romneycare, I Don’t Think We Would Have Obamacare’

Given the Affordable Care Act’s striking successes, it’s not surprising that its champions would look for some credit for bringing health security to millions of families. President Obama, Nancy Pelosi, Harry Reid, and plenty of other Democrats have reason to be proud of one of this generation’s greatest policy breakthroughs.

It is a little jarring, though, seeing a Republican look for credit, too. MSNBC’s Benjy Sarlin reported this afternoon:

In a surprising move, Mitt Romney seemingly took credit on Friday for inspiring the Affordable Care Act – after famously running as the 2012 Republican nominee on a platform of repealing the law.

Romney championed and signed a comprehensive health care law in Massachusetts when he was governor. Known as “Romneycare,” it had strong similarities with Obamacare, including a mandate to purchase insurance, but he had long resisted comparisons between the two. In a Boston Globe obituary of Staples founder and longtime Romney backer Thomas Stemberg, however, the former Republican nominee finally embraced the connection.

“Without Tom pushing it, I don’t think we would have had Romneycare,” Romney told the Boston Globe. “Without Romneycare, I don’t think we would have Obamacare. So, without Tom a lot of people wouldn’t have health insurance.”

And as a factual matter, there’s certainly some truth to that. Romney approved a state-based law that served as an effective blueprint for President Obama’s federal model. The two-time failed Republican presidential candidate has a point when he says “Romneycare” helped pave the way for “Obamacare.”

But that doesn’t make his new boast any less jarring. Romney wants credit for one of the president’s signature accomplishments – which Romney was committed to tearing down just a few years ago?

Those who followed the last two presidential elections closely may recall that Romney’s position on health care got a little convoluted at times. The former one-term governor initially said he believed his state-based plan could serve as a model for the nation. Then he said the opposite.

By 2012, Romney was promising voters that he would – on his first day in the White House – issue an executive order to undo the federal health care law without congressional input, regardless of the consequences.

Or to use Romney’s phrase, he vowed to scrap health insurance for “a lot of people.”

Three years later, however, Romney is apparently shifting gears once again, taking partial credit for the system he embraced, then rejected, then vowed to destroy, and is now re-embracing again.

And to think this guy struggled as a candidate for national office.

Update: MSNBC’s report added, “After an uproar on social media, Romney clarified in a Facebook post that he still opposed Obamacare, but did not backtrack on his apparent praise of the law’s expansion of insurance coverage and its ties to his own legislation.”

Romney wrote that “getting people health insurance is a good thing,” which he followed with some dubious criticisms of the ACA. To my mind, his online clarification changes very little about the substance of the story.

 

By: Steve Benen, The Maddow Blog, October 23, 2015

October 24, 2015 Posted by | Affordable Care Act, Mitt Romney, Obamacare | , , , , , , , | 6 Comments

“The Self-Defeating GOP”: The Difference Between Trying To Actually Legislate And Simply Grandstanding

These days, there is never a dull moment in the Republican Party. Today, the House of Representatives voted to pass a bill that would repeal significant portions of the Affordable Care Act, President Barack Obama’s signature health care reform law. This time the repeal measures are packaged in a budget reconciliation bill, so named because it carries out instructions that were outlined in the budget resolution which passed Congress earlier this year.

Budget reconciliation bills are subject to special rules which allow for limited debate in the Senate and are thus able to pass that chamber with a simple majority rather than the 60 votes necessary to end a filibuster. Opponents of the health care law view the reconciliation bill as their first opportunity to move a bill targeting the Affordable Care Act through the Senate and on to the president’s desk. Although the president is expected to veto the measure, many Republicans feel the political exercise would be a symbolic victory.

However, not everyone in the Republican Party is happy with the legislation. The Hill reports that three Republican senators, Ted Cruz of Texas, Marco Rubio of Florida and Mike Lee of Utah, will oppose the bill because it only repeals parts of the Affordable Care Act and not the entire law. The authors of the reconciliation bill were limited in what they could include in the package by the rules of the reconciliation process in the Senate. With narrow margins in the Senate, the defection of the three Senators puts Senate Majority Leader Mitch McConnell, R-Ky., perilously close to losing the vote altogether.

The three opposing senators have offered a plan to override the Senate parliamentarian and pass a more aggressive bill as the solution to the conundrum. As of this moment, it does not appear that their proposal has a lot of support.

The revolt over the reconciliation bill is illustrative of the overwhelming tension within the Republican Party. On the one hand is the segment of the party that wants to operate within the parameters of what is achievable, and on the other is the segment of the party that wants to adhere to strict conservative principles no matter what. It’s the difference between trying to actually legislate and simply grandstanding.

The commitment of Cruz and his followers to their talking points regarding full repeal is so blind they don’t even realize they are trying to nullify Senate rules just a few weeks after the conservative House Freedom Caucus managed to force out Speaker John Boehner for his supposed disregard of the House rules. The current party dust up is even more striking because it is over a bill that never has a chance to become law to begin with. As Rep. Thomas Massie, R-Ky., told The Hill, “It’s a pretend vote and people are upset because it doesn’t pretend enough.”

The conflict is not serving the party well. Never mind trying to keep the government open or negotiate a budget deal. It appears that even symbolic political achievements – in this case a standoff with the president – are now at risk. If this keeps up, Democrats won’t have to do anything. They’ll be able to stand back and watch the Republican Party defeat itself.

 

By: Cary Gibson, Thomas Jefferson Street Blog, U. S. News and World Report, October 23, 2105

October 24, 2015 Posted by | Budget Reconcilation, Conservatives, GOP, Obamacare | , , , , , , , | 4 Comments

“Obamacare After Obama”: The Next President Should Be Grateful To Have A Universal Health Care Program On Which To Build

The morning of the recent Republican debate, the U.S. Census Bureau reported that the number of uninsured Americans in 2014 had dropped by about 9 million from the year before. This was thanks, of course, to the Affordable Care Act.

So it did cross one’s mind that at least one of the Republican presidential candidates might lend a kind word to Obamacare. After all, some of the largest gains in health coverage were among moderate-income families, a group including much of the Republican base.

A futile hope. Not even Govs. John Kasich of Ohio and Chris Christie of New Jersey — who, to their credit, had accepted the law’s expansion of Medicaid coverage in their states — offered a shred of praise. Instead we heard vows to basically blow it up, the main difference being the number of dynamite sticks to use.

Grudging appreciation for Obamacare has also extended to significant parts of the Democratic base. In the 2012 election, many Democratic candidates actually avoided discussing it. You see, a flood of anti-Obamacare propaganda — which Democrats had neglected to counter — caused support for the program to swoon in the polls.The new Census Bureau numbers show that African-Americans and Latinos have enjoyed an especially sharp rise in health coverage under Obamacare. And that makes it painful to contemplate these groups’ dismal turnout in the 2014 midterm elections.

Back then, the newly won guaranteed health coverage was under grave threat. Republicans had tried to repeal Obamacare dozens of times. Had a case before the U.S. Supreme Court gone badly, the program could well have been destroyed.

You’d think that low-income Americans would have marched to the polls waving Obamacare flags. Problem was their so-called advocates had moved on to immigration and income inequality and saw the elections as an occasion to blame Democrats for what they held was inadequate progress. They forgot there was something precious to defend — and that Obamacare was a huge advance against said inequality.

Nowadays, Hillary Clinton not only is waving the flag but has hired a brass brand to march behind it. We await the details of her proposals for improving the program. Same goes for Joe Biden, should he choose to run.

Sen. Bernie Sanders, the Vermont independent seeking the Democratic nomination, gives Obamacare two cheers but not enough credit. In a recent CNN interview, he said he wants a “Medicare-for-all single-payer health care system.”

Expanding Medicare to everyone happens to be a super idea. But we must note that Medicare is not single payer. It is a multi-payer program combining government and private coverage. As such, Medicare is more like the top-ranked French and German health care systems than it is the good, but not-as-good, Canadian single-payer program.

Because Medicare has strong public support, Medicare for all can be imagined. It would be a very hard political sell, however. Recall that Democrats couldn’t even get the “public option” past Congress. That was to be a government-run health plan to compete on the new insurance exchanges with the private ones.

Sanders’ own Vermont tried but failed to put together a modified single-payer health plan. If Vermont can’t do single payer…

Suffice it to say, it would take a master politician to get a greatly expanded Medicare passed in this country. A master politician Sanders is not. But may his vision live on.

Happily, Obamacare now seems safe. Its imperfections well-documented, it remains a work in progress. But whoever is the next president should be grateful to have a universal health care program on which to build.

 

By: Froma Harrop, The National Memo, September 22, 2015

September 23, 2015 Posted by | Affordable Care Act, GOP Primary Debates, Obamacare | , , , , , , , , | 1 Comment

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