“Putting The Train Wreck On Hold”: Everything Anti-Obamacare Republicans Predicted Is Proving To Be The Opposite Of Reality
The Affordable Care Act, like every landmark piece of legislation in modern times, has faced its share of trials. Getting it through Congress was nearly impossible, and the law was very nearly killed by the Republican appointees on the U.S. Supreme Court.
But with the law now secure and President Obama re-elected, there’s one more major challenge for “Obamacare” to overcome: the implementation hurdle. As we discussed several weeks ago, this is at least as big a hurdle as the others, and more than a few observers have raised the prospect of a “train wreck.” Even those who generally defend the law are worried.
They are, however, a little less worried today. As Matt Yglesias explained, implementation of the law is “fundamentally” going quite well.
The latest evidence comes to us today from California, America’s largest state and one of the states that’s tried the hardest to actually implement Obamacare. As Sarah Kliff explains, their exchanges are getting set up, and it looks like premiums for “silver” and “bronze” plans are both going to be lower than was previously expected. Far from a “train wreck,” in other words, the biggest single set of clients for the program is getting something like a nice, smooth high-speed train ride.
There was also good news from Oregon recently, where insurers that had initially come in with high premium bids are now asking to resubmit with cheaper offerings in the face of competition. And the Affordable Care Act’s goal of slowing the growth in aggregate health expenditures is also coming true.
Yep, at least for now, everything anti-ACA Republicans predicted — on premiums, on competition, on exchanges, on escalating costs — is proving to be the opposite of reality.
Now, because of state-by-state differences, there will be quite a bit of variety in outcomes. If you live in California or another state dominated by Democratic officials, you’ll likely have a very positive impression of how the law is being implemented, and how it benefits you, your family, and your community.
If you live in, say, Texas, you’re likely to have a very different kind of experience.
As Jonathan Cohn explained this morning:
Unfortunately, millions of uninsured and under-insured Americans live in places like Florida and Texas, where there is far less sympathy — and a great deal more hostility — to the idea of Obamacare. It’s entirely possible that the insurance bids in those states will be a lot higher, precisely because state officials there are doing nothing to help and quite a bit to hurt implementation. But if that happens, blame won’t belong with the heath care law or the federal officials in charge of its management. It will belong with the state officials who can’t, or won’t, deliver to their constituents the benefits that California’s officials appear to be providing theirs.
It’s not necessarily an explicitly partisan matter — I’m not saying that Democrats are necessarily better at health care governance. Rather, the point is, Democrats don’t have an ideological axe to grind when it comes to trying to sabotage federal health care law. Rick Perry, however, does.
To be sure, these red-state residents won’t be left out entirely, and they’ll still benefit from all kinds of consumer protections and expanded access that they’ll really appreciate, even if they don’t yet realize the available benefits. But the full benefits of implementation will elude them for a while in ways blue-state residents won’t have to deal with.
Regardless, the news out of California is a bit of a breakthrough, and heartening news for anyone hoping to see the Affordable Care Act succeed. For more on this, also take a look at the reports this morning from Klein, Krugman, and Beutler.
By: Steve Benen, The Maddow Blog, May 24, 2013
“Arrested Governance”: Do Everything You Can To Sabotage Government To Keep It From Operating Effectively
The Internal Revenue Service was closed today, as employees were furloughed due to sequestration’s budget cuts. Conservatives found this to be an occasion for side-splitting humor; Sarah Palin, for example, tweeted, “The IRS is closed today, feel free to use your phones.” Get it, because the IRS was tapping … um … well, never mind. In any case, today is a reminder that this scandal could be an opportunity for reform that clarifies the law on political and non-political groups, leads to a greater professionalization of the agency, and makes future misconduct less likely. Or it could wind up being just the opposite.
As Kevin Drum reminded us yesterday, one of the low moments of the Gingrich years in Congress was a series of hearings meant to expose IRS wrongdoing, in which horror stories of the agency’s abuse of taxpayers were told to lawmakers eager to hear them. In response, the IRS’s authority was curtailed and its budget slashed. The predictable consequence was less enforcement of tax laws (warming Republicans’ hearts, no doubt), but also an agency that had to do more with less.
If anyone was forced to do more with less, it was the office in Cincinnati, where a small number of poorly trained employees had to process thousands of new applications from groups seeking tax-exempt status after 2010. That isn’t to say there was no wrongdoing, but if you want an agency that does its job well and upholds the highest standards of professionalism, cutting its resources is not the way to get it.
But that could well happen again, and Republicans would be only too happy about it. It would be of a piece with the way they approach so much of what passes for their attempts at governing: Do everything you can to sabotage government and keep it from operating effectively, and then when it falls short, shout “See?!? We told you government can’t do anything right!”
By: Paul Waldman, Contributing Editor, The American Prospect, May 24, 2013
“Full Speed Ahead”: Republican Overreach Is Coming Soon
A number of people have asked whether the Republicans will overreach in their reaction to the current collection of scandal-ish controversies (by the way, someone really needs to come up with a name that encompasses them all). The answer to that question is, of course they will. Try to remember who we’re talking about here. Overreaching is their thing. Congress will be going home this weekend, and I’ll bet the Republicans are going to come back from their recess reassured that their constituents really, really want them to pursue Barack Obama to the ends of the earth. I’ll explain why in a moment, but in the meantime the National Journal has details on their strategy:
Congressional Republicans head into next week’s Memorial Day recess armed with a strategy designed to keep the controversies that have consumed Washington in the news back home.
Both House and Senate Republicans will focus on the Internal Revenue Service targeting conservative groups for extra scrutiny as well as the still-open questions about Benghazi. And more and more, they’ll try to tie them together into a made-for-2014 narrative of an unaccountable and out-of-control government.
In interviews on local television and radio programs and with newspapers, Senate Republicans plan to talk about the Obama administration’s “credibility gap.” They’ll throw into the mix Health and Human Services Secretary Kathleen Sebelius’s request that health industry officials help fund “Obamacare,” a move Republicans call a “shakedown” of the companies she regulates, according to a Senate GOP leadership aide.
Lawmakers will argue that a “lack of details, stonewalling,” and what they call an “ever-changing White House narrative” on both Benghazi and the IRS have led to a trust deficit with the public, a sentiment reflected in recent polls, the aide said.
Part of the aim is to get voters to question how they can trust the administration, and the IRS more specifically, to enforce key provisions of Obama’s health care law after improperly targeting Americans.
This fits into Republicans’ emerging scandal-riding midterm election strategy—one that the GOP’s congressional campaign committees think can blend easily into their anti-Obamacare message to help the party take the Senate in 2014.
When they return from this recess, Republicans are going to be more sure than ever that they’re doing the right thing. Think about what a member of Congress does when he’s home. He’ll be doing those media interviews with friendly talk-radio hosts, for whom outrage is the bread and butter of their programming. He might do a couple of town meetings, and who comes to those? People who like him already (i.e. the Republican base, who will tell him to keep up the scandal-mongering) and people who are pissed off about something. But right now, the people who think the scandal thing is going too far aren’t really pissed off, they’re just kind of disappointed. So they won’t be so inclined to show up. And then the representative will just go around town talking to folks, and once again the ones he’s most likely to hear from are his supporters who want to tell him to stick it to that no-good socialist in the White House.
After a few days of that, he’ll come back to Washington thinking, “Wow, my constituents are really fired up about this stuff. Full speed ahead!”
By: Paul Waldman, Contributing Editor, The American Prospect, May 14, 2013
“Reverse Sticker Shock”: Reality-Based Evidence On Obamacare In California Amidst All The GOP Hysteria
For months now we’ve been told that the Affordable Care Act would produce a cataclysm of skyrocketing health insurance premiums, particularly in the individual insurance markets that the law most affects. Earlier this week alarms were raised particularly in California with the news that three major insurance companies had decided against participating in the health care exchanges that would offer Obamacare coverage.
So it’s a bit of a shock–sort of a reverse sticker shock–today to learn that preliminary assessments of the cost of the new, improved (because subject to new minimum coverage requirements) policies in California once the exchanges are up and running will in most cases be lower than what citizens of this high-cost state are accustomed to paying. TNR’s Jonathan Cohn summarizes the news:
Based on the premiums that insurers have submitted for final regulatory approval, the majority of Californians buying coverage on the state’s new insurance exchange will be paying less—in many cases, far less—than they would pay for equivalent coverage today. And while a minority will still end up writing bigger premium checks than they do now, even they won’t be paying outrageous amounts. Meanwhile, all of these consumers will have access to the kind of comprehensive benefits that are frequently unavailable today, at any price, because of the way insurers try to avoid the old and the sick.
Sarah Kliff of Wonkblog has more details:
Health insurers will charge 25-year-olds between $142 and $190 per month for a bare-bones health plan in Los Angeles.
A 40-year-old in San Francisco who wants a top-of-the-line plan would receive a bill between $451 and $525. Downgrade to a less robust option, and premiums fall as low as $221.
These premium rates, released Thursday, help answer one of the biggest questions about Obamacare: How much health insurance will cost. They do so in California, the state with 7.1 million uninsured residents, more than any other place in the country.
Multiple projections expected premiums to be relatively high.
The Congressional Budget Office predicted back in November 2009 that a medium-cost plan on the health exchange – known as a “silver plan” – would have an annual premium of $5,200. A separate report from actuarial firm Milliman projected that, in California, the average silver plan would have a $450 monthly premium.
Now we have California’s rates, and they appear to be significantly less expensive than what forecasters expected.
On average, the most affordable “silver plan” – which covers 70 percent of the average subscriber’s medical costs – comes with a $276 monthly premium.
Such numbers, it is important to note, do not reflect the actual cost to the estimated 2.6 million Californians who will qualify for Obamacare tax subsidies (available to those with incomes up to 400% of the federal poverty rate).
One of the “horror stories” we’ve been hearing from Obamacare opponents for years now is that the whole scheme will collapse once healthy, low-income young people realize they’ll face large news costs for the kind of minimum high-deductible catastrophic coverage they actually need. They’ll bail, it has been suggested, not only from Obamacare (screwing up the broad-based risk pools that make affordable coverage for older and sicker people possible), but from Obama’s political coalition as well. So this comment from Kliff about the California numbers is worth noting:
For a less robust “bronze” plan, which covers 60 percent of the average beneficiary’s costs, the tax credit could actually cover the entire premium for low-income twenty-somethings.
None of this should really be that surprising; the idea that a broader pool plus competition and guaranteed benefits would provide a better bargain (plus vastly greater security) for consumers in the individual market was central to the entire Affordable Care Act architecture. But it’s taken a while for facts to catch up with all the negative agitprop. It won’t keep House Republicans from voting to repeal the entire law a 38th or 39th or 40th time before the bulk of the Affordable Care Act becomes effective next year. Still, it’s nice to see some reality-based evidence amidst all the hysteria.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, May 24, 2013
“Unmistakable Trend Lines”: Sequestration Can Be Bad For Your Political Health
Since it’s Furlough Friday, a day when by recent tradition conservatives get together to festively celebrate how little across-the-board budget cuts actually affect anyone who matters, some findings from last week’s WaPo/ABC poll, as explained by ABC’s Gary Langer, are perhaps in order:
The federal budget sequester may be dampening a rise in economic optimism: Nearly four in 10 Americans now say sequestration has hurt them personally, up substantially since it began in March – and they’re far less sanguine than others about the economy’s prospects overall.
Thirty-seven percent in the latest ABC News/Washington Post poll say they’ve been negatively impacted by the budget cuts, up from 25 percent in March. As previously, about half of those affected say the harm has been “major.”
And as the effects of the sequester spread, the trend lines are unmistakable and cut across partisan and ideological lines:
More Americans continue to disapprove than approve of sequestration, now by 56-35 percent – again, a view influenced by experience of the cuts. Eight in 10 of those who report serious harm oppose the cuts, as do about two-thirds of those slightly harmed. But the majority, which has felt no impacts, divides exactly evenly – 46 percent favor the cuts, vs. 46 percent opposed.
Further, this poll, produced for ABC by Langer Research Associates, finds that 39 percent overall “strongly” disapprove of the cuts – but that soars to 66 percent of those who say they’ve been harmed in a major way. (Just 16 percent overall strongly approve.) Experience of the cuts even trumps partisanship and ideology: Among Republicans, conservatives and Tea Party supporters who’ve been harmed by the cuts, most oppose them. Support is far higher among those in these groups who haven’t felt an impact of sequestration….
Ideology has an effect: Forty-seven percent of “very” conservative Americans approve of the cuts, as do 42 percent of those who call themselves “somewhat” conservative. It’s 36 percent among moderates and 24 percent among liberals. But again, impacts of the cuts are a bigger factor in views on the issue. Among conservatives hurt by the cuts, 65 percent disapprove of them; among those unhurt, just 34 percent disapprove.
This means, of course, that the strongest constituency for the sequester is “very conservative” voters who have not been personally affected by the cuts. If that sounds like the “conservative base” that exerts a particularly strong influence on Republican lawmakers, maybe we have an explanation for why so many of said lawmakers incautiously chortled about the whole thing being a nothingburger that proved government had plenty of excess fat to shed.
They might want to rethink that position.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, May 24, 2013
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