“GOP’s Comically Inept Obamcare Delusion”: Why They’re So Sad About The Enrollment Numbers
Let’s run a quick thought experiment. The Department of Health and Human Services releases a report claiming that 99.9 percent of all people who signed up for private health plans through Obamacare had paid their monthly premiums. Let’s say this report provided a state-by-state breakdown of the data that conspicuously omitted a number of states. Let’s also say that some of the largest health insurers participating in Obamacare had already provided estimates that were far lower than 99.9 percent. The White House and Democrats across the country wave the report around as proof positive that not only is Obamacare working, it’s succeeding far beyond their most optimistic projections.
What would happen in this scenario? The conservative press would loudly, and rightly, accuse the Obama administration of cooking the books on Obamacare. Darrell Issa would schedule hearings and subpoena documents. Ted Cruz would call on Kathleen Sebelius to resign again. Louie Gohmert would call for impeachment, and Lindsay Graham would ask about the Benghazi talking points. Any media outlet that mouthed the administration’s line would see its credibility take a huge hit.
This is the situation we find ourselves in now, only the parties and the numbers are flipped. The House GOP this week released a laughably incomplete report claiming that Obamacare premium payments came in at just 67 percent. The report omitted states that aren’t part of the federal marketplace (and even a couple that are), relied upon incomplete data, and put out an estimate that was wildly at variance with those of big health insurers, which put payment rates as high as 90 percent. The report was, in the judgment of ACA sign-up tallyman Charles Gaba, a “big pile of crap.”
The crappiness of said pile was, for conservatives in the media, a secondary consideration (if it was ever a consideration at all). The right jumped on this comically inept analysis from House Republicans without so much as a moment’s hesitation. Yesterday I wrote about how conservatives are finding themselves suddenly short of ways to attack the ACA, so they’re seizing on anything they can to try and sustain the narrative that Obamacare is failing. This is a prime example of precisely that.
“The enrollment totals were bogus and worse than expected,” wrote Townhall.com’s Guy Benson. “The widely touted figure of eight million enrollments that Barack ‘Mission Accomplished’ Obama’s been pushing lately is flatly bogus,” was the take at Hot Air. The Weekly Standard, the Daily Caller, National Review – everyone got in on the pigpile.
On one level, you can understand their eagerness, given that the administration has yet to release data on premium payments for Obamacare enrollees, and has instead offered estimates from insurance companies as to how many people paid. But the House GOP’s report is not a good faith attempt to fill that data void. TPM obtained the survey that the Republicans on the Energy and Commerce Committee sent to insurers to collect the payment data, and according to sources they talked to it “appears designed to yield an unfavorable result.”
The whole point of the exercise seems to have been to get a low number out there for opponents of the law to latch onto. “Once information like this is out there,” observed Jonathan Cohn, “it becomes a permanent part of the conversation. Republicans and their supporters will keep citing it, over and over again. Some will even say it’s proof that Obama is ‘cooking the books’—even if it turns out that it’s Republicans, not the White House, playing games with the numbers.”
While the right keeps fumbling about with bad news of their own concoction, potentially good news about the ACA keeps trickling out. States like Florida and Michigan, which in 2014 will see competitive gubernatorial and Senate elections, respectively, saw huge surges towards the end of the open enrollment period. Over 270,000 Michigan residents signed up for coverage, beating early projections by a hefty 70 percent. The final push in Florida saw enrollment increase 123 percent between February and April, and the state’s final tally came in just under 1 million.
The nationwide enrollment tally, according to newly released HHS data, sits at just over 8 million people.
Again, the payment data haven’t been released yet so these can only be considered preliminary totals, but at the very least they represent a huge comeback for the ACA from the debacles of late 2013. Republicans and conservatives, however, are still desperately trying to bring back the doom-and-gloom from Obamacare’s doldrums, even as the political and policy terrain shifts beneath their feet.
By: Simon Malay, Salon, May 2, 2014
“Knowingly Deceiving The Public”: Obamacare Truthers Get Caught In A Lie On Delinquency Rate
First, the Obamacare Truthers—the Republicans and conservatives who insist that every piece of remotely positive news about the health-care law’s impact has to be a filthy lie—lost the battle of the enrollment figures. The issue here isn’t whether the Obama administration is telling the complete truth when it says 8 million. The issue is that the Truthers predicted 3 million, 2 million, 1 million, 0 million, a death spiral. And whether the administration is gilding the lily and the real number is 8 or 7.7 or 7.4 million, the hard fact is the Truthers were just crazy wrong.
Having lost that battle, they’ve now opened fire on a second front. Maybe the enrollment numbers are wrong, maybe they’re right, the Truthers say, but that doesn’t matter. What matters is the percentage of people who actually pay their premiums.
There is some truth (as opposed to Truth) to this. People can sign up with every intention of paying and then get hit with something—an unexpected car-repair bill—and they can’t pay. Or more likely, they’re young and healthy, and they decide “What was I thinking, I got all caught up in Zach Galifianakis fever?”—and they don’t pay. And if the young and healthy (who cost the insurance companies nothing) don’t pay, then the only people in the system are the old and sick, who cost the insurance companies a lot, and premiums skyrocket.
So in some ways the “percentage paying” number is even more important than the raw enrollment number. It is, after all, the real enrollment number, the number of people actually getting and keeping health coverage. And so the second the Truthers lost the enrollment fight, they moved to the percentage battle. This will prove that Obamacare can’t work.
On Wednesday, the House Energy and Commerce Committee put out a report looking at enrollment (“report” is overdoing it; it’s one page). It was methodologically pretty simple. They collected data from every insurer participating in what’s called the Federally Facilitated Marketplace (FFM) and looked at who’d signed up for coverage and who’d paid a first premium by April 15. The House panel’s answer was 67 percent.
Now, 67 percent doesn’t sound half bad to me, but the GOP spun it as yet another Obamacare disaster—it would push the “real enrollment” number down near 5 million and mean that one in three people who’d signed up for health-care coverage was already delinquent. They didn’t quite say that, but it was obviously the whole point of the report. “Tired of receiving incomplete pictures of enrollment in the health-care law, we went right to the source and found that the administration’s recent declarations of success may be unfounded,” said committee chairman Fred Upton of Michigan.
The committee got what it wanted: Headlines saying only 67 percent of ACA enrollees were paying. I’m sure there was ample coverage on Fox News, and it blasted out across the talk-radio waves. They have a talking point now, and a number, and it’s low enough that they can spin it as a lousy number.
The only problem is it’s a wrong number.
The Democratic minority on the committee released a memorandum slicing the majority’s logic to pieces in a matter of three paragraphs. Actually, it can be done in one sentence: Lots of enrollees’ first premiums weren’t even due by April 15!
Here’s a little language from the Democratic memo that lays it out a bit more fully: “As of April 15, premiums had only come due for individuals who had signed up for coverage before March 15. Five million individuals had enrolled in coverage through the marketplaces as of March 17. On April 17, the president announced that 8 million Americans had signed up for coverage through the marketplaces. That means that more than 3 million enrollees—or nearly 40 percent of all enrollees—did not have premiums due by April 15 and therefore were not required to have paid them by that point.”
In other words, people who didn’t even have premiums due yet, and who account for 37.5 percent of all enrollees, are counted in this GOP report as part of the delinquent third.
If you don’t want to take it from Democrats, take it from the insurance officials themselves. They dispute the GOP numbers. Karen Ignani of AHIP, a large group of providers, said the pay-up rate so far in her realm has been 85 percent. The Blue Cross-Blue Shield group says 80 to 85 percent of enrollees have been paying. And WellPoint announced, on the very day of the GOP report, that its figure was 90 percent.
In addition, Talking Points Memo’s Dylan Scott got hold of the questionnaire the committee sent to insurers, and it’s a joke. One industry source—not a Democratic operative—told Scott: “Everyone who saw it knew exactly what the goal was.”
I asked the GOP staff at the committee if they had a counter to the argument that their numbers were incomplete and in essence rigged. On background, one staffer there basically told me that they didn’t have a counter. The committee press release makes it clear, I was told, that these data represent payments only through April 15, and the committee will seek another report May 20.
In other words, this staffer is saying: Yep. Which makes it rather hard to avoid the conclusion that the committee knowingly put out a bad number. Why would a committee of the House of Representatives do something like that? Well, what am I saying? We know why.
The continuing truth about Obamacare is that it’s going pretty darn well so far. The other truth is that the Obamacare Truthers will forever be among us, saying, ah, but it’s the next step that’s crucial, and that’s where the death spiral will begin! That’s our Republican Party: Hoping that millions and millions of people don’t get health coverage, just to deny the president a political win. They don’t care how many people die, as long as they take Obamacare with them.
By: Michael Tomasky, The Daily Beast, May 2, 2014
“GOP’s Fuzzy Math On Obamacare Enrollments”: Creating A Bubble That Keeps Reality Out, Then Reinforcing The Bubble With Nonsense
If the point of a press stunt is to generate some attention for your cause, House Republicans are waking up this morning happy: stories like these were picked up by quite a few news outlets.
House Republicans on Wednesday said they have data from insurance companies that shows only 67 percent of people who selected a health plan under ObamaCare have paid their first month’s premium. […]
The House Energy and Commerce Committee’s subpanel on Oversight and Investigations said it contacted every insurance company involved in the federal marketplace, and based its data on people who had paid by April 15.
It’s the latest evolution in the GOP’s anti-healthcare line. What started with “no one will want to sign up” eventually became “no one should sign up,” which morphed into “not enough people are signing up,” and finally “those who did sign up don’t count.”
Notice, of course, that Republicans involved in this debate make no effort to hide the degree to which they’re rooting for failure.
In this case, though, the trouble with the new GOP argument is that’s painfully, demonstrably wrong. It’s so wrong, in fact, that I’m a little insulted – regular ol’ hackery is occasionally functional, but this latest scheme is just sad. It’s one thing for House Republicans to try to mislead the public, it’s something else for them to be lazy about it, treating voters and journalists as if we were all easily fooled children.
How deceptive is the report from the House Energy and Commerce Committee’s panel? Let us count the ways.
First, note that the Republican numbers are sharply at odds with the numbers from the insurance companies themselves, most of which put the total of enrolled customers who’ve paid their first premium at between 80% and 90%. Given this, either the insurers or GOP lawmakers are exaggerating, and since insurers have no incentive to lie about this, it would appear Republicans are trying to pull a fast one.
Second, GOP lawmakers picked an arbitrary and misleading cut-off date: they only count customers who paid premiums by April 15. But that’s ridiculous – as Charles Gaba explained, literally millions of Americans enrolled very close to the March 31 deadline and they were still receiving their first bill around April 15.
Third, as Jonathan Cohn reminds us, insurers specifically told these lawmakers that the data as of April 15 would be incomplete and paint a misleading picture. Republicans ignored this in order to launch a cheap attack intended to mislead.
And while these factual errors are obviously important, and were very likely deliberate, there’s also a thematic problem hanging over the effort itself: House Republicans, who can’t produce a health care plan of their own despite promises to the contrary, still believe ACA enrollment totals are both too high and too low at the same time.
Remember, if these conservative lawmakers had their way, the total number of consumers signing up for coverage through exchange marketplaces and paying premiums would be zero. For them to keep whining about the successful enrollment process, looking for new areas to complain about, is effectively an “Annie Hall” moment: “Two elderly women are at a Catskill mountain resort, and one of them says, ‘Boy, the food at this place is really terrible.’ The other one says, ‘Yeah, I know, and such small portions.’”
Whether or not Republicans understand any of this is unclear. At a certain level, I suspect the substance doesn’t much matter to them either way – it’s about making an attack, hoping the media will repeat it, and counting on at least some of the public to buy it.
But in a case like this, even this is self-defeating, since the actual data will soon be published and we’ll have a new round of evidence that the Republican attacks were plainly untrue.
So why do they bother? To establish the basis for a bogus talking point: thanks to yesterday’s misleading committee “report,” conservative media will repeat as gospel that “only 67%” of consumers paid premiums, so the right no longer has to believe the evidence about the Affordable Care Act exceeding its enrollment projections.
It’s about creating a bubble that keeps reality out, then reinforcing the bubble with nonsense.
Update: The “report” itself is online here. Note how it fits comfortably on one page.
By: Steve Benen, The Maddow Blog, May 1, 2014
“GOP Governors Hurting Their Own”: The Latest Plot To Undermine Obamacare And Prevent Millions From Enrolling In Medicaid
It’s actually quite easy to explain. The reason why 19 states have refused to expand Medicaid has nothing to do with the cost — the federal government would cover the full cost of the expansion for the next two years, then 95 percent of the cost thereafter. It definitely doesn’t have anything to do with a lack of need for such a solution. This, as with the refusal to establish health care marketplaces (exchanges), has everything to do with Obama Derangement Syndrome — Republican governors who refuse for a variety of cheap political excuses to attach their names to Obamacare. By doing so, they’re hurting their own people, including Republican voters by numbers into the hundreds of thousands per state.
The Affordable Care Act originally mandated that all states expand Medicaid eligibility from 100 percent of the Federal Poverty Level (FPL) to 138 percent of FPL. In other words, the government had previously established an income threshold for what constituted poverty: below the line and you’re considered poor and therefore eligible for certain safety-net benefits; above the line and you’re more or less on your own. But Obamacare raised the poverty threshold to qualify for Medicaid coverage, thus expanding Medicaid nationwide — until the Supreme Court ruled against that part of the law in 2012, allowing states to opt out of the expansion.
That’s a massive problem.
4.8 million Americans have incomes higher than the 100 percent threshold, so they don’t qualify for Medicaid without the expansion, but they don’t earn enough to qualify for health insurance premium subsidies through the marketplaces. The ACA was written with a nationwide Medicaid expansion in mind so the law’s premium subsidies only kick in where Medicaid coverage was supposed to leave off, after 138 percent of FPL. Hence the coverage gap.
In Kansas alone, home of climate and science denier Gov. Sam Brownback, there are 77,000 residents trapped in the coverage gap. 77,000 people who have no choice but to go without insurance and medical care, all because Brownback refuses to touch Obamacare with a 10-foot pole, either because of his raging ODS or because he and his fellow red state governors prefer to sabotage the law or both.
By the way, Medicaid expansion in Kansas is supported by 59 percent… of Republicans. Republicans! It’s supported by 72 percent of all voters.
In Georgia, there are around 400,000 residents in the gap, and no sign that Gov. Nathan Deal will participate in the expansion in spite of the fact that 54 percent of Georgians support it. 400,000 is a lot of people, and they’re being denied insurance in order for Deal to prove his quality to the extreme flank of his party.
In fact, Brownback and Deal are so maniacal about blocking the very popular expansion of Medicaid, they’re each lining up to sign recently passed legislation that would block future Democratic governors from expanding Medicaid without the approval of the solidly GOP state legislatures in each state.
In other words, GOP lawmakers have taken steps to guarantee that many of their poorest residents will remain uninsured under the health care reform law, no matter what happens in the gubernatorial election.
Georgia Gov. Nathan Deal (R) and Kansas Gov. Sam Brownback (R) both oppose Medicaid expansion. They both look likely — if not quite certain — to win re-election in November. That should make the bills passed by their respective state lawmakers unnecessary, but they seem intent on guarding against even the remote possibility of a Democratic governor.
Actually, the possibility of Democratic victories aren’t as remote as Talking Points Memo reported. Polls in both races are neck-and-neck, with PPP showing a slight advantage for the Democratic challengers to Brownback and Deal, Paul Davis in Kansas and state senator Jason Carter (grandson of former President Carter) in Georgia. And there it is: a possible explanation for the laws.
This is how far they’re reaching to stymie evil, evil Obamacare. Not only are they refusing to create state-run exchanges, oddly ceding state power to the federal government, but they’re refusing to allow the expansion of Medicaid, even though they don’t have to spend a penny to do it — worse, they’re passing laws that will prevent others from doing it, too. It’s yet another way to sabotage the law in a long list of plots to undermine it.
So, what are the consequences?
On Wednesday, the Orlando Weekly published the explosive and infuriating story of Charlene Dill, a struggling, 32-year-old mother of three who collapsed and died on a stranger’s floor late last month. According to Weekly reporter Billy Manes, Dill suffered from a treatable heart condition. She also fell into what policy experts call the Medicaid coverage gap–a hole the Supreme Court punctured in the health safety net when seven of its justices rendered the Affordable Care Act’s Medicaid expansion entirely voluntary.
We have no choice but to call this what it is: death by Obama Derangement Syndrome.
By: Bob Cesca, Managing Editor for The Daily Banter; Published in The Huffington Post, April 28, 2014
“Stuck In The First Stage Of Grief”: GOP Reflexively Making Themselves Feel Better About A Reality That’s Causing Them Pain
At a press conference last week, President Obama announced a figure that was hard to even imagine a month ago: 8 million consumers signed up for private insurance through exchange marketplaces during the Affordable Care Act’s open-enrollment period. Obama also took a moment to chide Republicans for having been wrong about practically every aspect of the debate.
“I recognize that their party is going through the stages of grief,” he said, “and we’re not at acceptance yet.”
That sounds about right, though I’m not sure the GOP is “going through the stages of grief” so much as it’s stuck on the first one. If the process is believed to have five stages – denial, anger, bargaining, depression, and acceptance – we have quite a ways to go before “acceptance” is even on the horizon.
Rep. Tim Huelskamp (R-Kan.) said Monday he believes the uninsured rate in his state has increased since implementation of the 2010 health care reform law.
“It’s hard to get accurate numbers on anything,” Huelskamp told his constituents at a town hall in Salina, Kan., according to video posted by Eagle Community Television. “But the numbers we see today is that – as I understand them – we believe there are more people uninsured today in Kansas than there were before the president’s health care plan went into effect. And I thought the goal was to bring more people into insurance.”
There are a wide variety of counts when it comes to determining just how many uninsured Americans have been able to get coverage, but all of the reports have something important in common: they all show the rate of the uninsured going down, not up. We can discuss exactly how many, whether that’s in line with expectations, whether that’s enough to sustain the larger system, and why progress is happening faster in blue states than red states.
But to argue that the number of uninsured people is climbing is comparable to arguing that the federal budget deficit is getting larger; the planet is experiencing global cooling; and Obama has pushed use of executive orders to new heights.
Oh wait, conservative Republicans often believe all of those bogus claims, too.
Obviously, the problem isn’t limited to Huelskamp. On Friday, Sen. Dean Heller (R-Nev.) said he doesn’t believe the Obama administration’s enrollment totals, calling the figures “all smoke and mirrors.” On Thursday, House Majority Whip Kevin McCarthy (R-Calif.) suggested consumers receiving ACA subsidies to defray the costs of coverage may be engaged in “fraud.”
Much of the Republican establishment quickly embraced the “cooking the books” conspiracy theory, which was soon after followed by the Census Bureau conspiracy theory.
The right doesn’t bother with evidence to bolster any of this – evidence is irrelevant. Denial isn’t about rationality; it’s about reflexively making one feel better about a reality that’s causing them pain.
That said, GOP officials aren’t just embracing denial, they’re swimming in it in the most self-indulgent fashion possible. Republicans almost seem to be enjoying their distaste for health care reality, seemingly eager to one up their far-right colleagues.
Let’s also not brush past the “heads I win, tails you lose” problem – “Obamacare” critics believe the numbers are correct and reliable when they point to facts Republicans want to hear. Enrollment totals are low? This is proof that conservatives were right all along and that the ACA is a failure. Enrollment totals soared in March? This is proof that the White House is perpetrating a fraud – because conservatives were right all along and that the ACA is a failure.
It’s become effectively impossible under conditions like these for the two sides to even have a conversation about health policy. Paul Krugman’s take over the weekend rings true:
Not a day goes by without some prominent Republican politician or pundit insisting that the enrollment numbers are phony, that more people are losing insurance than gaining it, etc.. I know that’s what the base believes, because it’s what they hear from Rush and Fox. But you would think that important people would have someone around who has a clue, who knows that enrollment data and multiple surveys are all telling the same story of unexpected success. OK, maybe not – if famous senators don’t have anyone to clue them in about BLS data, they might really still be living in the bubble. But that’s really their choice.
And the point is that with enrollment more or less closed for 2014, there’s not much point in spinning. OK, maybe if you can keep up the pretense all the way to November, you can slightly sway base voters for the midterms. But even that’s doubtful – by the fall, we’re going to have a very clear picture of how things went; and the shape of that picture has already been determined.
I guess that what gets me is the – to use the technical term – wussiness of it all. Isn’t there any space on the right for people who sell themselves as tough-minded, who condemn Obamacare on principle but warn their followers that it’s not on the verge of collapse? Is the whole party so insecure, so unable to handle the truth, that it automatically shoots anyone bearing bad news?
I’m going to assume those are rhetorical questions, because the answer seems pretty obvious.
By: Steve Benen, The Maddow Blog, April 21, 2014
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