“News People Can Actually Use”: The Media Needs To Do More To Help People Navigate Obamacare
Yesterday, Tim Noah made a point in an MSNBC appearance that I think deserves a lot more attention. Media outlets have been doing lots of reporting on the problems of the Affordable Care Act rollout. What they haven’t done is provided their audiences with practical information that could help them navigate the new system. Of course, most Americans don’t have to do anything, since they have employer-provided insurance. But for all the attention we’ve been paying to the individual market, media outlets haven’t done much to be of service. “The New York Times has published the URL for the New York exchange exactly twice,” Noah said, “both before October first.”
My experience in talking to journalists about the publication of this kind of thing—unsexy yet useful information, whether it’s how to navigate a new health law or understanding where candidates stand on issues—is that they often think that addressing it once is enough. When you ask them about it, they’ll say, “We did a piece on that three months ago.” The problem is that for it to be effective, they have to do it repeatedly or people won’t get it. What we have seen is that this information can be found somewhere on news outlets’ websites (here’s an example), but it isn’t on the evening-news broadcast or in the print edition of the paper.
Of course, conservatives would allege that if a newspaper writes a guide to getting insurance through the new exchange, it has demonstrated its liberal bias and become an arm of the Obama administration. But it’s the law. As of next year, if you don’t get insurance through your employer, you need to go to an exchange. Media outlets would just be helping people do what they have to do. I suppose conservatives could also argue that if the local paper puts up a tool on its website that helps people find their polling places and tells them what the voting hours are, it’s just trying to boost turnout, and everybody knows that helps Democrats. Or that if it reminds you to file your tax returns on April 15th, then it’s just helping fund big government. Or that if it tells you to set your clocks back for daylight savings, it’s just feeding the Illuminati/Bilderberg time-theft conspiracy.
People sometimes mock “news you can use” because it’s often delivered in forms that aren’t particularly useful (“There’s a silent killer in your refrigerator right now!”). But helping citizens understand and respond to changes in the law is part of any major media outlet’s mission. The fact that a law is controversial doesn’t absolve them of the responsibility.
By: Paul Waldman, Contributing Editor, The American Prospect, November 27, 2013
“The Rise Of Obamacare McCarthyism”: Anti-Obamacare Republicans Attack Each Other For Being “Crypto-Supporters” Of Obamacare
We talked yesterday about Rep. Jack Kingston, one of several House Republicans running for the U.S. Senate in Georgia, who infuriated the right. His transgression? The congressman pushed a bill to add a conservative provision to the Affordable Care Act.
Conservatives were livid, not because of the idea itself, but because House Republicans aren’t supposed to try to “fix” the health care law. To take even a modest step towards moving the law to the right, some conservatives said, is to “surrender on Obamacare.”
We’re seeing a similar situation play out in Wyoming.
A conservative nonprofit group is set to launch a TV attack ad Monday intimating that Republican Sen. Mike Enzi is less than pure in his opposition to Obamacare.
Americans for Job Security highlights the incumbent’s support for exchanges during the 2010 debate over Obamacare…. “I like the exchanges,” Enzi says in a brief clip. “These exchanges can be good.”
The ad is incredulous, as if the senator’s 2010 comments are ridiculous are on their face. It doesn’t matter if Enzi has repeatedly fought to destroy the Affordable Care Act and voted to repeal it; what matters now is that he once said it’s possible that marketplaces with competing private insurance plans are “good.”
And in 2013, that’s apparently a bridge too far.
What’s emerging is an expansive list of litmus tests – it’s not enough to hate “Obamacare,” Republicans must also hate everything within the law, including the Republican ideas.
In this case, the Wyoming attack ad concludes, “Tell Mike Enzi we don’t like these liberal, Big Government Obamacare exchanges.”
Got that? If private insurers compete for consumers’ business in a marketplace originally touted by the Heritage Foundation, it’s “liberal, big government.”
It’s hard to believe in the most gullible GOP primary voter would find this persuasive, but the takeaway here is the attack itself. We’ve reached the point at which a far-right Republican is being condemned for having described the single most capitalistic, free-market aspect of the health care law as “good.”
Josh Marshall described this as an example of “Obamacare McCarthyism,” in which “different anti-Obamacare Republicans attack each other for either being crypto-supporters of Obamacare, being Obamacare-curious or even just having earlier periods of Obamacare confusion.”
Ed Kilgore added this is “likely to be a continuing weapon against any Republican who doesn’t favor the most radical tactics available at any given moment to bring down the Great White Whale of the Affordable Care Act.”
By: Steve Benen, The Maddow Blog, November 27, 2013
“When In Doubt, Go Shopping”: The Affordable Care Act Puts People, Not Insurers, First
It’s pretty straightforward: A major reason we have 50 million uninsured people in the United States is that insurance companies do not see individuals as a profitable market.
The recent uproar over canceled health insurance plans not only highlights the insurance industry’s out-of-hand dismissal of this market, but also reinforces why there is a need for the new health reforms under the Affordable Care Act .
Consumers have reason to be angry but they should be angry at the insurers, not the health care law. Connecticut’s Insurance Commissioner, Thomas B. Leonardi, announced Monday that of the approximate 27,000 insurance policy cancellation notices which have gone out only 9,000 of them were because plans were not in compliance with the health care law. The new law forbids insurers to deny or drop coverage when people get sick or have a pre-existing condition such as hypertension, diabetes or obesity. Consumers will gain those protections in 2014 whether they buy through the insurance exchange called Access Health CT or on their own.
Mr. Leonardi’s comments highlight the fact that it has been a customary practice of insurers to send their policyholders notifications that a particular plan will no longer be available or there’s been a change in benefits. Only one-third of the policies being canceled in Connecticut were plans that did not have protection under the law’s grandfather clause and did not meet the benefit standards or the consumer protections required by the law. The other two-thirds were discontinued as part of the insurance companies’ business-as-usual practices.
Historically, the health insurance industry has made its fortune by denying coverage to sick people, decreasing benefits and jacking up prices. Insurers do not see the individual market as profitable unless they continue to shift risk onto consumers through high deductible plans and unless they can raise rates on their customers as they age and develop health problems to the point they can no longer afford health insurance. That’s why they’re getting out. The Affordable Care Act is stopping this bait and switch approach.
Understandably, the cancellation notices came as a jolt for policyholders, especially because the reasons behind them were not made clear. Furthermore, insurers failed to do the right thing and inform their policyholders that other coverage options are now available to them under the new health care law.
Fortunately for consumers though, President Barack Obama‘s decision to give insurance companies another year to continue their substandard health plans carried the proviso that they must inform their customers of the new coverage opportunities under the health care law.
It’s too bad the commotion over the cancellations happened to coincide with the rocky rollout of the new health insurance exchange website. But consumers would do well to keep their eyes on the big picture, beyond the political grandstanding and partisan bickering. Websites can be fixed. Health care reform is about improving the quality of coverage benefits and offering more choice and affordability through the health insurance exchanges. That’s what Connecticut is trying to do.
Friday’s announcement by Gov. Dannel P. Malloy that the state would not extend poor quality policies through 2014 re-emphasizes Connecticut’s commitment to making sure its residents have access to plans that will provide quality comprehensive care. The state also announced that it was pushing back the date people had to sign up by for coverage that begins Jan. 1. Now residents have until Dec. 22, giving them an additional week to weigh the options on Access Health CT, the state’s health insurance exchange, and to find a plan that fits their families’ needs.
According to Access Health CT, in the first month, more than 300,000 Connecticut consumers checked out their options on the Website, almost 40,000 calls have been answered through the call center and more than 13,000 Connecticut residents are now enrolled.
Clearly, consumers here are getting the message: When in doubt, go shopping.
By: Frances G. Padilla, President of Universal Health Care Foundation of Connecticut, Op-Ed Columnist, The Hartford Courant, November 22, 2013
“It’s Not All Doom And Gloom On Obamacare”: Just A Matter Of Time Before Republicans Start Criticizing Something New
Condemning the Affordable Care Act and its problem-plagued rollout is easy, but when the White House insists things are getting better, that’s not just spin. Brett Norman reports this afternoon:
Tech surge czar Jeff Zients said that HealthCare.gov will be able to handle 50,000 users at a time by the end of this month – up from 25,000 now, thanks to hardware additions and software additions the team is putting in this weekend and next week.
He said that will enable the site to handle 800,000 people a day – “a conservative estimate,” he said in a conference call with reporters.
It’s important to note that handling increased traffic, while clearly important, is not the resolution to all of the website’s troubles. Accurately connecting consumers to insurers and providing reliable data on subsidies is just as important, and to date, these are areas with which healthcare.gov has also struggled.
That said, Zients told reporters all of these issues are being addressed, and the increased website capacity should – should – keep the larger enrollment system on track towards its 2014 goals.
Indeed, even before Zients’s media briefing, Sarah Kliff highlighted reports of a “November surge” in enrollments.
By the end of October, the federal government had counted 106,000 people enrolled into private coverage through the new health insurance marketplaces, a small percentage of the projected half-million sign-ups.
By mid-November, though, with the 14 state-based marketplaces reporting fresh data, that number had just about doubled to more than 200,000…. State officials say they are seeing an uptick in sign-ups this month. California, which has had about 80,000 sign-ups, is now reporting about 2,000 enrollments per day. New York and Washington reported double-digit enrollment numbers as of this week.
Kaiser Family Foundation President Drew Altman told Kliff, “It’s not all doom and gloom.”
Reports from several states where officials want the system to work are reporting impressive numbers for the first half of November. California, in particular, appears to be leading the way – and given that the Golden State is the nation’s largest, that’s good news for the overall totals.
The law’s proponents shouldn’t be Pollyannaish about any of this, and we have not reached the point at which the system can fairly be described as “adequate.” It’s just not there yet.
But the administration can credibly say they’re putting out the fires; they’re making steady progress; and they’ve moving closer to their goals. The panic is subsiding. The recent chatter that “Obamacare” is going to destroy the president, Democrats, the health care system, and the idea of progressive governance on a conceptual level hasn’t quite gone away, but it’s looking increasingly silly.
And while I’m reluctant to look too far ahead with so much uncertainty still surrounding the system’s functionality, I can’t help but wonder about what the political world’s conversation will look like if, in the near future, healthcare.gov is working as it should, enrollment is strong, costs are contained, millions are gaining coverage they previously lacked, and millions more enjoy health care security that previously didn’t exist.
I have a very strong hunch we would, under this scenario, see very few headlines that say “Obama fixes problems, brings health care security to nation.” Rather, folks would just move past the hysteria of the last month, start criticizing something new, and Republicans could return to saying, “Now, about Benghazi….”
By: Steve Benen, The Maddow Blog, November 22, 2013
“When Ideology Collides With Reality”: Irrational Republican Exuberance Over Obamacare’s Problems
In these days of hyper-polarization, some readers may wonder why I always treat with great respect the findings and analysis of conservative number-cruncher Sean Trende of RealClearPolitics. I don’t always agree with what he says, but he’s willing to say uncomfortable things to people on his side of the barricades when data and history so indicate, as he did in a column today pouring ice water on the popular conservative idea that a collapse of Obamacare would lead to some sort of “existential crisis” for liberalism or “the welfare state.”
I’ve said before that our press corps suffers from histrionic personality disorder, and this is but the latest example. Wasn’t it just weeks ago that we were told the government shutdown could cost Republicans the House? But elections and the ideological orientation of the country don’t turn on such immediate, short-term events. The arc of history is long. Both parties, and both ideologies, have plenty of wins ahead of them, and neither is likely to suffer a knockout blow.
Let’s start by observing that we’re barely 50 days into Obamacare’s launch. While the program is clearly in much graver political danger than was the case a month ago, it’s still unclear that the ship won’t eventually be righted. Maybe the so-called “young invincibles” will sign up in droves, or maybe they won’t and the program will go into a death spiral. We just don’t know yet.
But even if the Affordable Care Act does collapse, I’m not sure that the liberal project will be kneecapped, much less destroyed. Americans have very short memories, and the pendulum will swing back quickly if Republicans mess up their next opportunity to govern.
Trende then goes through a long series of historical examples (dating back to 1890) of big political calamities for one party or the other that was followed in relatively short order, and sometimes almost instantly, by a big recovery, often because the other party over-estimated its advantages and overreached. And he notes that even in specific policy areas a misstep or defeat doesn’t necessarily take issues off the table:
Even the last failed attempt at health care reform, in the early 1990s, didn’t actually spell the end of reform efforts for the next two decades, as many suggest. It just proceeded incrementally, with some fairly significant steps. Congress in 1996 passed the Kennedy-Kassebaum bill, which established health insurance portability. The following year, Republicans helped to establish the State Children’s Health Insurance Program, which today provides health care for almost 8 million children. In 2001, before the 9/11 attacks, Congress was consumed with a debate over the Patient’s Bill of Rights, with the only major disagreement involving whether plaintiffs should be able to collect punitive damages while suing their HMO.
Sean even suggests an Obamacare “disaster” could produce an even more ambitious Democratic health care initiative:
[E]ven if Obamacare does collapse, the most liberal aspects of the American health care system — Medicare and Medicaid — will still be around. Democrats have already been pretty straightforward about what their “Plan B” will be: Medicare/Medicaid for all. Both programs are still very popular, and the Democratic standard-bearer in 2016 would almost certainly campaign on expanding them, perhaps to those over 55 for Medicare and under 25 for Medicaid. I’m not sure that would be a losing issue, even with an Obamacare collapse. In 10 years, I think it’d be a winner.
That is indeed the “silver lining” that a lot of single payer advocates have been seeing in the troubles involving the Obamacare exchanges, which are complex and hard to administer in no small part because of their reliance on a managed competition model many liberals never favored in the first place.
Trende thinks the major lesson here is that the ideological clash of ideas that activists often perceive in political events just isn’t shared by that many voters:
The American electorate is not intensely ideological, and is more motivated by things such as the state of the economy, whether there is peace abroad (or whether we’re winning a war), and whether the president is suffering from a major scandal.
I would agree in part, but would go further to say that today’s radicalized Republican Party has goals that have never commanded a majority of the electorate, and are even less likely to do so in the future. It is capable of making big gains when Democrats screw up, but is determined to risk them immediately to pursue an unpopular agenda. If the worst (or from their point of view, the best) happens and conservatives gain the power to implement that agenda, then the odds are extremely high they will, as Trende puts it, “mess up their next opportunity to govern.” And in that respect, ideology really does matter–when it collides with reality.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, November 20, 2013
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