“Hey, Obamacare Complainers”: You Hypocrites, Regular Insurance Has Tons of Glitches Everyday
The nation’s new health-insurance exchanges, the online marketplaces for medical coverage that are an integral part of Obamacare, opened for business last week. Immediately the trouble began. Web pages went blank. Attempts to enroll in coverage were delayed, or altogether stymied, as sites crashed. Critics of the law pounced. “Too many unanswered questions and too many unsolved problems,” said U.S. Sen. Orrin Hatch, Republican of Utah.
Yet there’s another way to see these growing pains: as evidence not of change but of continuity for consumers of health insurance in America. With each misstep, government officials are simply catching up to the record of headache-inducing frustrations produced by the longstanding private medical insurance system.
Whether you’re one of the 50 percent or so of Americans who already have private health insurance (mostly through an employer, as I do) or one of those who may now turn to the exchanges to buy coverage, the bureaucracy is often maddening. Sure, the Affordable Care Act may seem opaque and unwieldy, but make no mistake: Employer-provided healthcare—which offers plans by the very same companies now on the exchanges—is equally Byzantine. No wonder that only 22 percent of American consumers reported themselves as satisfied with the health care system in a 2012 survey from the Deloitte Center for Health Solutions.
A few weeks ago I had an all-too-typical experience. My insurance company, Anthem Blue Cross, sent me a letter saying, “It has come to our attention that we have been paying for certain . . . drugs that are not covered under your existing benefit plan.” Going forward, the letter added, my doctor would need to prescribe something different or I’d have to start paying for these particular medications myself.
And when would this kick in? According to one part of the letter, January 1, 2014. According to a different part of the letter, right away.
It concluded with the sentence I’ve come to dread most: “If you have any questions or concerns, please call the customer service number on your ID card.”
Bravely, I did. Forty-five minutes later, I had yet to talk to an actual human being. Finally, at the 50-minute mark, a customer-service representative showed up on the line. She was cheerful and peppy. I was not.
The Anthem representative was unable to clarify anything in the letter and asked if she could put me on hold while she did a little research. I said OK, but I made a special plea: to call me back if we somehow got disconnected. Just a week before, on another Anthem call—concerning a paid claim that Anthem said was unpaid—I’d gotten cut off after an hour or so on the phone. She assured me that she’d call me back, if need be.
Ten minutes later, the representative returned to tell me that the answer to when Anthem would stop covering my prescriptions was neither January 1 nor immediately. It was December 1.
Where did this new date suddenly come from? She couldn’t explain. I asked to speak to her supervisor directly. She countered with a classic chess move: I was put on hold for another 15 minutes. Then: “Thank you for calling Anthem Blue Cross. Good-bye.” The line went dead. Checkmate.
Despite my plea and the representative’s promise, no one from the company called me back. I have yet to find the stomach to phone Anthem again.
Sure, the implementation of the Affordable Care Act is hitting some bumps, especially in its early days. But before critics falsely brand these as the inevitable consequence of a “government takeover” of our healthcare system, let’s remember that when it comes to medical coverage, bureaucratic snafus are hardly the province of Obamacare alone.
By: Randye Hoder, Contributor, Time Magazine, October 9, 2013
“A Steady Stream Of Untruths”: Everything You’ve Heard About Obamacare Being A Job-Killer Is Wrong
The U.S. government is now “shut down” thanks in large part to yet another attempt to put the brakes on the Affordable Care Act, or ACA. Yet this week, the law’s health care exchanges went on line, promising affordable insurance coverage for millions of Americans with pre-existing conditions or jobs that did not previously offer a health plan and to millions of the unemployed. Nevertheless, a steady stream of untruths about the law continues to pop up in newspapers, blogs and Facebook feeds.
One of these tropes is that the ACA is causing employers to cut back on hours for full-time employees so that they will not have to provide coverage (under the ACA, companies with more than 49 employees are required to offer health insurance coverage to those employees working 30 or more hours a week or face penalties). Typically, the evidence for the cutbacks in hours is that someone knows someone else whose hours were cut earlier this year in anticipation of the law taking effect. Many pundits have been even lazier, just stating that employers are cutting back hours without citing concrete examples.
The reality, though, is that there is no widespread trend of employers cutting their workers back to just under 30 hours because of the ACA. In July, my colleagues Dean Baker and Helene Jorgensen analyzed recent data from the Current Population Survey. They found that only 0.64 percent of the workforce was working between 26 and 29 hours a week in the first half of 2013. This number is only slightly higher than it was for the first half of 2012 (0.61 percent).
In other words, there is no evidence of a widespread trend of employers reducing hours to avoid providing coverage. That sentiment was recently echoed by Moody’s Mark Zandi, who said of the supposed trend, “I was expecting to see it. I was looking for it and it’s not there.”
The basic story is that, yes, there are a small number of firms that have cut down on the number of full-time employees recently. And yes, over time, the 30-hour cutoff could have some effect on hours as employers adjust to the law and new businesses open. Of course, some companies may go the opposite route and move part-time workers to full time, as was recently the case at Disney World.
Regardless, the promulgation of the idea that the ACA will transform the U.S. workforce into a part-time workforce and negatively impact employment in the United States is dead wrong.
By: Alan Barber, U. S. News and World Report, October 4, 2013
“Obamacare Swallowed Conservatism Whole”: What Happens To Conservatism When The Obamacare War Is Over?
When we look back decades from now, one of the keys to understanding this period in our political history will be the story of how a set of market-based health insurance reforms that started as a proposal from the Heritage Foundation and then were successfully implemented by a Republican governor who later became the GOP presidential nominee, ended up being viewed by virtually all conservatives as not just an abomination but the very essence of statist oppression. Liberals have often expressed wonder or exasperation about the way conservatives changed their opinions about this particular brand of reform. But now that it’s driving a government shutdown (and soon a potential default on the debt), we have to acknowledge that it’s more than just a policy conservatives hate. The Affordable Care Act is far, far bigger than that. It has become the most important definer of conservatism in America circa 2013. It isn’t that conservatives don’t still want to cut taxes for the wealthy, or slash the social safety net, or liberate corporations from pesky regulations on worker safety and the environment, or make it impossible for women to get abortions, because they still want all those things. But Obamacare has swallowed conservatism whole.
Since the health-care exchanges opened yesterday, some have suggested that the increased attention brought to the fact of their opening by the shutdown has done the administration a favor, informing more people that open enrollment has begun than the Department of Health and Human Services could possibly have managed on its own. That’s probably true. This controversy has also served to remind conservatives that there is nothing more important than fighting Obamacare. Every Republican politician has to prove that their hatred of the law is as great as that of the angriest Tea Partier. Every conservative everywhere is being told that this is what it means to be a conservative, this is so important to their beliefs and the future prospects of their party and their ideological movement that it is worth laying waste to the government and even the economy itself. If you’re a conservative and you aren’t willing to risk everything on even the smallest chance to toss your spear into this foul beast’s heart, then you’re not really a conservative at all.
Let’s fast-forward a couple of years from now, after this crisis ends without the ACA being defunded or delayed. The law is all rolled out, and while it’s far from perfect, things are going pretty well. We don’t have universal coverage, but the vast majority of Americans now have insurance, including millions who didn’t have it before. It’s not dirt cheap, but the trends that are evident today—a slowdown in the overall health-care spending growth rate, mirrored by a slowdown in premium increases—are continuing. More states have put aside their ideological objections and accepted the expansion of Medicaid to cover all their poor citizens, even if there are a few straggler states left. What with “pre-existing conditions” and “job lock” things of the past, even the most doctrinaire Tea Partier admits that there’s no more question about whether Obamacare can be repealed. Its tendrils have reached too many people who now benefit from it and would react angrily if you tried to take it away.
Ted Cruz admitted to Sean Hannity back in July that “If we don’t [defund Obamacare] now, in all likelihood, Obamacare will never, ever be repealed. Why is that? Because on January 1, the exchanges kick in, the subsidies kick in,” and they’ll be unable to take away something people are benefiting from. And he’s surely not the only Republican who gets this, which is part of the explanation for the ferocity with which they’re fighting now. But in our future scenario, the fight over the law will be basically over. There might be some debates about adjusting parts of the law, as Democrats will want to do, but that won’t concern Republicans too much. Once there’s no possibility left that it can be killed, they’ll likely lose interest.
I think that’s the most plausible picture of what things will be like in, say, 2015. The question is, if eventually they have no choice but to accept that the argument over the ACA is settled, what on earth will Republicans do with themselves? Because over the last four years, opposition to Obamacare has taken on such an extraordinary power within the movement that all other issues have paled before it.
Sure, they could revert to the old standbys—Cut taxes! Cut regulations! Strong defense! But those are just positions you can take. Obamacare was a war to be fought. And nothing galvanizes, energizes, and defines us like our wars. That’s particularly true of the zealots who are driving the Republican party and form such a key part of its base. And if they aren’t fighting Obamacare, who will they be?
By: Paul Waldman, Contributing Editor, The American Prospect, October 2, 2013
“States Of Health”: Obamacare And GOP Obstructionism
Ours can be an unforgiving country. Paul Sullivan was in his fifties, college-educated, and ran a successful small business in the Houston area. He owned a house and three cars. Then the local economy fell apart. Business dried up. He had savings, but, like more than a million people today in Harris County, Texas, he didn’t have health insurance. “I should have known better,” he says. When an illness put him in the hospital and his doctor found a precancerous lesion that required treatment, the unaffordable medical bills arrived. He had to sell his cars and, eventually, his house. To his shock, he had to move into a homeless shelter, carrying his belongings in a suitcase wherever he went.
This week, the centerpiece of the Affordable Care Act, which provides health-insurance coverage to millions of people like Sullivan, is slated to go into effect. Republican leaders have described the event in apocalyptic terms, as Republican leaders have described proposals to expand health coverage for three-quarters of a century. In 1946, Senator Robert Taft denounced President Harry Truman’s plan for national health insurance as “the most socialistic measure this Congress has ever had before it.” Fifteen years later, Ronald Reagan argued that, if Medicare were to be enacted, “one of these days you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.” And now comes Senate Minority Leader Mitch McConnell describing the Affordable Care Act as a “monstrosity,” “a disaster,” and the “single worst piece of legislation passed in the last fifty years.” Lacking the votes to repeal the law, Republican hard-liners want to shut down the federal government unless Democrats agree to halt its implementation.
The law’s actual manifestation, however, is rather anodyne: as of October 1st, healthcare.gov is scheduled to open for business. A Web site where people who don’t have health coverage through an employer or the government can find a range of health plans available to them, it resembles nothing more sinister than an eBay for insurance. Because it’s a marketplace, prices keep falling lower than the Congressional Budget Office predicted, by more than sixteen per cent on average. Federal subsidies trim costs even further, and more people living near the poverty level will qualify for free Medicaid coverage.
How this will unfold, though, depends on where you live. Governors and legislatures in about half the states—from California to New York, Minnesota to Maryland—are working faithfully to implement the law with as few glitches as possible. In the other half—Indiana to Texas, Utah to South Carolina—they are working equally faithfully to obstruct its implementation. Still fundamentally in dispute is whether we as a society have a duty to protect people like Paul Sullivan. Not only do conservatives not think so; they seem to see providing that protection as a threat to America itself.
Obstructionism has taken three forms. The first is a refusal by some states to accept federal funds to expand their Medicaid programs. Under the law, the funds cover a hundred per cent of state costs for three years and no less than ninety per cent thereafter. Every calculation shows substantial savings for state budgets and millions more people covered. Nonetheless, twenty-five states are turning down the assistance. The second is a refusal to operate a state health exchange that would provide individuals with insurance options. In effect, conservatives are choosing to make Washington set up the insurance market, and then complaining about a government takeover. The third form of obstructionism is outright sabotage. Conservative groups are campaigning to persuade young people, in particular, that going without insurance is “better for you”—advice that no responsible parent would ever give to a child. Congress has also tied up funding for the Web site, making delays and snags that much more inevitable.
Some states are going further, passing measures to make it difficult for people to enroll. The health-care-reform act enables local health centers and other organizations to provide “navigators” to help those who have difficulties enrolling, because they are ill, or disabled, or simply overwhelmed by the choices. Medicare has a virtually identical program to help senior citizens sort through their coverage options. No one has had a problem with Medicare navigators. But more than a dozen states have passed measures subjecting health-exchange navigators to strict requirements: licensing exams, heavy licensing fees, insurance bonds. Florida has attempted to ban them from county health departments, where large numbers of uninsured people go for care. Tennessee recently adopted an emergency rule declaring that anyone who could be described as an “enrollment assister” must undergo a criminal background check, fingerprinting, and twelve hours of course work. The hurdles would hamper hospital financial counsellors in the state—and, by some interpretations, ordinary good Samaritans—from simply helping someone get insurance.
This kind of obstructionism has been seen before. After the Supreme Court’s ruling in Brown v. Board of Education, in 1954, Virginia shut down schools in Charlottesville, Norfolk, and Warren County rather than accept black children in white schools. When the courts forced the schools to open, the governor followed a number of other Southern states in instituting hurdles such as “pupil placement” reviews, “freedom of choice” plans that provided nothing of the sort, and incessant legal delays. While in some states meaningful progress occurred rapidly, in others it took many years. We face a similar situation with health-care reform. In some states, Paul Sullivan’s fate will become rare. In others, it will remain a reality for an unconscionable number of people. Of some three thousand counties in the nation, a hundred and fourteen account for half of the uninsured. Sixty-two of those counties are in states that have accepted the key elements of Obamacare, including funding to expand Medicaid. Fifty-two are not.
So far, the health-care-reform law has allowed more than three million people under the age of twenty-six to stay on their parents’ insurance policy. The seventeen million children with preëxisting medical conditions cannot be excluded from insurance eligibility or forced to pay inflated rates. And more than twenty million uninsured will gain protection they didn’t have. It won’t be the thirty-two million hoped for, and it’s becoming clear that the meaning of the plan’s legacy will be fought over not for a few months but for years. Still, state by state, a new norm is coming into being: if you’re a freelancer, or between jobs, or want to start your own business but have a family member with a serious health issue, or if you become injured or ill, you are entitled to basic protection.
Conservatives keep hoping that they can drive the system to collapse. That won’t happen. Enough people, states, and health-care interests are committed to making it work, just as the Massachusetts version has for the past seven years. And people now have a straightforward way to resist the forces of obstruction: sign up for coverage, if they don’t have it, and help others do so as well.
By: Atul Gawande, MD, The New Yorker, Published September 29, 2013
“The Revised GOP Ransom Note”: House Republicans Now Willing To Fund Government In Exchange For One Year Obamacare Delay
House Republicans are preparing to introduce a new, last minute Continuing Resolution that would fund the operations of government for a few more months in exchange for an agreement by Senate Democrats and the White House to delay the execution of Obamacare for one year.
This newest bid is being presented as a “compromise” as the initial proposal put forward by the House—one that was rejected by the Senate—hinged the funding of government on the full defunding of the Affordable Care Act.
Compromise?
I suppose it is if you consider that someone holding a gun to your head and demanding ten million dollars to spare your life becomes a “compromiser” when he suddenly drops the price to seven million after you’ve told your assailer that you can’t or won’t pay.
Or maybe you would consider a foreign power threating our country with thermonuclear destruction unless we surrender to them as being willing to compromise if they modify their demand so as to leave us with everything east of the Mississippi if we are prepared to give up all the territory to the west?
For those who would fool themselves into believing that the latest House offer is some effort to find “middle ground”, ask yourself this question—
Why do these people wish to delay enforcement of the Affordable Care Act for one year?
Does anyone imagine that those who have been seeking to deny funding to government absent the delay or destruction of a law that was passed by Congress, signed into being by the President, and approved by the Supreme Court actually want to hold off the implementation of that law so they can improve it?
At no time—since the blitzkrieg of misinformation and outright lies that have been peddled by Obamacare opponents following the Act’s creation–have the House Republicans so much as once suggested that they would like to improve the law. Having voted more than 40 times to repeal or defund the law, have they ever, since passage, voted on proposed amendments to the law that they claim would improve the healthcare reform act?
Never.
Indeed, they are not even pretending to want to make it better via a delay as not so much as one Republican elected official who has paraded in front of the TV cameras today to pitch defunding or delay has so much as hinted than an extra year would give Congress time to make some ‘fixes’ or ‘changes.’
So, again, why the one year extension?
The better to keep the issue ‘hot’ for Republicans going into the 2014 midterm elections.
After all, nothing is going to change in the next year that would improve the Republicans’ chances of doing away with the law.
Should the GOP hold the House in the 2014 elections and pick up enough seats in the Senate to gain a majority, absolutely nobody believes for a moment that the GOP could gain enough Senate seats so as to grant them the capability of overturning a presidential veto.
And, like it or not, the Democrats will hold the White House through 2016.
And yet, every Republican mug I see on the television screen today tells me that they are doing this for me.
Really?
My premium rates are scheduled to go down rather dramatically upon the opening of the healthcare exchange in my state. So, what exactly are these House Republicans doing for me—and the millions of other Americans who cannot get coverage due to preexisting conditions (like acne) or face using up their lifetime maximums when a serious illness strikes? What exactly are Ted Cruz and his friends doing for those who are denied their paid for coverage after they get sick by insurance companies who don’t want to pay off and can find a spelling error on the insured’s application? What about the millions of Americans who simply have been unable to afford health insurance coverage without the benefit of the government subsidies or those who are married forever to their job—whether they like it or not— because, to leave it, would mean putting their family in jeopardy should someone get sick?
Still, if the GOP continues to feel the need to use healthcare policy to hold up funding of the government, and they are truly doing this for my benefit, I have an additional policy change I’d like Speaker Boehner to add to the new House legislation—things that would truly be for my benefit and the benefit of my family—
I would like the Speaker to make the Continuing Resolution to keep the government’s doors open contingent upon gun control legislation that requires registration of all weapons at the time of purchase. That would be doing something that could truly help me and my family.
And before anyone tries to tell me that this would be unacceptable because—unlike Obamacare where the majority of the country currently opposes the law, the majority of Americans love their guns—I suggest you review the polls revealing that more Americans favor changes in gun registration laws than the number of Americans who oppose the Affordable Care Act.
I could go on with more ransom demands for the Speaker but I’ll settle for just this one. After all, Boehner only plans to fund the government through this December in exchange for destroying the Affordable Care Act so I don’t want to be too greedy as to what I would expect for a three month extension of an operating government.
If the House Republicans are unwilling to link the funding of government to the things that will really be of value to me, then I can only hope that the Senate Democrats and the President hold the line and allow the GOP to get what is coming to them for their behavior.
While I hate to see so many of my fellow Americans suffer the problems and serious inconveniences that are inevitable in a government shut down, I—like so many Americans that the right-wing prefers to pretend do not exist—have had enough of these eighty to one hundred extremists in Congress standing in the way of trying to make life better for so many Americans just so they can be re-elected . These are, after all, elected officials that come from congressional districts where constituents continue to be incapable of grasping that the debt ceiling debate is about paying for debts we’ve already incurred and not some limitation on what government can borrow or spend in the following year.
I also highlight that these people on the right prefer to pretend I do exist because of their continued suggestion that “Americans” do not want the healthcare reform law. Not so much as one supporter of defunding or delaying Obamacare, who has spoken to the cameras today, has said “some Americans” or “most Americans”. They simply say that this law is a train wreck and Americans don’t want it.
Like it or not, I am an American and I do want this alleged train wreck as do enough of my fellow Americans to constitute at least forty percent of the electorate. So, I would very much appreciate it if Rep. Jeb Henserling and the remaining band of the GOP talking heads haunting the airwaves would stop lumping me in with their political distortions.
The President is flat-out right on this one. If the Republicans want to argue over what should—or should not—be included in the next fiscal year’s budget, I’m all for it. Each branch of Congress can pass their version of a budget and the two can get into the conference committee room and beat each other up until they come to a budget agreement they can send over to the White House for signature.
But if these 100 or so Members of Congress want to screw up people’s lives because they have a fundamental problem with our system of government, we should give them no quarter.
And make no mistake, it is precisely these people’s resentment of how our government was created to operate that drives them to these extremist positions—no matter how much they pretend to be ‘strict constitutionalists’.
Just because GOP legislators like to carry a copy of the Constitution in their suit pocket doesn’t mean they’ve ever read it or could care less what it actually says. It just means they have pockets large enough to hold fat oil company checks and a tiny copy of our founding document at the same time.
By: Rick Ungar, Op-Ed Contributor, Forbes, September 29, 2013
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