“Just Don’t Say It Out Loud”: Every Member Of Congress Who Gets Coverage Through An Exchange Will Be Participating In Obamacare
In the very near future, congressional Republicans have some important decisions to make when it comes to health care policy. Will they threaten a government shutdown over funding for the Affordable Care Act? Will they use the issue as the basis for a debt-ceiling crisis?
And perhaps more directly, will they personally sign up for subsidized insurance through an exchange created by the health care law?
As we discussed a couple of weeks ago, the right is heavily invested in the idea that members of Congress are “exempt” from “Obamacare.” The claim is plainly untrue — thanks to a scheme Sen. Chuck Grassley (R-Iowa) stumbled into, lawmakers will give up their current health care coverage and get coverage through a marketplace where insurers compete for their business.
There are, however, some complications — these exchanges were designed for the uninsured and small-business owners looking to cover their employees, not wealthy federal lawmakers who already have perfectly good coverage. It’s why the Obama administration had to work out a fix for members of Congress and their aides a few weeks ago.
But for Republicans this creates yet another problem: if they sign up for coverage, doesn’t that mean they’re necessarily participating in the health care system they claim to hate? As far-right groups urge the uninsured to stay that way on purpose by staying out of the exchange, won’t those same lobbying efforts apply to lawmakers themselves?
If conservatives genuinely believe that Obamacare is a threat to the country they will extend their campaigns to convince people to skip Obamacare from nameless powerless young people to elected officials and their aides. And if those members and aides have the courage of their convictions they’ll follow suit.
To the extent that none of this happens — that conservative groups keep quiet, and conservative members and aides enroll in the exchanges — it’ll expose the right’s anti-Obamacare activism as a shallow enterprise undertaken by people who are happy to see millions go without insurance, so long as it’s not themselves or their families.
So, what are far-right lawmakers going to do? I’m glad you asked.
As Igor Volsky reported, so far, two current members are prepared to bypass the system on purpose.
[North Carolina Republican Robert Pittenger has] voluntarily withdrawn from health coverage altogether. [North Carolina Republican Mark Meadows] added that his staff has also voluntarily declined the subsidies. And while most members of Congress may be able to afford to forfeit the government contribution — Meadows has a net worth between $1,674,034 to $12,017,998 [and] Pittenger is worth between $18,615,005 to $48,551,997.
Two GOP members out of 233 in the House obviously isn’t a large number, but don’t be surprised if this number grows as right-wing lobbying becomes more intense.
Also note, a lot of these folks have convenient outs — if they have spouses with employer-based coverage of their own, members and staffers can get insurance anyway. For that matter, if you’re a multi-millionaire lawmaker, you can afford to get coverage without a subsidy anyway.
But the underlying point remains the same: every member of Congress, in both parties, who gets coverage in the coming months through an insurance exchange will be participating in “Obamacare,” even conservatives who will be reluctant to say so out loud.
By: Steve Benen, The Maddow Blog, August 26, 2013
“A Dog’s Life Can Be Dizzying”: The Obamacare Opposition Has Finally Caught Its Own Tail
It’s time to pop the champagne and blow the kazoos: the war on Obamacare has officially reached its point of reductio ad absurdum. Two of the opposition’s favored fevered conspiracy theories about the law have clashed, like two asteroids headed for the planet that smash into each other before they can do any damage below.
First, there was the opposition’s demand that members of Congress and their staff be subjected to Obamacare—that they be forced to give up their coverage in the health plans for federal employees and join the new insurance exchanges on the theory that “if Congress was going to impose Obamacare upon the country, it should have to experience what it is imposing firsthand.” This never really made sense from the outset since the exchanges, at least for the foreseeable future, are meant only for people without employer coverage and for small businesses buying coverage for their workers. That is, most of “the country” is not going to have anything to do with the exchanges—they are just going to keep being covered by their employers.
Forcing the incongruous requirement that Hill employees enter the exchanges resulted, inevitably, in a snafu: the exchanges are not designed for employers and employees to share the cost of plans that are selected by workers, since the exchanges are meant for people buying coverage on their own. Congress, like most large employers, covers the lion’s share of their workers’ premiums, but wasn’t going to be able to do so as the law was written, leaving Hill workers with thousands more dollars a year in premium costs than they now pay. To fix this problem—which was never intended even by the members of Congress who wanted Hill staff to share in the burdens of Obamacare—the administration and Congress agreed on a tweak that would maintain the requirement for congressional staff to enter the exchanges, while allowing for the federal government to pick up its share of the costs. Conservatives decried this as an “exemption” from Obamacare, which was flatly untrue: in fact, the Hill is being included in Obamacare to an extent beyond what the law was built to allow for. For a pithy dismissal of the “exemption” trope, see the recent letter to the editor in the Wall Street Journal by the gentleman from Verona.
Meanwhile, opponents of the law have since the early days of its drafting been busy fanning flames on another front as well: charging that the law would allow for federal funding of abortions, which has been barred for years. This line almost managed to stop the legislation in its tracks before supporters settled on a highly unwieldy compromise—plans on the exchanges can cover abortions (as many insurance plans now do) but the abortion coverage must be offered in a supplemental plan, purchased separately from the main coverage, and without the help of the federal subsidies many people will receive to help them buy the plans. This is such a messy arrangement that abortion rights supporters fear that precious few plans on the exchanges will even bother to include abortion coverage. And the law also allows states to pass laws banning abortion coverage, period, from plans in their exchanges, as many states have already done.
Do you see where this is headed? The law forces Congress and its staffers into the exchanges…the law, in theory, allows for plans with abortion coverage to be sold on the exchanges…and, voila, the crash in the skies above. Take it away, Associated Press:
The politics of the abortion debate are always tricky for lawmakers. They may soon get personal. An attempt to fix a problem with the national health care law has created a situation in which members of Congress and their staffers could gain access to abortion coverage. That’s a benefit currently denied to them and to all federal employees who get health insurance through the government’s plan…
Abortion opponents say the regulation would circumvent a longstanding law that bars the use of taxpayer funds for “administrative expenses in connection with any health plan under the federal employees health benefits program which provides any benefits or coverage for abortions.” Unlike many private corporate plans, federal employee plans only cover abortions in cases of rape, incest or to save the life of the mother.
“Under this scheme, (the government) will be paying the administrative costs,” said Rep. Chris Smith, R-N.J., author of the abortion funding ban for federal employee plans. “It’s a radical deviation and departure from current federal law, and it’s not for all federal employees, but for a subset: Congress. Us.” Smith is calling on the Obama administration to specify that lawmakers and staffers must choose a plan that does not cover abortions. The funding ban, in place since the 1980s, is known as the Smith amendment.
This framing is actually off the mark. It’s not “an attempt to fix a problem” with the law that has created this situation. It was the original demand by Republicans (Iowa Sen. Chuck Grassley led the way) that members of Congress and their staff be forced into the exchanges. The administration is downplaying the whole matter, noting that, technically, Hill members and staffers who buy a plan on the exchanges that comes with the abortion coverage will be paying for that part of the coverage out of their own pocket. But yes, in theory, a member of Congress and his or her staff may now be able to have abortion coverage, which was not the case previously. The horror! After all, we know that some members of Congress have a messy track record with abortions—like, say, demanding that their mistresses get one.
So, tiger, how does that tail of yours taste?
By: Alec MacGillis, Senior Editor, The New Republic, August 20, 2013
“An Inconvenient Truth”: The Big Republican Lie That Congress Is Exempt From Obamacare
Many lies persist simply because they sound plausible, or because they appear to confirm details of a broader trend that may well, in fact, be true. Decades ago, an upstate New York black teenager named Tawana Brawley was found in a trash bag, smeared with feces and with racial epithets written on her. She said she had been raped by six white men, and the charges – while horrifying – had the ring of truth.
It appeared to be a racist attack; why else would she be in such a condition? A grand jury found otherwise, and a prosecutor who was among the accused successfully sued her for defamation.
When Anthony Weiner at first denied he had sent photos of himself in his underpants to women on the Internet, suggesting his Twitter account had been hacked, it seemed plausible. His very name invited junior high school-level jokes, and people’s email and Twitter accounts are getting hacked all the time (not counting anything done by the NSA). Also, it just seemed insane that a sitting member of Congress, someone who had made no secret of his plans to seek the office of New York City mayor, would do something so categorically stupid and reckless. And yet, he did, and now he’s paying the price for it in the polls.
Everybody, or almost everybody, hates Congress these days, and there’s a determined group which really hates President Obama. So when conservatives and media types and even actual members of Congress –who should know better – make a claim about Congress getting special treatment under the new health care law, it seems like it would make sense. Congress and the Obama administration? Sparing the government from rules and regulations the rest of us have to follow? Well, doesn’t that sound like just the sort of thing those entitled rascals would do!
Except that it’s untrue. The Obama administration indeed made a fix to the way congressional employees will get their health care, but it was a fix that brought the workers back into the mainstream, putting them in the same category as the rest of us.
When Obamacare was being debated, opponents did everything they could to peel away support by raising issues ranging from “death panels” (a lie) and abortion (an issue sure to aggravate people on all sides). One item that did pass was a provision that required Congress and its employees to use the health care exchanges created for people who are uninsured or individually insured.
The exchanges might save a lot of people money; they might not. We’ll see. But people who work for large employers don’t have to think about it, since their employers are required to provide health insurance to full-time workers under the law.
The federal government, being quite a big employer, falls into this category. But Obamacare opponents, either out of spite or a desperate effort to kill the overall bill once and for all, stuck in a provision that requires congressional workers to use the exchanges anyway. This, in effect, is a special exception – except that the special exception didn’t benefit Congress; it punished it. It would have created a situation under which every full-time employee of a large company in the country would get coverage through work except for Congress and its employees. Obama’s recent edict ensures that the federal government will continue to make payments towards congressional employees health care – just as big employers must do across the country.
The amendment was petty and absurd. It was meant to flip a couple of votes, and it didn’t work. The Obama administration directive doesn’t fit into the convenient lie that government big-wigs are “exempting” themselves from the law. But we should all expect the government to live by the same laws the rest of us do – and that’s what the directive does.
By: Susan Milligan, U. S. News and World Report, August 19, 2013
“Purposeful Republican Misrepresentation”: Read This Before You Believe The Obamacare Premium Spike Hysteria
While some states are reporting lower than expected health care premiums in the exchanges established by the Affordable Care Act, a growing number of Republican-controlled states — like South Carolina, Ohio, Indiana, Florida and Georgia — are garnering screaming headlines about huge premium spikes under the law.
Calculating premium rates is a complicated and tedious task that will vary greatly among states and is open to interpretation and manipulation by both supporters and opponents of President Obama’s health care law. Generalities are particularly hard to draw, as the law will impact Americans differently: the new regulations will lead some younger people to may pay more than they’re contributing now, but will save older and sicker people hundreds, if not thousands of dollars a month.
Still, since Republicans are politically motivated to portray the proposed premium increases in a negative light and the media is far more interested in sensational claims about Obamacare failing, coverage of the new rates often leads readers with the mistaken perception that the law is coming off the tracks. Below is a short guide that will help you identify if someone is misrepresenting how much premiums will increase under Obamacare:
1. Do the premiums account for subsidies?
Most articles about premiums for health insurance in the exchanges relegate information about the Affordable Care Act’s tax credit subsidies to the lower two thirds of the piece, thus presenting the top rates as the actual amount families and individuals will be required to pay.
In reality, the number of applicants who are eligible for sliding-scale tax credits will vary — the credits are available to people making less than four times the poverty line — but the Congressional Budget Office (CBO) estimates that out of the 7 million Americans expected to enroll in coverage in 2014, 6 million will be eligible for subsidies. Those with incomes up to 400 percent of the Federal Poverty Line (FPL) will also see reduced the out-of-pocket limits.
Maryland officials, for instance, project that three-fourths of enrollees will receive assistance. In 2014, the average subsidy will be $5,510 and will increase in the years ahead.
2. What is the state comparing the new premiums to and does it break down the increases by the available levels of coverage?
While states like New York or California have already enacted strict regulations that mirror many of the new rules in the Affordable Care Act, others (like Indiana or South Carolina) allow insurers to sell skimpy bare-bones high deductible plans that provide little actual coverage.
Comparing the comprehensive plans that will be available in the exchanges (and the individual market) to the existing coverage is like likening a Lexus to a bicycle — yes, the car is more expensive, but it is in a whole different category of transportation. Under the law, all new insurance plans have to offer essential health benefits like prescription drug and mental health services.
3. Are cheaper coverage options mentioned?
Last month, state officials in Indiana announced that premiums for individual policies would be 72 percent higher than the premiums people currently play. But a closer look at the data revealed that the state wasn’t issuing actual premiums, but calculations for “allowed cost” or “the cost of insurance before calculating how much individuals would pay out-of-pocket, because of co-payments and deductibles.” The actual premiums turned out to be much lower.
What’s more, the numbers were averages of all plans in the exchange — from bronze plans that cover 60 percent of health care costs to platinum plans, which pay for 90 percent — and were not representations of the prices actual families will pay. Past experience in Massachusetts shows that consumers are very price conscious and will gravitate towards the cheaper bronze or silver plans. (In Massachusetts, 84 percent enrolled in bronze or silver policies.)
A catastrophic plan will also be available to those up to age 30 in the individual market. In Nevada, this coverage will be available for less than $100.
4. Has the state done all it could to reduce premiums?
Approximately two dozen states allow the state insurance department or commission “the legal power of prior approval, or disapproval, of certain types of rate changes” and under the Affordable Care Act, the federal government has offered grant funding “to help with rate review activities.” States like Maryland — which has some of the strongest rate-setting laws in the country — claims to have used its authority to deny rate increases to reduce the proposed premiums by “more than 50 percent.” Oregon regulators also slashed carriers’ rate requests by as much as 35 percent.
By: Igor Volsky, Think Progress, August 5, 2013
“Kill The Law, Kill The Patient”: The Most Insane Conservative Anti-Obamacare Gambit Ever
In a last-ditch effort to stop Obamacare, Tea Party groups are trying to sabotage the healthcare law in a way that could leave young people without coverage and increase insurance premiums for everyone else. It assumes that the end of “repealing Obamacare” justifies the means of potentially years of worse health.
The gambit, as explained by Sarah Kliff of the Washington Post, is to convince young people to eschew the Affordable Care Act’s health insurance exchanges and the subsidies they offer in order to destabilize the insurance risk pools. And now the leader of the effort is talking to Salon about the idea.
First, some background. The “plan,” such as it is, works like this: Young people tend to be healthier and thus cheaper to insure, so they essentially subsidize the cost of older and sick people. If enough young people don’t sign up, and the pool is mostly older and sick people, costs will skyrocket. A price “death spiral” is health policy experts’ biggest fear with the law, but it’s exactly what the conservative groups want to artificially induce, thus dooming the law.
To that end, conservatives are trying to rally young people to skip the healthcare exchange and pay the fine for violating the individual mandate to have health insurance. They’re making their case with GIFs, Op-Eds and a campaign to burn Obamacare draft cards (which don’t actually exist, but can be downloaded from FreedomWorks’ website for later incineration). Americans for Prosperity is even considering setting up kiosks at Universal Fighting Championship matches and college football games to tell people not to enroll.
But, if this gambit is successful, wouldn’t that lead to millions of young people living without health insurance, and older and sick people paying higher health insurance premiums? And since Obama will never repeal his signature law, we’re talking about at least three years of intentionally inflicted misery, all for a shot at repealing Obamacare sometime in the future and replacing it with something that doesn’t even exist yet. What about the human toll?
We asked Dean Clancy, the vice president of FreedomWorks who is spearheading the effort. “Yes, we would like to hasten the collapse of the exchanges, but the purpose is not to drive up anybody’s insurance. The purpose is to get this law defunded or delayed so we can get to a patient-centered system,” Clancy said in a telephone conversation Thursday evening. “Without young people, Obamacare can’t work.”
Regardless of intention, wouldn’t it have the effect of driving up premiums? “I would not say it will drive up premiums for older Americans, I would say it will allow premiums to rise,” he said. “It would allow premiums to rise faster than they otherwise would if everybody bought the overpriced coverage, including the younger, healthier people.”
And what about young people who currently lack insurance – 90 percent of whom will qualify for subsidies in the Obamacare exchanges — what should they do? “You can get coverage outside the exchanges,” Clancy said, pointing to catastrophic care plans, healthcare savings accounts, or even Medicaid.
Even without the subsidies, which are only available through the exchanges, Clancy said, it would still be cheaper for young people to pay the fine and go their own way. “We encourage people to go for a health savings account with a high deductible policy, and to pay cash for repeat medical expenses. It’s a great way to save money and helps the system be more efficient,” he said. Plus, there’s always free-riding: “And they have to take you when you get sick, that’ll be in the law now.”
What if you get in a car accident or something and don’t have time to sign up for insurance? A pause as he consulted with the communications director, who was also on the call. “In that case, you may incur some costs,” Clancy acknowledged. “You may have to deal with, as people do today who don’t have funds available, paying it back in installments, or uncompensated care, or you can sign up for Medicaid.” In other words, you’re on your own. Most uninsured people can’t afford medical bills.
“Just to be clear, we’re telling people: ‘Do what you think is best for you,’” he added. “But understand that if Obamacare continues, you’re going to have to pay more and more to get less and less.”
For Judy Feder, a prominent health policy expert at Georgetown who supports the health reform law, this approach is “crazy.” “It’s not even killing the patient to save the patient — it would stick with killing the patient. They just want to kill the law, which doesn’t save anybody,” she said.
It’s hard to overstate how nihilistic this plan is. If the scheme succeeds — which it will not, since more than enough young people are saying they’ll purchase insurance through the exchange — not only would some people lack good health coverage they’d otherwise be entitled to, but costs would be higher on everyone else. “It is as outrageous as you say it is,” Feder confirmed.
This is basically the “Cloward–Piven strategy” Glenn Beck always rants about, but 1) applied to healthcare instead of the economy, and 2) real.
By: Alex Seitz-Wald, Salon, August 2, 2013
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