“What If We Just Called It NixonCare?”: Republicans Have No Business Being Upset About Obamacare
House Majority Leader Eric Cantor says Republicans will seek to delay a requirement of the 2010 Affordable Care Act that all Americans obtain health insurance or face a tax penalty. “With so many unanswered questions and the problems arising around this rollout, it doesn’t make any sense to impose this one percent mandate tax on the American people,” Cantor said last week.
While Republicans plot new ways to sabotage the Affordable Care Act, it’s easy to forget that for years they’ve been arguing that any comprehensive health insurance system be designed exactly like the one that officially began October 1st, glitches and all.
For as many years Democrats tried to graft healthcare onto Social Security and Medicare and pay for it through the payroll tax. But Republicans countered that any system must be based on private insurance and paid for with a combination of subsidies for low-income purchasers and a requirement that the younger and healthier sign up.
Not surprisingly, private health insurers cheered on the Republicans while doing whatever they could to block Democrats from creating a public insurance system.
In February 1974, Republican President Richard Nixon proposed, in essence, today’s Affordable Care Act. Under Nixon’s plan all but the smallest employers would provide insurance to their workers or pay a penalty, an expanded Medicaid-type program would insure the poor and subsidies would be provided to low-income individuals and small employers. Sound familiar?
Private insurers were delighted with the Nixon plan but Democrats preferred a system based on Social Security and Medicare and the two sides failed to agree.
Thirty years later a Republican governor, Mitt Romney, made Nixon’s plan the law in Massachusetts. Private insurers couldn’t have been happier although many Democrats in the state had hoped for a public system.
When today’s Republicans rage against the individual mandate in the Affordable Care Act, it’s useful to recall this was their idea as well.
In 1989, Stuart M. Butler of the conservative Heritage Foundation came up with a plan that would “mandate all households to obtain adequate insurance.”
Insurance companies loved Butler’s plan so much it found its way into several bills introduced by Republican lawmakers in 1993. Among the supporters were Senators Orrin Hatch (R-UT) and Charles Grassley (R-IA). Both now oppose the mandate under the Affordable Care Act. Newt Gingrich, who became Speaker of the House in 1995, was also a big proponent.
Romney’s heathcare plan in Massachusetts included the same mandate to purchase private insurance. “We got the idea of an individual mandate from [Newt Gingrich] and [Newt] got it from the Heritage Foundation,” said Romney, who thought the mandate “essential for bringing the health care costs down for everyone and getting everyone the health insurance they need.”
Now that the essential Republican plan for healthcare is being implemented nationally, health insurance companies are jubilant.
Last week, after the giant insurer Wellpoint raised its earnings estimates, CEO Joseph Swedish pointed to “the long-term membership growth opportunity through exchanges.” Other major health plans are equally bullish. “The emergence of public exchanges, private exchanges, Medicaid expansions … have the potential to create new opportunities for us to grow and serve in new ways,” UnitedHealth Group CEO Stephen J. Hemsley effused.
So why are today’s Republicans so upset with an Act they designed and their patrons adore? Because it’s the signature achievement of the Obama administration.
There’s a deep irony to all this. Had Democrats stuck to the original Democratic vision and built comprehensive health insurance on Social Security and Medicare, it would have been cheaper, simpler and more widely accepted by the public. And Republicans would be hollering anyway.
By: Robert Reich, The Robert Reich Blog, October 29, 2013
“The Right’s Sickest Obamacare Lie Yet”: Republicans Believe People Who Live In Flat Places Shouldn’t Have To Buy Cars With Brakes
During Congressional hearings with Health and Human Services Secretary Kathleen Sebelius, Congresswoman Marsha Blackburn (R-Tenn.) made an interesting argument that some Americans don’t want quality health insurance. “Some people like to drive a Ford and not a Ferrari,” Blackburn asserted. But that begs the question: What kind of Ford?
As early as 1972, there were reports that when a Ford Pinto was involved in a low-speed collision, the car would spontaneously burst into flames. According to a 1977 investigation by Mother Jones magazine, Ford was aware of the problem — resulting from a flaw in the gas tank design — but instead of paying to recall and redesign the car, Ford decided it would be cheaper to pay for the lawsuits. Ultimately, at least 27 people and as many as 180 people died as a result of Pinto fires. But it took the government forcing Ford to recall the Pinto for the problem to actually be solved.
In 2009, millions of Americans lacked any health insurance whatsoever and millions more had private health insurance metaphorically designed to explode at the hint of any serious illness or pre-existing conditions or exorbitant medical costs. So, in 2009, 14,000 Americans were losing their health insurance every single day. And medical bills were prompting more than 60% of all bankruptcies in our nation. In other words, many health insurance policies were patently dangerous and unsafe.
Now, Congresswoman Blackburn and her ilk might argue that people should have been free to buy the Pinto if they wanted, without government intrusion into personal choices or private business practice — just like they seem to want to argue that Americans should be free to hold onto their inadequate, costly and reckless insurance policies that throw them off at the slightest sign of illness while forcing costs up for the rest of us. But arguably most Americans want to buy cars that are safe. Auto companies didn’t want to install seat belts and airbags, just like Ford didn’t want to fix the Pinto. That was government regulation at work, making us all more safe — even if, in some cases, it made cars more expensive. We ultimately save, in every way imaginable, when the number of traffic deaths are dramatically cut.
This is, in effect, exactly what the Affordable Care Act does with respect to some currently existing, private insurance policies. If those policies don’t meet a new, higher bar of quality coverage, then the government will no longer allow insurance companies to sell them. Instead, the 5 percent of Americans who rely on the individual insurance market for their coverage will have other options, all that provide better quality coverage and many of which are far less expensive. Plus at least half of folks on the individual market will be eligible for subsidies that further bring costs down.
A great example comes from Deborah Cavallaro, who has been making the rounds on television complaining about her current insurance plan being cancelled. Cavallaro had not looked into her other, new options under Obamacare until a Los Angeles Times reporter called. Together, they looked at Cavallaro’s options — and found a “silver” plan for Cavallaro that would cost slightly more in her monthly premium but save her tons in terms of her annual deductible and out-of-pocket costs as well as doctor visit expenses. Plus, thanks to Obamacare, this plan would not be subject to the annual payment caps or pre-existing condition clauses that have been exploding in the faces of consumers for decades. After all, it’s important to remember that in 2009, most Americans were not very satisfied with their insurance plans. People wanted better options and now, thanks to Obamacare, they’ve got ‘em!
Congresswoman Blackburn and her cohort might fire back something about young healthy men being required to pay for good insurance plans that cover maternity — one of 10 basic coverage requirements mandated under the Affordable Care Act, this one designed to undo the history of insurance plans discriminating against women and families. Perhaps Republicans might also argue that Americans who live in really flat places should be able to buy cars without breaks. But that wouldn’t be safe for drivers or the rest of us. And in the case of health care reform in particular, the point here is to bring down costs and raise the quality of care for all of us. Those young, healthy men are going to grow up and have families one day — and then eventually become elderly — and will benefit from an insurance system that keeps costs manageable throughout and doesn’t kick off the elderly or infirm. Just like we all benefit from seatbelts and airbags, even if we never get in an accident.
Nobody is forcing anyone to buy a Ferrari plan in the individual health insurance exchange. At least 6.4 million Americans will pay less than $100 per month for coverage in the Obamacare exchanges — which means there are plenty of Ford’s available. What the Affordable Care Act simply ensures is that those policies will be safe and reliable — and not catch fire when we least expect it.
By: Sally Kohn, Salon, October 31, 2013
“Defiant Obamacare Defense”: A New World Where Insurers Have To Cover Categories Of Treatments They Never Had To Before
President Obama’s speech at Faneuil Hall was probably his most passionate and unapologetic defense of the health-care law in ages, maybe since its passage. At times like this in the past, Old Mr. Reasonable has hemmed and hawed, ceding that his opponents had a point, but insisting—reasonably, of course—that he had a better one if you just stopped and thought about it. But Wednesday afternoon in Boston gave us a different Obama. He took a page out of the Bush playbook or, dare I say it, even the Cheney one. If things are going a little rocky at the moment, it doesn’t matter; cede nothing. Stick to plan. No matter the merits or facts, it’s the only approach that our political culture respects.
The money moment of the speech, of course, came when he answered the questions raised by the NBC report Tuesday. According to NBC, people who had bought insurance on the private market who don’t have either employer or government coverage were getting hammered by Obamacare. They were getting letters telling them their coverage had expired and then finding that the new coverage available to them was going to cost more. It flew in the face, said NBC’s Lisa Myers, of Obama’s promise that if you had coverage now and liked it, nothing would happen to you.
She was right. He shouldn’t have said it. And in Boston he didn’t exactly say, “I shouldn’t have said it.” But he did turn it around and say for that small percentage of people, the coverage they’re going to end up with is better! It also just might be cheaper, he said, and they are going to have peace of mind: “They can’t use allergies or pregnancy or sports injury or the fact that you’re a woman to charge you more. They can’t do that anymore!”
It’s an interesting, by which I mean preposterous, meme that’s developing on the Republican side. On Wednesday morning, Rep. Marsha Blackburn (R-TN) pressed Health and Human Services Secretary Kathleen Sebelius on the issue. Some people, Blackburn said, “would rather drive a Ford than a Ferrari.” No denying that; in my younger and single and childless days, I certainly would have opted for a Ford plan instead of a Ferrari plan, so up to a point, Blackburn is making sense.
But Obamacare creates a world where insurers have to cover several categories of treatments that they never had to cover before, and since people with those conditions are now going to sign up and use those services, it’s going to cost more in some cases. And it’s understandable if people are upset about that. But Blackburn’s analogy, of course, breaks down because any citizen, at some unknowable future point, may be hit with one of those conditions. A person might develop mental illness. Or their child might. No imaginable circumstance could make a reasonable Ford-owner think, “Damn, I should have bought that Ferrari.” But numerous circumstances could make the self-employed citizen or parent think, “Damn, I’m glad I bought that Ferrari plan.”
What’s most fascinating to me about the whole thing is that the experience is training, or is going to train, Americans to rethink the really fundamental questions about how life and society are organized in a way politics rarely does. One of the major differences between liberals and conservatives is that conservatives believe in the primacy of the individual, while liberals want people to think about the community. Another difference, related, has to do with the two creeds’ opposing conceptions of individualism. Conservatives go for the whole rugged individualism thing, whereas the liberal view of the individual is closer to “there but for the grace of God go I.”
Well, the nature of health-care coverage is it has the power to bring consideration of these questions to the fore. A country where people have to sit down and choose how best to protect themselves and their loved ones against pain and death, and where they have to think about the trade-offs between paying more and having better coverage, is a country where people are being forced, in a way, to think about the most profound questions of community and the individual—of how much responsibility we ought to be forced to shoulder for each other.
I used to think, “This is just like auto insurance; you’re a safe driver, but you insure yourself against the unsafe drivers, and everybody understands that, so why should this be different?” But it is, somehow. It’s so much more personal. It’s about our frailty as human beings, and contemplation of our frailty makes us both obstinate and individualistic (“I can take of myself, Jack!”) and, in our more honest moments, vulnerable and communitarian (“What will I do if I really get sick?”). Forcing people to think about their coverage forces them to think about all that.
How will it turn out? Who knows. It has the positive potential of making people, a majority of people, see that this all makes a kind of sense, that they are not, whether they like it or not, autonomous actors. That, come to think of it, is what terrifies conservatives. Since 1980, they have trained people to think chiefly about themselves, unburdened of the context of society. Obamacare will force them to think of society. And most people, not being selfish asses (and most people aren’t), will, once the kinks are worked out, accept it. Polls are already indicating that. No wonder Ted Cruz is losing it.
By: Michael Tomasky, The Daily Beast, October 30, 2013
“Obamacare Witch Hunt”: Republican Halloween Witch Trials About Obamacare Avoid The Facts
Watch out for the hobgoblins! The knives are out. The hearings are on. The charges are flying. Obamacare is on the hot seat … again!
The sad result is that as we get these unconfirmed anecdotes, these stories about problems with insurance companies, these people who face hardship supposedly because of Obamacare, few Republicans think back to pre-2010. Then the costs of health care were skyrocketing – from $1,000 per person in 1980 to about $3,000 in 1990 to $4,000 in 2000 to nearly $8,000 before the Affordable Care Act was passed. The next highest nation for cost: Norway at $5,352.
According to the Commonwealth Fund, 49.9 million Americans were without health insurance in 2009, up 13 million from 2000. Houston, we have a problem.
And remember the stories of pre-existing conditions? Getting kicked off your health insurance or unable to get coverage? How about caps on your care? Or huge deductibles, especially for women? Horror story after horror story.
The facts are clear: 17 million Americans had pre-existing conditions; 34 percent lacked coverage for mental health; 62 percent lacked maternity coverage.
How soon we forget the problems that the ACA was written to solve. Right now, only 5 percent of Americans are covered by individual plans – if you had your plan prior to 2010, you are grandfathered in and can keep it. If the insurance companies want to kick you off they have to alter your plan, but they can no longer kick you off because of a pre-existing condition or because you cost them too much.
Most of these individual plans are renewed yearly and, according to current figures, 48 percent of those with individual plans would get a tax credit under the Affordable Care Act. The average “rebate” would be $5,500, not exactly chump change. Nearly half of those who believe they are suffering sticker shock from their insurance companies would get better coverage for less money.
So, before more and more people are dragged up before Republican-led congressional committees and berated, maybe it is time to get the facts. Maybe it is also time to work to fix what problems may exist and to offer solutions and not engage in more Salem-like witch trials just before Halloween.
By: Peter Fenn, U. S. News and World Report, October 30, 2013
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