“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
“Forget The Conventional Wisdom”: What Florida Really Tells Us About Obamacare
Was it really Obamacare that sunk Sink? I mean of course Alex Sink, the Democratic Florida congressional candidate who lost to Republican David Jolly on Tuesday. After the results were announced, Washington’s conventional wisdom congealed immediately: This was all about Obamacare, and it’s going to doom the Democrats come November.
Not so fast, says Geoff Garin, the pollster who did Sink’s polling in the race. Garin argues in a memo he released the day of the voting that “the issue ultimately provided more of a lift than a drag to her campaign.” He followed up by telling me yesterday: “She would have done worse if she’d neglected to hit back and engage the issue.” There’s a lesson in there for Democrats as they march toward November.
Garin put two key questions to the district’s voters. The first paraphrased the criticisms of Sink on Obamacare: Sink supports this law that will take away $716 billion from Medicare, and that caused 300,000 Floridians to lose their coverage and 2,500 patients at a district cancer center to have to change doctors. The second paraphrased criticisms of Jolly’s health-care position: He wants to totally repeal the law instead of fix it, a position that would let insurers again discriminate against the already ill and charge women more than they charge men for coverage. Repeal would also cut expanded prescription-drug coverage for Medicare recipients.
Respondents were asked to say whether this information gave them “very major doubts” about the candidates, “fairly major” doubts, “just some” doubts, or “no real” doubts. Results: While 43 percent now entertained very major doubts about Sink, 50 percent said they had very major doubts about Jolly. And 35 percent had no real doubts about Sink while only 26 percent had no real doubts about Jolly.
If that polling is accurate, then “more lift than drag” is accurate and fair. Guy Molyneux, a partner of Garin’s who oversaw some Obamacare polling for a couple of unions in January, echoed the point that there are at least three things Democrats can say about the law and the Republicans’ repeal zeal that poll really well. People broadly understand, Molyneux told me, that the law protects against discrimination based on pre-existing conditions, and they approve of that strongly. They also know that insurers can no longer drop sick people on whim, and they like that. And they’re getting to know that the law prevents insurers from charging women more than men, and they like that, too; even men.
There’s one more thing that people don’t yet know very well, but the polling indicates that it could be a strong debating point, too: Under the law, insurers have to publicly justify any rate increases greater than 10 percent. This is called rate review, and it and the medical-loss ratio provisions of the law (explained here) are the two main planks that guard against willy-nilly rate hikes. A Heath and Human Services study from last September found that nearly 7 million citizens had saved more than $1 billion because of rate review, and moreover, that insurance companies were seeking increases of 10 percent far less frequently than before the law because of the added oversight.
Since everybody and his brother assumes that the Affordable Care Act is going to increase their rates, seems to me it’d be awfully useful for the Democrats to develop a sharp talking point or two explaining to people that the law actually helps prevent crazy premium increases.
This all makes the Obamacare story a lot more complicated than “disaster for Dems.” It just doesn’t have to be. Republicans know this, too. Why are they, or some of them, suddenly talking about replacing the law? Precisely to try to insulate themselves from the effective Democratic attack that they’d give carte blanche to insurance companies to go back to their old ways.
It’s worth dwelling on this for a paragraph—it’s important to understand. It was in the spring of 2010 that the GOP unveiled “repeal and replace.” They stuck with that through the election. Then, once they’d retaken the House, they dropped “replace” and went for “repeal” only. Now that a midterm election is coming again, though, they’re starting to put “replace” back in their rhetoric. But it’s as hollow this time as it was then. “Our challenge,” Molyneux told me, “is to show that there’s nothing behind the curtain there.”
Lord knows, the Democrats have more problems than health care staring them in the face for the fall. The turnout question is the biggest one, although they say they’re making efforts this time that have no precedent in a midterm election. And Obama’s bad approval numbers—worse still in many of the states with high-profile Senate contests—are a huge factor. “If Obama’s still at 41 percent in mid-October, we’re in a world of hurt,” Molyneux says. And finally, but far from least, the economy. An awful, awful number from this week’s NBC/Wall Street Journal poll: Fully 57 percent of those surveyed said they think we’re still in a recession.
So yeah, there’s a lot for Democrats to worry about. But in most of the contested states—not Louisiana, probably not Arkansas, but the others—they can make Obamacare a net wash if they can be clear about the implications of “repeal” and call out their GOP opponents on “replace.” And maybe as a bonus show they have some fight in them, and give those unmotivated young and Latino voters some good reasons to go to the polls.
By: Michael Tomasky, The Daily Beast, March 14, 2014
“Health Care’s Resistors And Adapters”: Why The ‘Bette’ And ‘Boostra’ Stories Fall Apart
You’ll recall that Washington state Rep. Cathy McMorris Rodgers, in delivering one of the 17 GOP State of the Union responses, spoke of “Bette,” the Spokane woman whose premiums were going up under Obamacare by $700 a month. The state’s jackboot, according to McMorris-Rodgers, was planted right on Bette’s throat, and there was nothing she could do about it. Bette would “have no choice” but to pay the extra, socialistic freight. Awful, awful, awful.
But the Spokane newspaper tracked Bette down and got the whole story, which was that her insurer did indeed cancel Bette’s then-current plan, which didn’t meet all the new ACA coverage requirements. When she called, the insurer tried to steer her to a plan that cost around $500 a month more. However, Bette never went to the Washington state web site to check out all the options available to her. If she had, the LA Times reported, she’d have found that in fact many options were available to her, “and with a deductible far lower than the $10,000 she was paying under the old plan and broader coverage, though lacking a provision for four free doctor visits a year provided by her old plan.” But Bette just didn’t want to go on “that Obama web site at all.”
Now, the Detroit News has found another Bette. Julie Boonstra has cancer, and last month she starred in a Koch Brothers-funded ad for one of the Republican candidates for U.S. Senate. The ad claimed that Obamacare would make her medication so unaffordable that she might die. The News looked into the details of her new plan and found that she is going to save $1,200 a year. Here’s how the News summarizes the details:
Boonstra’s old plan cost $1,100 a month in premiums or $13,200 a year, she previously told The News. It didn’t include money she spent on co-pays, prescription drugs and other out-of-pocket expenses.
By contrast, the Blues’ plan premium costs $571 a month or $6,852 for the year. Since out-of-pocket costs are capped at $5,100, including deductibles, the maximum Boonstra would pay this year for all of her cancer treatment is $11,952.
Like Bette, Boonstra just isn’t buying it. It “can’t be true” and “I personally don’t believe that.” She’s the ex-wife of a former GOP county chairman who was named by the Republican governor to a seat on the state Court of Appeals, though she told the News she’s never been political.
Maybe not. And she does have cancer, so the point here is not to lay into her. The point is the way people’s views have been set in concrete because of all this hatred and all these lies coming from Republicans and groups like the Koch’s Americans for Prosperity.
Most people love the feeling of having their anger and suspicions confirmed. The chance to say “I knew it!” is rare enough in this world, and most people relish it. They relish it on some level even more than being wrong but ending up pleasantly surprised, at least in cases where for whatever reason they’ve developed some kind of emotional commitment to the outcome that confirms their worst fears.
So people were told: Obamacare is going to screw you over. Most people—conservatives, of course, but just general people with a default distrust of government—accepted this as logical. So they looked only for evidence that would support their being screwed over. Evidence to the contrary, even when it benefits them, is dismissed. Bette and Boonstra both do this. Bette wouldn’t even go look at the web site, where she’d have seen she had numerous options. Boonstra, told by newspaper reporters the objective facts of her situation, said she simply doesn’t believe it.
I wrote a piece a couple of months ago for which I went on the recently fixed up ACA web site, pretended to be a married, modest-income guy from Kansas, and found that I was offered a staggering 42 different plans, from very cheap (and really high deductible) ones to quite pricey ones, with lots of stops in between. Most people who bother to look will find the same thing.
But they have to look. The baseline question, as it so often is in politics these days, is about emotional resistance. How long will it take before people who get letters about changes to their insurance just go on the ACA web site and calmly shop around? Some smallish number does that now, but I daresay there are more Bettes and Boonstras. One big determinant of how Obamacare ends up playing in the elections this November will be how many resistors have become adapters.
Meanwhile, it’s comical, but also kind of sick, that the law’s opponents keep producing these lies and can’t find any real victims. I’m sure some are out there, but far, far more people will benefit from the fine print of this law, which is why these stories fall apart.
By: Michael Tomasky, The Daily Beast, March 11, 2014
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