“The Power Of Personality”: “ObamaCares” And The Tea Party Doesn’t
Does anybody care that millions of Americans can’t afford health care? Does anyone care that before health care reform, insurance companies had the power to screw their customers royally? Does anyone care that Americans spend more per person on health care than people anywhere else in the world but are not nearly as healthy as the citizens of nations which provide comprehensive health care coverage to their residents?
Barack Obama does and the tea party doesn’t.
The most important stat that I saw in the 2012 National Election Day Exit Poll was the power of personality in the presidential race. A majority of the voters who looked for leadership, vision and shared values in 2012 supported Mitt Romney. The only other personal dimension measured by the exit poll was caring. The voters who sought compassion in their president supported Barack Obama by an overwhelming margin. The president’s advantage on empathy was so big that it overwhelmed the support that Mitt Romney had on the other three personality dimensions.
Compassion brings us to the Affordable Care Act or, as I like to call it, ObamaCares.
Many Americans who oppose ObamaCares also dislike the mean spirited nature of the tea party. You can talk about issues until the cows come home, but Americans vote for people, not issues. Voters use the candidates’ positions on issues to make personal judgments about their character. Many Americans may have philosophical reservations about the Affordable Care Act, but more than anything else they resent the tea party’s blind opposition to any proposal that improves the quality of health care available to the public. The tea party has demonstrated its indifference to the suffering of millions of Americans by its failure to offer its own plan to improve the floundering system of health care that undermines the health, wealth and well being of the United States
Politics is full of irony, which is what makes Washington so interesting. Republicans pushed hard on the budget because they wanted to use the threat of a shutdown as leverage against ACA. But on the same day that the wacko birds forced the federal government to close with dismal reviews, enrollment in Obamacare began with such a big demand that it overwhelmed computer systems. My guess is the wingnuts don’t see the irony, but do see a lot of red.
The early returns on the shutdown should worry Republicans. A CBS News survey conducted since the federal government closed for business early Tuesday morning indicates that a large majority (72 percent) of Americans oppose the shutdown over Obamacare. The tea party doesn’t seem to care about its electoral fortunes any more than it does about the well being of the working families who make this country great. The party’s indifference to people and politics will cost it dearly next year in the midterm elections.
By: Brad Bannon, U. S. News and World Report, October 3, 2013
“If Liberals Hate Something, It Must Be Terrific And Effective”: Those Obamacare Rape Ads Are A Scam On Conservatives
I suppose I have to talk about the creepy anti-Obamacare ads that everyone, or at least all the liberal bloggers, are talking about today.
Look, folks: this is a very obvious scam.
This is not about stopping the ACA.
This is about money.
Oh, for the donors, it’s presumably about stopping Obamacare.
But for the people putting together the ads, unless they are incredibly stupid and naive, it’s almost certainly about raising money from those donors. And, perhaps, making a name for themselves (or a bigger name — I’m not looking to see who is responsible) within the conservative movement.
These ads could not be better designed to do one thing: to get condemned by liberals. Thus impressing easily scammed conservative marks, who tend to really believe that if liberals hate something, it must be terrific and effective.
This campaign is not designed to convince young people to “opt out” of Obamacare. It’s part of a “campus tour” supposedly designed to convince those young people to go without insurance, but that’s transparently a fraud; traditional-aged college students, the ones who are supposedly being targeted, aren’t really the customers that matter (it’s their older brothers and sisters…yes, some traditional-age college students may purchase their own insurance under ACA, more than was the case before, but it must be a fairly small group).
No, there are real efforts to undermine the law — harassing the “navigators,” pressuring the NFL and others not to publicize it, and more — but this campaign isn’t one of them.
Will it have any effect on actual consumer behavior? I doubt it. But it is worth noting that if it does “work” at all, it’s going to work on the people who respond best to the affect evoked by the ads: in other words, people already primed and ready to hate Obama(care), people already primed and ready to hate the government of the United States, people primed and ready to suspect the very worst of the program. And do note: the way it “works” is by convincing them to go without health insurance.
So basically: if you’re a rich conservative who isn’t very smart about how you give your money, this ad is designed to pick your pocket. If you’re a non-rich conservative, you might get duped into some foolish behavior, but that’s just acceptable collateral damage. For everyone else, it’s an occasion for (to be fair, entirely justified) outrage, I suppose, but basically it’ll come and go without any real effects.
Hey, I know: we’re not supposed to question motives. I believe that. So I’ll say again: it’s possible that these ads are not a scam, but a real political campaign undertaken by seriously naive and stupid operatives. Just as it’s possible that the people doing the “defund” campaign sincerely believe that a government shutdown threat would achieve that, as opposed (as Jamelle Bouie and others pointed out) just finding it an effective money-raising tool). I have to admit, however: that’s not what I think is going on.
By: Jonathan Bernstein, Washington Monthly, Ten Miles Square, September 20, 2013
“Money For Medical Bills Grows On Trees”: New Koch-Funded Front Group Tells Youth They Are Better Off Uninsured
For a new Koch-funded front group for young people, money for medical bills apparently grows on trees.
Generation Opportunity, a nonprofit financed with $5.04 million from a fund controlled by the Koch brothers’ lobbying team, just launched a new television advertisement to kick off an anti-Obamacare campaign. The ads, which provides no actual information about healthcare reform and instead seem designed to scare people away from doctor visits, have already been dissected by many in the media. What’s more revealing is Generation Opportunity’s real agenda, which was explained to Yahoo News in a story unveiling the new campaign (emphasis added):
Their message: You don’t have to sign up for Obamacare. “What we’re trying to communicate is, ‘No, you’re actually not required to buy health insurance,’” Generation Opportunity President Evan Feinberg told Yahoo News in an interview about the campaign. “You might have to pay a fine, but that’s going to be cheaper for you and better for you.”
So, the big idea here is that young people should decline health insurance? Having no health insurance is “better for you?” When a car accident happens, or someone is sent to the hospital needing critical care, who picks up the bill? For slash-and-burn Koch groups, that doesn’t seem to matter.
Notably, the young men and women hired by Generation Opportunity are provided health insurance, says organization’s communications director David Pasch, who spoke to TheNation.com over the phone. Lucky them.
Ethan Rome, the executive director of Health Care for America Now, says young Americans without health insurance will be “buried by bills and unable to recover for the rest of their lives.” “What they’re advocating is seriously unconscionable,” says Rome in response to Generation Opportunity’s call for youth to go uninsured.
Generation Opportunity also told Yahoo News that it will be passing out pizza and hosting tailgate parties to promote its campaign of opposing health insurance.
These antics, of course, are nothing new for the Koch brothers and their endless array of front groups. In the nineties, Koch-funded fronts fought healthcare reform by sponsoring a “broken-down bus wreathed in red tape symbolizing government bureaucracy and hitched to a tow truck labeled, ‘This is Clinton Health Care.’ ” They also fought environmental regulations, from acid rain to industrial air pollutants, not through sound policy arguments but by sponsoring populist-appearing agit-prop. More recently, Koch fronts have paid for moonbounces and other festival-type forms of outreach to lobby on issues critical to Koch Industries’ bottom line, like weakening the Environmental Protection Agency rules that affect Koch-owned facilities.
In the end, Koch operatives seem willing to use any marketing device that works, regardless of the truth or how it might affect regular people. In this case, encouraging young Americans to abandon health insurance is worth scoring political points against healthcare reform.
By: Lee Fang, The Nation, September 19, 2013
“The Obamacare Is Falling! The Obamacare Is Falling!”: Here Are The Reasons You Shouldn’t Believe Any Of It
As we approach the full implementation of the Affordable Care Act at the end of the year, confusion still reigns. Most Americans don’t understand what the ACA does or how it works, which is perhaps understandable. It is, after all, an exceedingly complex law, and from even before it passed there was an aggressive and well-funded campaign of misinformation meant to confuse and deceive Americans about it, a campaign that continues to this day and shows no sign of abating. To undo uncertainty and banish befuddlement, we offer answers to a few questions you might have about Obamacare.
What’s Happening When?
The next important date is October 1, when open enrollment for insurance plans on the new exchanges begins. Those who sign up will begin their new insurance on January 1, when the rest of the high-profile components of the law take effect. The individual mandate, requiring everyone to carry insurance or pay a fine, takes effect, as does the rule forbidding insurance companies from denying anyone coverage (or charging them exorbitant premiums) because of pre-existing conditions. In fact, after January 1 the entire notion of the “pre-existing condition” will become nothing but a historical curiosity, a feature of the dark past we’ve moved beyond. Insurance companies will also be forbidden from imposing annual limits on what people are covered for (an accompanying ban on lifetime limits is already in effect). Tax credits for small businesses to offer their employees insurance will be expanded, and millions of low-income Americans will be eligible to be covered through Medicaid. While we talk about January 1, 2014 as the date of full implementation, dozens of provisions have already gone into effect, from free preventive care to expanded coverage for young adults to the closing of the Medicare prescription drug “donut hole” (you can read a comprehensive implementation timeline here if you’re so inclined).
How Many States Are Expanding Medicaid?
There is probably no provision of the ACA that will have a more immediate and profound impact on as many people’s lives as the expansion of Medicaid. In the current system, each state determines how poor you have to be to become eligible for the joint federal-state program, but under the ACA anyone with an income up to 133 percent of the federal poverty level would be eligible. Unfortunately, the Supreme Court declared that states could refuse to accept the expansion, and many states dominated by Republicans couldn’t wait to say “no” to Barack Obama and to their own poor citizens who desperately need insurance, even though the federal government will be picking up almost all of the tab.
The cruel irony is that many of the states refusing the expansion are those that have the largest proportion of poor people who could benefit, and are already the stingiest with Medicaid eligibility. For instance, in Texas, a working adult with children can’t be covered in Medicaid if her income exceeds 25 percent of the poverty level. So a single mother with three children who makes over $5,888 a year is considered too wealthy to get Medicaid. In Alabama it’s 23 percent; in Louisiana it’s 24 percent. These are all states with high rates of poverty, and states where the Republican governors and legislatures have refused to accept the money the federal government is offering to expand Medicaid. In these states, if you’re a middle-income person, you’ll be able to get government subsidies through the new health-care exchanges, but if you’re poor but not quite desperately poor enough to fall below the Scroogian eligibility limits, you’ll get no help at all. These states have essentially cut off their noses to spite Barack Obama’s face, giving up billions in federal money, a reduction in uncompensated care they end up paying for, and a healthier and more productive populace, all so they can give the finger to the President.
When you look at map of which states are accepting the Medicaid expansion, with just a few exceptions it looks a lot like an electoral college map, with Republican states saying no and Democratic states saying yes:
In just the last few weeks, Michigan has decided to accept the expansion, and Pennsylvania has proposed to take the federal money but use it to give low-income citizens private insurance (the Department of Health and Human Services has to approve such a plan). That will bring the total to 25 states plus the District of Columbia accepting the expansion, with another four (Indiana, Tennessee, Ohio, and New Hampshire) still debating the issue. After the Supreme Court’s decision, many predicted that even Republican-dominated states would find the money the government is offering too good to pass up. So far it hasn’t happened, meaning millions of poor Americans who live in Republican states are out of luck. And you’ll be shocked to learn that the poor in these states, mostly in the South, are disproportionately black.
What’s Up With The Exchanges?
Setting up a health-care exchange requires time, effort, and some minimal level of concern for seeing your citizens be able to take advantage of the ACA’s benefits. So it isn’t surprising that nearly all the Republican states that said no to the Medicaid expansion also didn’t choose to bother setting up their own exchange. In the end, 17 states (including D.C.) decided to do it themselves. Another nine are partnering with the federal government on an exchange, leaving 25 states that have left the process entirely to the federal government. This certainly makes HHS’s job harder, but no one yet knows how well those federally-run exchanges will work. All of those 25 have Republican governors, legislatures, or in most cases, both.
One potential pitfall is that in many of those Republican-run states, the state government is taking active steps to sabotage the exchanges, particularly by making the work of the “navigators” as difficult as possible. These are local groups, like universities, hospitals, churches, and the like, who have gotten federal grants and training to help people find their way through the process of getting insurance through the exchange. For example, Georgia is forcing navigators to get special state licenses (the Republican state insurance commissioner pledged to do “everything in our power to be an obstructionist”); Florida has banned them from the grounds of state health facilities. It remains to be seen just how much of an impact the sabotage efforts will have.
Are My Premiums Going To Go Up?
The answer to that question can be summed up as 1) It’s complicated, and 2) It depends. If like most people you get insurance through your employer (or your spouse’s), things probably won’t change for you. Your premiums have risen steadily in recent years, and in the short term, they’ll probably continue to rise. Nevertheless, recent data show a dramatic slowdown in the rate of increase. Last year, premiums rose by 4 percent, half of the 8 percent per year average of the last decade. That mirrors a slowdown in overall health spending. In other words, that curve the ACA was designed to bend is already bending.
If you’re now on the individual market (or uninsured) and you’ll be buying insurance on the exchanges, how much you pay will depend on how old you are, where you live, what your income is, and what plan you choose. If you make less than 400 percent of the poverty level you’ll get a subsidy so that your premium doesn’t rise above a certain percentage of your income; if you want to try to figure out now what it would be, you can read this report to get an idea of what you might pay. While we can’t make any sweeping statements that apply to everybody, there will certainly be a lot of people who find that insurance is more affordable than they thought. On Monday, the Department of Health and Human Services released a report showing that because of the subsidies, 6.4 million people would be able to buy insurance through the exchanges for less than $100 a month. As one Rand Corporation study concluded, “after accounting for tax credits, average out-of-pocket premium spending in the nongroup market is estimated to decline or remain unchanged.” While there are some people who could pay more than they do now—say, young people who make too much to qualify for subsidies, used to have bare-bones insurance, and are now getting one of the more comprehensive plans available through an exchange—overall it doesn’t appear that the threats of “rate shock” will be borne out.
How Many People Are Going To Get Insurance Who Didn’t Have It Before?
This is also a difficult question to answer precisely, because there are a few unknowns. First, over time more states could accept the Medicaid expansion, increasing the number of newly insured people. Second, the fines for those who choose not to carry insurance are quite small, so some people (particularly the young, who are immortal and never get sick) could decide that it’s better to pay a fine that costs less than insurance does, but nobody knows how many of them will. Third, each state will be doing its own outreach to sign people up for the exchanges and for Medicaid; some will inevitably do a better job than others.
All of those variables make precise estimates difficult. One National Bureau of Economic Research experiment to see how uninsured people respond to the cost of getting covered concluded that “75 percent of the uninsured are projected to enroll, implying that 39 million individuals would gain coverage as a result of the law.” The Congressional Budget Office, on the other hand, projects that the ACA will reduce the ranks of the uninsured by 25 million. One thing we can say is that though tens of millions will probably become newly insured, there will still be millions of uninsured people in America. One of the main tasks in coming years will be getting that number as close to zero as we can.
Are There Going To Be Terrible Effects On The Economy?
If you’ve been paying attention to health-care news, you’ve probably seen stories featuring an employer who has 49 employees and says he’d love to hire more people, but since Obamacare’s employer mandate kicks in at 50 employees and he’d have to offer health coverage if he hired anybody else, he won’t do it. It’s quite remarkable how reporters always seem to find that business with just under 50 employees (my suspicion is that the National Federation of Independent Business, a conservative small-business group, finds them, recruits them, and passes them along to journalists). But the truth is that they’re extremely rare. According to the Kaiser Family Foundation, 93 percent of companies that size already offer health benefits, even before the law’s requirements kick in. And the administration has delayed the employer mandate by a year anyway.
Another charge is that employers everywhere are cutting employees’ hours below 30 per week, the level at which the mandate will eventually kick in, so they don’t qualify as full-time. While there are certainly employers who have done this, there’s little evidence it’s happening on a large scale. The number of workers just below that 30-hour cutoff is tiny to begin with and didn’t increase as the original date for the mandate approached. If employers were rushing to cut workers’ hours, those numbers would be large and growing; instead, the opposite is true.
You could condemn an employer who figures out a way to avoid giving her workers health benefits, even if not all of them are as repulsive as John Schnatter, the CEO of Papa John’s, who whined that if he had to give his employees health coverage it could raise the price of a pizza by as much as a shocking 14 cents. But one of the main things the ACA was meant to accomplish was to make those employer decisions less damaging to employees. “Job lock,” where you’re forced to keep a job you’d rather leave in order to hold on to your insurance, will be a thing of the past. And now that affordable insurance will be available to anyone regardless of whether they’ve been sick before, employers can decide to drop insurance without necessarily hurting their employees.
To see how, consider this story. Last week, Trader Joe’s announced that it would no longer be offering coverage for its employees who work less than 30 hours per week. Instead, it will give them $500 and send them to the exchanges. This seemed surprising, since Trader Joe’s is known for being an employee-friendly company. But as the company argues pretty persuasively, employees at that level are likely to get a better deal through an exchange than through their company policy when subsidies are factored in (and of course, the company will save money). We might see this pattern repeated with other employers. But would that be a bad thing? If an employee gets equivalent coverage for less money on an exchange, then they’ve effectively gotten a raise. Companies save money, which allows them to either raise salaries or hire more people. On the other hand, there is a cost to the federal budget of more people getting subsidies, but that may be a cost we’re willing to pay. It may be some time before we know how common an occurrence this is and what effect it’s having on the economy and the budget.
Is Obamacare Going To Make Doctors Quiz Me About Who I’m Sleeping With?
Here’s a good tip: if you read a story with a crazy new allegation about what the Affordable Care Act is going to do to you, there’s a good chance two things are true. First, it’s false. Second, Betsy McCaughey probably had something to do with it. She’s the woman who gave us “death panels,” and her latest bit of crazy is to try to convince you that because of Obamacare, doctors are suddenly being forced to ask you inappropriate questions about your sex life (this is a pattern you’ll become familiar with: she takes an ordinary feature of health care, like the fact that questions about sex are standard practice when taking a medical history, and makes it sound both sinister and a product of Obamacare). You can decide whether this kind of thing is just silly or pernicious and generally despicable (I lean toward the latter), but don’t be surprised if we see a whole round of new allegations like this one. Conservatives failed to stop the ACA from being passed into law, then failed to get it overturned in the Supreme Court, then failed to win the election that would have allowed them to repeal it. They will almost certainly get increasingly desperate after January 1st when the law is implemented and we don’t all suddenly find ourselves standing in breadlines wearing gray sackcloth, our spirits broken by the socialist hellhole into which we’ve descended. So who knows what they’ll come up with.
By: Paul Waldman, Contributing Editor, The American Prospect, September 20, 2013
“You’re Not Invincible”: Young Adults Can’t Afford To Tune Out Obamacare Insurance Requirement
Before passage of the Affordable Care Act, becoming an adult meant getting kicked to the curb when it came to health coverage.
“Our gift when people turned 19 was to take away their health insurance,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. “Turn 19 and we kick them out.”
If you were in college, you could usually stay on your parents’ insurance until you turned 22. But until health-care reform came about, young adults who didn’t find jobs with health coverage or qualified for government insurance were often left uninsured and vulnerable to massive medical bills.
Now there’s a present awaiting young adults.
Thanks to the ACA, commonly referred to as Obamacare, you may now be able to get insurance or continue to be covered under a parent’s plan up to the age of 26. And this coverage is available even if you’re married, not living at home, attending school or are financially independent. Starting next year, young adults up to 26 can stay on their parents’ employer plan even if they have another offer of coverage through an employer.
The downside for some parents is that they might have to pay extra to keep young adult children covered. But at least they will have insurance.
And, in just a few weeks, a new marketplace will open at www.healthcare.gov, giving young adults, particularly those older than 26, another option for obtaining health insurance. Trust me, this is one shopping trip that you need to go on.
There is concern that not enough young healthy adults will buy insurance, which will help offset the cost of those who are older and sicker and will need a lot of health-care services. Some experts believe these concerns are overstated. They note that insurance plans in the new marketplace will cover a core set of benefits such as hospitalization, maternity and newborn care, mental health and substance-use disorder services, and prescription drugs.
With the help of trained personnel called navigators, insurance shoppers will be able to compare plans based on factors including price and benefits. They’ll also be able to determine if they qualify for subsidies to help pay for the coverage.
When you’re young and healthy, you may think you can put off getting insurance. Maybe money is tight and you figure this is something you can delay until you get older, like contributing to a retirement plan.
“Health insurance is something at the moment I feel I can’t afford,” said Josh Nece, 29, a restaurant server in Oakland, Calif.
Nece, who suffers from severe eczema, says with rent, transportation, student loan payments and other expenses, he couldn’t afford the cost of insurance on his own. But he needs insurance to help pay for the medication and doctor visits when his eczema breaks out. He says he often goes without treatment or medication because he can’t afford it.
He plans to check out the marketplace in his state. I’m going to follow up with him to see if he does.
“I’m pretty sure I’m going to get health insurance,” he says. “Going into my 30s, I know it’s one of the adult things I need to do.”
In June, Kaiser asked young adults whether they wanted and valued health insurance. The answer was a resounding yes, contrary to the conventional wisdom about young adults feeling they are invincible.
Still, for those who think they can wait, here’s something to ponder: A tumble off a skateboard could end up costing you $20,000, as it did for Pollitz’s 22-year-old son, who works part time in a day-care center.
“He hit a rock, and the skateboard slid under him,” she said. “He broke his wrist.”
Pollitz said the bill was a “teachable moment.” Thankfully, he was covered on his parents’ plan. Otherwise, “that would have been a financial catastrophe for him.”
It is stories like hers that make Pollitz passionate about getting out the word to young adults to get health insurance. Although most young adults already have coverage, more than 19 million lack basic health insurance. In 2011, 27.9 percent of Americans ages 19 to 25 were uninsured. About the same percentage in the 25-to-34 age bracket also didn’t have insurance, according to Kaiser.
Some young adults might not get health insurance because the penalty for not buying it isn’t stiff enough. If the government determines that you are in the financial position to pay for coverage and you don’t fall under an exemption, you’ll have to pay a penalty for being uninsured when you file your federal income tax. The penalty starts next year at $95 annually for an individual and can go up to $285 for a family, or 1 percent of a family’s household income, depending on which is higher.
I like to believe millennials are smart enough to recognize they can’t afford not to get health insurance. It’s a gift that can keep them not only healthy, but out of medical debt.
By: Michelle Singletary, Columnist, The Washington Post, September 13, 2013
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