“Republican Health Care Panic”: Willing To Risk Economic And Fiscal Crisis To Deny Essential Health Care And Financial Security To Millions
Leading Republicans appear to be nerving themselves up for another round of attempted fiscal blackmail. With the end of the fiscal year looming, they aren’t offering the kinds of compromises that might produce a deal and avoid a government shutdown; instead, they’re drafting extremist legislation — bills that would, for example, cut clean-water grants by 83 percent — that has no chance of becoming law. Furthermore, they’re threatening, once again, to block any rise in the debt ceiling, a move that would damage the U.S. economy and possibly provoke a world financial crisis.
Yet even as Republican politicians seem ready to go on the offensive, there’s a palpable sense of anxiety, even despair, among conservative pundits and analysts. Better-informed people on the right seem, finally, to be facing up to a horrible truth: Health care reform, President Obama’s signature policy achievement, is probably going to work.
And the good news about Obamacare is, I’d argue, what’s driving the Republican Party’s intensified extremism. Successful health reform wouldn’t just be a victory for a president conservatives loathe, it would be an object demonstration of the falseness of right-wing ideology. So Republicans are being driven into a last, desperate effort to head this thing off at the pass.
Some background: Although you’d never know it from all the fulminations, with prominent Republicans routinely comparing Obamacare to slavery, the Affordable Care Act is based on three simple ideas. First, all Americans should have access to affordable insurance, even if they have pre-existing medical problems. Second, people should be induced or required to buy insurance even if they’re currently healthy, so that the risk pool remains reasonably favorable. Third, to prevent the insurance “mandate” from being too onerous, there should be subsidies to hold premiums down as a share of income.
Is such a system workable? For a while, Republicans convinced themselves that it was doomed to failure, and that they could profit politically from the inevitable “train wreck.” But a system along exactly these lines has been operating in Massachusetts since 2006, where it was introduced by a Republican governor. What was his name? Mitt Somethingorother? And no trains have been wrecked so far.
The question is whether the Massachusetts success story can be replicated in other states, especially big states like California and New York with large numbers of uninsured residents. The answer to this question depends, in the first place, on whether insurance companies are willing to offer coverage at reasonable rates. And the answer, so far, is a clear “yes.” In California, insurers came in with bids running significantly below expectations; in New York, it appears that premiums will be cut roughly in half.
So is this a case of something for nothing, in which nobody loses? No. In states like California, which have allowed discrimination based on health status, a small number of young, healthy, affluent residents will see their premiums go up. In New York, people who don’t think they need insurance and are too rich to receive subsidies — probably an even smaller group — will feel put upon by being obliged to buy policies. Mainly, though, those insurance subsidies will cost money, and that money will, to an important extent, be raised through higher taxes on the 1 percent: tax increases that have, by the way, already taken effect.
Over all, then, health reform will help millions of Americans who were previously either too sick or too poor to get the coverage they needed, and also offer a great deal of reassurance to millions more who currently have insurance but fear losing it; it will provide these benefits at the expense of a much smaller number of other Americans, mostly the very well off. It is, if you like, a plan to comfort the afflicted while (slightly) afflicting the comfortable.
And the prospect that such a plan might succeed is anathema to a party whose whole philosophy is built around doing just the opposite, of taking from the “takers” and giving to the “job creators,” known to the rest of us as the “rich.” Hence the brinkmanship.
So will Republicans actually take us to the brink? If they do, it will be crucial to understand why they would do such a thing, when their own leaders have admitted that confrontations over the budget inflict substantial harm on the economy. It won’t be because they fear the budget deficit, which is coming down fast. Nor will it be because they sincerely believe that spending cuts produce prosperity.
No, Republicans may be willing to risk economic and financial crisis solely in order to deny essential health care and financial security to millions of their fellow Americans. Let’s hear it for their noble cause!
By: Paul Krugman, Op-Ed Columnist, The New York Times, July 25, 2013
“Political Skullduggery”: Indiana Fudges Truth On Health Exchange Rates To Make Obamacare Look Bad
Sometimes, the political urge simply overwhelms anything resembling common sense and appropriate behavior.
Witness the latest example of political skullduggery playing out in the great State of Indiana where GOP Governor Mike Pence has found it necessary to take extreme liberties with the reporting of the state’s healthcare exchange data—all to justify his anti-Obamacare political positioning.
Anyone paying attention to data projecting what a health insurance policy will likely cost on the newly formed individual policy insurance exchanges could hardly miss the headlines late last week announcing that premiums for health insurance policies stood to rise to an average monthly price of $570—a 72 percent increase over current rates in Indiana.
Of course, if this data is correct, it would be quite a blow to Indiana residents at the hand of the dreaded Obamacare.
At first glance—the only glance the Indiana officials intend for you to see—this is certainly disturbing news. Even those willing to accept the projections and claims made by the President during last week’s health care address—where he referred to the ‘good news’ in California, Oregon, Washington and, particularly, New York—would have to come to the understanding that there may, indeed, be states where the law is going to badly hurt consumers.
Fortunately, there are those whose job it is to dig below the surface of that ‘first glance’ to discover the truth of any situation—and, in this situation, we learn that Indiana has sought to play cute in its efforts to present a grim picture of the healthcare reform law, even when the data reveals otherwise.
You see, while the states that have already released their projections have based their price expectations on what insurance company filings suggest will be the cost of a ‘Silver’ plan (the second least expensive option to be offered on the exchanges), Indiana decided to publish their projections based on a calculation that took all the levels of plans to be offered—ranging from the less expensive Bronze and Silver plan to the most expensive Gold and Platinum plans—and averaged them all together to come up with their projected rates.
As Sy Mukherjee points out, “That’s like saying the average cost of a car in an Indiana dealership is $100,000 because it sells $20,000 Fords, $60,000 BMWs, and $220,000 Lamborghinis — technically true, but highly misleading.”
Exactly.
What possible benefit can there be to taking an average of costs ranging from most expensive to least expensive when we know full well that the overwhelming majority of those living in Indiana—and, for that matter, everywhere else—will purchase the policies in the lower cost ranges?
How do we know this?
We know this because we have the evidence of buying patterns provided by the State of Massachusetts, a state that has been utilizing this system for quite some time now.
As Sarah Kliff at the Washington Post reports—
“In Massachusetts, 8 percent of enrollees bought a gold plan. Eighty-four percent chose bronze or silver. At least one carrier in Indiana seems to agree with this distribution. In state rate filings, Physicians Health Plan of Indiana estimates that 45 percent of its enrollees will pick bronze and 38 percent take up silver. It is expected that the average mix of Individual Market will be more toward less rich benefit plans and credit should be given for the associated reduction in induced utilization,” the company wrote in its filing. In other words, the average plan cost isn’t a great estimation of what the average person will pay.”
Ms. Kliff also did a little digging to discover that the actual prices for Bronze and Silver plans in Indiana are going to be far below the $512 a month estimate provided by the state’s government.
“Anthem’s rate filing includes projections for health insurance costs in their bronze plans. A 47-year-old male who does not smoke would be charged, on average, $307 per month. Sample plans from another plan, MDWise, predict a 47-year-old man will be charged $294 and $391 for a bronze and silver plan, respectively.”
While you may find the actual rates of the policies to be made available on the Indiana individual exchange to be good news or bad— depending on what you currently pay for health coverage—one would at least hope that the state would want to put out an honest analysis.
“No Unchecked Corporate Power”: If Republicans Love Competition, Why Do They Still Hate Obamacare?
When asked what makes the world work, any self-respecting right-wing Republican knows the politically correct answer: competition! (With at least one exclamation point.) It is the paramount principle and universal solvent perennially touted by the right to cure whatever ails us – in the abstract.
What they don’t seem to like so much, in reality, is the competitive impact of the Affordable Care Act, which is forcing health insurance companies into a contested marketplace – and seems to be driving down rates, state by state. The latest data arrived this week from New York, where insurance regulators announced that the new rates approved for 2014 will be 50 percent lower, on average, than current rates.
That stunning report follows similar news from California, where rates may drop by as much as 29 percent, as well as Oregon, Rhode Island, Vermont and several other states where the early indications show rates declining. Based on data compiled from 10 states and the District of Columbia, the Department of Health and Human Services says that 2014 premiums for mid-range (or “silver”) health care plans in those states will be nearly 20 percent lower on average than its own earlier estimates.
The reason is simple, as anyone familiar with the American health care marketplace knows. Most states until now have had no meaningful competition among insurance companies — and certainly nothing like the health insurance “exchanges” created by Obamacare to guide consumer choices.
In states that have actively promoted the exchanges, real competition is arising thanks to a marketplace that allows consumers to examine and understand choices, plans, and prices with ease. “That’s a very different dynamic for these companies, and it’s prodding them to be more aggressive and competitive in their pricing,” explains Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reform.
For those of us who preferred (and still favor) a single-payer system providing Medicare to everyone, the compromises of Obamacare always provoked doubts about efficiency and fairness. Many liberals supported the Affordable Care Act reluctantly as a bad deal that was acceptable only in lieu of no deal.
But why do self-styled conservatives continue to hate health care reform with such ferocity? They may not care that it is truly “pro-life” and “pro-family,” with the clear promise of saving thousands of lives annually among families that were previously uninsured. Yet they should surely appreciate a statute that promotes competition where there was none, improving services and reducing prices through freer enterprise.
Solving that conundrum exposes one of the ugly little secrets of the Republican right today – and one of many reasons why that movement no longer merits the honorable title of “conservative.” For what we can now observe in practice is that the Republicans perversely prefer a corporate marketplace without competition over a marketplace with competition overseen by government. While European conservatives have long accepted the need for strictly regulated markets, especially in health care, their American counterparts would rather allow corporate power to run unchecked at whatever cost.
It is an ideological preference that damages public health, ruins finances both public and private, and actually kills people every day, but it also swells corporate profits – which seems to be the primary value cherished by Obamacare’s partisan opponents. Such destructive irrationality is what passes for “conservatism” in our time.
So the congressional Republicans persistently attack and undermine reform, as they did by passing a resolution this week to delay the law’s individual mandate. Rather than do anything productive, they proceeded with that meaningless action. And they did so despite warnings from the insurance industry that a delay would only increase rates for everyone.
Supporters of the Affordable Care Act have long reassured each other that the law would gain popularity someday. But if present trends continue, the public may come to realize as early as next year that the benefits of Obamacare greatly outweigh the flaws – and that the law’s opponents offer nothing to most Americans except higher rates, less coverage, and a sicker, sadder, harder life.
By: Joe Conason, The National Memo, July 19, 2013
“Under Obamacare, Millions Will Die”: The Coming Campaign Against The Affordable Care Act
I have questions. For instance, are Charles and David Koch aliens from the planet Fnerzblax 6, come here to feast on the entrails of Earth humans to give them strength for their coming war with the barbarians of Fnerzblax 4? We don’t know, and that’s what has me so concerned.
I ask because Americans for Prosperity, the group through which the Kochs channel much of their political activism, is initiating a new television campaign to get people afraid of and angry about Obamacare, and this seems to be the method of the campaign. The first ad, called “Questions,” asks whether Obamacare is going to take money from a worried-looking young mother and deprive her sick child of the care he needs to survive. Not that it would truly do these things, but hey, she’s just asking: http://youtu.be/XOMAuo4C8kk
Beyond the just-asking format, there’s a preview here of something else we’ll be seeing as Obamacare gets implemented over the next couple of years. Every problem that anyone has with anything related to health care will be characterized as a consequence of Obamacare, which in some tortured sense might be almost true. The ad mentions not being able to choose your doctor, which would be bad. If you chose an insurance plan in an exchange established by Obamacare, that plan will probably have a network of doctors from which you have to choose if you want your care paid for, and if your doctor isn’t on it, then you’ve been prevented from choosing your own doctor.
Of course, that isn’t because of Obamacare, it’s because of the way insurance works in America; it’s how it worked before Obamacare, and it’s how it’ll work after Obamacare. But it’s a lot simpler to say, “Now that we’re under Obamacare, I didn’t get to choose my doctor!” And did you know that under Obamacare, medications could come with dangerous side effects? Or that under Obamacare, kids who get shots will cry? Not only that, under Obamacare, you could get cancer and die—even if your doctor wanted to save you. In fact, under Obamacare, we’re all going to die one day. Thanks for all the misery, pain, and death, Obama.
By: Paul Waldman, Contributing Editor, The American Prospect, July 8, 2013
“Holy Crap”: Christian Employers Claim Their Religion Puts Them Above the Law
Ready for the next court fight over Obamacare? Get to know Hobby Lobby, the chain of stores fighting the Affordable Care Act’s requirement that the health insurance employers offer their employees cover contraception, and the next Christian martyr to the unholy scourge of health coverage for employees. Hobby Lobby’s owners are conservative Christians, and though their company isn’t a church, they’d like to choose which laws they approve of and which they don’t, and follow only the laws they like. And a federal appeals court just ruled that not only can their suit go forward, but they’re likely to win. Because apparently, “This law violates my religious beliefs” is now a get-out-of-jail-free card.
The decision is simply mind-blowing, essentially finding that private businesses are just like religious institutions, and therefore they can decide which laws they have to obey:
“Hobby Lobby and Mardel have drawn a line at providing coverage for drugs or devices they consider to induce abortions, and it is not for us to question whether the line is reasonable,” the judges wrote. “The question here is not whether the reasonable observer would consider the plaintiffs complicit in an immoral act, but rather how the plaintiffs themselves measure their degree of complicity.”
Hobby Lobby Stores Inc., Mardel Inc. and their owners, the Green family, argue for-profit businesses — not just religious groups — should be allowed to seek an exception if the law violates their religious beliefs. The owners approve of most forms of artificial birth control, but not those that prevent implantation of a fertilized egg — such as an IUD or the morning-after pill.
Hobby Lobby is the largest and best-known of more than 30 businesses in several states that have challenged the contraception mandate. A number of Catholic-affiliated institutions have filed separate lawsuits, and the court suggested faith-based organizations can follow for-profit objectives in the secular world.
“A religious individual may enter the for-profit realm intending to demonstrate to the marketplace that a corporation can succeed financially while adhering to religious values. As a court, we do not see how we can distinguish this form of evangelism from any other,” they wrote.
I’m not a lawyer, so maybe there’s something I’m missing here, but my reaction upon reading this was, “Holy crap!” It’s not for the court to question whether Hobby Lobby’s interpretation of what laws it would rather follow is correct? Seriously? And they don’t see how they can distinguish selling pipe cleaners and finger paint from any other form of evangelism?
Before we get to the core question here, it’s just incredible that one of the reasons the court found in favor of Hobby Lobby was that the company didn’t want to pay for insurance that would pay for “drugs and devices that the plaintiffs believe to be abortifacients.” But what they believe is utterly irrelevant. One of the methods they object to is Plan B, the morning-after pill. But Plan B isn’t an abortifacient. The plaintiffs can choose to “believe” that it is if they want, but they’re asking that the state accept their belief as if it were true just because they believe it, and thereby exempt them from obeying the law. In effect that creates a justification for anyone who wants to ignore the law to create their own factual universe, then use that invented universe to say they’re exempt from the laws everyone else has to follow. If you get caught by a speed camera going 50 in a 35 zone, you can’t say, “Your honor, I believe that all speed cameras automatically register cars as going 15 miles per hour over their actual speeds. Therefore, I was going 35, and I am exempt from this fine.”
This is not the last challenge we’re going to see to this part of the ACA; there are going to be many other companies coming forward to say, “We’re Christian, so therefore the law doesn’t apply to us.” But just think for a moment about the principle they’re using to justify that position. There isn’t any question about the constitutionality of this provision of the ACA. It was passed by Congress and signed by the President. It’s the law of the land. But these private companies are saying that they have the right to choose which laws they obey, simply by saying “It’s my religion.”
To put this in context, the law doesn’t distinguish between “real” religions and fake religions, and properly so. One of the reasons we have the religious freedom we do in America is that the founders didn’t want to set up a system like the one that existed in Europe, where there was a single state religion and none others had protection. So if you want to get married by a clergyman from the Church of Holy Toenail, you might have to fill out some extra paperwork, but you’ll be able to do it.
And that means that if we apply this rationale more broadly, anyone, whatever religion they claim to believe in, should be able to declare themselves exempt from any law they don’t like. And what’s more, they don’t even need any evidence from their religious tradition or texts to justify it. You know what the Bible says about contraception? Absolutely nothing. Not a word. But along the way, some Christians decided that God disapproves of contraception, even though most Christians use it. So now anyone can declare that their religion, i.e. their personal interpretation of their religion, has a greater legal force than actual laws.
I have to pay taxes? Sorry, I’m a Hindu, so I think taxes are an abomination unto the Lord. Sure, there’s no justification for that position in any Hindu text, but the Bible says nothing about contraception either, and Christians are getting an exemption for that, so I decided that Hinduism forbids tax paying. You caught me breaking into my neighbor’s garage and stealing his nice new 18-volt cordless drill? Well, I’m a Buddhist, and I believe that private property is an impediment to enlightenment, so what’s his is mine. The zoning laws in my neighborhood forbid retail establishments? Sorry, I’m a member of the Church of the Homemade Energy Bar, which mandates that all adherents sell energy bars out of their homes, so the zoning rules don’t apply to me.
I only skimmed the decision in this case, so maybe there’s something there I missed that makes this seem less appalling. But religious organizations get all kinds of special treatment from the government as things stand today, and what the plaintiffs in this case (along with their supporters) seem to be arguing is that religious people ought to enjoy a special privileged status that puts them above the law.
By: Paul Waldman, Contributing Editor, The American Prospect, June 28, 2013
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