“What A Terrible Thing To Do To People”: Republican Attacks On Obamacare Are Turning Into An Argument Against Repeal
If health insurance isn’t important, why would receiving a letter telling you that you need to change your plan be a tragedy that can get you on Fox News nearly immediately?
Republicans have seized on the millions of cancellations of current plans happening as a result of the Affordable Care Act remaking the individual insurance market, which currently offers the worst customer satisfaction of any type of health coverage.
By glorifying these “horror” stories, which have often turned out to be overinflated at worst and actual Affordable Care Act (ACA) success stories at best, Republicans are sending a clear message to Americans: We must defend the sanctity of health insurance.
This powerful theme is extremely opportune, as long as cancellation notices are contradicting a promise the president made, Healthcare.gov is flagging and the ACA’s paid enrollment numbers are low. However, it becomes much more complicated as the site starts working and 2014 begins with millions of people enjoying health care coverage and subsidies that the GOP would be voting to take away.
This would effectively doom the “repeal” strategy Republicans have fixated on for years, argues Salon’s Brian Beutler:
Obamacare is driving policy cancellations right now, but it at least creates a coverage guarantee for those affected. Repeal without replace would impose a greater burden without providing any counterweight.
If they pass the Keep Your Health Plan Act this week, House Republicans will see their stylized sympathy for people whose policies have been canceled come into tension with their explicit desire to take Obamacare benefits away from many of the same people, and millions more.
Becoming the party that opposes all cancellations of insurance policies also completely undermines any Republican “plan” that might be an alternative to the ACA. “Such a starting position would make true market-oriented reform impossible,” explains The Washington Examiner‘s Philip Klein.
John McCain’s health care plan, one part of his platform conservatives love, would have ended health care tax exemptions for employers and employees. This would have likely resulted in millions and millions of Americans ending up in new plans. The Republican Study Committee has offered a “serious” Obamacare alternative that would try to end the system of employer-based health care, disrupting the current health care system far more than the ACA does.
Even as Republicans are vindictively leaping on any cancellation story, other right-wing groups are trying to spread the idea to people in their 20s to optout of the ACA, even though millions of younger Americans can get coverage for free. One Koch-funded group, Generation Opportunity, brought its scary Uncle Sam and some models to tailgate before the University of Miami-Virginia Tech football game to let the students know that opting out of health insurance is, as the kids say, cool.
So health insurance is lame and having it changed in any way whatsoever is the greatest atrocity an American can be expected to suffer.
Republicans have been fine with these kinds of contradictions throughout President Obama’s time in office. The deficit suddenly became a problem on January 21, 2009. Tea Partiers demanded that we get our gubmint hands off their Medicare. The GOP won the House by campaigning against cuts to Medicare that they then included in Paul Ryan’s budget.
But there is evidence that efforts to actually take something away from Americans results in a substantial backlash.
The wave of voting restrictions across the South after the 2010 election was mostly blocked by the federal courts empowered by a Voting Rights Act that had not yet been gutted. But Republicans did successfully restrict early voting in the crucial swing states of Ohio and Florida. Despite this, or as a result of it, African-American turnout hit an all-time high in the 2012 election.
North Carolina passed some of the most radical voting restrictions on students in the nation and local Republicans specifically attempted to block Elizabeth City State University senior Montravias King from running for city council where he was attending college. Their efforts backfired.
“On October 9, King was elected to the Elizabeth City city council, winning the most votes of any candidate,” The Nation‘s Ari Berman reported. “He’s now the youngest elected official in the state.”
Students must have figured: If voting weren’t important, why would Republicans be doing everything they can to stop me from doing it?
In only 10 states, 444,000 people have already signed up for Medicaid. The fact that the GOP would deny them and about five million more poor people health insurance isn’t big news for a couple of reasons.
First, they’re poor. Second, these people haven’t had anything taken away from them — yet.
But on January 1, the story changes. Suddenly Republicans will be trying to do exactly what they’re accusing President Obama of: taking away health insurance with nothing to replace it. And thanks to the GOP, now it’s clear what a terrible thing that is to do to a person.
By: Jason Sattler, The National Memo, November 12, 2013
“Obamacare Expansion In The Offing?”: Republicans Crying About People Losing Junk Insurance Should Expand The ACA
Every few days, a new poster child for the horror of Obamacare comes along, the person who just loves their insurance plan but has been told it’s being cancelled. Pretty much every time, their story turns out to be full of holes—the plan they’re on is junk insurance, they’d be able to get better and cheaper coverage through the exchanges, and so on (here’s the latest). But without a doubt, this small group of people (and not, say, the millions who are getting free or low-cost coverage for the first time) have become the momentary face of the Affordable Care Act, at least in the mainstream news media’s eyes.
So now the administration is scrambling to deal with this political problem, and here’s the latest twist:
The most popular idea for a fix on the Hill is legislation that would entitle someone who purchases health insurance coverage through the end of this year to keep that coverage. Other legislative responses may include extending the health exchange enrollment deadline or or delaying the penalty for not purchasing coverage.
Obama is also considering a different approach.
According to the administration source, the White House is “looking at an administrative fix for the population of people in the individual market who may have an increase in premiums, but don’t get subsidies.”
Such a fix would address the issue of “sticker shock” that has been popping up across the country, as individuals are losing their coverage and finding only higher-cost alternatives. Under the ACA, there are tax subsidies to help individuals and families with income between 133 percent and 400 percent above the poverty level purchase insurance. Those with incomes higher than 400 percent above poverty get no such assistance. The proposed administrative fix would address this group.
Allowing the junk insurance plans to continue is a terrible idea, no less terrible because it’s being pushed by some Democrats. But giving more subsidies? That’s got some promise. As a big-government liberal, I’m all for the government helping as many people as possible afford coverage. I’m also very skeptical that the administration can just take this move administratively without an act of Congress, but let’s talk about it. Since for the first time in history Republicans are suddenly so very concerned about people not being able to afford health insurance, perhaps they can be pressured into signing on with something that puts their money where their mouths are.
Fat chance, I know. But as long as we’re going to start proposing fixes, how about we let everyone who got a threatening letter from an insurance company buy in to Medicare? If Republicans are going to take the opportunity to demagogue the issue, why not take the opportunity to expand our extremely popular socialized medicine program?
By: Paul Waldman, Contributing Editor, The American Prospect, November 8, 2013
“A Market Of Systematic Discrimination”: President Obama Shouldn’t Apologize For Blowing Up The Terrible Individual Market
Last night, NBC’s Chuck Todd asked President Obama about the people losing their health insurance despite his promise that “anyone who likes their plan can keep it.” (See the video and read the transcript here.)
“I am sorry that they are finding themselves in this situation based on assurances they got from me,” Obama replied.
The answer is a bit of a dodge. People aren’t finding themselves in this situation based on the president’s promises. They’re finding themselves in this situation based on his policy. And Obama isn’t apologizing for the policy.
“Before the law was passed, a lot of these plans, people thought they had insurance coverage,” he said. “And then they’d find out that they had huge out of pocket expenses. Or women were being charged more than men. If you had preexisting conditions, you just couldn’t get it at all.”
Obama was wrong to promise that everyone who liked their insurance could keep it. For a small minority of Americans, that flatly isn’t true. But the real sin would’ve been leaving the individual insurance market alone.
The individual market — which serves five percent of the population, and which is where the disruptions are happening — is a horror show. It’s a market where healthy people benefit from systematic discrimination against the sick, where young people benefit from systematic discrimination against the old, where men benefit from systematic discrimination against women, and where insurers benefit from systematic discrimination against the uninformed.
The result, all too often, is a market where the people who need insurance most can’t get it, and the people who do get insurance find it doesn’t cover them when it’s most necessary. All that is why the individual market shows much lower levels of satisfaction than, well, every other insurance market:
(Graph by Jon Cohn)
Those numbers, of course, don’t include the people who couldn’t get insurance because they were deemed too sick. Consumer Reports put it unusually bluntly:
Individual insurance is a nightmare for consumers: more costly than the equivalent job-based coverage, and for those in less-than-perfect health, unaffordable at best and unavailable at worst. Moreover, the lack of effective consumer protections in most states allows insurers to sell plans with ‘affordable’ premiums whose skimpy coverage can leave people who get very sick with the added burden of ruinous medical debt.
Jonathan Cohn puts a human face on it:
One from my files was about a South Floridian mother of two named Jacqueline Reuss. She had what she thought was a comprehensive policy, but it didn’t cover the tests her doctors ordered when they found a growth and feared it was ovarian cancer. The reason? Her insurer decided, belatedly, that a previous episode of “dysfunctional uterine bleeding”—basically, an irregular menstrual period—was a pre-existing condition that disqualified her from coverage for future gynecological problems. She was fine medically. The growth was benign. But she had a $15,000 bill (on top of her other medical expenses) and no way to get new insurance.
This is a market that desperately needs to be fixed. And Obamacare goes a way toward fixing it. It basically makes the individual market more like the group markets. That means that the sick don’t get charged more than the well, and the old aren’t charged more than three times as much as the young, and women aren’t charged more than men, and insurance plans that don’t actually cover you when you get sick no longer exist. But the transition disrupts today’s arrangements.
(Interestingly, recent Republican plans have focused on disrupting the employer market by ending, limiting, or restructuring the tax exclusion for employer-based plans. There’s an extremely good case to be made that that needs to be done, but it means much more disruption for a much larger number of people. Obamacare’s focus on disrupting the individual market — and only the individual market — is a more modest approach to health-care reform.)
There’s been an outpouring of sympathy for the people in the individual market who will see their plans changed. As well there should be. Some of them will be better off, but some won’t be.
But, worryingly, the impassioned defense of the beneficiaries of the status quo isn’t leavened with sympathy for the people suffering now. The people who can’t buy health insurance for any price, or can’t get it at a price they can afford, or do get it only to find themselves bankrupted by medical expenses anyway have been left out of the sudden outpouring of concern.
If people have a better way to fix the individual market — one that has no losers — then it’s time for them to propose it. But it’s very strange to sympathize with the people who’ve benefited from the noxious practices of the individual market while dismissing the sick people who’ve been victimized by it.
Obama is rightly taking flack for making a promise he wasn’t going to keep, and he’s right to apologize for it. But he shouldn’t apologize for blowing up the individual market. It needed to be done.
By: Ezra Klein and Evan Soltas, WonkBook, The Washington Post, November
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