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“Conservative Crybabies Lose Again”: The Right’s Laughable New Obamacare Conspiracies, Officially Debunked

If you click through a few conservative news websites, you’ll learn all about the latest and most nefarious bit of lawless chicanery from the Obama administration as it tries to paper over the Affordable Care Act’s obvious failures. Jumping off from a New York Times report that the Census Bureau “is changing its annual [healthcare] survey so thoroughly that it will be difficult to measure the effects of President Obama’s health care law in the next report,” conservatives have put two and two together and come up with CONSPIRACY.

Megan McArdle asks, “Is Obama cooking the Census books for Obamacare?” Townhall’s Guy Benson suspects this change was implemented to boost Democratic fortunes for the midterms: “The brand new survey questions will unquestionably ‘reveal’ a dramatic decrease in the uninsured population, bureau experts say, which will deliver Democrats a super handy talking point. And oh-by-the-way, the artificially improved numbers will be released … this fall.” Mediaite’s Noah Rothman writes that the conservatives who argle-bargled in 2009 about the White House politicizing the census now look prescient. “The fears of some that the Census Bureau could be corrupted by the imperatives of the political operatives in the White House was today proven accurate.”

Nonsense. The timing of the switch is obviously not ideal, though, as Vox’s Sarah Kliff notes, the new methods will be used to collect data for 2013, before the state marketplaces went up and the Medicaid expansion took effect. The suggestion of political interference from the White House, however, is a bombshell accusation that, despite Rothman’s insistence, is nowhere near being “proven.” Evan McMorris-Santoro of BuzzFeed talked to a census official who said that the White House had precisely zero involvement in the changes implemented, and that the bureau had been discussing the shift “way before the ACA was an idea.”

Regardless, it’s a big story on the right, and not just because conservatives love a good conspiracy. In the past week or so, conservatives have seen their reliable avenues for attacking the Affordable Care Act evaporate right in front of them.

The announcement that Kathleen Sebelius was stepping down as Health and Human Services secretary sparked a brief round of schadenfreude and some enthusiastic sand-kicking at Ezra Klein, but ultimately Sebelius’ departure means that Republicans and conservatives have lost one of their favorite ACA punching bags. Her successor-in-waiting, Sylvia Mathews Burwell, is an experienced administrator and the rarest of rare things: an Obama administration official who is actually on good terms with key Republicans in Congress. They’ll have a tough time painting her as controversial, and (assuming she’s confirmed) Burwell will assume control of Obamacare as it swings upward from its functional and political nadir.

Speaking of which, as conservatives are trying to suss out White House manipulation of the Census Bureau, Obamacare keeps on doing exactly what it was intended to do. This week the Congressional Budget Office found that Obamacare will cover more people for less money than initially estimated, and that insurance premiums likely will not spike next year, thus driving a stake through three core conservative attacks on the health law.

Health insurers, who just last month were floating anonymous warnings of massive premium increases, are now starting to warm to the state health exchanges. “At least two major national insurers intend to expand their offerings,” reported Politico on April 16, “although a handful of big players like Aetna, Humana and Cigna, are keeping their cards close for now. None of the big-name insurers have signaled plans to shrink their presence or bail altogether after the first rocky year. And a slew of smaller health plans are already making moves to join more states or get into the Obamacare business for the first time.”

And, in a development that should shock no one, Gallup found that in states that embraced Obamacare (i.e., set up their own health exchanges and expanded Medicaid) the rate of uninsured adults declined three times faster than in those states that rejected the Medicaid expansion or had the feds set up their insurance marketplace. All told, Gallup’s findings translate to about 10 million newly insured Americans.

Obamacare works in states that want it to work, and the tangible benefits of that success are putting pressure on Republicans who have to date been antagonistic toward the law. As Greg Sargent observed, Republican Senate candidates are now suddenly reticent when it comes to discussing the Medicaid expansion. Most notable among them is Tom Cotton in Arkansas, where Medicaid was expanded under a compromise measure in which federal dollars are used to purchase private plans. Cotton supports the full repeal of Obamacare, but won’t comment specifically on Arkansas’ “private option” for Medicaid, amusingly dismissing it as “a state-based issue.”

I certainly don’t want to leave the impression that the Affordable Care Act has been neutralized as a political issue or that it won’t face problems down the road – a looming increase in healthcare costs, for example. But for now Obamacare is shoring up some of its biggest political vulnerabilities, leaving conservatives to sputter about census conspiracies.

 

By: Simon Maloy, Salon, April 17, 2014

 

April 18, 2014 Posted by | Affordable Care Act, Conservatives, Obamacare | , , , , , | Leave a comment

“As Dumb As It Is Predictable”: The Dumbest Thing The Right Is Saying About Sebelius’ Replacement

President Obama may have had troubles with the Healthcare.gov rollout, but he’s rolling out a replacement for departing Health and Human Services Secretary Kathleen Sebelius nicely. Appointing Sylvia Mathews Burwell, who was confirmed last year to head the Office of Management and Budget 96-0, virtually insures he’ll get someone into Sebelius’ seat before midterm politics heat up.

That doesn’t mean the right won’t try to throw garbage at the centrist and well-respected Burwell. On PJ Tatler today they’re calling her “the person who shut down the veterans’ memorials,” because as OMB chief, she signed the memo telling agencies “to execute plans for an orderly shutdown due to the absence of appropriations” when Sen. Ted Cruz and the GOP shut down the government last year.

You’ll recall that Cruz and the right had the audacity to blame Obama and the Democrats for the shutdown, which backfired on them spectacularly. But not before Cruz, Sarah Palin and a Confederate-flag-waving moron challenged the closure of the World War II veterans’ memorial with a protest that moved to the White House, where Larry Klayman told President Obama “to put the Quran down … and come out figuratively with your hands up.” Good times.

So yeah, they’re going to try that whole thing again, but it’s not going to work. (An aside: this NBC News story calls Burwell “the woman who ordered the government shutdown,” which at the time probably seemed like a feature writer’s flourish to pull people into a dull story about the OMB director, but in hindsight didn’t accurately describe the way the mess unfolded.)  Sen. John McCain immediately tweeted, “Sylvia Burwell is an excellent choice to be the next #HHS Secretary.” While righties are hoping that red state Democrats will turn on the woman who supposedly ordered the shutdown of veterans’ memorials, Sen. Joe Manchin praised Burwell’s appointment, too. (It probably helps that she’s from West Virginia.)

On the larger question of Sebelius’ legacy, we can only say that millions of people got health insurance, and millions more still need it. Ezra Klein trolled the right by declaring that it means “Obamacare has won,” which is pretty funny given that he helped lead the national freak-out over Healthcare.gov’s troubles back in October. Jonathan Cohn has a more balanced take in the New Republic. He acknowledges Sebelius’ management mistake in letting the federal exchange website’s troubles mount without letting the president know – there’s evidence she herself didn’t know – but he appropriately notes she’ll be remembered for the millions newly insured, particularly because she worked hard with Republican governors who bucked conservative constituencies to expand Medicaid.

Of course, confirming Burwell won’t mean the GOP stops trying to sabotage the Affordable Care Act. They had mostly stopped blaming Sebelius, because the new talking points say nobody could have made the law work, because by definition it can’t work. Having done everything in their power to insure it can’t work, which is literally costing American lives, they blame Obama for its shortcomings. However brilliant an HHS pick she may be, Sylvia Burwell can’t change that.

 

By: Joan Walsh, Editor at Large, Salon, April 11, 2014

April 12, 2014 Posted by | DHHS, Government Shut Down | , , , , , , , | Leave a comment

“Extending The Hardship Exemption”: You Can Still Have Weak Health Insurance Under Obamacare, For Now

If you liked your old skimpy health plan, you may not be able to keep it. But now you can get a new, somewhat skimpy health plan instead, at least for a little while.

That’s a rough translation of an Obamacare policy change that the Administration announced on Thursday. The change, first reported by Louise Radnofsky of the Wall Street Journal, represents yet another effort to help people about to lose their existing insurance policies, usually because those policies do not comply with the Affordable Care Act’s standards for benefits and pricing. Those old policies left out major benefits, were sold only to people without pre-existing conditions, and so on.

As you know, plan cancellations have been a source of tremendous controversy—and, for the president, immense political grief. Some estimates have suggested several million people received these cancellation notices. The vast majority of those people have already found new coverage, either directly through insurers or through one of the Obamacare exchange websites, according to the Administration. While some are paying more money, others have discovered that the new policies are cheaper—or, at least, are grateful for the extra protection. Lucia Graves of National Journal wrote about some of their stories the other day.

But some people still haven’t found insurance. Administration officials think, based on conversations with state regulators and insurers, that about half a million people fall into this category. That’s half a million people who could, because of the individual mandate, face tax penalties because they have declined to get affordable coverage.

Now, however, people with cancelled policies have a new option. The individual mandate has always contained a hardship exemption: If you qualify for it, you don’t have to pay the penalty and you have access to the cheaper, slightly less comprehensive catastrophic insurance plans otherwise available only to people under 30. The only question with the hardship exemption has been who gets it. The law gives the administration flexibility over that question and, on Thursday, Health and Human Services Secretary Kathleen Sebelius announced that it would apply to people who just lost their policies and are unable to find replacements that cost the same or less money.

HHS made the announcement by posting a guidance and sending a letter to a half-dozen more conservative members of the Senate Democratic caucus. And neither document answers all of the relevant questions, like how strictly the government will apply the new criteria or for how long this exemption will last. (Administration officials say it will be temporary.)

Conceptually, making the change is not so different from allowing more people to have grandfather protection for their existing coverage—after all, it’s basically telling people who have bare-bones coverage now that they can take out bare-bones policies next year. And imposition of the individual mandate was always supposed to be a gradual process. The financial penalty starts out relatively low, but will increase in 2015 and 2016. The administrative flexibility over the hardship exemption was designed to give the administration some leeway over enforcing the mandate, particularly early on, in order to ease the transition to a new and reformed insurance market. (The Massachusetts reforms, which were a model for the Affordable Care Act, also included a hardship exemption and called for increasing penalties over time.)

Administration officials don’t seem to think many people will take up this new option. They are probably right about that. Catastrophic policies aren’t dramatically different in coverage from the “bronze” policies, which cover 60 percent of the typical person’s medical expenses and comply with all Obamacare requirements. But if you buy a catastrophic policy, you’re not eligible for federal tax credits. If you buy a bronze policy, you are. As a result, most lower- and middle-income people would probably still find the bronze policies a better deal.

Still, some people—primarily, the ones who don’t qualify for subsidies—will opt for the catastrophic policies because they will be moderately cheaper. And some people will opt not to get insurance at all. That will mean fewer people in good health paying premiums for the exchange policies. That’s a potential problem for insurers, who count upon those premiums to offset the medical bills of people in poor health. (For health policy wonks: The catastrophic policies are an independent risk pool, separate from other policies in the exchanges. So for every person who selects one of those policies, that’s one fewer person putting premiums into the larger pot of money for the exchange policies.) There’s also a danger that, as Ezra Klein points out, the administration will come under more pressure to pull back on the mandate for other people. “This latest rule change could cause significant instability in the marketplace and lead to further confusion and disruption for consumers,” said Karen Ignani, president of America’s Health Insurance Plans.

Yes, insurers say those sorts of things all the time. And this singular change probably won’t cause serious, irreparable harm, any more than any of the previous ones did. The number of people whose behavior changes is likely to be small and the new system is more resilient than most people realize. But even minor changes can become major if there are enough of them.

Note: This item has been updated. As a friend reminds me, even the catastrophic plans under Obamacare aren’t that skimpy. They still cover all essential benefits, for example, and the actuarial value really isn’t much different from bronze plans.

By: Jonathan Cohn, The New Republic, December 21, 2013

December 21, 2013 Posted by | Affordable Care Act, Health Insurance Companies | , , , , , , , | Leave a comment

“No, The World Didn’t End”: Maybe We’ll All Survive After All

I’m a bit amused at some of the articles dribbling out of Washington at present that find various silver linings for the demise of the filibuster against executive-branch and lower-court-judicial appointments. I mean, we all know it Killed the Senate As We Know It, at which act the angels are still weeping, and it spoiled the great and dignified work of the “gangs” cutting ad hoc deals to avoid this or that filibuster. I know it’s hard to imagine anything that would significantly offset such terrible damage–what will Lindsey Graham do between primary challenges?–but The Hill‘s Elise Viebeck finds one that has the added bonus of giving Republicans a trophy to mount on its wall:

Kathleen Sebelius may become the biggest loser in the Senate’s approval of filibuster reform.

The Health and Human Services (HHS) secretary has kept her job despite the botched rollout of ObamaCare’s insurance exchanges, but it will now be easier for Obama to replace her.

After the Senate’s vote, confirming an executive-branch nominee now takes just 51 Senate votes. Some think that raises the likelihood Sebelius will soon be a former Cabinet member.

“The president’s hands were previously tied,” said John Hudak, a fellow in governance studies at the Brookings Institution, who wrote a piece on the topic Thursday.

“Now, he has more breathing room and he is able to fire whoever he wants at HHS. That’s a very, very appealing approach, whether it fixes the problems with ObamaCare’s rollout or not.”

Better yet, Democrats can approve appointments to the Obamacare Death Panel without Republicans getting their hands dirty with complicity in genocide.

The filibuster vote could also make it easier for Obama to fill the healthcare law’s controversial cost-cutting board, another big advantage for the president.

Known as IPAB, the panel has no members yet is meant to submit its first proposed cuts in January. Any nominees from Obama require Senate confirmation, which is now an easier prospect.

Before Thursday’s vote, Obama’s nominees needed 60 votes to survive procedural motions. Now they need 51.

And hey, maybe the nuclear option shattered the deal-making dreams of “moderate” Republicans, but it might help keep some Democratic “centrists” in the Senate:

Beyond helping Obama, the change could make life easier for some of the Senate Democrats who face tough reelection contests in 2014. The chamber is controlled by 53 Democrats and two Independents who caucus with the majority party.

“Obama now has breathing room among Democrats,” Hudak said.

“He can actually let some of the Democrats who are in tough races off the hook, which has some real electoral implications for those members.”

So see? Maybe we’ll all survive after all.

 

By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, November 25, 2013

November 26, 2013 Posted by | Filibuster, Senate | , , , , , , , | Leave a comment

“Revisionist History”: Chris Christie Shows Why The GOP Is Hopeless On Health Care Reform

With the rollout of the health care exchanges created by Obamacare hitting some bumps, to put it mildly, and President Obama’s approval rating falling to new lows, it seems like now would be the perfect time for Republicans to take control of the health care issue. Yet they haven’t.

Why? To figure that out, look no further than the GOP’s darling of the moment, New Jersey Gov. Chris Christie.

Fresh off a re-election rout, plenty of conservatives are pointing to Christie as the hope for a new, modern and revitalized GOP. And at the Wall Street Journal’s CEO Council 2013 yesterday, Christie knew his cue, saying, “Obamacare is a failure, it’s always been a failure and it will not succeed. It just won’t.”

But when asked what he would replace it with, Christie first demurred, saying he didn’t have enough time to flesh out a solution, but then added:

Obamacare is wrong, it’s a failure, it’s the most extraordinary overreach of government power in the history of our country. And it’s being run by people who have never run anything. So why are we surprised it’s failing?

What do we need to replace it? We need a robust debate among both sides. Unlike last time, where the president jammed this down everybody’s throat and got not one Republican vote because he was unwilling to make any compromise, including tort reform, for god’s sake. Well, then this time we need a robust conversation between both sides where everybody brings skin to the table and everybody compromises. And if we do that we can craft a solution.

This is just red meat, not a constructive discussion of the nation’s health care problems. And it’s emblematic of the mainstream GOP’s fact-free approach to health care reform and the problems it’s having landing punches against Obamacare.

For starters, it’s simply incorrect that the Obamacare exchanges are “being run by people who have never run anything.” Secretary of Health and Human Services Kathleen Sebelius, after all, ran a state (she was the governor of Kansas, not exactly a socialist utopia), which I imagine Christie counts as executive experience. And President Obama, like it or not, has been at the helm of the world’s largest economy and military since 2009.

But far more importantly, Christie’s only solution to the health care conundrum is more “debate.” He seems to believe that health care reform would have gone just fine if mean old Obama hadn’t “jammed this down everybody’s throat” without making any compromises. That’s revisionist history, to say the least.

Back here in reality, Senate Finance Committee Chairman Max Baucus, D-Mont., spent months fruitlessly trying to get Republicans to sign onto a health care bill, which was also endlessly debated in committee, in each chamber of Congress and on the airwaves. There are a slew of provisions in the law that come from various proposals Republicans have put forth over the years, including some lifted from their Obamacare alternative, but they earned Obama not one Republican vote.

Obama also ditched the public option – a government run plan in the health care exchange – as a concession, for which he got nothing in return except accusations that he was engineering a “government takeover” of health care.  Oh, and Christie’s magical tort reform, the GOP silver bullet? Obama has offered it to Republicans multiple times, and in response, they did nothing. (Tort reform, in the end, would result in scant savings anyway.)

This is not to deny that Obamacare has its problems, but simply to highlight that the GOP had the opportunity to be constructive during the health care debate, and instead chose across-the-board opposition and obstruction as an explicit political strategy to bring about Obama’s “Waterloo.”

Now, years later and with Obamacare faltering, the best the GOP’s newest star can muster is to tell the same old tales in the same old way. Complicating the matter is the fact that the few ideas conservatives do have for health care reform would result in many of the same things which Republicans are now criticizing. Reforms favored by the GOP would cause people to lose their insurance plans, even if they like them. And they would cut Medicare. Gasp!

Christie either knows this and can’t say it, because he would then be vilified by the conservative base, or he is just another Republican who doesn’t understand the tradeoffs involved in reforming America’s inefficient, wasteful and oftentimes completely backward health care system. And his refusal to even try to formulate a coherent health care alternative shows why, even after 40-something repeal votes and a disastrous rollout of the exchanges, Obamacare is still very much the law of the land.

 

By: Pat Garofalo, U. S. News and World Report, November 19, 2013

November 24, 2013 Posted by | Affordable Care Act, Health Reform | , , , , , , , | Leave a comment

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