“End Times For Obama?”: Just Another Round Of The Media’s Trumped-Up Crises That Turn Out To Be Wrong And Overheated
It’s damn near end times for Barack Obama, to hear some tell it.
There’s a new Pew poll that has him at 41 percent approval, 53 disapproval, which Pew notes ominously is only five percentage points better than George W. Bush’s at this point in his term. (Hurricane Katrina had happened in August of Bush’s fifth year.) Conservative columnists are chuckling and clucking and tweeting to beat the band. Centrist journalist Mark Halperin, on MSNBC yesterday, declared that Obama had lost the media, which was now cheering against the success of the Affordable Care Act and just wants to see… well, people go without insurance, I guess. If everything—everything!—isn’t fixed by Nov. 30, we’re looking at a presidency that is going to collapse into utter disaster.
It’s obvious enough why conservatives would be saying this. They’ve wanted Obama to fail from the start, and they’ve certainly wanted the health-care bill to fail from the moment of its passage. Journalists like Halperin say these things not for ideological reasons, but temperamental ones: In this Halperinesque/Politico-esque world view, politics is less about people’s lives than it is about who is displaying mastery of the game and who is being mastered at any given moment (of course, seeing politics so insistently through that lens is a kind of ideology of its own, but we’ll let that pass). To that group of mainstream journalists, how Obama handles the current crisis will determine whether the administration will survive or whether he might as well just resign now.
I don’t deny that the current situation is a crisis, and one of the administration’s own making. Obama misled people. It’s a small percentage of people. They’re at the mercy of the most horrible end of the private-insurance market, and the vast majority of them are going to be better off after everything shakes out and they see that their new plans are largely better than their old ones were. But even so, they’re people, and they’re getting termination notices, and he misled them. Combine it with the website chaos, and it’s bad, there’s no sense in denying it.
What I do deny, vigorously, is that this is a make-or-break moment. Yes, I know that Obamacare is his signature initiative and all that. And I know that if problems persist after Nov. 30, pressure will mount on Harry Reid to let some kind of tinkering legislation be debated. This is a very important three weeks for the administration, and the 30th is an extremely important deadline.
But there’s a certain type of political journalism that so exists in the moment that numerous such moments have been declared to be disasters for Obama, going back to Jeremiah Wright. This kind of hyperventilating approach always turns out to be wrong and overheated. It turned out that all those things were pretty bad, but it also turned out that Obama survived them. And he’ll survive this, too.
What will happen in all likelihood is what usually happens in life and politics—that is, nothing all that dramatic. Nov. 30 will come, and the website will be more or less (though not entirely) fixed up, and life, and Obamacare, will go on. There will be more horror stories, natch, but there will be more success stories too, and sometime between now and next March 31, when the enrollment period ends, the media are going to get a little bored with the whole thing, and it will just go on irresolutely for a while, but eventually it will start becoming clear to the American people that the reform is working pretty well in the states that tried and pretty poorly in the states that didn’t, and people will start to get the point about Republican sabotage.
And then, provided health care survives that initial stage without being altered for the worse by Congress, it’s going to start to work. Well. Resistant insurance companies and even some resistant governors and state legislatures are going to see that it appears to be here to stay, and they will accommodate themselves to that reality.
Obamacare will never be a raging success. This is another error much of journalism is prone to make—looking for it to be an overwhelming success. That won’t happen because at the end of the day we’re still talking about private health insurance, and private health insurance was a pain in the tuchus before Obamacare and will remain one after it. People will always complain about their coverage. But by early 2016, I have little doubt, there will be millions more Americans who’ll be doing the complaining, and they’ll be happy to have the opportunity to do so.
Conservatives are desperate for health care to be Obama’s Katrina. Certain centrist journalists want to see it just for entertainment’s sake or as a test of Obama’s presidential “character.” I won’t say there’s zero chance of it happening. If Nov. 30 comes and the website is an unmitigated disaster, then maybe that’ll be the case. But I will say that I think the chances of it are very slim indeed. The unfortunate thing is the Republicans have just enough power to gum up the works so that even if the administration does fix up everything on its end, the GOP can keep hauling Kathleen Sebelius up to the Hill and taking other steps to make sure things look worse than they are. But Obama will survive, and more importantly, Obamacare will too.
By: Michael Tomasky, The Daily Beast, November 8, 2013
“Breathtakingly Cynical”: Guess Who Really Wants to Take Away Your Insurance? Republicans!
Republicans are outraged that some Americans must give up their current insurance plans because they don’t satisfy Obamacare’s new regulations for benefits and pricing. Partly they are mad at President Obama, because he repeatedly said people who like their coverage would get to keep it. And that’s fine. As I said yesterday, Obama should have said “most” people, not “all” people. Readers can decide for themselves whether, by the standards of politics, that’s a felony or misdemeanor.
But Republicans are also making a substantive argument here. It’s unconscionable, they say, that lawmakers would force people to give up their current coverage. Just a few minutes ago, during congressional testimony by Health and Human Services Secretary Kathleen Sebelius, an angry Representative Marsha Blackburn from Tennessee practically screamed at the witness: “You’re taking away their choice!”
It’s good politics, I’m sure. It’s also breathtakingly cynical. Republicans have repeatedly endorsed proposals that would take insurance away from many more Americans—and leave them much, much worse off.
Start with the federal budgets crafted by Paul Ryan. You remember those, right? Those proposals passed through the House with unanimous Republican support and were, in 2012, a basis of the Republican presidential platform. Those budgets called for dramatic funding cuts to Medicaid. If Republicans had swept into power and enacted such changes, according to projections prepared by Urban Institute scholars and published by the Kaiser Family Foundation, between 14 and 20 million Medicaid recipients would lose their insurance. And that doesn’t even include the people who are starting to get Medicaid coverage through Obamacare’s expansions of the program. That’s another 10 to 17 million people.
And it’s not just people on Medicaid who would lose coverage if Republicans got their way. While Republicans in Congress have not unified by a single alternative to Obamacare, a building block of virtually every proposal in circulation is to equalize the tax treatment of employer-sponsored insurance and individual insurance—which, in layman’s terms, means making it much more appealing for somebody who gets coverage on the job to buy coverage on his or her own. Typically these proposals would allow insurers selling individual coverage to continue some of their current practices, like charging higher premiums or refusing to cover certain services for people with pre-existing conditions, or offering coverage with serous gaps in benefits. Most experts believe such reforms would hike the cost of employer plans, as only sicker people remained on them, potentially creating a “death spiral” that would lead to fewer employers offering plans. (Even the more optimistic estimates assume erosion of employer-sponsored insurance.)
Note the difference in scale here. Nobody knows exactly how many people are giving up non-group policies because insurers are reacting to Obamacare regulations. But it’s probably in the millions—and still substantially less than the number of people who would lose insurance if Ryan’s proposal for Medicaid became law.
More important, though, look at the kind of change taking place. Almost everybody giving up a non-group policy today has the option to get new insurance either through Medicaid or one of the new Obamacare marketplaces. Some people will pay more for these policies, some will pay less, but everybody will be getting coverage that includes an array of “essential” benefits, limits out-of-pocket spending, and can never be taken away or limited because the policyholder gets sick. In other words, everybody ends up with comprehensive, stable insurance. It may not be the policy he or she has today. But the vast majority of people with non-group market don’t keep the same policy for more than two years anyway.
Under the Republican plan, by contrast, people losing employer insurance would end up in the dysfunctional, non-reformed individual market—the one full of confusing, junk policies that might not cover basic services like maternity or mental health or have huge gaps in coverage. And the people losing Medicaid? They would end up with … nothing at all.
The real issue here isn’t simply Republican opportunism and hypocrisy—although, please, let’s not ignore that either. The real issue is about the true trade-offs of policy. Both sides offer them. With Obamacare, a small number of people lose their current insurance but they end up with alternative, typically stronger coverage. Under the plans Republicans have endorsed, a larger number of people would lose their current insurance, as people migrated to a more volatile and less secure marketplace. Under Obamacare, the number of Americans without health insurance at all will come down, eventually by 30 or 40 million. Under most of the Republican plans, the number of Americans without insurance would rise.
Honest Republicans would justify their policies by arguing that Medicaid is a wasteful, inefficient program not worth keeping—and their changes, overall, would reduce health care spending while maximizing liberty. In other words, forcing people to give up their coverage is worth it. I don’t agree with those arguments, but they are honest. But they should stop pretending that it’s possible to address the problems of American health care without disrupting at least some people’s insurance arrangements—because, after all, they want to do the very same thing.
By: Jonathan Cohn, The New Republic, October 30, 2013
“The Right’s Sickest Obamacare Lie Yet”: Republicans Believe People Who Live In Flat Places Shouldn’t Have To Buy Cars With Brakes
During Congressional hearings with Health and Human Services Secretary Kathleen Sebelius, Congresswoman Marsha Blackburn (R-Tenn.) made an interesting argument that some Americans don’t want quality health insurance. “Some people like to drive a Ford and not a Ferrari,” Blackburn asserted. But that begs the question: What kind of Ford?
As early as 1972, there were reports that when a Ford Pinto was involved in a low-speed collision, the car would spontaneously burst into flames. According to a 1977 investigation by Mother Jones magazine, Ford was aware of the problem — resulting from a flaw in the gas tank design — but instead of paying to recall and redesign the car, Ford decided it would be cheaper to pay for the lawsuits. Ultimately, at least 27 people and as many as 180 people died as a result of Pinto fires. But it took the government forcing Ford to recall the Pinto for the problem to actually be solved.
In 2009, millions of Americans lacked any health insurance whatsoever and millions more had private health insurance metaphorically designed to explode at the hint of any serious illness or pre-existing conditions or exorbitant medical costs. So, in 2009, 14,000 Americans were losing their health insurance every single day. And medical bills were prompting more than 60% of all bankruptcies in our nation. In other words, many health insurance policies were patently dangerous and unsafe.
Now, Congresswoman Blackburn and her ilk might argue that people should have been free to buy the Pinto if they wanted, without government intrusion into personal choices or private business practice — just like they seem to want to argue that Americans should be free to hold onto their inadequate, costly and reckless insurance policies that throw them off at the slightest sign of illness while forcing costs up for the rest of us. But arguably most Americans want to buy cars that are safe. Auto companies didn’t want to install seat belts and airbags, just like Ford didn’t want to fix the Pinto. That was government regulation at work, making us all more safe — even if, in some cases, it made cars more expensive. We ultimately save, in every way imaginable, when the number of traffic deaths are dramatically cut.
This is, in effect, exactly what the Affordable Care Act does with respect to some currently existing, private insurance policies. If those policies don’t meet a new, higher bar of quality coverage, then the government will no longer allow insurance companies to sell them. Instead, the 5 percent of Americans who rely on the individual insurance market for their coverage will have other options, all that provide better quality coverage and many of which are far less expensive. Plus at least half of folks on the individual market will be eligible for subsidies that further bring costs down.
A great example comes from Deborah Cavallaro, who has been making the rounds on television complaining about her current insurance plan being cancelled. Cavallaro had not looked into her other, new options under Obamacare until a Los Angeles Times reporter called. Together, they looked at Cavallaro’s options — and found a “silver” plan for Cavallaro that would cost slightly more in her monthly premium but save her tons in terms of her annual deductible and out-of-pocket costs as well as doctor visit expenses. Plus, thanks to Obamacare, this plan would not be subject to the annual payment caps or pre-existing condition clauses that have been exploding in the faces of consumers for decades. After all, it’s important to remember that in 2009, most Americans were not very satisfied with their insurance plans. People wanted better options and now, thanks to Obamacare, they’ve got ‘em!
Congresswoman Blackburn and her cohort might fire back something about young healthy men being required to pay for good insurance plans that cover maternity — one of 10 basic coverage requirements mandated under the Affordable Care Act, this one designed to undo the history of insurance plans discriminating against women and families. Perhaps Republicans might also argue that Americans who live in really flat places should be able to buy cars without breaks. But that wouldn’t be safe for drivers or the rest of us. And in the case of health care reform in particular, the point here is to bring down costs and raise the quality of care for all of us. Those young, healthy men are going to grow up and have families one day — and then eventually become elderly — and will benefit from an insurance system that keeps costs manageable throughout and doesn’t kick off the elderly or infirm. Just like we all benefit from seatbelts and airbags, even if we never get in an accident.
Nobody is forcing anyone to buy a Ferrari plan in the individual health insurance exchange. At least 6.4 million Americans will pay less than $100 per month for coverage in the Obamacare exchanges — which means there are plenty of Ford’s available. What the Affordable Care Act simply ensures is that those policies will be safe and reliable — and not catch fire when we least expect it.
By: Sally Kohn, Salon, October 31, 2013
“Defiant Obamacare Defense”: A New World Where Insurers Have To Cover Categories Of Treatments They Never Had To Before
President Obama’s speech at Faneuil Hall was probably his most passionate and unapologetic defense of the health-care law in ages, maybe since its passage. At times like this in the past, Old Mr. Reasonable has hemmed and hawed, ceding that his opponents had a point, but insisting—reasonably, of course—that he had a better one if you just stopped and thought about it. But Wednesday afternoon in Boston gave us a different Obama. He took a page out of the Bush playbook or, dare I say it, even the Cheney one. If things are going a little rocky at the moment, it doesn’t matter; cede nothing. Stick to plan. No matter the merits or facts, it’s the only approach that our political culture respects.
The money moment of the speech, of course, came when he answered the questions raised by the NBC report Tuesday. According to NBC, people who had bought insurance on the private market who don’t have either employer or government coverage were getting hammered by Obamacare. They were getting letters telling them their coverage had expired and then finding that the new coverage available to them was going to cost more. It flew in the face, said NBC’s Lisa Myers, of Obama’s promise that if you had coverage now and liked it, nothing would happen to you.
She was right. He shouldn’t have said it. And in Boston he didn’t exactly say, “I shouldn’t have said it.” But he did turn it around and say for that small percentage of people, the coverage they’re going to end up with is better! It also just might be cheaper, he said, and they are going to have peace of mind: “They can’t use allergies or pregnancy or sports injury or the fact that you’re a woman to charge you more. They can’t do that anymore!”
It’s an interesting, by which I mean preposterous, meme that’s developing on the Republican side. On Wednesday morning, Rep. Marsha Blackburn (R-TN) pressed Health and Human Services Secretary Kathleen Sebelius on the issue. Some people, Blackburn said, “would rather drive a Ford than a Ferrari.” No denying that; in my younger and single and childless days, I certainly would have opted for a Ford plan instead of a Ferrari plan, so up to a point, Blackburn is making sense.
But Obamacare creates a world where insurers have to cover several categories of treatments that they never had to cover before, and since people with those conditions are now going to sign up and use those services, it’s going to cost more in some cases. And it’s understandable if people are upset about that. But Blackburn’s analogy, of course, breaks down because any citizen, at some unknowable future point, may be hit with one of those conditions. A person might develop mental illness. Or their child might. No imaginable circumstance could make a reasonable Ford-owner think, “Damn, I should have bought that Ferrari.” But numerous circumstances could make the self-employed citizen or parent think, “Damn, I’m glad I bought that Ferrari plan.”
What’s most fascinating to me about the whole thing is that the experience is training, or is going to train, Americans to rethink the really fundamental questions about how life and society are organized in a way politics rarely does. One of the major differences between liberals and conservatives is that conservatives believe in the primacy of the individual, while liberals want people to think about the community. Another difference, related, has to do with the two creeds’ opposing conceptions of individualism. Conservatives go for the whole rugged individualism thing, whereas the liberal view of the individual is closer to “there but for the grace of God go I.”
Well, the nature of health-care coverage is it has the power to bring consideration of these questions to the fore. A country where people have to sit down and choose how best to protect themselves and their loved ones against pain and death, and where they have to think about the trade-offs between paying more and having better coverage, is a country where people are being forced, in a way, to think about the most profound questions of community and the individual—of how much responsibility we ought to be forced to shoulder for each other.
I used to think, “This is just like auto insurance; you’re a safe driver, but you insure yourself against the unsafe drivers, and everybody understands that, so why should this be different?” But it is, somehow. It’s so much more personal. It’s about our frailty as human beings, and contemplation of our frailty makes us both obstinate and individualistic (“I can take of myself, Jack!”) and, in our more honest moments, vulnerable and communitarian (“What will I do if I really get sick?”). Forcing people to think about their coverage forces them to think about all that.
How will it turn out? Who knows. It has the positive potential of making people, a majority of people, see that this all makes a kind of sense, that they are not, whether they like it or not, autonomous actors. That, come to think of it, is what terrifies conservatives. Since 1980, they have trained people to think chiefly about themselves, unburdened of the context of society. Obamacare will force them to think of society. And most people, not being selfish asses (and most people aren’t), will, once the kinks are worked out, accept it. Polls are already indicating that. No wonder Ted Cruz is losing it.
By: Michael Tomasky, The Daily Beast, October 30, 2013
“The Uproar Over Insurance “Cancellation” Letters”: Offering Terrible Products To Desperate People Is No Longer Acceptable
Kathleen Sebelius, the Health and Human Services secretary, took a lot of grief this morning from Republicans on the House Energy and Commerce Committee who were outraged that some people’s individual insurance policies had been “cancelled” because of health care reform.
Some of the rants bordered on the comical. Cory Gardner, Republican of Colorado, brandished his “cancellation” letter and demanded that Ms. Sebelius nullify the health law for all residents of his congressional district.
Most lawmakers mentioned President Obama’s unfortunate blanket statement that all Americans would be allowed to keep their insurance policies if they liked them. He failed to make an exception for inadequate policies that don’t meet the new minimum standards.
But in between lashings, Ms. Sebelius managed to make an important point. Yes, some people will be forced to upgrade their policies, she said. But that’s preferable to the status quo before the passage of the Affordable Care Act, when insurers could cancel policies on a whim.
“The individual market in Kansas and anywhere in the country has never had consumer protections,” she testified at the hearing. “People are on their own. They could be locked out, priced out, dumped out. And that happened each and every day. So this will finally provide the kind of protections that we all enjoy in our health care plans.”
A true cancellation is when someone gets a letter saying that she’s losing her insurance and cannot renew. That was common practice in the individual market for people with expensive conditions. Under the new law, no one will ever get a letter like that again. They cannot be turned down for insurance.
The so-called cancellation letters waved around at yesterday’s hearing were simply notices that policies would have to be upgraded or changed. Some of those old policies were so full of holes that they didn’t include hospitalization, or maternity care, or coverage of other serious conditions.
Republicans were apparently furious that government would dare intrude on an insurance company’s freedom to offer a terrible product to desperate people.
“Some people like to drive a Ford, not a Ferrari,” said Marsha Blackburn of Tennessee. “And some people like to drink out of a red Solo cup, not a crystal stem. You’re taking away their choice.”
Luckily, a comprehensive and affordable insurance policy is no longer a Ferrari; it is now a basic right. In the face of absurd comments and analogies like this one, Ms. Sebelius never lost her cool in three-and-a-half hours of testimony, perhaps because she knows that once the computer problems and the bellowing die down, the country will be far better off.
By: David Firestone, Editors Blog, The New York Times, October 30, 2013
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