“Everyone Just Chill Out”: Memo To Democratic Chicken Littles, The Sky Is Not Falling
Ah, now this is what politics is supposed to be like: Ruthless Republicans, gleeful at the prospect that they might increase the net total of human suffering. Timorous Democrats, panicking at the first hint of political difficulty and rushing to assemble a circular firing squad. And the news media bringing out the “Dems In Disarray!” headlines they keep in storage for just this purpose.
The problems of the last couple weeks “could threaten Democratic priorities for years,” says Ron Brownstein. It’s just like Hurricane Katrina, says The New York Times (minus the 1,500 dead people, I guess they mean, though they don’t say so). “On the broader question of whether Obama can rebuild an effective presidency after this debacle,” says Dana Milbank, “it’s starting to look as if it may be game over.” Ruth Marcus also declares this presidency all but dead: “Can he recover? I’m sorry to say: I’m not at all confident.”
Oh please. Everyone just chill out.
It’s incredible how often reporters and pundits proclaim that what’s happening this week is the most important political development in years, and the balance of political advantage today will remain just as it is indefinitely into the future. Then a few weeks or months later things change, and they forget about what they said before, declaring once again that today’s situation is how things will be forevermore. Not long ago, people were saying that the fact that Obama couldn’t get a congressional vote authorizing a bombing campaign in Syria had crippled his presidency. Then the Republicans shut down the government, and people were saying they wouldn’t win another election in our lifetimes. That’s just in the last few months. And now people are saying that Obama’s second term, which has three years left to go, is an unrecoverable disaster.
So let’s try to see things from a less panicky perspective. The rollout has been a mess, but it’s important to remember that this period is all a preparation for the actual implementation of the law. Nothing that’s happening now is permanent. People have gotten cancellation notices, but no one has lost their coverage. The website sucked when it debuted, it sucks slightly less now, but there’s still lots of time for people to sign up for plans that take effect next year. And if things aren’t working properly by December, they’ll probably extend the open enrollment period to a point at which everything’s working. That’s a hassle, sure. But you can’t call the Affordable Care Act a failure until it takes effect and does or does not achieve its goals. That would be like calling your team’s season a failure because they lost a couple of pre-season games.
A few Democrats will probably vote today for the Republican bill that purports to address the problem of cancellations but it’s an attempt to gut the entire ACA. That’s because they’re cowards and fools, who think that they can protect themselves from a momentary political headwind by rushing into the Republicans’ arms. And you know what will happen? Nothing. You can just add this vote to the 47 prior ones repealing the law; it’ll have the same impact. It won’t ever get to the Senate, and even if it did it wouldn’t ever be signed by the President. It isn’t even worth paying attention to.
Here’s what’s going to happen. The administrative fix Obama announced yesterday will temporarily staunch the political bleeding. But it will have very little effect on the actual insurance market, which is a good thing. In some states, insurance commissioners won’t let the insurance companies continue to sell the junk plans we’ve been talking about. In others, insurers won’t want to go back and re-offer the plans they cancelled. Some of the people with the junk plans will end up keeping them, but most of them will end up going to the exchanges. Many will find that they can get subsidies, or even without them find an affordable plan. Some may find that they’re paying more for a plan that offers real insurance. Those in the latter group will grumble, but it won’t be front-page news anymore, because the media are extraordinarily fickle, and they’ve already told that story.
Over the next year, the rest of the law will be implemented. There may be problems here and there, but overall it will probably go reasonably well. There will be plenty of things Democrats can point to in order to convince people that it was a good idea, like the fact that now nobody can be denied coverage because of a pre-existing condition, or the fact that millions of people who couldn’t afford coverage or were denied before now have it. There will also be things Republicans will say to try to convince people it was a terrible idea, like the fact that premiums didn’t plummet, and health care is still expensive, and Obamacare didn’t give every little girl a pony.
And what else will happen in the next year? Other things. The economy may get worse, or it may get better. There may be a foreign crisis. Controversies we can’t yet anticipate will emerge, explode, then disappear. A young singer may move her posterior about in a suggestive manner, causing a nation to drop everything and talk about nothing else for a week. We might start talking about immigration reform again. There’s going to be another budget battle. In other words, all sorts of things could affect the next election, and the election after that.
So yes, this is a difficult period for President Obama, and for the Affordable Care Act. But everyone needs to take a deep breath and remember that things will change. They always do.
By: Paul Waldman, Contributing Editor, The American Prospect, November 15, 2015
“The Burdens Of A Contradictory Message”: Is The Republican Position, “We’d Prefer To Leave You Behind With Nothing”?
On the surface, the Republican strategy on health care is proving to be more effective than they probably could have hoped. After waging a three-year sabotage campaign, the rollout of the Affordable Care Act has gone poorly; Democrats are divided; President Obama’s poll numbers are falling; the media is in a frenzy; the website still doesn’t work; and no one seems to remember the time Republicans shut down the federal government – just last month.
If RNC officials had written a script, it would look something like this.
And in the short term, at least as far as the politics are concerned, it’s quite possible that nothing else will matter. But at some point, I wonder if the political world will pause to consider the Republican message with a little more depth.
A few weeks ago, Matt Miller raised an important point: “What conservative officials, pundits and advocates are screaming is closer to the following: How dare you totally screw up something that we think shouldn’t exist!” Indeed, as we talked about as oversight hearings got underway a few weeks ago, conservatives are complaining about the functionality of a website that they’d just as soon destroy. They’re furious Americans are struggling to sign up for benefits that Republicans don’t want them to have. They’re demanding better performance of a system they’ve spent years deliberately trying to gut, and have no intention of trying to help fix.
The contradiction was more acutely obvious yesterday, with the release of October enrollment numbers: 106,185 consumers signed up for health insurance through an exchange, another 396,261 Americans have gained coverage through Medicaid expansion, and another million consumers were deemed eligible for coverage but have not selected a plan. GOP lawmakers considered this hilarious, noting a variety of sports venues that hold more than 106,185 attendees.
And that’s fine. Indeed, it’s predictable. About 500,000 Americans signed up for health care coverage last month, but because that number was far below the Obama administration’s original projections for the exchange marketplaces, critics of “Obamacare” want to take this opportunity to strut and gloat.
But that was yesterday. Today, I’d love to hear some of those same critics answer a couple of simple questions. First, for those mocking October enrollment numbers, do you wish that number was bigger or smaller? Because at this point, the answer appears to be “both,” which doesn’t make any sense. The Republican line currently seems to be, “We’re outraged that the number was so small, and we wish the totals were zero.”
That plainly doesn’t make any sense.
Second, for the 106,185 Americans who signed up for coverage through an exchange, and the 396,261 Americans who are now insured under Medicaid, is the Republican position, “We’d prefer to leave you behind with nothing?” What about those who sign up for coverage in November? And December?
By: Steve Benen, The Maoow Blog, November 14, 2013
“Darrell Issa’s Credibility Collapses”: Feeding Bogus Stories To Unsuspecting Journalists
House Oversight Committee Chairman Darrell Issa (R-Calif.) has a favorite trick: his staff puts together a partial transcript of closed-door testimony, they edit it in a misleading way to advance a far-right narrative, and then they look for a news organization who’ll fall for the scam.
This week, the trick involved Henry Chao, HealthCare.gov’s chief project manager at the Centers for Medicare and Medicaid Services, and an alleged memo involving security risks. CBS News fell victim to Issa’s swindle, and as was first reported right here on Maddow Blog, the story was quickly proven fraudulent.
At an Oversight Committee hearing yesterday, Rep. Gerald Connolly (D-Va.) questioned Chao on this point directly, made clear that the CBS report was wrong, and saw Chao explain that his words had been “rearranged” by the partial transcript Issa released.
But wait, there’s more.
Issa also insisted this week that the White House directed the CMS to disable the so-called “anonymous shopper” function of the Affordable Care Act’s website in order to prevent “sticker shock.” How’d that work out?
Three weeks ago, Issa alleged that the White House ordered contractors to disable the “anonymous shopper” function that would allow people to compare plans. “The White House was telling them they needed these changes,” he told CBS News. Why? He told Fox News that the administration “buried the information about the high cost of Obamacare” so that consumers wouldn’t get “sticker shock.”
In testimony Wednesday, however, an administration IT expert testified that he ordered the “shopper” function disabled until defects could be repaired and that there had been no political interference.
“So when Chairman Issa stated on national television that the White House ordered you . . . to disable the shopper function in September for political reasons, to avoid consumer sticker shock, that’s not true, is it?” asked Rep. John Tierney (D-Mass.).
Issa immediately objected, but it was too late – Issa’s lie (which is to say, his latest in a series of lies) had been exposed. The Republican said Tierney was mischaracterizing his claims, so Tierney read Issa’s discredited arguments out loud. (See the video http://youtu.be/oNSQn2zVdSU.)
I’m sure Issa and his office will continue to feed bogus stories to unsuspecting journalists. I’m less sure why anyone would keep falling for the same nonsense from someone lacking all credibility.
By: Steve Benen, The Maddow Blog, November 14, 2013
“Medicaid Matters”: Where Is The Outrage Over GOP Governors Cutting Off Lower-Income Americans From Access To Medicaid
E.J. Dionne Jr. raises an argument in his column this morning that’s been getting short shrift by too much of the political world lately: Medicaid expansion matters, and far too many state Republican policymakers are blocking it for no reason.
“President Obama apologized last week after all the criticisms of what’s happening in the individual insurance market,” Dionne explained. “But where is the outrage over governors and legislators flatly cutting off so many lower-income Americans from access to Medicaid? The Urban Institute estimates that 6 million to 7 million people will be deprived of coverage in states that are refusing to accept the expansion.”
The recent disruption in the health care marketplace certainly matters, and the Obama administration has a lot of work to do to put things right. But if we’re going to talk about policymakers who need to apologize and show some semblance of regret, can we at least start to have a conversation about those keeping millions of struggling Americans from having access to coverage, largely out of partisan spite?
Jonathan Cohn published a good piece on this earlier:
Today it’s a few hundred thousand people. By next year, it will be at least a few million. Their health insurance status is changing dramatically: What they have in 2014 and beyond will look nothing like what they had in 2013 and before. For many of these people, the difference will be hundreds or even thousands of dollars a year. In a few cases, it may be the difference between life and death.
You probably think I’m talking about the people getting cancellation notices about their private insurance policies. I’m not. I’m talking about the people getting Medicaid. Both stories are consequences of the Affordable Care Act. But one is getting way, way more attention than the other.
There’s been an obvious preoccupation – on Capitol Hill, with Beltway media, etc. – with website dysfunction and cancelation notices, while Medicaid expansion, which arguably affects a larger group of people, has been routinely overlooked.
Maybe it’s because Washington is “wired” for Republicans and it’s the right’s complaints that have been driving the recent conversation. Perhaps it’s the result of Medicaid beneficiaries lacking the kind of political capital that keeps their plight on the political world’s front-burner. Maybe it’s a matter of timeliness, with implementation disruption seeming “new” in ways Medicaid is not. Perhaps it’s a combination of things.
Regardless, by my standards, this is a genuine scandal. The administration’s missteps are real, but they’re not deliberate. “Red” states rejecting Medicaid expansion because of some misguided contempt for “Obamacare” are leaving struggling families behind on purpose. The callousness is outrageous.
Cohn concluded, “”Should the president have been more candid about the impact his plan would have on people buying their own coverage? Yes. Should we pay attention to those people, particularly when they must now pay more for equivalent coverage? Definitely. Should this put extra pressure on the administration and some states to fix their websites? You bet. But that’s not the only Obamacare news right now. The law is making life better for a great many people – and would help even more if only Republican lawmakers would relent.”
By: Steve Benen, The Maddow Blog, November 11, 2013
“Separating Myth From Reality On Obamacare”: The Greatest Good For The Greatest Number, More People Are Better Off In The End
My heart sank when I got an email late last month from my friend Robert, who has been battling multiple sclerosis for the past decade. He wrote to tell me that he was among the many Americans who in recent weeks received letters from their insurance companies saying that their policies won’t be available next year.
Insurance companies are sending those letters primarily because the policies they will no longer offer don’t provide enough coverage — or have deductibles that are too high — to comply with the Affordable Care Act. In many cases, however, the policyholders getting those letters are simply victims of a business practice insurers have engaged in for years: discontinuing policies because they’re no longer sufficiently profitable.
Robert understandably was worried. Like most of us, he’d been seeing the news stories about people who had received similar letters and seemed to be resigned to having to pay more in premiums next year for comparable or even less coverage, thanks to Obamacare.
Considering his very serious and costly preexisting condition — his medications alone cost more than $5,000 a month — Robert was nervous as he started looking for a replacement policy. How much more would he have to pay to stay insured?
A couple of weeks went by. I assumed Robert, like many others, was still waiting for the Obama administration to fix Healthcare.gov so he could shop online for coverage. It turns out Robert wasn’t willing to just wait. He decided to call an insurance agent and talk to a real live human being about his options for next year.
He could barely believe what he heard: he could get better coverage than the policy being discontinued — and pay less — thanks to Obamacare.
“The overall cost of the plans I’m considering is cheaper than the plan I am currently paying for,” he wrote me this week. “My total cost for coverage now, including premiums and out of pocket costs, is about $9,800. Two of the plans I’m seriously considering for next year have total costs of $8,400. I’m shocked, but in a good way.”
So not only did Robert not experience the sticker shock he had been expecting, he will save $1,400 next year on health insurance.
The plan he is leaning toward — a top-of-the line “platinum” plan — will have a higher monthly premium, but he will still save on average about $117 a month because of the way his out-of-pocket costs will be calculated.
Robert is among many who are losing their current coverage but in the end will be better off. In fact, considering that many folks buying coverage on the individual market have at least one pre-existing condition — which insurers can no longer take into consideration when pricing their policies — it’s likely that more people will get more for their insurance buck next year than less.
In addition, most of the people who buy coverage through the new insurance marketplaces (as Robert will when the balky Healthcare.gov website is working more smoothly) will be eligible for tax credits and subsidies from the federal government that will lower their monthly and overall costs even more.
Robert knows that you can’t determine how much you’ll spend on coverage during a given year just by multiplying the monthly premium by 12. If you don’t take into consideration out-of-pocket costs and just pick the policy with the cheapest premium, you could wind up paying more overall than if you picked a plan with a slightly higher monthly premium.
Robert also will be able to spread the cost of his coverage more evenly over the year. Under his current plan, he had to have at least $5,000 in the bank at the beginning of every year when his policy renewed to cover the cost of his medications for just one month. Under the new plans he is considering for next year, his monthly out-of-pocket costs will range from $80 to $120 a month.
“It will be easier to manage paying for my drugs spread out over a period of 12 months instead of in one lump sum at the beginning of the year,” Robert told me.
Robert said the insurance agent told him his case is not unique, that a lot of the people she talks to who have been frightened by the media coverage are pleasantly surprised to learn that they will get better coverage for less money next year. Once the Healthcare.gov website is fixed, more people who have received letters from their insurance companies will get a similar pleasant surprise.
By: Wendell Potter, The Center for Public Integrity, November 12, 2013
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