“Stunning New Report Undermines Central GOP Obamacare Claim”: The Arguments Made By Republicans Simply Lack A Firm Factual Basis
A crucial GOP line of attack against the Affordable Care Act (ACA) is that millions of people will supposedly lose coverage thanks to shifting requirements on the health insurance exchanges — a flagrant violation of President Obama’s infamous “if you like your plan, you can keep it” proclamation. The truth has always been more complicated, of course. Republicans are constantly blurring the line between people who lose a plan and people who lose coverage. That is, many people might lose a particular insurance plan but immediately be presented with other options.
Now, a new report from the minority staff of the House Committee on Energy and Commerce has destroyed the foundation of that particular GOP claim. It projects that only 10,000 people will lose coverage because of the ACA and be unable to regain it — or in other words, 0.2 percent of the oft-cited 5 million cancellations statistic.
The report starts with an assumption that 4.7 million will receive cancellation notices about their 2013 plan. (Notably it doesn’t endorse that figure, just takes it on for the sake of argument.) But of those, who will get a new plan?
- According to the report, half of the 4.7 million will have the option to renew their 2013 plans, thanks to an administrative fix this year.
- Of the remaining 2.35 million individuals, 1.4 million should be eligible for tax credits through the marketplaces or Medicaid, according to the report.
- Of the remaining 950,000 individuals, fewer than 10,000 people in 18 counties will lack access to an affordable catastrophic plan.
“This new report shows that people will get the health insurance coverage they need, contrary to the dire predictions of Republicans,” said Rep. Henry Waxman (D-Calif.), the ranking committee member. “Millions of American families are already benefiting from the law.”
The report is somewhat speculative, of course, since there is no central repository of data on the individual health insurance market. But the methods are clear, and the onus is now on Republicans to explain why it isn’t true.
As we’ve noted, Republicans have had an awful hard time finding people who completely lost coverage because of the ACA. (Think of the man who starred in Americans for Prosperity ads last week and whose story still hasn’t been fully explained.) Perhaps it’s because there just aren’t that many of them.
Of course, there’s no doubt that for those 10,000 people, the health-care law left them worse off than before. And by no means is the rocky political ride over for Democrats — back-end problems still present a serious threat to implementation. But as is sadly too often the case, the arguments made by Republicans simply lack a firm factual basis — and deserve much more scrutiny that they’ve received in many sectors of the mainstream press.
By: George Zornick, The Plum Line, The Washington Post, December 31, 2013
“Call It A Comeback”: More Than 9 Million Americans Have Health Insurance Through Obamacare
You don’t get much credit for fixing something that should have worked in the first place, but the Obama administration has avoided a major catastrophe by delivering on its promise to fix HealthCare.gov for most Americans.
After two months of barely functioning, the federal online health care exchanges delivered, racking up 975,000 enrollments in the month of December. That brings the total number of people who have picked a plan through an exchange since October 1 to about two million. The administration reached about two-thirds of its goal of enrolling 3.3 million by the end of 2013 after being fully operational one-third of the time. And it turns out most of the enrollments came during the one-week extension the White House gave itself after the initial problems with the site became apparent.
Four million people have qualified for Medicaid, according to ACASignups.net. Another 3.1 million young adults are covered by their parents’ health insurance, thanks to a provision in the Affordable Care Act (ACA).
This means over nine million people have gained coverage through the ACA since it first became law.
That number could easily shrink or grow as insurers report on how many people purchased ACA-compliant policies directly through them. It’s also unclear how many canceled policies were replaced by plans purchased through the exchanges.
Looking at the rate of enrollments for Medicare Part D, president of health research firm Avalere Health Dan Mendelson believes that the administration can hit its goal of seven million enrollments by the close of open enrollment on March 31.
“Where they are, with about two million enrolled, if they continue to enroll at the present rate, and there’s a little acceleration at the end, they could get to seven million,” Mendelson told the Washington Post‘s Sarah Kliff.
However, Republicans are still predicting doom for the president’s signature legislative accomplishment, suggesting that the disastrous rollout of the exchanges is just the beginning of the problems.
“Just about everyone on the right is still living in October, the annus horribilis of Obamacare (yes, I know it was just a month, and I don’t care), and is waiting to move in for the kill after the whole thing collapses,” The New York Times‘ Paul Krugman wrote.
Republicans are assuming that the estimated 3 percent of Americans who will be paying more under the law along with disruptions of relationships with doctors will overwhelm both the news of millions gaining coverage and Republican states denying Medicaid expansion to five million working people.
Predictions of Obamacare’s death made sense when it seemed a very real possibility that HealthCare.gov could not be fixed.
Now that those predictions have been proven wrong, the law will have a chance to be judged on its merits.
By: Jason Satler, The National Memo, December 30, 2013
“Things Are Looking A Lot Better”: We Don’t Know If Obamacare Is Working Well, But We Know It’s Working
Obamacare got off to a lousy start. But things are looking a lot better now.
Nearly a million people signed up for private health plans via healthcare.gov in December, according to statistics the Obama Administration released on Sunday morning. That pushed the total number of sign-ups for the year to 1.1 million. Combined with the totals that states are likely to report by year’s end, it probably means more than 2 million people have signed up for private health insurance though the Affordable Care Act’s marketplaces. That doesn’t count several million who enrolled in Medicaid, the newly expanded federal-state program that provides insurance to low-income people.
The official enrollment number doesn’t tell us many things. It doesn’t tell us whether these people getting private (or public) coverage had insurance previously—or, if they had insurance, how much they were paying for it. It doesn’t tell us how many of these people have actually paid premiums, which is essential for coverage to take effect. It doesn’t tell us whether insurers have proper data on these people or what kind of access and protection the new coverage will give. It doesn’t tell us how many of the enrollees are in relatively good health or how many are in relatively poor health—or how that mix will affect insurance prices going forward.
In addition, the numbers do not appear to match the Administration’s own targets. According to internal projections, later reported by the Associated Press, officials expected more than 3.3 million enrollments by year’s end, with about 1.8 million of those coming through the federal website.
For all of those reasons, and a few others, it’s premature to say Obamacare is meeting expectations.
But those internal enrollment targets don’t include people who signed up for coverage directly through insurers. And while lower-than-predicted enrollment could be a sign consumers don’t like the new policies, they could also represent the lingering effects of the site’s technical problems. The internal projections were never particularly scientific: Administration officials extrapolated them from the Congressional Budget Office’s projection of overall private plan enrollment in 2014 (about 7 million) and with necessarily imperfect data from prior programs. “What’s important now is that the systems are mostly functioning so that anyone who wants to get coverage can,” says Larry Levitt, senior vice president at the Kaiser Family Foundation. “The outreach campaigns and advertising by insurers likely haven’t peaked yet, so I wouldn’t be at all surprised if enrollment in March is even bigger than December.”
MIT economist Jonathan Gruber, an architect of reforms, has a similarly nuanced take. “Given the technical problems at the start, and given that the important deadline is March 31, what matters right now is the trend in enrollment. In terms of overall enrollment, the trend looks quite good,” Gruber says. “What matters more is the mix in terms of the health of those enrolling, and we won’t have a clear answer on that until we see 2015 rates from insurers.”
While we wait to see more numbers—and parse the meaning of the numbers we have—we do know a few things for sure.
We know, first and foremost, that healthcare.gov is a (mostly) functioning website. This was no sure thing even a few weeks ago. At the end of November, when officials announced that they had met their goal of constructing a website that worked well for most customers, they were cautious to warn about future problems. Partly that was because their previous predictions of success proved so unbelievably wrong. And partly that was because they feared a late surge of customers would overwhelm the site’s capacity, threatening a whole new period of chaos. But the system held up just fine, as the high enrollment numbers indicate.
More important, we know that many of the people getting insurance are very, very happy to have it. In the fall, when insurers began sending notices of rate increases and plan cancellations, all we heard about was people unhappy with—and in many cases angry about—their new options. Now, however, we are increasingly hearing stories about people who are saving money and, in some cases, getting access to health care they’ve desperately needed for a long time.
Here two examples, culled from a new story by Lena Sun and Amy Goldstein in the Washington Post:
Adam Peterson’s life is about to change. For the first time in years, he is planning to do things he could not have imagined. He intends to have surgery to remove his gallbladder, an operation he needs to avoid another trip to the emergency room. And he’s looking forward to running a marathon in mid-January along the California coast without constant anxiety about what might happen if he gets injured.
These plans are possible, says Peterson, who turned 50 this year and co-manages a financial services firm in Champaign, Ill., because of a piece of plastic the size of a credit card that arrived in the mail the other day: a health insurance card. …
Dan Munstock knows this. A 62-year-old retiree in Greenville, Tenn., he hasn’t had insurance since he left his job as a crisis counselor in Miami six years ago. He lives on Social Security income of less than $15,000 a year. Although he does not know of any major ailments, he would like a checkup because, he said, “you can seem fine until the day you drop over with something.”
Like thousands of other Americans, Munstock ran into technical problems with the federal Web site before managing to pick a health plan Dec. 1. He qualified for a federal subsidy to help him afford the insurance, so he has to pay just $87.57 a month toward his premium. After his welcome packet from Blue Cross Blue Shield of Tennessee arrived in the mail, Munstock was so eager to finish the process of enrolling and getting an insurance card that he picked up the phone to pay the first premium instead of using the mail.
“It felt really good,” he said. Paying toward his own insurance, he said, gives him “a certain dignity,” a feeling that he is not “one of the takers.” The next day, he called the doctor’s office. His appointment for a physical is Jan. 2. …
Like the stories of rate hikes and plan cancellations, anecdotes of people gaining insurance or saving money will frequently prove more complicated than they seem at first blush. Some people will discover they owe more out-of-pocket costs than they imagined, because of high deductibles and co-payments. Some won’t be able to see the doctors they want, because plans have limited networks of providers. Some will haggle with insurers over particular bills or services. And that’s not to mention the many other trade-offs in the law—like higher taxes on the wealthy, cuts to various industry groups, higher premiums for some people buying their own coverage, and other steps that made possible the law’s expansion of health insurance.
But nobody ever promised that Obamacare would solve all of the health care system’s ills—or that it would come without costs of its own. The goal has always been to make insurance more widely available, so that more people had access to care and protection from crippling medical bills, while beginning the difficult work of reengineering medical care to make it more efficient. The new enrollment numbers should give us new reason to think it will.
By: Jonathan Cohn, The New Republic, December 29, 2013
“The GOP’s Sad Scrooge Agenda”: A Real Anti-Poverty Agenda Involves Raising The Minimum Wage
It’s the most wonderful time of the year … unless your unemployment benefits are set to run out three days after Christmas. But there’s a little bit of holiday cheer for the long-term unemployed: Democrats are showing some new spine in fighting to help them.
For decades Democrats have had, at best, a stealth agenda when it comes to fighting poverty. After backing GOP-inspired welfare reform in 1996, most favored work-support programs taxpayers couldn’t necessarily see, like the Earned Income Tax Credit, and borrowed Republican rhetoric dividing the deserving from the undeserving poor. Expanding eligibility for food stamps and Medicaid was mainly defended in terms of an agenda to support the working — i.e. “deserving” — poor, and even for someone as ostensibly liberal as President Obama, deficit reduction has been a higher-profile priority than fighting income inequality throughout most of his five years in office, and the word “poverty” rarely crosses his lips at all.
That’s slowly been changing, for Obama and his party. Increasingly Democrats seem to believe poverty and income inequality are not only important issues morally, but politically. Now comes the liberal group Americans United for Change with polling, advertising and a political campaign designed to make sure Republicans suffer for their Scrooge agenda in 2014.
Polling by PPP finds that in four swing House districts currently held by Republicans, at least two-thirds of voters support continuing the expanded unemployment benefits that are set to expire Dec. 28, just three days after Christmas. Even in Speaker John Boehner’s district, 63 percent of voters want benefits extended, including 52 percent of Republicans.
But it’s not just PPP polling. A new Pew poll finds the public supports maintaining programs for the poor over deficit reduction 59-33; among independents it’s 53-38.
Of course, one of the tough things about being a progressive is that you can often find poll data supporting your policy agenda. And yet when push comes to shove in the only polls that matter, the ones that open on Election Day, economic fairness issues haven’t driven liberal voters quite the way social issues have turned out conservatives. Of course that’s because conservatives have had a head start organizing on issues like abortion and gun rights while liberals too often assume the obvious correctness of their world view will prevail over time.
But the fight over unemployment looks different. Americans United for Change, along with labor groups, plans an advertising and media push focused on vulnerable Republicans. Already, an effort to publicize the cost of cutting unemployment in those members’ home districts has paid off in remarkable local media coverage, as Greg Sargent laid out two weeks ago.
Senate Majority Leader Harry Reid has already announced that extending unemployment is at the top of his agenda when the Senate reconvenes in January. He’ll of course face pushback from the Tea Party caucus — Sen. Rand Paul continues to insist that extending unemployment is a “disservice” to the unemployed, as if he has any interest in policies that would actually be of “service” to them. Sen. Ted Cruz insists unemployment benefits “exacerbate” joblessness. But vulnerable and moderate Republicans in the House and Senate could conceivably surprise Paul and Cruz — they don’t want to find themselves in the unemployment line come 2015.
Still, it’s not time to celebrate just yet. Democrats weren’t tough enough to insist that an unemployment extension become part of the budget compromise. And there’s been little comparable innovative organizing around restoring food stamp cuts. Of course, a real anti-poverty agenda involves not just improving the safety net but raising the minimum wage, strengthening union rights, increasing spending on both preschool and higher education and restoring fairness and progressivity to the tax code. None of those things is going to happen with the current Congress.
But the Democrats’ new strength and political savvy on unemployment insurance is just more evidence that the party is no longer exclusively playing defense when it comes to an economic populist agenda. If progressives can demonstrate real political benefits to that agenda, expect cowardly Blue Dog Dems and even some Republicans to see the light.
Joan Walsh, Editor at Large, Salon, December 23, 2013
“Making The Poor, And The U.S. Poorer Still”: It’s Both Unjust And Economically Unsound For Congress To Cut Benefits To The Poor
Congress may take up legislation this week to cut food stamps. The Senate passed a bill in June mandating $4 billion in cuts over 10 years; the House version, passed in September, imposes nearly $40 billion in reductions. A conference committee has been charged with resolving these differences. Somehow, this negotiation is occurring amid the worst poverty levels in two decades, a weak overall economy and rapidly falling budget deficits. Under these circumstances, it would be economically and morally unsound to carry out the cuts.
Nearly 20 percent of Americans are officially poor or near poor. The Census Bureau reports that 15 percent of the population — nearly 47 million people — lives in poverty, including 22 percent of children. For an individual, this means annual income of $12,000 or less. For a family of four, the poverty threshold is $24,000 or less. Consider what living on those amounts would mean.
Roughly 18 million other people are near poor, living within 130 percent of the poverty line, according to census data. For individuals, this means earning $15,000 or less. These people often weave in and out of official poverty, depending on the month.
Most Americans living in poverty experience hunger or the pervasive fear of it. The U.S. Department of Agriculture reported that 49 million Americans, including 16 million children, lived in food-insecure households last year. That means that at some point in 2012, these households did not have enough food or were uncertain of having enough. That is as if all of California, Oregon and Washington were experiencing hunger or were afraid of it. There are serious social, economic and health consequences; for instance, diabetes, obesity and other chronic conditions afflict Americans who don’t have access to adequate nutrition.
Total federal spending on the Supplemental Nutrition Assistance Program (SNAP), this country’s main hunger prevention program, was $82.5 billion in fiscal 2013. To some that sounds like a lot, but it’s a small fraction of a $3.5 trillion budget and $16 trillion economy. This is evident when per-capita benefits are studied: The 2009 American Recovery and Reinvestment Act temporarily raised the weekly SNAP benefit by $25 to $33 for a family of four. But that temporary increase was allowed to expire this fall, so the SNAP benefit is back to the lower figure, or less than $1.40 per person per meal. These are small amounts relative to grocery costs, and even then only those with incomes below 130 percent of the poverty line are eligible for the aid.
It is hard to reconcile traditional American values of hard work and generosity with the levels of poverty and fear of hunger in our country, especially because large shares of those suffering this plight work. Nearly 11 million working Americans had annual income below the poverty line last year.
The working poor or near poor are also disadvantaged by our tax system. When a low-wage worker gets a raise or his or her spouse joins the workforce, food stamps are cut back. The family’s Medicaid eligibility is in jeopardy, and earned-income tax credit refunds are reduced or eliminated. A November 2012 Congressional Budget Office analysis concluded that the marginal tax rate imposed on increased income for such workers can be as much as 95 cents on every additional dollar earned. This is counterproductive.
Food stamps aren’t just a question of social justice; they are also a matter of economic policy. SNAP spending was increased in 2009 as part of the stimulus legislation to help rescue the economy. Like other elements of that legislation, the idea was to put money into the pockets of financially distressed Americans who would immediately spend it. The CBO reported that this legislation was largely effective in protecting the economy. More broadly, investments such as SNAP equip the poor and near poor to succeed economically. Good nutrition — as well as health care, education and secure housing — is a requisite for productivity, helping unemployed or marginally employed workers move into better jobs. This also allows them to build a better life for their children.
We believe that it would be both unjust and economically unsound for Congress to cut benefits to the poor and near poor. It has been a generation since our country last had a robust conversation about combating poverty. Now is the time to reinvigorate that conversation, not cut needed benefits.
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