“Doing Nothing Was Not An Option”: Obamacare Is Lowering Some Health Care Costs
The snippy tone of the letter from my health insurance company really threw me for a minute. Very officious, very much this-is-totally-not-our-fault-the-bad-government-made-us-do-it, the letter informed me that because of the Affordable Care Act, my premium might change. Under the law, as of this year, insurance carriers would no longer be allowed to differentiate (or discriminate) on the basis of gender, and this, I was informed in a letter dripping with derision, might end up affecting how much I have to pay for my individual insurance each month.
Well, it did. My premiums are now 7 percent lower than they were.
Yes, that’s lower. Despite the fact that foes of Obamacare are screaming about how the law will bankrupt families and small businesses (the impact on buyers of individual policies never seems to come up), despite all the pols showing that Americans are terrified that their health care costs will grow, my premium went down. This will not be true for everyone—it was women who were routinely charged more for insurance for no other reason than their gender. That includes, incidentally, the handful of states in which it was perfectly legal for insurance companies to deem victims of domestic violence as having a “pre-existing condition.” But it’s reason to believe that the worry—verging on hysteria—over the law might be a bit much.
Health care costs are absurdly high in this country, and they must be reined in. And it’s not because we have the best health care in the world; we don’t. If you need a heart transplant, yes, this is where you want to be. But for most of the health care most of us will need in our lives, we are simply not getting the bang for our buck.
Health care premiums may indeed go up for many people, but they were going up before Obamacare was passed. That was the point of trying to do health care reform. That was the point during the Nixon administration, when both parties worried about the social and financial impact of the uninsured. It was the point in 1992, when Bill Clinton was running for president, and at nearly every campaign stop, someone told a sad story of a child with leukemia, and an insurance company refusing to pay for the treatments, or of someone who got laid off and couldn’t get a job because he had a “pre-existing condition” the new employer would find too expensive to cover through its insurance. The problem has merely gotten worse every single time Congress and the White House built the momentum to do something and came close but ultimately failed.
Is Obamacare the cure? The reality is, three years after the law was passed, is that we simply don’t know. House Democratic Leader Nancy Pelosi was criticized for saying we don’t know what the law will do until it’s in place, but she was right. That’s true of a lot of sweeping legislation (No Child Left Behind being the best recent example). The idea is to give it a shot, and then tweak it where necessary.
One thing is clear—doing nothing, yet again, was not an option.
By: Susan Milligan, U. S. News and World Report, March 22, 2013
“Inside The Anti-Obamacare Resistance”: A Facinating Glimpse Into Warped Conservative Ideology And Tactics
The two largest states that have so far failed to join in the Medicaid expansion provided for in the Affordable Care Act are Florida and Texas, where Republicans control the legislature and the governor’s office. Looking more closely at the intra-Republican battle over how and whether rich new federal funds can be captured without “surrendering” to the hated Obama provides a fascinating glimpse into conservative ideology and tactics.
Florida offers the murkiest situation. Gov. Rick Scott, who was beginning to look rather toasty in his 2014 re-election prospects, roiled conservative circles in his own state and nationally by suddenly coming out for Medicaid expansion in exchange for permission from the Obama administration to move Medicaid beneficiaries into private managed care plans. But Scott’s been stopped cold by GOP legislators, who in turn seem split between outright rejectionists centered in the state House and those in the Senate who want an even better “deal” that would utilize the state’s CHiP program, which is a privatized premium support scheme, instead of Medicaid for the expansion.
A conservative Florida reporter presents the views of the rejectionist camp quite vividly:
Tom Lauder, a reporter for Media Trackers Florida, which is closely following the Florida Obamacaid debate, says House Republicans appear likely to stand firm….
“Grassroots conservatives are particularly upset with Gov. Scott using the language of the left in his efforts to build momentum for Obamacaid,” Lauder explained. “When Scott argues, ‘I cannot, in good conscience, deny the uninsured access to care,’ he asserts that the only time people have access to goods and services is when government gives it to them as an entitlement. Scott has enraged his conservative base by making this big-government argument. This isn’t a question of whether government should give Medicaid to the poor and disabled, because the poor and disabled already qualify for Medicaid.”
At issue, Lauder says, is the rejection of Scott’s argument that federal funding will come without cost to state taxpayers.
“Scott’s conservative base also resents Scott talking about federal funding as if it were free money,” Lauder added. “Even if the federal government kept its promise to fund most of the Florida Medicaid expansion, which many conservatives doubt will be the case, Floridians pay federal taxes in addition to state taxes. Federal dollars flowing into Florida are not free dollars, even for Floridians.
In other words: Florida’s “true conservatives” don’t much care what mechanism is being used to expand coverage; they’re just flatly against it.
In Texas, meanwhile, the rejectionist camp is led by Gov. Rick Perry, as Ron Brownstein explains in a National Journal column:
Republican state Rep. John Zerwas, a health care leader who represents a district outside Houston, says legislators are getting an earful at home from providers and local officials worried about the state rejecting the money.
Against that backdrop, Zerwas and some GOP state House colleagues are searching for ways to steer Texas into the expansion. They assume the state will not move more people into the existing Medicaid program. But they consider it misguided to simply reject the federal money and deny insurance coverage to so many people who could obtain it. “We are not going to make this better … without doing something that substantially reforms how we deliver Medicaid,” Zerwas says. However, “we have to have a solution for this group of people.”
Last week, Zerwas introduced legislation that would authorize state health officials to negotiate with the Obama administration to expand while delivering coverage for the newly eligible through new means. He likes the deal the administration is discussing with Arkansas, which could allow the state to use Medicaid expansion dollars to instead buy private insurance for its eligible adults, and he believes that approach could be “sellable to the governor.”
Many here, though, wonder if Perry would take any deal. The widespread belief is that he intends to seek the GOP presidential nomination again in 2016, and accepting more Medicaid money would smudge his image of Alamo-like resistance to Obama.
This is an interesting scenario given recent efforts from the Perry camp (outlined earlier this week in another National Journal piece by Michael Catalini) to depict the swaggering, gaffe-prone Texan as “ahead of his time” in understanding the need for Republican outreach to Latinos. Notes Brownstein:
[I]f state Republicans reject federal money that could insure 1 million or more Hispanics, they could provide Democrats with an unprecedented opportunity to energize those voters—the key to the party’s long-term revival. With rejection, says Democratic state Rep. Rafael Anchia of Dallas, Republicans “would dig themselves into an even deeper hole with the Hispanic community.”
It’s unclear how this will all play out in Florida and Texas. But nobody recently has lost any money betting on the hard-core conservative approach, particularly on an issue as incendiary to the Right as Obamacare. That rejecting any sort of coverage expansion beyond that absolutely required by the ACA would mean leaving vast sums of federal money on the table would in fact be considered a badge of honor by a lot of the people involved.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, March 22, 2013
“Victory For The Middle Class”: On Obamacare’s Third Birthday, There Are Already Reasons To Be Grateful
On March 23, 2010, Obamacare — formally known as the Patient Protection and Affordable Care Act — was signed into law by President Obama.
Three years later, the bulk of the first serious attempt at near-universal health care has not yet taken effect. Health marketplaces are still being formed, states are still deciding if they’ll take Medicaid expansion and the subsidies that will help tens of millions of Americans afford health care won’t roll out until January 1, 2014.
Implementing Obamacare won’t be easy, as even some of the biggest fans of the program admit. Expanding Medicare to cover all Americans would have to be an even simpler solution but a complete political impossibility — given that Joe Lieberman (I-CT), whose vote was necessary to pass the law, single-handedly vetoed a provision that would allow 55- to 64-year-olds to buy into Medicare. It’s a compromise solution that uses unpopular provisions — like the individual mandate — to achieve extremely popular results — ending lifetime limits and banning insurance companies from dropping patients once they become sick.
There will be plenty of time to debate the efficacy of Obamacare — especially with insurance companies enjoying record profits threatening to raise rates in order to justify changes to the law.
But right now we should celebrate the greatest victory for the middle class since Medicare and Medicaid. At its heart, Obamacare is a program that asks the rich and corporations to pay a little more to help working Americans get insurance they can count on, thus lowering the cost of health care for everyone. We already pay for each other’s health coverage, but just in the dumbest possible way — emergency rooms.
Here are five reasons to be grateful for Obamacare, which is already making life better for the middle class.
Obamacare Frees Workers And Entrepreneurs
One of the most popular aspects of Obamacare is that beginning in 2014, insurance companies will no longer be able to deny people coverage because of pre-existing conditions. Because insurance companies had been able to do this, many people avoided going to the doctor for fear of being diagnosed with a disease or condition that would brand them for the rest of their lives. Some stayed in jobs they didn’t want and others didn’t take the leap to start a new business for fear of not being able to get coverage. These changes especially free women — who by federal law can no longer be charged more for care because of their gender — to pursue new opportunities.
Insurance Companies Pay You Back
Insurance companies are required for the first time to prove that they’re spending between 80 and 85 percent of premiums, depending on the size of the company, on actual health care. If companies don’t spend that amount on coverage, they have to return that money to their customers — $1.2 billion was returned in 2012 to self-employed Americans whose insurers didn’t hit the proper ratio.
Millions Of Young People Already Covered
An estimated six million college students are already taking advantage of Obamacare’s provision that lets them stay on their parents’ insurance until the age of 26. This has led to a record drop in uninsured young people, allowing them to go back to school or pursue graduate degrees without taking on as much student loan debt.
Seniors Spend Less On Drugs
One of the most immediate benefits of Obamacare was the closing of the Medicare D prescription drug “donut hole,” which requires seniors to pay for the coverage gap between their deductible and yearly limit, at which point the plan covers all medication — $6.1 billion in drug coverage has already been distributed to seniors, which leads to the irony that Republicans ran and won in 2010 on saying that Obamacare cuts Medicare when, in fact, benefits for seniors have only increased. All the savings come from reforming the way providers are paid.
The Red States Get To Pay The Blue States Back
When the Supreme Court ruled that the mandate in Obamacare was Constitutional, it also gave states the chance to opt out of the Medicaid expansion that will provide free public health care for those not already on Medicaid, but who earn up to 133 percent of the poverty level. The states that are turning down the expansion, unfortunately, are some of those that need it the most. All of the states that have rejected the federal extra funding — which begins at 100 percent of the cost of the expansion and goes down to 90 percent — are states that generally vote Republican.
You probably know that most red states take in more federal money than they contribute, as Republican policies encourage growth of programs like food stamps. Though Republican governors can reject the benefits of Medicaid expansion, their richest citizens and corporations will still have to pay the taxes. As a result, they won’t be such “takers.”
Unfortunately, the working poor of red states — who earn too much to be on basic Medicaid — will suffer without the health insurance they need. Those on Medicare and Medicaid will likely see fewer doctors who want to accept clients from these programs, as Medicaid expansion was supposed to make up for the cut in reimbursement rates that begins in 2014. And all residents will not enjoy the slowdown in the growth of health care costs that will come from shrinking the number of the uninsured.
For red state governors, it’s a chance to fulfill the prophecies of doom Republicans made when Obamacare passed. But for residents of blue states, it’s a chance to make America’s health care system more equitable, with red states finally paying closer to their fair share.
By: Jason Sattler, The National Memo, March 22, 2013; Photo: The Advisory Board Company
“Live By The Teaparty, Die By The Teaparty”: Florida Governor Rick Scott Is In Deep Trouble
According to a new Public Policy Polling poll, Florida voters are eager to vote Governor Rick Scott out of office.
The poll finds Scott’s approval rating at a dismal 33 percent, with 57 percent disapproving. These numbers are unchanged from PPP’s previous Florida poll in January, despite Scott’s concerted effort to appeal to Florida’s moderates over the past two months.
If the election were held today, former governor Charlie Crist would easily defeat Scott, 52 to 40 percent. Crist, the Republican-turned-Democrat who served as governor from 2007 through 2011, holds a 46 percent approval rating, with 43 percent of Floridians disapproving. These numbers aren’t great, but should be good enough to top the deeply unpopular Scott.
The poll also finds Scott trailing two other potential Democratic candidates; former Tampa mayor Pam Iorio leads Scott 44 to 37 percent, and former Florida chief financial officer Alex Sink — who Scott defeated by less than 1 percent in the 2010 gubernatorial election — would lead the incumbent 45 to 40 percent.
Perhaps more troubling for Scott is that he is no longer even a safe bet to win the Republican Party’s nomination next year — 42 percent of Republicans say they want Scott to be their candidate in 2014, while 43 percent say they would prefer someone else. An overwhelming 55 percent of self-described moderates want to replace Scott; just 34 want him to seek re-election. “Somewhat conservative” Republicans support Scott 43 to 38 percent, and “very conservative” Republicans back him 46 to 42 percent. These numbers would theoretically leave the governor very vulnerable to a primary challenge.
Scott’s struggles among moderate Republicans help to explain his recent shift towards the center; after spending most of his term railing against government spending and Obamacare, in the past two months Scott moved to expand funding for education and accepted the Affordable Care Act’s Medicaid expansion. So far, these decisions have not helped Scott’s poll numbers.
They may have consequences with Scott’s few remaining supporters, however. Scott’s flip-flop on Medicaid expansion left one Florida Tea Party group so angry that it penned the governor a “breakup note,” wondering “how the Medicaid expansion is going to pay for the surgery to remove the knife planted in my back.”
If Scott isn’t careful, one of the first governors to be swept into office by the Tea Party movement may end up being swept out by the exact same forces.
By: Henry Decker, The National Memo, March 20, 2013
“A Total Howler”: Paul Ryan’s Budget, His Own Facts And Obamacare
Hello, I am back. We will discuss aspects of my vacation in due course, but first, our friend Mr. Ryan.
He’s facing lots of derision for assuming the repeal of Obamacare in his new budget. First of all, credit where it’s due–it was apparently Chris Wallace of Fox News who brought this information to light in questioning Ryan, so good for him.
And second of all, yes, this is a total howler. Repeal of Obamacare? Not going to happen. Could theoretically happen in 2017, one supposes, but by that time, even if there is a Republican president and Republican majorities in both houses of Congress, including the super-majority of 60 in the Senate that would presumably be needed to enact full repeal, states will be getting billions in federal funding to put working poor people on the rolls of their new exchanges. It seems pretty unlikely that broad support for undoing that would exist.
So Ryan’s assumption doesn’t pass any known laugh test. So why does he do it? Well, because of the old saying “that’s my story, and I’m stickin’ to it.” Which is to say…
The Republicans have spent the years since the passage of the Affordable Care Act insisting that it’s a deficit-buster. You heard Mitt Romney say this a thousand times. It wasn’t true, and it isn’t true. In June 2012, Politifact gave Romney a flat-out “false” when he made the claim, writing:
…for claims about deficits, we consider the Congressional Budget Office, often called the CBO, to be the standard by which we fact-check claims.
The CBO said this about the health care law back in 2010: It lowers the deficit, by about $124 billion over 10 years.
And in 2011, when Republicans offered a bill to repeal the health care law, the CBO said that increased the deficit, by about $210 billion over 10 years.
Now, is the CBO infallible? Certainly not. And good questions have been raised about some of the CBO’s methods in accounting for the health care law’s effects. We reported on some of those concerns in great detail in a fact-check of statements from U.S. Rep Paul Ryan, R-Wisc. He said the law was “accelerating our country toward bankruptcy.” We rated that Mostly False.
So Ryan has been telling this lie for a while, as have all Republicans. The month after this Politifact assessment, the CBO issued a second report running some new numbers and finding the same result. And this year, The New York Times reported in mid-February that the deficit was decreasing (and it is, and rapidly; see Krugman today on this) largely because of lower health-care costs, by no means all but some of which could be traced to the ACA.
In other words, in reality land, Obamacare contributes to deficit reduction. By how much, we certainly don’t yet know. But all the signs we have–the experts’ projections and the early evidence–suggest that this is the case.
But in Republican land, it’s an article of faith that the ACA increases the deficit. This being the case, or “the case” as it were, then how in the world could Ryan introduce a new budget to eliminate the deficit in 10 years (the full thing is being unveiled Wednesday) that includes Obamacare? He’d be destroyed by the agitprop machine of the right if his budget did that, both because they just detest the thing and because it “increases” the deficit. They’ve agreed on this! Anyone who says otherwise is guilty of apostasy.
So again, this is our “new” GOP. Making up realities according to how the howling half of the base would respond. That sounds kind of like the old GOP to me.
By: Michael Tomasky, The Daily Beast, March 11, 2013
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 