“Health Reform Turns Real”: Even The “Bad News” On Obamacare Start-Up Is Really Good News For The Program’s Future
At this point, the crisis in American governance has taken on a life of its own. Some Republicans are now saying openly that they want concessions in return for reopening the government and avoiding default, not because they have any specific policy goals in mind, but simply because they don’t want to feel “disrespected.” And no endgame is in sight.
But this confrontation did start with a real issue: Republican efforts to stop Obamacare from going into effect. It’s long been clear that the great fear of the Republican Party was not that health reform would fail, but that it would succeed. And developments since Tuesday, when the exchanges on which individuals will buy health insurance opened for business, strongly suggest that their worst fears will indeed be realized: This thing is going to work.
Wait a minute, some readers are saying. Haven’t many stories so far been of computer glitches, of people confronting screens telling them that servers are busy and that they should try again later? Indeed, they have. But everyone knowledgeable about the process always expected some teething problems, and the nature of this week’s problems has actually been hugely encouraging for supporters of the program.
First, let me say a word about the underlying irrelevance of start-up troubles for new government programs.
Political reporting in America, especially but not only on TV, tends to be focused on the play-by-play. Who won today’s news cycle? And, to be fair, this sort of thing may matter during the final days of an election.
But Obamacare isn’t up for a popular referendum, or a revote of any kind. It’s the law, and it’s going into effect. Its future will depend on how it works over the next few years, not the next few weeks.
To illustrate the point, consider Medicare Part D, the drug benefit, which went into effect in 2006. It had what was widely considered a disastrous start, with seniors unclear on their benefits, pharmacies often refusing to honor valid claims, computer problems, and more. In the end, however, the program delivered lasting benefits, and woe unto any politician proposing that it be rolled back.
So the glitches of October won’t matter in the long run. But why are they actually encouraging? Because they appear, for the most part, to be the result of the sheer volume of traffic, which has been much heavier than expected. And this means that one big worry of Obamacare supporters — that not enough people knew about the program, so that many eligible Americans would fail to sign up — is receding fast.
Of course, it’s important that people who want to sign up can actually do so. But the computer problems can and will be fixed. So, by March 31, when enrollment for 2014 closes, we can be reasonably sure that millions of Americans who were previously uninsured will have coverage under the Affordable Care Act. Obamacare will have become a reality, something people depend on, rather than some fuzzy notion Republicans could demonize. And it will be very hard to take that coverage away.
What we still don’t know, and is crucial for the program’s longer-term success, is who will sign up. Will there be enough young, healthy enrollees to provide a favorable risk pool and keep premiums relatively low? Bear in mind that conservative groups have been spending heavily — and making some seriously creepy ads — in an effort to dissuade young people from signing up for insurance. Nonetheless, insurance companies are betting that young people will, in fact, sign up, as shown by the unexpectedly low premiums they’re offering for next year.
And the insurers are probably right. To see why anti-Obamacare messaging is probably doomed to fail, think about whom we’re talking about here. That is, who are the healthy uninsured individuals the program needs to reach? Well, they’re by and large not affluent, because affluent young people tend to get jobs with health coverage. And they’re disproportionately nonwhite.
In other words, to get a description of the typical person Obamacare needs to enroll, just take the description of a typical Tea Party member or Fox News viewer — older, affluent, white — and put a “not” in front of each characteristic. These are people the right-wing message machine is not set up to talk to, but who can be reached through many of the same channels, from ads on Spanish-language media to celebrity tweets, that turned out Obama voters last year. I have to admit, I find the image of hard-line conservatives defeated by an army of tweeting celebrities highly attractive; but it’s also realistic. Enrollment is probably going to be just fine.
So Obamacare is off to a good start, with even the bad news being really good news for the program’s future. We’re not quite there yet, but more and more, it looks as if health reform is here to stay.
By: Paul Krugman, Op-Ed Columnist, The New York Times, October 3, 2013
“A Steady Stream Of Untruths”: Everything You’ve Heard About Obamacare Being A Job-Killer Is Wrong
The U.S. government is now “shut down” thanks in large part to yet another attempt to put the brakes on the Affordable Care Act, or ACA. Yet this week, the law’s health care exchanges went on line, promising affordable insurance coverage for millions of Americans with pre-existing conditions or jobs that did not previously offer a health plan and to millions of the unemployed. Nevertheless, a steady stream of untruths about the law continues to pop up in newspapers, blogs and Facebook feeds.
One of these tropes is that the ACA is causing employers to cut back on hours for full-time employees so that they will not have to provide coverage (under the ACA, companies with more than 49 employees are required to offer health insurance coverage to those employees working 30 or more hours a week or face penalties). Typically, the evidence for the cutbacks in hours is that someone knows someone else whose hours were cut earlier this year in anticipation of the law taking effect. Many pundits have been even lazier, just stating that employers are cutting back hours without citing concrete examples.
The reality, though, is that there is no widespread trend of employers cutting their workers back to just under 30 hours because of the ACA. In July, my colleagues Dean Baker and Helene Jorgensen analyzed recent data from the Current Population Survey. They found that only 0.64 percent of the workforce was working between 26 and 29 hours a week in the first half of 2013. This number is only slightly higher than it was for the first half of 2012 (0.61 percent).
In other words, there is no evidence of a widespread trend of employers reducing hours to avoid providing coverage. That sentiment was recently echoed by Moody’s Mark Zandi, who said of the supposed trend, “I was expecting to see it. I was looking for it and it’s not there.”
The basic story is that, yes, there are a small number of firms that have cut down on the number of full-time employees recently. And yes, over time, the 30-hour cutoff could have some effect on hours as employers adjust to the law and new businesses open. Of course, some companies may go the opposite route and move part-time workers to full time, as was recently the case at Disney World.
Regardless, the promulgation of the idea that the ACA will transform the U.S. workforce into a part-time workforce and negatively impact employment in the United States is dead wrong.
By: Alan Barber, U. S. News and World Report, October 4, 2013
“Pride Goeth Before The Shutdown”: The “Special Role” Of Boehner And The Screaming Tykes
It’s remarkable how much the current crop of House Republican radicals seems bent on repeating the mistakes of their Gingrichian forebears. First, of course, they shut down the government. The ostensible reason was implacable opposition to Obamacare in the name of “ the American people” (even if the American people actually support neither rolling back the Affordable Care Act nor shutting down the government), but as the New York Times’ Jonathan Weisman detailed Saturday, that message has gotten muddled in a GOP talking points funhouse mirror where conservatives are suddenly defenders of government and seekers of compromise.
But the most plausible reason enunciated to this point – now openly verbalized by at least two Republican House members – also happens to be the most offensive: pride.
Florida GOP Rep. Dennis Ross told Weisman that the shutdown is imperiling the “significant gains” conservatives have made on cutting spending because – wait for it – “there’s no connection now between the shutdown and the funding of Obamacare.” So what’s going on then? “I think now it’s a lot about pride,” said Ross, a tea party conservative who has elsewhere acknowledged that the GOP has already “lost the [continuing resolution] battle.”
Indiana Rep. Marlin Stutzman, another denizen of the conservative fringe, told the Washington Examiner’s David Drucker that “we’re not going to be disrespected. … We have to get something out of this. And I don’t know what that even is.”
Side note to Congressman Stutzman: While it’s often said “respect must be earned,” that’s actually not the case in Washington. Inside the beltway titles and offices get their due respect – disrespect must be earned. And there’s no surer way to do that than shutting down the government and refusing to reopen it on the grounds that “we have to get something out of this. And I don’t know what that even is.”
In any case, Stutzman later issued a statement trying to walk back his comment, saying that he had “carelessly misrepresented the ongoing budget debate.” But if he was careless it was only in the sense of committing the classic Washington gaffe: telling the truth. As the Washington Post’s Ezra Klein wrote on Thursday:
Stutzman is right. The fight over the shutdown has become unmoored from any particular policy demands the GOP believes it can secure. It’s become an issue of pride and politics. At this point, Republicans simply need something so they can tell themselves, and their base, that they didn’t lose. They don’t know what that something is, exactly. But it needs to be something.
Decoupled from Obamacare, the shutdown has become about soothing the flustered tea party wing of the GOP. These pols have adopted a kindergarten-esque view of legislating: they deserve some sort of reward just because they tried really hard and because they really, really want it. The government’s been shut down? It’s all good because, in the memorable words of Minnesota GOP Rep. Michele Bachmann, “This is about the happiest I’ve seen members in a long time, because we see we are starting to win this dialogue on a national level.” (Given the initial polling of the shutdown, she seems to have a unique definition of winning.)
As I noted yesterday, the Times reported that Boehner and his team know that they’ve got an untenable position but are determined to drag the showdown on long enough wrap the debt ceiling fight into it. They want to minimize the number of tantrums the caucus’s conservative fringe throws over its inability to win on either of its quixotic quests.
This view of shutting down the federal government as some sort of tea party therapy strategy brings us back to the ghosts of 1995. One of the turning points of the first government shutdown came when the New York Daily News (a corporate cousin, as both it and U.S. News & World Report are owned by Mort Zuckerman) published a famous front page portraying then-House Speaker Newt Gingrich as a cry-baby. Gingrich had complained to reporters about feeling slighted after he had been made to sit at the back of Air Force One and exit through the rear door when he flew back with President Clinton from the funeral of Israeli Prime Minister Yitzhak Rabin. “This is petty,” Gingrich said. “I’m going to say up front it’s petty, but I think it’s human.” The public got the basic pettiness of bringing the work of governance to halt over personal pride.
John Boehner, with his endearing crying jags and carefully timed minor profanities isn’t so stupid as to articulate the reasons for shutting the government down in terms of personal or movement pride. But if the Daily News recycles its famous front page some time in the next few days it won’t be a caricature of one giant crybaby but instead one of a hapless Boehner surrounded by dozens of screaming tykes. How long will it be before more members of the tea party fringe, empowered by their unshakable belief in their own special role of spokesperson for “the American people,” follow the lead of Stutzman and Ross?
By: Robert Schlesinger, U. S. News and World Report, October 6, 2013
“Making The Tea Party Feel Better”: Republicans Finally Admit What The Shutdown Is About
The conservative media began to report strange rumblings from Republicans on Wednesday, the second day of the government shutdown. Suddenly, Tea Partiers were saying that the government shutdown wasn’t about Obamacare, though they refuse to vote for a continuing resolution passed by the Senate because all their amendments related to the Affordable Care Act have been stripped out.
What is the shutdown about, then? What do Republicans want?
“We’re not going to be disrespected,” Rep. Marlin Stutzman (R-IN) told The Washington Examiner. “We have to get something out of this. And I don’t know what that even is.”
I repeat: “And I don’t know what that even is.”
It’s reminiscent of a classic scene from The Godfather II, when Fredo Corleone explained to his brother Michael why he was angry at being passed over by his father: http://youtu.be/2X9E9n6GHC8
Stutzman is a member of the so-called Suicide Caucus, 80 members of the House who signed a letter to Speaker John Boehner (R-OH) urging him to pursue a strategy of defunding Obamacare in exchange for funding the government. But given that this strategy could never work and the government is now shut down, Tea Partiers want “something,” but they “don’t know what that even is.”
Rep. Michele Bachmann (R-MN) told Fox News’ Sean Hannity Wednesday night, “This is about the happiest I’ve seen members in a long time because we’ve seen we’re starting to win this dialogue on a national level.”
Despite a new poll showing that show more voters blame Republicans and nearly three-quarters didn’t want a shutdown, Bachmann is still sure Republicans are finally winning.
Now they just need to figure out what they’re winning.
By: Jason Sattler, The National Memo, October 3, 2013
“Plan Beats No Plan”: In This Clash, Democrats Deserve The Victory
“Plan beats no plan.”
That was Tim Geithner’s political axiom in internal White House debates as the president’s team worked to mend the financial meltdown. Today his slogan does duty nicely as a preview of the public’s judgment on the shocking Republican choice to shut down the government over Obamacare.
Communications strategy in politics generally involves people in power crafting messages for less knowledgeable people (the press) to transmit to even less knowledgeable people (voters). (If you doubt this, have a look at the brilliant man-on-the-street segment Jimmy Kimmel did asking people whether they prefer “Obamacare” or “The Affordable Care Act.”). The idea in these messaging wars is to convey “values” that resonate with the public and trump your opponent’s.
Consider the current showdown in this context. President Obama championed a plan through which government will spend hundreds of billions of dollars to help millions of low- and middle-income Americans buy decent private health coverage. As can never be said often enough, Obama’s plan also happens to have been based on a sensible Republican design that Mitt Romney enacted successfully in Massachusetts.
Republicans have no plan — literally, nothing serious whatsoever — to help more than a handful of the roughly 50 million uninsured Americans get such coverage. Yes, the GOP offers little talking points around the edges so that its team has something to say. But all of its “ideas” — from group purchasing for small business to buying coverage across state lines — are pseudo-plans. Nothing the Republican leadership has offered reaches more than 3 million people.
Once you understand this, you understand how deeply disingenuous Republican messaging has been. House Speaker John Boehner delivered a sound bite Monday night: “ We think there ought to be basic fairness for all Americans under Obamacare .” That’s why the GOP wouldn’t budge.
Is Boehner kidding? Is that all they have? By “fairness” Boehner means the law’s individual mandate should be delayed for a year, just like the employer mandate has been put off. To save people from “the harms” of Obamacare, in Sen. Ted Cruz’s (R-Tex.) irritating collegiate debate lingo. Democrats are on the side of big business, you see, while the GOP is fighting for the little guy.
Now, to say that this message is an insult to our intelligence isn’t the end of the discussion, because no one ever lost a political fight by insulting the American public’s intelligence.
But that Republicans are staking the shutdown on this thin gruel is revealing. They’re not saying, “we have a better plan to help Americans achieve health security.” They can’t say that, because the president already enacted the Republican plan. Instead, they’re ginning up a phony “fairness” issue and trying to make it sound real.
But the employer mandate is a sideshow in Obamacare. It’s there for one reason: to keep employer money in the game to reduce the cost on public budgets of extending health-care coverage. Ending the employer role in health-care coverage and shifting these costs to public ledgers would be economically rational — better both for citizens and for businesses. Politically, however, the White House judged this to be untenable.
So let’s stipulate that over time the employer mandate should be scrapped. The individual mandate, by contrast — the “unfairness” the GOP now bemoans — is essential. As conservatives taught us via Romneycare, you can’t move toward universal coverage with private health-insurance plans without requiring everyone to be in the insurance pool (and also without subsidizing folks who need help buying coverage). Without a mandate and subsidies, younger, poorer and healthier folks opt out, making rates spiral. This is Insurance 101.
Trying to equate these mandates as a “fairness” issue is to assume the press and the public are idiots. Crafting a message that works only if people are idiots is a grim way to do politics — and deeply cynical. Republicans hardly have a monopoly on cynical political tactics, but to use cynicism in the service of denying basic health security to millions is morally unattractive, to put it mildly. Not something you want to tell the kids about.
“What did you do today, Daddy?” asks the son of one of these House Republicans in my imagination.
‘Hey, Junior, I twisted truth and logic to make sure millions of poor American workers can still go broke if someone in their family gets seriously ill. . . . Junior, why are you looking at me like that?”
John Boehner may look tanned and rested, but the suave speaker has a Dorian Gray problem. Somewhere in the attic, his likeness in a painting is rotting.
There’s a wonderful poster from World War II in which Churchill exhorts British citizens to “Deserve Victory.”
In this clash, Democrats do.
By: Matt Miller, Opinion Writer, The Washington Post, October 2, 2013
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