“Purposeful Republican Misrepresentation”: Read This Before You Believe The Obamacare Premium Spike Hysteria
While some states are reporting lower than expected health care premiums in the exchanges established by the Affordable Care Act, a growing number of Republican-controlled states — like South Carolina, Ohio, Indiana, Florida and Georgia — are garnering screaming headlines about huge premium spikes under the law.
Calculating premium rates is a complicated and tedious task that will vary greatly among states and is open to interpretation and manipulation by both supporters and opponents of President Obama’s health care law. Generalities are particularly hard to draw, as the law will impact Americans differently: the new regulations will lead some younger people to may pay more than they’re contributing now, but will save older and sicker people hundreds, if not thousands of dollars a month.
Still, since Republicans are politically motivated to portray the proposed premium increases in a negative light and the media is far more interested in sensational claims about Obamacare failing, coverage of the new rates often leads readers with the mistaken perception that the law is coming off the tracks. Below is a short guide that will help you identify if someone is misrepresenting how much premiums will increase under Obamacare:
1. Do the premiums account for subsidies?
Most articles about premiums for health insurance in the exchanges relegate information about the Affordable Care Act’s tax credit subsidies to the lower two thirds of the piece, thus presenting the top rates as the actual amount families and individuals will be required to pay.
In reality, the number of applicants who are eligible for sliding-scale tax credits will vary — the credits are available to people making less than four times the poverty line — but the Congressional Budget Office (CBO) estimates that out of the 7 million Americans expected to enroll in coverage in 2014, 6 million will be eligible for subsidies. Those with incomes up to 400 percent of the Federal Poverty Line (FPL) will also see reduced the out-of-pocket limits.
Maryland officials, for instance, project that three-fourths of enrollees will receive assistance. In 2014, the average subsidy will be $5,510 and will increase in the years ahead.
2. What is the state comparing the new premiums to and does it break down the increases by the available levels of coverage?
While states like New York or California have already enacted strict regulations that mirror many of the new rules in the Affordable Care Act, others (like Indiana or South Carolina) allow insurers to sell skimpy bare-bones high deductible plans that provide little actual coverage.
Comparing the comprehensive plans that will be available in the exchanges (and the individual market) to the existing coverage is like likening a Lexus to a bicycle — yes, the car is more expensive, but it is in a whole different category of transportation. Under the law, all new insurance plans have to offer essential health benefits like prescription drug and mental health services.
3. Are cheaper coverage options mentioned?
Last month, state officials in Indiana announced that premiums for individual policies would be 72 percent higher than the premiums people currently play. But a closer look at the data revealed that the state wasn’t issuing actual premiums, but calculations for “allowed cost” or “the cost of insurance before calculating how much individuals would pay out-of-pocket, because of co-payments and deductibles.” The actual premiums turned out to be much lower.
What’s more, the numbers were averages of all plans in the exchange — from bronze plans that cover 60 percent of health care costs to platinum plans, which pay for 90 percent — and were not representations of the prices actual families will pay. Past experience in Massachusetts shows that consumers are very price conscious and will gravitate towards the cheaper bronze or silver plans. (In Massachusetts, 84 percent enrolled in bronze or silver policies.)
A catastrophic plan will also be available to those up to age 30 in the individual market. In Nevada, this coverage will be available for less than $100.
4. Has the state done all it could to reduce premiums?
Approximately two dozen states allow the state insurance department or commission “the legal power of prior approval, or disapproval, of certain types of rate changes” and under the Affordable Care Act, the federal government has offered grant funding “to help with rate review activities.” States like Maryland — which has some of the strongest rate-setting laws in the country — claims to have used its authority to deny rate increases to reduce the proposed premiums by “more than 50 percent.” Oregon regulators also slashed carriers’ rate requests by as much as 35 percent.
By: Igor Volsky, Think Progress, August 5, 2013
“Time For Conservatives To Face Reality”: Deal With It, ObamaCare Will Not Be Repealed Or Defunded
On March 21, 2010, my former boss and mentor, David Frum, wrote a story that ran on FrumForum.com under the headline “Waterloo.” It harshly criticized conservatives for their uncompromising opposition to the bill officially titled the Patient Protection and Affordable Care Act, but which most of us know simply as ObamaCare. David agreed that in a perfect world, ObamaCare would never see the light of day. However, surveying the legislative landscape, David observed that the GOP never had enough votes to defeat the health-care bill.
While conservatives could not prevent the bill from becoming law entirely, David argued that they could have engaged with Democrats and possibly watered down many of the bill’s most unconservative provisions. Instead, though, the GOP refused to participate at all because the worse the bill the unchecked Democratic Congress passed, the better Republicans would do in the 2010 midterm elections.
“Waterloo” went live on the website at around 5 p.m. on the 21st. Within 24 hours, American Enterprise Institute President Arthur Brooks took David to lunch and fired him, essentially for daring to disagree.
More than three years and two elections have passed since David was shouted down for pointing out the flaws in the GOP’s “strategy” for handling ObamaCare. History appears to have provided David right. While the GOP did seize control of the House in November 2010, the party has failed to secure the Senate and, more importantly, Barack Obama won re-election. Realistically, what that means is that repeal is not an option, since even if the GOP did somehow manage to secure a filibuster-proof majority in the Senate in 2014 (which even the most optimistic prognosticators will tell you is not going to happen), the GOP still could not affect repeal (since the president would veto). And yet, despite this harsh reality, serious members of the GOP are still promising voters that they will repeal the law. Indeed, Mike Lee and Ted Cruz are threatening to shut down the government if the president does not defund the law.
Not surprisingly, plenty of smart liberals have taken note of the GOP’s obstinacy on this issue. But more interesting is the fact that some of the brightest voices within the conservative movement are beginning to speak out against the futility of the strategy that my old boss was fired for raising back in 2010. The question ought never have been whether we can prevent ObamaCare, but rather how bad ObamaCare was going to be when the bill finally was delivered to the president for signing.
Late last week, Charles Krauthammer finally put his foot down in the face of Cruz and Lee’s continued efforts to shape GOP policy proposals as if they lived in a perfect conservative world that simply does not exist. Krauthammer did not mince words, describing the Cruz/Lee ultimatum as “nuts.” While he acknowledged that he would support defunding ObamaCare if he thought it would work, he also said it’s obvious that it won’t work, and that he does not fancy “suicide.” Indeed, while Lee and Cruz will undoubtedly claim those who don’t support their cause are less than full conservatives, Krauthammer correctly observed that one’s position on their proposal has little to do with principle and everything to do with “sanity.”
Interestingly, the point that Krauthammer makes is virtually identical to the one David made three years ago. The proposition underlying both articles is that electoral realities must govern ideological decision-making. In a perfect world, Republicans simply could have prevented ObamaCare’s passage by voting against it. Similarly, now, in a perfect world, Republicans would have the votes to repeal or defund ObamaCare.
But alas, this is not a perfect world and that being the case, true conservatives adjust their tactics and their expectations. Over the past three years, the GOP base has become so enamored with the idea of ideological purity that they have been willing to throw the realities of real world politics overboard to chase it. But real defenders of conservatism must learn to embrace the painful compromises of day-to-day governance. Otherwise, we will become a party that stands by and debates itself while living under completely unchecked legislation shaped wholly by our ideological opponents.
By: Jeb Golinkin, The Week, August 6, 2013
“The GOP’s Limited Appeal”: New Data Shows Why The Next Republican Nominee Is Screwed
Immigration reform isn’t quite dead yet, but the political fall-out of immigration reform’s demise is pretty clear: the GOP rebrand is going to be pretty tough. Despite relatively favorable circumstances, immigration reform advocates weren’t able to drag the party toward the center. And if congressional Republicans can’t advance the rebrand by allowing losing issues—like a pathway to citizenship or background checks on gun purchases—to advance through Congress and depart from consideration in 2016, then the next Republican nominee will be left with the difficult task of broadening the appeal of the GOP.
Today, a new Pew Research survey suggests that Republican presidential candidates won’t find it easy to move toward the center. The poll shows that Republicans recognize the need for change—with 59 percent even suggesting they need to change on the issues. But when it comes to the specifics, most Republicans support maintaining the party’s current positions or even moving further to the right. When asked about the party’s current stance on gay marriage, immigration, government spending, abortion, and guns, at least 60 percent of Republicans said they thought the party was about right or too moderate.
Desire for change was greatest, if still very limited, on cultural conservative issues. On gay marriage, 31 percent of Republicans said they wanted the party to moderate. But 27 percent thought the party wasn’t conservative enough (do they want a return to sodomy laws?) and another 33 percent were satisfied with the party’s current stance. The numbers were similar on abortion: 25 percent wanted the party to moderate, but 26 percent thought the party wasn’t conservative enough, and another 41 percent were satisfied with the party’s current position.
On immigration, where the party’s current position is potentially less clear to voters, the Republican rank-and-file isn’t itching to get behind a compromise. 17 percent support moving to the left on immigration, compared to 36 percent who want the party to get more conservative. More generally, 67 percent of Republicans think the party is compromising too much or the right amount with Democrats.
Unfortunately, the poll offered fewer answers on economic issues, the center of much of the discussion of the Republican “rebrand.” The poll only asked about government spending, where Republicans are predictably all but unified—only 10 percent want the party to moderate, compared to 46 percent who want a more conservative stance and another 41 percent who are satisfied with the party’s current position. But the poll offers few answers on other economic issues, like taxes, Wall Street, or the various proposals for making the party more “populist” within its current ideological bounds. The degree of party unity on government spending, however, suggests that there might not be very much space for movement on economic issues.
With little Republican appetite for moderation, it’s not surprising that Rubio’s numbers have dropped. It’s also not surprising that he’s moving to reaffirm his conservative credentials on the push to defund Obamacare and ban abortion after twenty weeks. These numbers suggest that the Republicans won’t be eager to nominate someone pushing the party to moderate, at least on cultural issues and government spending. Chris Christie’s favorability ratings suggest as much: He’s only at plus-17, with 47 percent favorable and a sizable 30 percent holding an unfavorable opinion. That’s worse than Romney ever had, and it’s probably inconsistent with winning the Republican nomination.
The composition of the Republican primary electorate makes the challenge even greater. In the Pew poll, 49 percent of Republicans who participate in every primary support the tea party—just 22 percent consider themselves moderate. In last year’s primaries, evangelical Christians represented more than 40 percent of the electorate in just about every major contest, including relatively moderate Romney states like Illinois, Michigan, Ohio, and Florida.
Given today’s numbers and Mitt Romney’s difficulty securing the nomination, it’s highly unclear whether Republicans could nominate a candidate who wants to moderate the party. And if the primary process is unlikely to yield a candidate who can moderate the party, then the Republican House would be wise to preemptively bail out the next Republican candidate, and relieve them of the obligation to oppose a pathway to citizenship, background checks on gun purchases, or whatever else. That doesn’t look like it will happen. Instead, it looks like Republicans will need to count on the appeal of their 2016 presidential candidate and economic fundamentals to overcome the party’s limited appeal.
By: Nat Cohn, The New Republic, July 31, 2013
“The Notion Of The Shiny Object Theory”: Conservative Firebrands Want Scalps, Not Hollow Victories
Ornery first-term Republican senators and bomb-throwing conservative activist groups are locking horns again with the Republican establishment.
Tea Party firebrands want to defund Obamacare by threatening to shut down the government at the end of the fiscal year. Other Republicans decry this as irresponsible.
Insurgents say the Establishment doesn’t really care about conservative goals. The Establishment says the right-wingers confuse a difference in tactics for a lack of principle.
To understand the tension, it helps to explore the notion of the “Shiny Object.”
Mike Needham is the CEO of Heritage Action for America, the lobbying arm of the conservative Heritage Foundation. Heritage Action is the spearhead of the Beltway Tea Party. Needham is the sharp tip of that spear. He’s also the author of the Shiny Object theory.
Republican lawmakers want to please their conservative constituents, especially in these days of Tea Party primaries. To mollify the base, GOP members come home touting a conservative vote or a victory over the Democrats. Far too often, Needham says, these supposed conservative accomplishments are just “shiny objects” intended to distract conservative voters from the lack of accomplishments by Washington Republicans.
Needham first used this term with me while discussing the gun control battle of last spring. Republican senators went back to their districts trumpeting that they had defeated Harry Reid’s assault-weapons ban.
“There was no chance that an assault weapons ban was going to pass,” Needham tells me. Defeating the assault-weapons ban was a shiny object that Republicans could hold out to distract conservatives, providing cover for mandating background checks.
Conservative congressional aides, current and past, complain that this shiny-object method has been the standard operating procedure.
New power dynamics disrupt this.
On gun control, the Tea Partiers refused to let the shiny-object strategy work. Freshman Sen. Ted Cruz, R-Texas, raised a stink, accusing GOP senators of being “squishes” on gun rights. Outside groups ran ads in the districts of GOP senators, ignoring the assault-weapons ban and saying the real fight was the background-check provision crafted by Senators Pat Toomey, R-Pa., and Joe Manchin, D-W.Va.
The grassroots responded, and Republican members heard about it during the congressional recess. Toomey-Manchin failed.
Heritage Action, FreedomWorks, Club for Growth, and Americans for Prosperity — with their broad networks of local conservatives — all make the shiny-object trick harder. Politicians are no longer voters’ only source of inside-the-Beltway intelligence.
So when a Republican congressman says at his town hall he has voted to repeal Obamacare, the member might get pointed questions from some AFP member or local activist who sat in on a Heritage Action weekly conference call. Obamacare-repeal votes are shiny objects, these groups tell the grassroots. They are not really going to change policy.
The insurgents demand actions that could get real results. “Defund it or own it,” Sen. Mike Lee, R-Utah, said on the Senate floor Tuesday. “If you fund it, you’re for it.”
How can a minority party defund Obamacare? By threatening to kill all appropriations for fiscal year 2014. Republican leaders think this unwise, and they bristle at the suggestion that they’re fine with Obamacare.
“We’ve been fighting this thing with everything we’ve got for four years,” one GOP Senate aide told me. “We don’t have a difference in goals, we have a difference in strategies … The party continues to be united in the effort to repeal it, but this is just not the right strategy.”
But Needham and allies argue that the Establishment’s strategy equals giving up. He has a point. Many Republicans quietly say what my Washington Examiner colleague Byron York writes: The 2012 election was the last chance to kill this beast.
Needham says he’s just trying to hold Republicans to their word: “When they tell their constituents, ‘I will come to Washington and do everything I can to block Obamacare,’ if they don’t do everything they can … They should have to explain themselves.”
This appears suicidal to many. Conservative columnist Ramesh Ponnuru writes: “The chance that Democrats would go along … approaches zero percent. So if Republicans stay firm in this demand, the result will be either a government shutdown or a partial shutdown combined with a debt default.” And Republicans will take the blame.
But even if you can’t get your opening ask, the insurgents say, you can get something. Hold out until late September, and maybe Democrats will agree to delay the individual mandate — or delay the exchanges until the government thinks it can determine eligibility for subsidies.
These conservatives believe Republicans have been fooling them with shiny objects. This time, they want actual scalps.
By: Timothy P. Carney, The Washington Examiner, July 30, 2013
“You Made Your Bed, Now Sleep In It”: Hey Republican “Grown-Ups”, Ted Cruz Does Not Care About You
A small contingent of the more Tea Party-ish Republican senators has decided to shut down the government unless “Obamacare” is “defunded.” (Or, at least, they plan to threaten to shut down the government.) Defunding Obamacare is not really as simple as it sounds. The ACA involves a lot of “mandatory” as opposed to “discretionary” spending, so you can’t really effectively repeal the program through the Continuing Resolution. (Here’s Karl Rove explaining the issue.) The plan was Sen. Mike Lee’s (R-Utah) idea, but its current most vocal proponent is Ted Cruz, R-Texas, a very smart man who purposefully talks like a very crazy man, because he understands how to become a celebrity in the modern conservative movement.
Cruz doesn’t care if the plan makes sense, either as policy or even as political tactics. If he cared about passing conservative legislation, he wouldn’t spend all of his time purposefully angering his Republican colleagues. If he cared about the Republican Party’s national image and reputation, as opposed to his own image within the conservative activist community, he would have offered rhetorical support for immigration reform, as Rand Paul did. Cruz is in it for himself and himself alone. A majority of Americans want the GOP to be more conciliatory and moderate. A majority of Republicans strongly believe that the party must be even more conservative.
So if all the “grown-ups” — the respectable, professional Republicans — tell Ted Cruz not to do something, he is going to be even more dedicated to doing that thing. This week, all the respectable, professional Republicans told Ted Cruz not to try to shut down the government over Obamacare.
Karl Rove said it, in a Fox News editorial. His argument is that no matter how awful Obamacare is, a shutdown will hurt the party. He is correct. (The important point about Rove is that he is a professional liar, but he is one whose motivation — helping the Republican Party win and hold on to as much power as possible — is sincere.) But Cruz doesn’t care about the party.
Jennifer Rubin — who has clearly detested Cruz for a while now — has been relentless in her attacks on Cruz and his shutdown caucus. This has actually been a tad inconvenient, because one of Rubin’s favorite pols right now is Marco Rubio, who supports the Lee/Cruz plot. Rubin has done her best to dissuade him.
Charles Krauthammer called the Lee and Cruz plan “nuts” and “yet another cliff dive as a show of principle and manliness.” Former Bush speechwriter Michael Gerson, who has an opinion column in the Washington Post for some utterly unfathomable reason, is similarly opposed.
To all these critics, the only reasonable response is, hope you enjoy this bed you made for yourselves. Ted Cruz is the right man for the decadent decline stage of the conservative movement, which has always encouraged the advancement of fact-challenged populist extremists, but always with the understanding that they’d take a back seat to the sensible business interests when it came time to exercise power. The result has been a huge number of Republican activists who couldn’t figure out why the True Conservatives they kept voting for kept failing to achieve the creation of the perfect conservative state once in office. That led to an ongoing backlash against everyone in the party suspected of anything less than perfect ideological purity. Meanwhile all the crazies got rich simply for being crazy. There’s no longer any compelling reason, in other words, not to act like Ted Cruz, and the result is Ted Cruz.
And if Ted Cruz is reading, all of these columns are only going to strengthen his resolve. Just look at this amazing conservative Facebook image macro shared by Gawker’s Max Read: Cruz is in the company of batshit far-right folk heroes like Allen West and Oliver North, people revered as much because of the disdain they inspire in both liberals and professional conservatives as for their actual beliefs or accomplishments.
Ted Cruz just won the Colorado Christian University 2016 straw poll and he will be a featured guest at Erick Erickson’s “RedState Gathering.” It’s working. Your “logic” won’t interest him.
By: Alex Pareene, Salon, August 2, 2013
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