“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
“Hatred Overwhelming Judgment”: The “Refuse To Enroll” Campaign Gets To Work Against Obamacare
When Reuters reported last week that Republicans and their allies “are mobilizing … to dissuade uninsured Americans from obtaining health coverage,” it caused a bit of a stir. After all, what kind of people would invest time and energy into convincing struggling families to turn down access to affordable health care? Who would be so callous as to put partisan spite over the basic health care needs of their community?
Well, now we know. The Dayton Daily News has hidden the story behind a paywall, but the paper reported yesterday on groups like the “Citizens’ Council for Health Freedom,” which is rallying behind the “Refuse to Enroll” campaign.
With time running out, opponents of the Affordable Care Act have taken to the airwaves in Ohio and elsewhere with ad campaigns not only attacking the bill’s merits but also actively encouraging uninsured Americans not to sign up for coverage under the health care law.
The Obama administration has acknowledged the success of the law, commonly referred to as Obamacare, depends in large part on broad-based participation in federal and state-run health exchanges that will begin selling government-subsidized health plans to the uninsured on Oct. 1.
The anti-enrollment campaigns reflect the resignation and desperation of many Obamacare opponents who have given up hope of a government repeal or court-ordered injunction to stop full implementation of the law beginning next year.
This is clearly an important stage in the larger fight. Desperate right-wing activists know the law won’t be repealed; they know it can’t be stopped in the courts; and they know there’s a limit to Republican efforts to sabotage the federal health care system. So they’ve been reduced to one last-ditch effort: convince people with no health care coverage to voluntarily turn down affordable insurance so as to advance their ideological cause.
And why do conservative activists want this? It’s not altogether clear, exactly, but apparently their hatred for President Obama has overwhelmed their judgment and basic sense of morality to a degree that can only be considered alarming.
Twila Brase, for example, is putting the “Refuse to Enroll” campaign on her radio show, which is “broadcast on more than 350 stations nationwide, including the American Family Radio Network with stations throughout Ohio.” And she’ll have lots of company, including support from her Koch brothers allies.
The conservative group Americans for Prosperity, which has a chapter in Ohio, has launched another campaign attacking Obamacare with television and online ads that began airing in Ohio last week.
Joan McCarter summarized this nicely: conservatives “have to convince people that either paying through the nose for insurance or going without, all to make a political point, makes sense. Because ‘Freedom’ means never being able to go to the doctor. Seriously. They are spending millions of dollars to try to con people out of getting affordable health insurance.”
To reiterate what we discussed last week, I hope folks will pause to let this sink in for a moment. Unlike every other industrialized democracy on the planet, the United States — easily the wealthiest nation on earth — has tolerated a significant chunk of its population going without basic health care coverage. These Americans and their families can’t afford to see a doctor and are one serious illness from financial ruin. Many have died because they live in a country that allows people to go without access to basic care.
After nearly a century of politicians talking about the problem, President Obama actually signed the Affordable Care Act into law three years ago, giving working families a level of health-care security they’ve never had before, and throwing a life preserver to the uninsured. Now, Republicans aren’t just actively trying to sabotage the law, they’re telling struggling Americans it’s better to drown than accept the life preserver.
By: Steve Benen, The Maddow Blog, July 30, 2013
“Public Ninth Amendment Fund?”: Ohio PAC, “We’re Buying George Zimmerman A New Gun And We Need Your Help”
The Buckeye Firearms Association, an Ohio-based political action committee, has issued a startling statement in the wake of the George Zimmerman trial: “We’re buying ZIMMERMAN a NEW GUN – We need your help.”
The PAC is in fact not just buying Zimmerman a new gun, but asking the public for donations — “$100 … $50 … $25 … even just $10” – to fund the replacement of his “firearm, holster, and other gear.”
The statement even reminds readers that Zimmerman – who stood trial for the fatal shooting of unarmed 17-year-old Trayvon Martin in Florida – has “no current source of income.”
And last week, conservative author Brad Thor used Twitter to say that he would buy Zimmerman a new gun and “as much ammunition as he wants.”
The offers come after both Thor and the pro-gun group expressed their disagreement with the Department of Justice’s decision to put a hold on all evidence in the case, including the gun that he used to kill Martin, until it can determine whether or not to charge Zimmerman with violating Martin’s civil rights.
The Buckeye Firearms Foundation has now established what it calls the “Zimmerman Second Amendment Fund,” arguing that the fund is “about more than mere principle. …Gun owners must stand together and refuse to allow an injustice like this to go unanswered.”
The article also adds: “Zimmerman and his family now face daily threats on their lives. More than ever, he has a right to defend himself against those who would seek to do him harm.”
Unfortunately, there is no such thing as a “Public Ninth Amendment Fund” to protect those of us who have to share the streets with a gun-toting murderer while still being told we have the right to life.
By: Elissa Gomez, The National Memo, July 22, 2013
“Women’s Health Is In Danger”: A Fiercely Anti-Choice Ohio GOP Redefines “Pregnancy” To Mean “Not-Pregnancy”
Last night, Ohio Governor John Kasich took a little time from his weekend to sign a new $65 billion budget for the state. There are many moving parts to the law, including a $2.5 billion tax cut which—like most Republican tax cuts—is meant to help the rich at the expense of everyone else. But of those parts, the most relevant for discussion—given last week’s fiasco in the Texas Senate—are the new restrictions on all reproductive services.
In addition to slashing tax burdens on the wealthiest Ohioans, the budget measure signed yesterday would allocate federal funds away from Planned Parenthood—which uses them to provide contraception and other health services, not abortion—to crisis pregnancy centers, which claim to offer support, counseling and a full range of options for women who think they may be pregnant. In reality, they are overtly anti-abortion. “[A]ccording to personal accounts compiled by the National Abortion and Reproductive Rights Action League (NARAL),” notes the Guttmacher Institute, “once women are inside the office, counselors subject them to antiabortion propaganda, characterizing abortion as painful and life threatening, with long-lasting physical and psychological consequences.” While the psychological impact of abortion varies from woman to woman, in terms of medical safety, abortion ranks on the low end of risky procedures. CPC’s also discourage use of contraceptives like the morning-after pill, which are presented as abortion equivalents.
The Ohio law also requires doctors to give a verbal description of the ultrasound, including a fetal heartbeat if available. It compels abortion providers to tell patients that a fetus can feel pain and that a woman who has an abortion can increase her risk for breast cancer. This claim, touted frequently by anti-abortion activists, has little basis in fact. “The scientific evidence,” notes the American Cancer Society, “does not support the notion that abortion of any kind raises the risk of breast cancer or any other type of cancer.”
The law also redefines “pregnancy” and “fetus” in ways that could affect the availability of certain forms of birth control. Ohio Republicans have defined as “human offspring developing during pregnancy from the moment of conception and includes the embryonic stage of development,” and declared pregnancy as beginning with “fertilization.” Biological science, by contrast, defines pregnancy as beginning with the implantation of a fertilized egg in the uterine lining. Why? Because a fertilized egg isn’t guaranteed to become an embryo; it can fail to implant and be expelled by the body.
There are also explicit restrictions to abortion access, as well as new requirements for doctors who perform them. Abortion providers are banned from having transfer agreements with public hospitals. Given that clinics are required to have transfer agreements, this could cause the closure of some clinics, and otherwise hamper access to reproductive health services. What’s more, the waiting period for abortions is extended from 24 hours to 48 hours, and the law would also eliminate “medical necessity” as a reason to waive the waiting period, replacing it with a waiver for “medical emergency.”
The difference, as the Cleveland Plain Dealer notes, is that the former is defined “as a medical condition that complicates the pregnancy so that it warrants an immediate abortion,” while the latter is “a condition that would result in the woman’s death without an abortion.” In practical terms, a necessity is a state of urgency where you may need an abortion in the future, whereas an emergency is where you need one now. It doesn’t seem like a big change, but it could have major implications, especially when coupled with the new penalties for violating these restrictions.
A doctor who does could be charged with a first-degree felony and a fine of up to $1 million—penalties normally reserved for rape, murder, attempted murder, and aggravated robbery (among others). We have no idea how many doctors will hesitate or refuse to perform abortions under serious circumstances, but my guess is that it will be more than a few, with serious consequences for women’s health.
As with the proposed law in Texas, it’s hard to describe these measures as anything other than backdoor attempts at making abortion unavailable in Ohio, through harsh restrictions, new regulations, or the legal intimidation.
Yesterday, on Meet the Press, House Minority Leader Nancy Pelosi said that there was “currently an assault on women’s health” and that “women’s health was in danger.” She’s absolutely right. Since the 2010 midterm elections—when Republicans swept statehouses and governorships across the country—there’s been a concerted push to deny women access to the wide array of reproductive health services.
On one hand, there’s a refreshing clarity about these efforts. Conservative lawmakers have all but dispensed with attempts to sound moderate, arguing that rape exceptions are unnecessary, and pushing for proposals—like defunding Planned Parenthood and limiting sex education—that would increase the rate of unplanned pregnancies (and thus abortions).
Of course, the only reason Republicans have become so open about this is because—on the whole—they are winning this fight.
By: Jamelle Bouie, The American Prospect, July 1, 2013
“Slick And Slicker: A Gingrich-Santorum Unity Ticket Was Still A Loser
Mitt Romney’s financial and organization advantages in the 2012 Republican primaries were commanding, but conservatives who opposed him had faint cause for hope: Rick Santorum and Newt Gingrich combined for more support than Romney for most of the primary season. If one of them conceded, then the other could consolidate Romney’s conservative opposition.
These hopes were far-fetched. Polls showed that Romney would have maintained his lead if either Santorum or Gingrich departed the race, since Romney was actually the second choice of many of their voters. Still, the theory was nearly put to the test. On Friday, Business Week reported that Santorum and Gingrich apparently discussed an unprecedented “unity ticket” to block Romney from winning the nomination. A Santorum-Gingrich ticket could have won critical primaries and led the national polls, but it still probably wouldn’t have won the nomination—a fact that should alarm conservatives heading into 2016.
The plan failed, not surprisingly, because Gingrich and Santorum couldn’t agree which one of them should be on top of the ticket. But let’s assume that they had. A unity ticket would have presumably done better than either candidate would have on his own, since a Gingrich voter who preferred Romney to Santorum might still support the combination of Santorum and Gingrich. But even if the unity ticket didn’t immediately consolidate the Gingrich-Santorum vote, the formation of an unprecedented primary alliance would have received tremendous media attention, potentially generating momentum. Indeed, polls can’t really predict how candidate dropouts will affect a race: In 2008, polls said that Hillary Clinton would maintain a clear lead over Barack Obama if John Edwards dropped out. Yet Obama surged in late January, after his win in the South Carolina primary, Edwards’ departure, and a wave of high profile endorsements.
The combination of a unity ticket and a few big primary wins could have given Santorum-Gingrich the lead in national polls. According to the article, Gingrich and Santorum mulled a unity ticket before three critical primaries in Florida, Michigan, and Ohio. Realistically, a Gingrich-Santorum ticket would have struggled to win Florida, since Romney’s 46 percent of the vote actually exceeded Santorum and Gingrich’s combined 45 percent. But a unity ticket would have done better in Michigan or Ohio.
After sweeping Minnesota, Missouri, and Colorado, Santorum actually led the national polls until he lost the Michigan primary by a narrow 3 point margin. But Santorum held a lead in Michigan polls until just 5 days before the primary and Gingrich won 6.5 percent of the vote—the combination of Gingrich voters and momentum from a unity ticket announcement could have easily given Santorum a narrow win. Regardless of whether Santorum carried Michigan, a unity ticket probably would have won Ohio, where Romney won by just 1 point and Gingrich, who won nearly 15 percent of the vote, probably played the spoiler—especially since Gingrich excelled in the socially conservative southwestern part of the state. Either way, Santorum-Gingrich would have exited Super Tuesday with plenty of momentum and a lead in the national polls heading into a wave of favorable primaries and caucuses in Kansas, Alabama, and Mississippi.
Whether momentum would have allowed Santorum-Gingrich to breakthrough a Romney firewall like Illinois is hard to say. And it would have still struggled to actually win the nomination, even in the best case scenarios: The delegate math was stacked in favor of Romney. Romney would still have been favored to win a disproportionate share of the winner-take-all states, like Florida, Arizona, and New Jersey. The same was true for the big states using modified or conditional winner-take-all systems, like California and New York. In contrast, Santorum-Gingrich’s biggest wins would have been diluted by various methods of proportional delegate allocation in Texas, Georgia, North Carolina, and Tennessee (footnote: Tennessee is actually a conditional winner-take-all, but it’s condition is far more difficult than the other conditional winner-take-all states, since a candidate would need 66 percent of the popular vote). Neither Gingrich nor Santorum made the ballot in Virginia, giving all but 3 of Virginia’s 46 delegates to Romney. Unless Romney’s national support completely collapsed, Santorum-Gingrich would have been hard pressed to overcome the GOP primary system’s bias toward Romney’s coalition.
Conservatives should take note. The RNC’s Growth and Opportunity Project report’s proposal to end conservative caucuses for the purpose of allocating convention delegates has been panned as an attempt to help establishment candidates win the GOP nomination. But the RNC explicitly took “no position” on whether contests should be winner-take-all or proportionate, since “both methods can delay or speed up the likelihood of a nominee being chosen [depending] on who is winning and by what margins.” That’s technically true: A uniformly winner-take-all or proportionate system wouldn’t necessarily favor any type of candidate. But 2012’s mix of winner-take-all and proportionate states favored an establishment candidate. The same delegate allocation rules that would have doomed a hypothetical Santorum-Gingrich unity ticket could again doom a competitive conservative candidate.
By: Nate Cohn, The New Republic, March 25, 2013
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