“ACA Plays ‘Remarkable’ Role In Cancer Detection”: A Striking Picture Of Increased Early-Stage Diagnoses Among Young Women
As the Affordable Care Act has taken root, there’s been quite a bit of anecdotal evidence pointing to people whose lives were saved – quite literally – by the law’s existence. But at this point, we’re also able to measure the ACA’s efficacy beyond just the anecdotes.
The New York Times reported on a substantial increase in the number of young women who’ve been diagnosed with early-stage cervical cancer, and there doesn’t seem to be much of a mystery to explain the trend. Because “Obamacare” covers young adults before their 26th birthday, the percentage of uninsured 19- to 25-year-olds has plummeted.
You can probably guess what that means: more young women are able to see a doctor, more doctors are able to do cancer screenings, and more exams are detecting cancer at early stages. From the Times’ report:
Researchers from the American Cancer Society wanted to examine whether the expansion of health insurance among young American women was leading to more early-stage diagnoses. Early diagnosis improves the prospects for survival because treatment is more effective and the chance of remission is higher. It also bolsters women’s chances for preserving their fertility during treatment. And women with health insurance are far more likely to get a screening that can identify cancer early.
Researchers used the National Cancer Data Base, a hospital-based registry of about 70 percent of all cancer cases in the United States. They compared diagnoses for women ages 21 to 25 who had cervical cancer with those for women ages 26 to 34, before and after the health law provision began in 2010.
The results painted a striking picture of increased early-stage diagnoses among the younger group, with no meaningful change in the older group.
One of the researchers, Dr. Ahmedin Jemal, said the effect of the Affordable Care Act is hard to miss, leading to results he described as “very remarkable.”
For the ACA’s proponents, it’s additional evidence to suggest the law is literally a life-saver, and for the ACA’s opponents, it’s another challenge in explaining why the law must be destroyed in its entirety, regardless of the consequences.
By: Steve Benen, The Maddow Blog, November 25, 2015
“Health Reform Lives!”: The Reality Is That Obamacare Is An Imperfect System, But It’s Workable — And It’s Working
To the right’s dismay, scare tactics — remember death panels? — and spurious legal challenges failed to protect the nation from the scourge of guaranteed health coverage. Still, Obamacare’s opponents insisted that it would implode in a “death spiral” of low enrollment and rising costs.
I mention all of this to give you some perspective on recent developments that mark a break in the string of positive surprises. Yes, Obamacare has hit a few rough patches lately. But they’re much less significant than a lot of the reporting, let alone the right-wing reaction, would have you believe. Health reform is still a huge success story.
Obamacare seeks to cover the uninsured through two channels. Lower-income Americans are covered via a federally-funded expansion of Medicaid, which was supposed to be nationwide but has been rejected in many Republican-controlled states. Everyone else has access to policies sold by private insurers who cannot discriminate based on medical history; these policies are supposed to be made affordable by subsidies that depend on your income.
Nobody ever expected Obamacare to cover all the uninsured. In fact, Congressional Budget Office projections made in 2013 suggested that about 10 percent of nonelderly U.S. residents would remain uncovered: some because they are undocumented immigrants, some because of the gap created by red-state Medicaid rejection and some because they would fall through the cracks of a complicated system. But the law was nonetheless projected to produce a sharp reduction in the number of Americans without insurance, and it has, especially in states like California that have tried to make it work.
Meanwhile, both insurance premiums and the cost of subsidies designed to make them affordable came in far below expectations in both 2014 and 2015.
Sooner or later, of course, there were bound to be some negative surprises. And we’re now, finally, getting a bit of bad, or at least not-great, news about health reform.
First, premiums are going up for next year, because insurers are finding that their risk pool is somewhat sicker and hence more expensive than they expected. There’s a lot of variation across states, but the average increase will be around 11 percent. That’s a slight disappointment, but it’s not shocking, given both the good news of the previous two years and the long-term tendency of insurance premiums to rise 5-10 percent a year.
Second, some Americans who bought low-cost insurance plans have been unpleasantly surprised by high deductibles. This is a real issue, but it shouldn’t be exaggerated. All allowed plans cover preventive services without a deductible, and many plans cover other health services as well. Furthermore, additional financial aid is available to lower-income families to help cover such gaps. Some people may not know about these mitigating factors — that’s the problem with a fairly complex system — but awareness should improve over time.
Finally, UnitedHealth Group made a splash by announcing that it is losing money on the policies it sells on the Obamacare exchanges, and is considering withdrawing from the market after next year. There were some puzzling things about the announcement, leading to speculation about ulterior motives, but the main thing to realize is that UnitedHealth, while a huge provider of employment-based insurance, is actually a fairly small player in this market, and that other players are sounding much more positive.
Oh, and official projections now say that fewer people will enroll in those exchanges than previously predicted. But the main reason is that surprisingly few employers are dropping coverage; overall projections for the number of uninsured Americans still look pretty good.
So where does that leave us? Without question, the run of unexpectedly good news for Obamacare has come to an end, as all such runs must. And look, we’re talking about a brand-new system in which everyone is still learning how to function. There were bound to be some bobbles along the way.
But are we looking at the beginnings of a death spiral? Some people are indeed saying that, but as far as I can tell, they’re all people who have been predicting disaster every step of the way, and will still be predicting imminent collapse a decade from now.
The reality is that Obamacare is an imperfect system, but it’s workable — and it’s working.
By: Paul Krugman, Op-Ed Columnist, The New York Times, November 23, 2015
“From GOP ‘Con Man’ To Newly Elected Governor”: Health Coverage For Kentuckians Was On The Line, And They Appear To Have Lost
Under two-term Gov. Steve Beshear (D), Kentucky has been one of the best-run states in the nation. Not only is the Bluegrass State’s unemployment rate at a 14-year low, but Kentucky has been so successful in implementing health care reform, it’s cut its uninsured by over 40%.
Perhaps the state’s voters grew tired of success and decided to go in a different direction.
Voters in Kentucky elected Republican Matt Bevin as governor Tuesday.
Bevin beat Democratic Attorney General Jack Conway. Unofficial results from the Kentucky State Board of Elections had Bevin beating Conway 52.52% to 43.82% with all 120 counties reporting Tuesday night.
Independent Drew Curtis was also on the ballot, and garnered 3.6% support – not enough to affect the overall outcome. Statewide turnout was only about 30%, meaning that over two-thirds of the state’s voters didn’t bother to show up at all.
Bevin’s road to the governor’s office was, for lack of a better word, improbable. A year ago, the right-wing candidate, who’s never served a day in public office, launched a primary fight against incumbent Sen. Mitch McConnell (R-Ky.). Republicans quickly labeled Bevin a “con man” who lies “pathologically.” The first-time candidate was exposed a man who lied about his educational background, and who even struggled in the private sector – his business needed a taxpayer bailout.
At one point, he even delivered a speech at a cockfighting gathering and then lied about that, too.
Bevin lost that primary. A year later, he’s a governor-elect.
The smart money bet against him. Indeed, even as this year’s race unfolded, the Tea Partier seemed on track to lose. In September, the Republican Governors Association scaled back its investments in the Kentucky race, and as recently as mid-October, Bevin’s own internal polling showed him trailing.
Complicating matters, the GOP candidate “created a nightmare for Kentucky’s political reporters” by lying – about a wide variety of issues – on an almost habitual basis, and then creating an “enemies list” of journalists who challenged the accuracy of his falsehoods.
And yet, voters in Kentucky yesterday overlooked all of this and handed Bevin a relatively easy victory.
What happens now is likely to have a major impact on many of his constituents’ lives. One of the central tenets of Bevin’s odd platform has been scrapping Medicaid expansion, which would have the effect of taking away health care benefits from many low-income families statewide. And because outgoing Gov. Steve Beshear (D) used executive orders to create much of the state’s health network, the new right-wing governor-elect will have the power to undermine the health security of a significant chunk of Kentucky’s population rather quickly.
The question is simple: will he? This sets the stage for the the first real test of whether far-right officials are prepared to hurt their own constituents, on purpose, to advance a partisan goal. It’s one thing for Republican state policymakers to block Medicaid expansion from taking effect, but in Kentucky, the Affordable Care Act has already been fully implemented – and it’s working beautifully.
Bevin’s stated goal is to roll back the clock, consequences be damned. Coverage for over 400,000 struggling Kentuckians was on the line in yesterday’s election, and as of last night, they appear to have lost.
By: Steve Benen, The Maddow Blog, November 4, 2015
“The Challenge Of Being Paul Ryan”: He’s Been Anointed As A Savior, And Saviors Often Meet A Bad End
Paul Ryan had excellent reasons for not wanting to be speaker of the House. He’s a smart guy and knows that the Republican caucus he is about to lead is nearly ungovernable. He’s been anointed as a savior, and saviors often meet a bad end.
Moreover, the Wisconsin native (and ardent Packers fan) is still very much a work in progress. He was happy to stay away from the center stage as he mapped out the next steps of his life and the direction of his thinking. As chairman of the Ways and Means Committee, he could pick his fights and choose the issues he wanted to highlight. As speaker, the issues will often pick him and he may well have to wage battles he might prefer to avoid.
Ryan has always wanted to be several things at the same time, and they have not been easy to keep in balance.
On the one hand, he is, from my experience, a genuinely nice and warm person who wants to be seen as thoughtful, wonkish and willing to delve deeply into policy details. He’s a religious man who knows that his faith teaches the imperative of compassion and the urgency of justice. He has repeatedly given speeches declaring his determination to alleviate poverty.
But he is also an ideologue — one reason the right-wingers in the House could accept him as speaker. He has said that the unforgiving libertarianism of Ayn Rand — whose books include one called “The Virtue of Selfishness” — inspired him to enter politics. In a speech before the Heritage Foundation in 2011, he divided the world between “takers” and “makers” and spoke of government programs as creating “a hammock that ends up lulling people into lives of dependency and complacency.” I doubt that poor people think they spend their lives swaying gently between the trees.
The budgets he has proposed over the years are his signature. The Center on Budget and Policy Priorities, a liberal group that is very careful about its numbers, repeatedly found that roughly two-thirds of the cuts in Ryan’s budgets came from programs for low- and moderate-income people. Take that, you takers!
Had Ryan not been pushed toward the speakership, he would have more room to refine his views and would not face constant pressure to appease the right. That pressure led him to criticize the process that outgoing Speaker John A. Boehner (R-Ohio) used to save Ryan from having to deal with impossible problems around the budget and the debt ceiling. Being Paul Ryan has just gotten even harder.
But let’s give Ryan a brief respite by focusing on his virtues. When he insisted that he would not take the speaker’s job unless he could protect his “family time,” he showed what kind of person he is and made a statement that could transform the debate about work and family.
I personally identify with Ryan because we were both 16 when our dads died and, like him, I have three kids. Time with my family has been a treasure for me, too. Good for Ryan for placing his family at the heart of his life.
Yet his statement brought him immediate and sharp criticism because he had voted against mandatory paid family leave. Rather than resenting his critics, he should take them very seriously by admitting that he enjoys a degree of bargaining power that so many Americans lack. And he should not pretend that the “flex time” proposals he has endorsed are the answer. They would merely undermine employees’ existing rights to overtime.
Ryan might take a look at a 2006 essay in the Weekly Standard by Yuval Levin, a conservative thinker I am sure he admires, acknowledging the tension between the market and the family. Levin noted that the market “values risk-taking and creative destruction that can be very bad for family life” and that “the libertarian and the traditionalist are not natural allies.”
Sometimes, despite what Ayn Rand says, government action is essential to preserving individual rights in the marketplace and protecting the integrity of family life. Many families are under severe economic pressures. There are times when only government is in a position to relieve them, often through the programs Ryan would cut.
Thus a hope: Ryan could use the first days of his speakership to signal his intention of bridging at least some of the great ideological gaps in our country. A man who so honorably values his own family could start by changing his mind on family leave.
By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, October 28, 2015
“Jindal’s Trumpism-Without-Trump Tax Plan”: His Distinctive Tax “Idea” Is One Of The Dumbest In The Conservative Arsenal
With all the excitement going on this week, I totally missed the fact that my favorite Republican presidential candidate, the Gret Stet of Loosiana’s Bobby Jindal, released a tax plan, or at least a tax-based messaging document. WaPo’s Catherine Rampell informs us it’s everything you’d expect from the candidate who’s offering the GOP Trumpism Without Trump:
Jindal — who once declared that the Republican Party needed to stop being the “stupid party” — decided he, too, wanted to pander to stupidity.
That is, he decided to out-Trump Trump.
In a sprawling, largely detail-free plan released Wednesday, Jindal tried his hand at the tax-cut buzz saw. On a static basis, the Tax Foundation estimates, Jindal’s proposal would cut revenue by $11.3 trillion over the next decade.
That’s in the same ballpark as Trump. Yet rather than denying or trying to draw attention away from the gigantic hole he intends to blow in the budget (as Trump and Bush, respectively, have done), Jindal touts it with pride.
“Governor Jindal’s plan reduces the amount of money the federal government will be able to spend,” his Web site boasts, invoking long-ago disproven “starve the beast” rhetoric. The main effect of previous attempts to “starve the beast” through tax cuts, as Jindal surely knows, has not been spending decreases, but subsequently legislated tax increases.
But here’s the fun part:
Jindal’s plan is also, impressively, even more regressive than Trump’s. While Trump would raise the after-tax incomes of the top 1 percent by a mere fifth (21.6 percent), Jindal would increase their incomes by a full quarter (25 percent).
Then, in addition to lowering taxes on the rich, Jindal — but not Trump — would raise taxes on the poor.
Yes, you read that right. Jindal wants to engineer a reverse Robin Hood, taking money from the poor to give to the rich.
As Dylan Matthews explains at Vox, Jindal’s plan would eliminate the child tax credit, the standard deduction, the personal exemption, and the dependent exemption, with the very explicit goal of making everybody, even the poorest Americans, pay income taxes (hey, he does keep the EITC, but maybe that was an oversight!). So in effect his most distinctive tax “idea” is one of the dumbest in the conservative arsenal: going after the “lucky duckies,” the 47% who don’t pay income tax (though they do pay payroll taxes, state and local sales taxes, property taxes, etc. etc.).
At least Bobby’s being consistent: he spent years unsuccessfully trying to get Louisiana to shift from an income tax to a sales tax system for financing state government. Don’t want those job creators to have to pay taxes if they can instead be borne by those proles lucky enough to work for them, right?
Maybe the very conservative voters of Iowa, with whom Jindal is spending most of his time these days, like this approach; you should not underestimate the power of resentment of those people when two or more conservatives gather. But I dunno: as with his efforts to be Mr. Christian Right in a crowded presidential field, I suspect most voters otherwise attracted to Trumpism-Without-Trump would also prefer Jindalism-Without-Jindal.
By: Ed Kilgore, Contributing Writer, Political Animal Blog, The Washington Monthly, October 9, 2015
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