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“Watch What You Pray For, You May Get It”: Republicans Have Boxed Themselves In A Corner On Obamacare

There’s an adage that perfectly captures the Republicans’ conundrum on Obamacare: Watch what you pray for; you may get it. Having spent the past five years viciously battling the Affordable Care Act, GOP leaders are worried that the U.S. Supreme Court may grant them a victory.

If the high court rules in favor of conservatives who have challenged the health care law — essentially gutting it — millions of Americans will lose the subsidies that allow them to purchase health insurance.

They’ll no longer be able to afford to see a doctor. They won’t be able to pay for knee replacements or chemotherapy treatments. They won’t have the money for drugs for hypertension and diabetes.

And they’ll be furious — just in time for the 2016 presidential election. Now that so many people have reaped the benefits of access to medical care, they want to keep enjoying them. They will be fighting mad if their health insurance is suddenly taken away.

That’s because the Affordable Care Act is doing exactly what it was designed to do. Consider a report from the highly respected RAND Corp. — a nonpartisan research group — which issued its latest judgment on the Affordable Care Act in May.

Its study found that nearly 17 million people now have health insurance because of Obamacare. In addition, families may keep adult children on their policies until age 26. There are no longer “lifetime caps” that limit the amount of money insurers will spend on the chronically ill. Patients are no longer turned down for health insurance because they are already sick.

“The Affordable Care Act has greatly expanded health insurance coverage, but it has caused little change in the way most previously covered Americans are getting health insurance coverage,” said Katherine Carman, who, according to a RAND press release, was the study’s lead author. In other words, the law didn’t wreak havoc on those who already had health insurance, as its critics had predicted.

It has slowly dawned on some Republican leaders that the law has provided tangible benefits to millions of Americans, and that they are likely to be blamed if those benefits are jerked away. But they have locked themselves into a very small room and lost the key. They can’t seem to find a way out.

President Obama noted the GOP’s intransigence in a speech to the Catholic Health Association a few days ago. “Once you see millions of people having health care, once you see that all the bad things that were predicted didn’t happen, you’d think that it’d be time to move on. It seems so cynical to want to take coverage away from millions of people,” he said.

But leading GOP officials have taught their aging base, many of whom are Medicare recipients, that the passage of Obamacare was tantamount to a communist takeover. Republican politicians have insisted for years that the Affordable Care Act would corrupt the health care system, ruin the economy and pave the way for a dictatorship. Now, they’d have a hard time persuading those voters, especially the Tea Partiers, it was all just extreme partisan rhetoric.

This latest high court challenge, King v. Burwell, is itself a symbol of Republicans’ determination to strip health care away from millions of Americans. (It’s also a sign of the partisanship that has overtaken the nation’s highest court, which should never have accepted the case.) It’s a frivolous suit that turns on the interpretation of four words in the statute — even though it’s perfectly clear what Congress meant.

If the court agrees with the challenger, chaos will ensue. The GOP will have to take responsibility for finding coverage for millions of people, although its fractious caucus is unlikely to agree on a fix.

Given the stakes, there are undoubtedly those among GOP elders who want the U.S. Supreme Court to maintain the status quo, even if they won’t say so publicly. After all, as Obama put it, “This isn’t … just about the Affordable Care Act. … This is now part of the fabric of how we care for one another. This is health care in America.”

Let’s hope at least five justices concur.

 

By: Cynthia Tucker, Pulitzer Prize Winner for Commentary in 2007; Featured Post, The National Memo, June 13, 2015

June 14, 2015 Posted by | Affordable Care Act, King v Burwell, Republicans | , , , , , , , | Leave a comment

“Health Care Nightmares”: There’s An Extraordinary Ugliness Of Spirit Abroad In Today’s GOP America

When it comes to health reform, Republicans suffer from delusions of disaster. They know, just know, that the Affordable Care Act is doomed to utter failure, so failure is what they see, never mind the facts on the ground.

Thus, on Tuesday, Mitch McConnell, the Senate minority leader, dismissed the push for pay equity as an attempt to “change the subject from the nightmare of Obamacare”; on the same day, the nonpartisan RAND Corporation released a study estimating “a net gain of 9.3 million in the number of American adults with health insurance coverage from September 2013 to mid-March 2014.” Some nightmare. And the overall gain, including children and those who signed up during the late-March enrollment surge, must be considerably larger.

But while Obamacare is looking like anything but a nightmare, there are indeed some nightmarish things happening on the health care front. For it turns out that there’s a startling ugliness of spirit abroad in modern America — and health reform has brought that ugliness out into the open.

Let’s start with the good news about reform, which keeps coming in. First, there was the amazing come-from-behind surge in enrollments. Then there were a series of surveys — from Gallup, the Urban Institute, and RAND — all suggesting large gains in coverage. Taken individually, any one of these indicators might be dismissed as an outlier, but taken together they paint an unmistakable picture of major progress.

But wait: What about all the people who lost their policies thanks to Obamacare? The answer is that this looks more than ever like a relatively small issue hyped by right-wing propaganda. RAND finds that fewer than a million people who previously had individual insurance became uninsured — and many of those transitions, one guesses, had nothing to do with Obamacare. It’s worth noting that, so far, not one of the supposed horror stories touted in Koch-backed anti-reform advertisements has stood up to scrutiny, suggesting that real horror stories are rare.

It will be months before we have a full picture, but it’s clear that the number of uninsured Americans has already dropped significantly — not least in Mr. McConnell’s home state. It appears that around 40 percent of Kentucky’s uninsured population has already gained coverage, and we can expect a lot more people to sign up next year.

Republicans clearly have no idea how to respond to these developments. They can’t offer any real alternative to Obamacare, because you can’t achieve the good stuff in the Affordable Care Act, like coverage for people with pre-existing medical conditions, without also including the stuff they hate, the requirement that everyone buy insurance and the subsidies that make that requirement possible. Their political strategy has been to talk vaguely about replacing reform while waiting for its inevitable collapse. And what if reform doesn’t collapse? They have no idea what to do.

At the state level, however, Republican governors and legislators are still in a position to block the act’s expansion of Medicaid, denying health care to millions of vulnerable Americans. And they have seized that opportunity with gusto: Most Republican-controlled states, totaling half the nation, have rejected Medicaid expansion. And it shows. The number of uninsured Americans is dropping much faster in states accepting Medicaid expansion than in states rejecting it.

What’s amazing about this wave of rejection is that it appears to be motivated by pure spite. The federal government is prepared to pay for Medicaid expansion, so it would cost the states nothing, and would, in fact, provide an inflow of dollars. The health economist Jonathan Gruber, one of the principal architects of health reform — and normally a very mild-mannered guy — recently summed it up: The Medicaid-rejection states “are willing to sacrifice billions of dollars of injections into their economy in order to punish poor people. It really is just almost awesome in its evilness.” Indeed.

And while supposed Obamacare horror stories keep on turning out to be false, it’s already quite easy to find examples of people who died because their states refused to expand Medicaid. According to one recent study, the death toll from Medicaid rejection is likely to run between 7,000 and 17,000 Americans each year.

But nobody expects to see a lot of prominent Republicans declaring that rejecting Medicaid expansion is wrong, that caring for Americans in need is more important than scoring political points against the Obama administration. As I said, there’s an extraordinary ugliness of spirit abroad in today’s America, which health reform has brought out into the open.

And that revelation, not reform itself — which is going pretty well — is the real Obamacare nightmare.

By: Paul Krugman, Op-Ed Columnist, The New York Times, April, 11, 2014

April 11, 2014 Posted by | Affordable Care Act, GOP, Medicaid Expansion | , , , , , , | Leave a comment

“More People Have Health Insurance”: Another Day, Another Sign That Obamacare Is Working

Gallup on the Uninsured, April 7 update

It’s impossible to say how big an impact the Affordable Care Act is having on the uninsured. But it’s getting impossible to deny that it’s having an impact at all.

The latest evidence comes from the Gallup organization, which surveys respondents about insurance status. According to Gallup, the percentage of adults without health insurance has been falling since the middle of last year. Now, Gallup says, it’s down to 15.6 percent. That’s the lowest rate that Gallup has recorded since late 2008.

These tracking surveys on the uninsured are far from precise. Among other things, people answering these surveys aren’t always sure of their own insurance status. Nobody should treat them as gospel.

But Gallup also found the most dramatic change in insurance status among low-income and minority populations, which would be consistent with implementation of a law that has its most dramatic impact on people with the least money. It’s also consistent with three other pieces of information

  • Health Reform Monitoring Survey. In this survey, conducted by the Urban Institute and supported by the Robert Wood Johnson Foundation, the rate of uninsurance among non-elderly adults fell from 17.6 percent in the first quarter of 2013 to 15.2 percent in the first quarter of 2014.
  • The Rand Corporation. According to reporting by Noam Levey of the Los Angeles Times, unpublished research from Rand suggests that the percentage of uninsured Americans fell from 20.9 in late 2013 to 16.6 percent in early 2014.

The Congressional Budget Office has projected that 13 million Americans will get health insurance because of Obamacare. Gallup’s numbers would correspond to a significantly smaller decline, although the numbers depend on what you choose as a starting point. Then again, Gallup’s numbers don’t account for the end of open enrollment—when, by all accounts, large numbers of people rushed to sign up for coverage. They also don’t account for a full year of enrollment in Medicaid and the Children’s Health Insurance Program, since people can sign up for those programs all year long.

In short, it seems pretty clear that, because of Obamacare, more people have health insurance. And, yes, that accounts for people who lost existing coverage because insurers cancelled old policies. The question is how big a difference the law is making. And it’s going to be a while before anybody knows.

 

By: Jonathan Cohn, The New Republic, April, 7, 2014

April 8, 2014 Posted by | Affordable Care Act, Health Insurance, Obamacare | , , , , , , , | Leave a comment

   

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