“About Those Canceled Plans”: When “Victims” Become Beneficiaries
When pressed for specifics, the Affordable Care Act’s detractors tend to focus on two main areas of concern: the website and the cancelation notices. The website is obviously important and administration officials are doing what they can. Maybe it’ll be fixed quickly, maybe it won’t – we’ll find out soon enough.
But the cancelation notices are a different kind of concern. As we’ve discussed, we’re talking about a very small percentage of the population that has coverage through the individual, non-group market and are now finding that their plans are being scrapped. When the House Republican “playbook” looks for people saying, “Because of Obamacare, I lost my insurance,” these are the folks they’re talking about.
But the story about these “victims” of reform is coming into sharper focus all the time.
Only a small sliver of the Americans who buy their own health insurance plans and may be seeing them canceled under Obamacare will pay higher premiums, according to an analysis released Thursday.
More than seven in 10 Americans who purchase health plans directly will get subsidies to help pay for coverage under the Affordable Care Act, according to the report by Families USA, a Washington-based organization that supports the health care reform law.
“It is important to keep a perspective about the small portion of the population that might be adversely affected,” said Ron Pollack, executive director of Families USA. “That number is a tiny fraction of the 65 million non-elderly people with pre-existing health conditions who will gain new protections through the Affordable Care Act. It is also a small fraction of the tens of millions of uninsured Americans who can also get help.”
Let’s put this another way. A tiny percentage of consumers will receive cancelation notices, and of them, more than 70% will get new, more secure coverage that ends up costing them less.
They’re not, in other words, victims. They’re beneficiaries.
In fairness, many of them won’t know this for a while because they can’t yet go to healthcare.gov and see how much they’ll benefit, but we’re talking about the health care system itself – for all the talk about the cancelations, by a 2-to-1 margin, these folks are going to be better off, including receiving subsidies through the Affordable Care Act.
In reference to the remaining folks who’ll pay more, Pollack told the Huffington Post, “That’s approximately 1.5 million people, and that’s not trivial and I don’t in any way suggest that we shouldn’t be concerned about that group. But … the number of people at risk of this becoming a problem is considerably smaller than the tens of millions of people who are going to get substantial help.”
And here’s the larger question: if the evidence had pointed in the other direction, and 71% of these folks were poised to pay more, not less, would the story have gotten more attention? Would the coverage be dominated by “More bad news for Obamacare”?
This week, after years in which Obamacare critics said the law would fail to control costs, we saw remarkable evidence that the law is succeeding in controlling costs. Didn’t hear much about that? Neither did I.
I’m starting to get the sense that there’s an approved narrative – the Affordable Care Act is failing and is in deep trouble – and developments that point in the opposite direction are filtered out, while developments that reinforce the thesis are trumpeted.
The debate is often confusing enough, but this isn’t helping.
By: Steve Benen, The Maddow Blog, November 22, 2013
“Revisionist History”: Chris Christie Shows Why The GOP Is Hopeless On Health Care Reform
With the rollout of the health care exchanges created by Obamacare hitting some bumps, to put it mildly, and President Obama’s approval rating falling to new lows, it seems like now would be the perfect time for Republicans to take control of the health care issue. Yet they haven’t.
Why? To figure that out, look no further than the GOP’s darling of the moment, New Jersey Gov. Chris Christie.
Fresh off a re-election rout, plenty of conservatives are pointing to Christie as the hope for a new, modern and revitalized GOP. And at the Wall Street Journal’s CEO Council 2013 yesterday, Christie knew his cue, saying, “Obamacare is a failure, it’s always been a failure and it will not succeed. It just won’t.”
But when asked what he would replace it with, Christie first demurred, saying he didn’t have enough time to flesh out a solution, but then added:
Obamacare is wrong, it’s a failure, it’s the most extraordinary overreach of government power in the history of our country. And it’s being run by people who have never run anything. So why are we surprised it’s failing?
What do we need to replace it? We need a robust debate among both sides. Unlike last time, where the president jammed this down everybody’s throat and got not one Republican vote because he was unwilling to make any compromise, including tort reform, for god’s sake. Well, then this time we need a robust conversation between both sides where everybody brings skin to the table and everybody compromises. And if we do that we can craft a solution.
This is just red meat, not a constructive discussion of the nation’s health care problems. And it’s emblematic of the mainstream GOP’s fact-free approach to health care reform and the problems it’s having landing punches against Obamacare.
For starters, it’s simply incorrect that the Obamacare exchanges are “being run by people who have never run anything.” Secretary of Health and Human Services Kathleen Sebelius, after all, ran a state (she was the governor of Kansas, not exactly a socialist utopia), which I imagine Christie counts as executive experience. And President Obama, like it or not, has been at the helm of the world’s largest economy and military since 2009.
But far more importantly, Christie’s only solution to the health care conundrum is more “debate.” He seems to believe that health care reform would have gone just fine if mean old Obama hadn’t “jammed this down everybody’s throat” without making any compromises. That’s revisionist history, to say the least.
Back here in reality, Senate Finance Committee Chairman Max Baucus, D-Mont., spent months fruitlessly trying to get Republicans to sign onto a health care bill, which was also endlessly debated in committee, in each chamber of Congress and on the airwaves. There are a slew of provisions in the law that come from various proposals Republicans have put forth over the years, including some lifted from their Obamacare alternative, but they earned Obama not one Republican vote.
Obama also ditched the public option – a government run plan in the health care exchange – as a concession, for which he got nothing in return except accusations that he was engineering a “government takeover” of health care. Oh, and Christie’s magical tort reform, the GOP silver bullet? Obama has offered it to Republicans multiple times, and in response, they did nothing. (Tort reform, in the end, would result in scant savings anyway.)
This is not to deny that Obamacare has its problems, but simply to highlight that the GOP had the opportunity to be constructive during the health care debate, and instead chose across-the-board opposition and obstruction as an explicit political strategy to bring about Obama’s “Waterloo.”
Now, years later and with Obamacare faltering, the best the GOP’s newest star can muster is to tell the same old tales in the same old way. Complicating the matter is the fact that the few ideas conservatives do have for health care reform would result in many of the same things which Republicans are now criticizing. Reforms favored by the GOP would cause people to lose their insurance plans, even if they like them. And they would cut Medicare. Gasp!
Christie either knows this and can’t say it, because he would then be vilified by the conservative base, or he is just another Republican who doesn’t understand the tradeoffs involved in reforming America’s inefficient, wasteful and oftentimes completely backward health care system. And his refusal to even try to formulate a coherent health care alternative shows why, even after 40-something repeal votes and a disastrous rollout of the exchanges, Obamacare is still very much the law of the land.
By: Pat Garofalo, U. S. News and World Report, November 19, 2013
“Calling-Out Bad Analysis”: False Equivalency And Crocodile Tears
I’m delighted to see that amongst the wailing and gnashing of teeth over the “nuclear option’s” invocation, there’s some robust calling-out of bad analysis and crocodile tears.
WaPo was Ground Zero for “centrist” bemoaning of the terrible partisanship this step would unleash. But Jonathan Chait was having none of it:
The bizarre, defining feature of this argument is that, unlike the crocodile tears being shed by Republicans, the centrist Establishmentarians all take the view that the Republican judicial blockade was completely unacceptable. They argue that the solution to the unacceptable blockade is that, as the Post piously insists, “Both parties should have stepped back and hammered out a bipartisan compromise reform.”
That Republicans did not offer to compromise or in any way back down from the stance the Post calls unacceptable is a fact so fatal to this argument that none of the three [WaPo]writers in any way acknowledges it. I would agree that a 50-vote threshold for lifetime judicial appointments represents a sub-optimal arrangement. It would be better if there were some way for the Senate to filter out extreme nominees without having the power to wantonly blockade a vital court for nakedly partisan reasons. Given the refusal of Republicans to back down, I prefer majoritarianism to the existing alternative. The Establishmentarians refuse to grapple with the trade-off. They are against fires and fire hoses alike.
Unfortunately, now that the “nuclear option” has been officially recorded as the efficient cause of whatever happens next in the descent to partisan polarization, it will become the ever-ready justification for future false equivalency arguments of the sort Chait eviscerates.
An even more interesting deconstruction of today’s wailathon comes from Jonathan Bernstein, writing, as it happens, at WaPo’s Plum Line. He suggests it may have been the “reasonable” Senate Republicans pitching the biggest fits about the nuclear option who precipitated it by their languid-at-best attempts at a preemptive deal, and who may actually welcome it privately because it gets them out of a jam:
The problem with the summer compromise is that it was horrible for deal-making Republicans. The deal essentially said: Republicans will continue to filibuster nominations, but will supply enough votes for almost all of them so that the filibusters will be defeated. But that meant that in practice a handful of Republicans were forced to tag-team their votes, making sure that Democrats always had 60. What’s more, the shutdown fight — which began right after the Senate deal was struck — revealed that radical Republicans led by Sen. Ted Cruz (R-Tex.) were eager to scapegoat those same deal-making Republicans. That raised the cost of the executive branch nominations agreement for tag-teamers such as Sens. Lamar Alexander (R-Tenn.), Bob Corker (R-Tenn.) and John McCain (R-Ariz.). In other words, the summer deal might or might not have been stable, but it certainly couldn’t hold in a world in which the majority of Republican senators are looking for ways to separate themselves from mainstream conservatives, and then using that separation to attack them.
Now Obama gets his judges, and “mainstream conservatives”–especially those like Alexander and Graham who are facing 2014 primary threats–can happily vote against them. What’s not to like?
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, November 22, 2013
“Stupid Obamacare!”: Profit Maximizing Private Insurance Companies Got You Down, Blame Obama
It has been said many times over the last few years that now that Democrats successfully passed a comprehensive overhaul of American health insurance, they own the health-care system, for good or ill. Every problem anyone has with health care will be blamed on Barack Obama, whether his reform had anything to do with it or not. Your kid got strep throat? It’s Obama’s fault! Doctor left a sponge in your chest cavity? Stupid Obama! Grandma died after a long illness at the age of 97? Damn you, Obama!
OK, so maybe it won’t be quite as bad as that, but pretty close. Here’s an instructive case in exactly how this plays out. Take a look at this article that ran in yesterday’s Washington Post, telling how in order to keep premiums down and attract customers, some insurers are limiting their networks. “As Americans have begun shopping for health plans on the insurance exchanges,” the article tells us, “they are discovering that insurers are restricting their choice of doctors and hospitals in order to keep costs low, and that many of the plans exclude top-rated hospitals.”
So insurance companies—private actors seeking to maximize profit—are making decisions that some potential customers find less than perfectly appealing. The article itself is clear about why this is happening, but in the newspaper’s print edition, the subtitle read, “Exchanges Exclude Doctors, Hospitals.” Of course, that’s completely false. The exchanges haven’t excluded any doctors and hospitals, the insurance companies offering plans on the exchanges have made a decision to exclude them. The insurance companies are perfectly free to make a different decision, but they’ve decided not to.
So the newspaper runs this story, with the headline writers mistakenly portraying what for some small number of people is an unwelcome development as a decision made by the Obama administration. Conservatives will then take articles like this and others like it, and say, “See? Obama said you could keep your doctor! He lied! This law is a disaster!” Barack Obama never said that he’d forbid any insurance company from ever changing anyone’s policy or offering policies that provide something less than spectacularly gold-plated coverage at absurdly low prices. But now, every profit-maximizing decision by a corporation becomes Barack Obama’s fault.
The second component of Barack Obama coming to own all the problems with the health-care system is that with the rollout of the ACA, you suddenly have a lot of political reporters doing stories on health care, and many of them have only the thinnest understanding of the law. That limited understanding makes it easier for them to just focus on whatever negative things are happening in health care, blaming them on the ACA, and assuring themselves that they’ve been appropriately “tough” in their reporting.
There’s nothing wrong with reporters fully exploring all the changes our ever-evolving health-care system goes through, so long as they do it accurately. But you might notice that they are completely uninterested in the stories of people who are being helped by the Affordable Care Act. Harold Pollack estimates that there are over 10 million uninsured Americans who have significant medical issues like a cancer diagnosis or diabetes, and thus find it difficult or impossible to get insurance on the individual market under the pre-ACA system. These people will now be able to get reasonably priced insurance, which for many will be literally life-saving. But journalists find these people boring and not worth talking about. They’re much more interested in people who find something problematic in the new system, and they’re working hard to find every last one of those people’s stories and share them with the country. And that’s how Barack Obama ends up owning the health-care system.
By: Paul Waldman, Contributing Editor, The American Prospect, November 22, 2013
“Ignoring The Elephant In The Room”: No, President Obama’s Policies Are Not Holding Back The Economy
Wall Street Journal columnist Daniel Henninger had fun this week arguing that President Obama’s problems implementing health reform pale next to his problems getting the economy back to health. The attack on Obama’s economic stewardship, however, looks just like the standard conservative attack on health reform: it’s light on sound arguments and ignores the elephant in the room — Republican obstructionism.
First, health care. As the president says, it’s on him that the rollout of HealthCare.gov and the health insurance marketplaces — where individuals can purchase health insurance to avoid the fine for not having it — has been, to put it kindly, rocky. But Republicans have provided no clear alternative to expand access to good quality, affordable health care, and they have made the rollout more difficult.
Many Republican governors and state legislatures have left implementation of their health insurance marketplaces (also known as exchanges) to the federal government rather than do it themselves — hardly the usual position of a party that believes in devolving as much power as possible to the states. And, at the moment, 25 states are not moving forward to implement the Medicaid expansions — which are a very good deal for them — leaving a significant coverage gap among low-income adults and complicating the determination of eligibility for coverage on the exchanges.
Finally, Republican proposals to “fix” the problem would undermine, not improve, health reform. The president’s proposal, while not perfect, is the best on the table.
Like problems with the health care rollout, the problems in the economy are plain to see. Henninger plays fair when he notes that the president did not cause the Great Recession, which is the source of the problems with which we’re still grappling. But, he’s wrong to say it’s the president who “has the economy on lockdown.”
First, he ignores what many economists and policymakers see as the main problem we still face – inadequate demand for goods and services. Second, he cavalierly dismisses the benefits of economic stimulus in such an economy. Third, he insists the main thing holding back the recovery is excessive business regulation. With that mindset, he naturally doesn’t acknowledge the drag on economic activity and job creation from the premature austerity that Congress has imposed on the economy since Republicans regained control of the House in the 2010 mid-term elections and the barriers that Republicans have put in the way of a budget plan that could boost the recovery in the short run while still putting deficits and debt on a sustainable longer-run trajectory.
Just a reminder to all who, like Henninger, parrot the shibboleth that stimulus did not work: the Congressional Budget Office finds that gross domestic product has been higher each year since 2009 than it would have been without the 2009 American Recovery and Reinvestment Act and unemployment has been lower (see chart).
CBO includes a broad range of estimates about the recovery act’s impact to encompass the views of economists who continue to doubt the mounting evidence that stimulus is highly effective under the economic conditions prevailing in recent years. But, that evidence suggests that act’s impact is quite likely much nearer the high than the low estimate.
Here’s what the International Monetary Fund says about that research, the expansionary effects of fiscal policy (tax cuts and increases in government spending) and the “old Keynesian mulitplier” that Henninger mocks: “While debate continues, the evidence seems stronger than before the crisis that fiscal policy can, under today’s special circumstances, have powerful effects on the economy in the short run [and] that fiscal multipliers are larger.”
The powerful effects of fiscal policy in today’s special circumstances work both ways. The economic forecasting firm Macroeconomic Advisers estimates that the economic uncertainty and policy choices to raise taxes and cut spending that we’ve made since 2010 have cost the economy up to a percentage point per year of slower economic growth and up to 2 million jobs.
It’s Republicans whose policy preferences have pulled policy toward greater near-term fiscal austerity through spending cuts; Democratic plans look more like bipartisan proposals for less spending restraint in the short term and more deficit reduction that’s balanced between revenues and spending down the road when the economy is stronger.
It’s Republicans who have the U.S. economy on lockdown.
By: Chad Stone, Chief Economist, Center on Budget and Policy Priorities, U. S. News and World Report, November 22, 2013
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