By: Jay Inslee, Steve Beshear and Dannel P. Malloy, Opinion Pages, The Washington Post, Published: November 17, 2013: Jay Inslee, a Democrat, is governor of Washington. Steve Beshear, a Democrat, is governor of Kentucky. Dannel P. Malloy, a Democrat, is governor of Connecticut.
“A Right Wing Non-Plan”: Ted Cruz Reveals He’s A Thin-Skinned Wuss, Hypocrite And Policy Lightweight
Sen. Ted Cruz pretends to be a tough guy, but mostly he spends his time trashing Democrats in front of adoring right-wing crowds and conservative journalists. On Wednesday he sat down with CNN’s Chris Cuomo – you didn’t expect him to go to MSNBC, did you? – and showed himself to be incredibly thin-skinned when pressed just a little on how he would replace the Affordable Care Act he wants to repeal. It was an interesting window on Cruz’s temperament as well as his cynical, threadbare “policy” agenda.
Cuomo asked Cruz how he would replace the law he inveighs against, and as usual, Cruz dodged the question and kept on inveighing instead. Cuomo followed up. “You don’t think that you have a responsibility as a U.S. senator to do better than that, in terms of offering a solution for what to do next?” he asked.
And Cruz shot back: “Well, I appreciate your trying to lecture me in the morning.”
Cuomo didn’t leave it there.
“No, no, no, not at all, Senator. I’m worried, same as you, anybody who looks at the situation has worries.”
So Cruz tried to turn the tables. “If you’re worried, did you speak out for the 5 million people who have lost their health insurance?”
Cuomo had an answer: “Absolutely — we’ve been covering it doggedly. The problem is, I don’t have the power to fix it. You do. That’s what a U.S. senator does, is you sponsor law. You know this. It’s not a lecture, it’s a concern; I’m asking, what are you going to do about it?”
Apparently Cruz isn’t used to being grilled. Cuomo got him to share what passes for an answer from conservatives these days: “Let people purchase health insurance across state lines.”
Wow. That’s what Princeton and Harvard Law degrees get you: a warmed-over right wing non-plan that’s been around forever. As Ezra Klein reported back in 2010, the Congressional Budget Office looked at it in 2005 and found it didn’t reduce the number of uninsured and would only save the federal government $12 billion over the next eight years. (By contrast, the CBO says the ACA will reduce the deficit by $41 billion in 2013 alone.)
The CBO also found that allowing people to buy insurance plans across state lines would “make insurance more expensive for the sick and cheaper for the healthy, and lead to more healthy people with insurance and fewer sick people with insurance.” Other than that, it’s a terrific idea.
Of course, insurers like Cruz’s non-plan because it would mean a boon for the states that provide the least regulation and thus encourage the “cheapest” but least protective insurance policies. Rather than insuring states’ rights and competition, which conservatives pretend to like, it would, in effect, create a national insurance-regulation standard, as states then raced to the bottom to compete. Of course, a state’s “rights” usually diminish, for conservatives, whenever that state decides to give its citizens more power and its corporations less.
So in just one morning, Ted Cruz was revealed as a wuss, a hypocrite and a policy lightweight. The last one doesn’t matter on the right, but the first two won’t wear well in a presidential race. Kudos to Cuomo for not accepting Tea Party platitudes as a substitute for governing proposals.
By: Joan Walsh, Editor at Large, Salon, November 20, 2013
“Blaming Obamacare Is A Smokescreen”: Sorting Out The Real Reasons Why Insurers Cancel Health Insurance Policies
Now that President Obama has said it’s OK with him if insurance companies keep their policyholders in health plans that don’t meet the standards established by the Affordable Care Act, at least for another year, the big question is whether insurers will take him up on the offer.
The answer: it depends.
Some insurance executives will view the offer as one they can’t turn down. Even though Karen Ignagni, president of America’s Health Insurance Plans, the industry’s big PR and lobbying group, had nothing good to say about Obama’s proposal, keep in mind that she doesn’t run an insurance company. While industry executives look to her to comment on what politicians do, they make their own decisions when it comes to their companies’ bottom lines.
Here’s what Ignagni was quoted as saying in a FOX News story Friday:
“The only reason consumers are getting notices about their current coverage changing is because the ACA (Affordable Care Act) requires all polices to cover a broad range of benefits that go beyond what many people choose to purchase today.”
Not so fast. There are other reasons some folks are being told they’ll have to change health plans next year. Many of them are having to switch plans not because of Obamacare but because their insurance companies want to move them into policies with higher profit margins.
Insurance companies have been sending similar notices to their customers for years. My son Alex — and thousands of other customers of a Blue Cross plan in Pennsylvania — got such a notice four years ago, months before Congress passed the health reform law.
Why? The insurer wanted to move those policyholders out of a plan with a reasonable $500 annual deductible and into one with a deductible ten times that amount. To accomplish that, Blue Cross notified its policyholders that their health plan would not be available in 2010. Their options were to switch to the high-deductible policy, which would still cost them a couple of dollars more each month, or to another plan with that reasonable $500 deductible. If they chose the latter, their monthly premiums would increase 65 percent.
Notices like the one Alex got have provided a mechanism for insurers to implement a years-long industry strategy of shifting more and more of the cost of medical care to their policyholders. And that strategy will continue until every last one of us is in a high-deductible plan.
Some of you are likely old enough to remember the days before managed care when almost all Americans with private health insurance were in indemnity plans. In an old-fashioned indemnity plan, the insurer didn’t constrain us in a limited network of doctors and hospitals and didn’t call the shots about whether a knee replacement or liver transplant your doctor recommended was really necessary.
Those days are long gone. Everybody eventually got notices that those plans were being discontinued. They were replaced by HMOs and PPOs with limited provider networks and armies of utilization review nurses and medical directors who decided if you would get coverage for your new knee or new liver.
In most cases, it was our employers who killed off the indemnity plans in favor of managed care. But eventually, HMOs and PPOs also fell out of favor. The managed care backlash of the late 1990s forced insurers to abandon some of their utilization review practices and to add more doctors and hospitals to their skinny networks. That led to shrinking profit margins — and to the latest silver bullet from the insurance industry: high-deductible plans.
Before Obama signed the Affordable Care Act, insurance companies already were making rapid progress in implementing their business plans of “migrating” their customers from traditional managed care plans to so-called “consumer-directed” plans, the industry euphemism for high-deductible policies. At the same time they’ve been requiring us to pay more out of our own pockets for care, they’ve also been implementing a strategy of reducing benefits. Investors and Wall Street financial analysts refer to these common industry practices as “benefit buydowns.” That’s another euphemism, by the way.
I myself — and thousands of my fellow Cigna employees — were notified several years ago, long before I left my job, that our HMOs and PPOs were being discontinued. Yep, we got notices in the mail. If we wanted to stay in a Cigna-subsidized health plan, we would have to switch to a high-deductible plan. The same thing has happened to tens of millions of other Americans in recent years.
Yet if you relied on the Washington media for your news and information about health care, you’d think that insurance companies would never have considered sending policy discontinuation notices to their policyholders until forced to do so by Obamacare.
The truth: they have always done this when profits were at stake.
Which is why some insurers will be happy as clams to be able to keep their policyholders in plans that don’t meet the ACA’s standards. Many of those plans — especially the junk insurance plans many folks are in — are exceedingly profitable.
For people who are in those plans who have complained about their discontinuation notices, I hope they will shop around. Chances are, they’ll be able to get much better coverage at a better price. Thanks to the Affordable Care Act.
By: Wendell Potter, The Center for Public Integrity, November 18, 2013
“Such Noble Sentiments”: Why Republicans Suddenly Care, Deeply, About All Those Canceled Health Policies
Amid the current national uproar over the troubles of the Affordable Care Act, it is almost uplifting to hear the deep concern expressed by politicians, pundits, lobbyists, and corporate leaders over cancellation of existing health insurance policies. They empathize loudly with the millions of potential victims, whose plight infuriates these worthy observers. They fill hours of television and pages of print with expressions of outrage.
Suddenly everyone in Washington is intensely concerned about Americans who are losing their health insurance.
The outpouring of noble sentiment would be laudable — indeed, long overdue — if only there was any reason to believe these protestations are sincere. Sadly, the evidence points in the opposite direction, for a single obvious reason: Millions of people in this country have been losing health insurance for many years, resulting in untold thousands of serious illnesses, bankruptcies, and early deaths – but until insurance cancellations became a political embarrassment for Barack Obama, the usual right-wing reaction was silence. (Except for that awkward and revealing outburst during the Republican debates of 2012, when a live audience howled its approval for the “let him die” plan.)
For anybody who ever honestly cared about people losing their health coverage – for instance, President Obama or his Democratic predecessor Bill Clinton – the depressing statistical reality has long been plain. Every day of every year, thousands of people leave the rolls of the private insurance industry in this country, almost never voluntarily.
People often forfeit insurance after losing a job, which happened to millions during the Great Recession. At the recession’s height, when the Tea Party Republicans were fighting to kill Obamacare in the cradle, more than 44,000 people were losing their health coverage every week. In May 2009, the policy journal Health Affairs published a projection that nearly 7 million Americans would lose coverage by the end of 2010.
People also lose insurance because their insurance company doesn’t want to pay the cost of a grave illness (having gorged on costly premiums for years), which has happened to many thousands more. The most recent congressional report on the subject found that three major insurance companies had saved at least $300 million through “rescission” of policies held by 20,000 seriously ill clients, while their profits mounted.
Or people lose insurance because the cost rises and they can no longer afford it, which happens routinely to nearly half the population at some point during every decade. A report released by the Treasury four years ago found that “nearly half of non-elderly Americans” had lived without health coverage at some point between 1997 and 2006, a period of relative prosperity and high employment.
The consequence, as everybody ought to know by now, is that upward of 45 million Americans have gone without health insurance at any given moment since 2007. And the further consequence is that many of those uninsured – men, women, and children — go without needed health care, leading to untold suffering and premature deaths for as many as 45,000 annually, perhaps more.
But such dismal facts have never seemed to trouble the Republicans who are screaming so loudly now about the terrible toll of Obamacare. The perennial GOP attitude was set forth by neoconservative eminence Bill Kristol back in 1993, when the prime objective was to kill the nascent Clinton health plan. “There is no health care crisis,” Kristol famously declared, and for him — then a well-paid flack in the Murdoch empire — that was true enough.
After two decades of medical costs skyrocketing above inflation, threatening fiscal and economic ruin, while millions went without insurance, such smug right-wing complacency remains largely intact. The only “health care crisis” ever feared by Republicans like Kristol is the prospect that reform will help Americans – as Obamacare is already doing, despite their worst efforts.
Let’s hope that the president’s team swiftly solves the inherent problems of providing universal coverage through private insurers. It is certainly possible, if never optimal, as Massachusetts and other states seeking to advance that goal are already proving.
And meanwhile, let’s please have no illusions about this momentary flurry of concern on the right over insurance lost. It would disappear instantly and permanently — if only Obamacare could be repealed.
By: Joe Conason, Featured Post, The National Memo, November 15, 2013
“How We Got Obamacare To Work”: We Urge Congress To Get Out Of The Way And Support Efforts To Make Health-Care Reform Work
In our states — Washington, Kentucky and Connecticut — the Affordable Care Act, or “Obamacare,” is working. Tens of thousands of our residents have enrolled in affordable health-care coverage. Many of them could not get insurance before the law was enacted.
People keep asking us why our states have been successful. Here’s a hint: It’s not about our Web sites.
Sure, having functioning Web sites for our health-care exchanges makes the job of meeting the enormous demand for affordable coverage much easier, but each of our state Web sites has had its share of technical glitches. As we have demonstrated on a near-daily basis, Web sites can continually be improved to meet consumers’ needs.
The Affordable Care Act has been successful in our states because our political and community leaders grasped the importance of expanding health-care coverage and have avoided the temptation to use health-care reform as a political football.
In Washington, the legislature authorized Medicaid expansion with overwhelmingly bipartisan votes in the House and Senate this summer because legislators understood that it could help create more than 10,000 jobs, save more than $300 million for the state in the first 18 months, and, most important, provide several hundred thousand uninsured Washingtonians with health coverage.
In Kentucky, two independent studies showed that the Bluegrass State couldn’t afford not to expand Medicaid. Expansion offered huge savings in the state budget and is expected to create 17,000 jobs.
In Connecticut, more than 50 percent of enrollment in the state exchange, Access Health CT, is for private health insurance. The Connecticut exchange has a customer satisfaction level of 96.5 percent, according to a survey of users in October, with more than 82 percent of enrollees either “extremely likely” or “very likely” to recommend the exchange to a colleague or friend.
In our states, elected leaders have decided to put people, not politics, first.
President Obama announced an administrative change last week that would allow insurance companies to continue offering existing plans to those who want to keep them. It is up to state insurance commissioners to determine how and whether this option works for their states, and individual states will come to different conclusions.
What we all agree with completely, though, is the president’s insistence that our country cannot go back to the dark days before health-care reform, when people were regularly dropped from coverage, and those with “bare bones” plans ended up in medical bankruptcy when serious illness struck, many times because their insurance didn’t cover much of anything.
Thanks to health-care reform and the robust exchanges in our states, people are getting better coverage at a better price.
One such person is Brad Camp, a small-business owner in Kingston, Wash., who received a cancellation notice in September from his insurance carrier. He went to the state exchange, the Washington Healthplanfinder, and for close to the same premium his family was paying before got upfront coverage for doctor’s office visits and prescription drug , vision and dental coverage. His family was able to keep the same insurance carrier and doctors and qualified for tax credits to help cover the cost.
Since Howard Stovall opened his sign and graphics business in Lexington, Ky., in 1998, he has paid half the cost of health insurance for his eight employees. With the help of Stovall’s longtime insurance agent and Kentucky’s health exchange, Kynect, Stovall’s employees are saving 5 percent to 40 percent each on new health insurance plans with better benefits. Stovall can afford to provide additional employee benefits, including full disability coverage and part of the cost of vision and dental plans, while still saving the business 50 percent compared with the old plans.
In Connecticut, Anne Masterson was able to reduce her monthly premiums from $965 to $313 for similar coverage, including a $145 tax credit. Masterson is able to use her annual premium savings of $8,000 to pay bills or save for retirement.
These sorts of stories could be happening in every state if politicians would quit rooting for failure and directly undermining implementation of the Affordable Care Act — and, instead, put their constituents first. Health reform is working for the people of Washington, Kentucky and Connecticut because elected leaders on both sides of the aisle came together to do what is right for their residents.
We urge Congress to get out of the way and to support efforts to make health-care reform work for everyone. We urge our fellow governors, most especially those in states that refused to expand Medicaid, to make health-care reform work for their people too.
“The Burdens Of A Contradictory Message”: Is The Republican Position, “We’d Prefer To Leave You Behind With Nothing”?
On the surface, the Republican strategy on health care is proving to be more effective than they probably could have hoped. After waging a three-year sabotage campaign, the rollout of the Affordable Care Act has gone poorly; Democrats are divided; President Obama’s poll numbers are falling; the media is in a frenzy; the website still doesn’t work; and no one seems to remember the time Republicans shut down the federal government – just last month.
If RNC officials had written a script, it would look something like this.
And in the short term, at least as far as the politics are concerned, it’s quite possible that nothing else will matter. But at some point, I wonder if the political world will pause to consider the Republican message with a little more depth.
A few weeks ago, Matt Miller raised an important point: “What conservative officials, pundits and advocates are screaming is closer to the following: How dare you totally screw up something that we think shouldn’t exist!” Indeed, as we talked about as oversight hearings got underway a few weeks ago, conservatives are complaining about the functionality of a website that they’d just as soon destroy. They’re furious Americans are struggling to sign up for benefits that Republicans don’t want them to have. They’re demanding better performance of a system they’ve spent years deliberately trying to gut, and have no intention of trying to help fix.
The contradiction was more acutely obvious yesterday, with the release of October enrollment numbers: 106,185 consumers signed up for health insurance through an exchange, another 396,261 Americans have gained coverage through Medicaid expansion, and another million consumers were deemed eligible for coverage but have not selected a plan. GOP lawmakers considered this hilarious, noting a variety of sports venues that hold more than 106,185 attendees.
And that’s fine. Indeed, it’s predictable. About 500,000 Americans signed up for health care coverage last month, but because that number was far below the Obama administration’s original projections for the exchange marketplaces, critics of “Obamacare” want to take this opportunity to strut and gloat.
But that was yesterday. Today, I’d love to hear some of those same critics answer a couple of simple questions. First, for those mocking October enrollment numbers, do you wish that number was bigger or smaller? Because at this point, the answer appears to be “both,” which doesn’t make any sense. The Republican line currently seems to be, “We’re outraged that the number was so small, and we wish the totals were zero.”
That plainly doesn’t make any sense.
Second, for the 106,185 Americans who signed up for coverage through an exchange, and the 396,261 Americans who are now insured under Medicaid, is the Republican position, “We’d prefer to leave you behind with nothing?” What about those who sign up for coverage in November? And December?
By: Steve Benen, The Maoow Blog, November 14, 2013
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