“Health Reform Turns Real”: Even The “Bad News” On Obamacare Start-Up Is Really Good News For The Program’s Future
At this point, the crisis in American governance has taken on a life of its own. Some Republicans are now saying openly that they want concessions in return for reopening the government and avoiding default, not because they have any specific policy goals in mind, but simply because they don’t want to feel “disrespected.” And no endgame is in sight.
But this confrontation did start with a real issue: Republican efforts to stop Obamacare from going into effect. It’s long been clear that the great fear of the Republican Party was not that health reform would fail, but that it would succeed. And developments since Tuesday, when the exchanges on which individuals will buy health insurance opened for business, strongly suggest that their worst fears will indeed be realized: This thing is going to work.
Wait a minute, some readers are saying. Haven’t many stories so far been of computer glitches, of people confronting screens telling them that servers are busy and that they should try again later? Indeed, they have. But everyone knowledgeable about the process always expected some teething problems, and the nature of this week’s problems has actually been hugely encouraging for supporters of the program.
First, let me say a word about the underlying irrelevance of start-up troubles for new government programs.
Political reporting in America, especially but not only on TV, tends to be focused on the play-by-play. Who won today’s news cycle? And, to be fair, this sort of thing may matter during the final days of an election.
But Obamacare isn’t up for a popular referendum, or a revote of any kind. It’s the law, and it’s going into effect. Its future will depend on how it works over the next few years, not the next few weeks.
To illustrate the point, consider Medicare Part D, the drug benefit, which went into effect in 2006. It had what was widely considered a disastrous start, with seniors unclear on their benefits, pharmacies often refusing to honor valid claims, computer problems, and more. In the end, however, the program delivered lasting benefits, and woe unto any politician proposing that it be rolled back.
So the glitches of October won’t matter in the long run. But why are they actually encouraging? Because they appear, for the most part, to be the result of the sheer volume of traffic, which has been much heavier than expected. And this means that one big worry of Obamacare supporters — that not enough people knew about the program, so that many eligible Americans would fail to sign up — is receding fast.
Of course, it’s important that people who want to sign up can actually do so. But the computer problems can and will be fixed. So, by March 31, when enrollment for 2014 closes, we can be reasonably sure that millions of Americans who were previously uninsured will have coverage under the Affordable Care Act. Obamacare will have become a reality, something people depend on, rather than some fuzzy notion Republicans could demonize. And it will be very hard to take that coverage away.
What we still don’t know, and is crucial for the program’s longer-term success, is who will sign up. Will there be enough young, healthy enrollees to provide a favorable risk pool and keep premiums relatively low? Bear in mind that conservative groups have been spending heavily — and making some seriously creepy ads — in an effort to dissuade young people from signing up for insurance. Nonetheless, insurance companies are betting that young people will, in fact, sign up, as shown by the unexpectedly low premiums they’re offering for next year.
And the insurers are probably right. To see why anti-Obamacare messaging is probably doomed to fail, think about whom we’re talking about here. That is, who are the healthy uninsured individuals the program needs to reach? Well, they’re by and large not affluent, because affluent young people tend to get jobs with health coverage. And they’re disproportionately nonwhite.
In other words, to get a description of the typical person Obamacare needs to enroll, just take the description of a typical Tea Party member or Fox News viewer — older, affluent, white — and put a “not” in front of each characteristic. These are people the right-wing message machine is not set up to talk to, but who can be reached through many of the same channels, from ads on Spanish-language media to celebrity tweets, that turned out Obama voters last year. I have to admit, I find the image of hard-line conservatives defeated by an army of tweeting celebrities highly attractive; but it’s also realistic. Enrollment is probably going to be just fine.
So Obamacare is off to a good start, with even the bad news being really good news for the program’s future. We’re not quite there yet, but more and more, it looks as if health reform is here to stay.
By: Paul Krugman, Op-Ed Columnist, The New York Times, October 3, 2013
“Way Off Base”: Busting Zombie Obamacare Myths
The Republican effort to defund or delay health care reform at any cost has kept alive many misconceptions and false claims about the Affordable Care Act. This roundup of Center on Budget and Policy Priorities’ work on issues related to health reform and the federal government shutdown provides a large dose of reality.
A delay in the individual mandate is neither harmless nor fair: Let’s start with the big one: that a one-year delay in the individual mandate requiring everyone to acquire health insurance as long as it is affordable is harmless and fair because the Obama administration delayed for a year the requirement that large employers provide health insurance or pay a penalty. I discussed some flaws in that argument in an earlier post on this blog.
In CBPP’s shutdown roundup, Edwin Park reiterates why a delay in the individual mandate is neither harmless nor fair. It’s not harmless because it would cause 11 million more Americans to remain uninsured in 2014 and result in higher premiums in the individual market for many others, according to the Congressional Budget Office. It also would disrupt the new health insurance exchanges and likely delay the availability of coverage through the exchanges.
It’s also not fair to equate delay of the individual mandate to a delay in the employer requirement. Park highlights an Urban Institute analysis which showed that the employer delay would have only a small effect on the coverage gains expected under the ACA and which concluded that it would “be dangerously wrong” to assume a similarly small effect from a delay of the individual mandate. Similarly, CBO estimates that delaying the employer requirement would increase the number of uninsured by less than 500,000 – a far cry from the estimated 11 million increase from delaying the individual mandate.
The ACA will not likely cause a significant shift to part-time work: The employer responsibility provision whose implementation was delayed until 2015 requires larger employers (those with at least 50 full-time-equivalent workers) to offer health coverage to their full-time employees (those working 30 or more hours a week) or pay a penalty. Critics claim that we could already see a shift to part-time work in the data before the announced delay. Some have argued that the cutoff for defining full-time work should go from 30 hours a week to 40.
In CBPP’s shutdown roundup, Paul Van de Water shows that data this year provides scant evidence of a significant shift toward part-time work and that there’s every reason to believe that the ultimate effect will be small as a share of total employment. Van de Water shows, however, that raising the threshold from 30 to 40 hours a week would expose a significant number of workers to a reduction in hours.
Medical device manufacturers are unlikely to lose from the ACA despite a tax: A strong lobbying effort is underway to repeal the ACA’s 2.3 percent tax on certain medical devices such as coronary stents, artificial knees and hips, cardiac pacemakers, irradiation equipment and imaging technology. In the CBPP roundup, Paul Van de Water explains why that tax, which helps pay for extending health coverage to millions of uninsured Americans, is sound and the arguments against it are not.
First, the tax does not apply to wheelchairs, eyeglasses and other devices that the public generally buys at retail and for individual use. Second, the tax is levied on equipment that manufacturers will likely see a boost in revenue from due to the increase in health coverage afforded by the ACA. As Van de Water points out, a study by Wells Fargo Securities finds that health reform will increase device sales by 1.5 percent in 2014 and by 3.6 percent cumulatively through 2022 – enough to offset the tax.
Finally, this is a highly profitable industry, and the stock prices of the top device manufacturers have generally outperformed market averages since the tax was introduced this year.
The ACA is a major piece of legislation with many interrelated moving parts, and there will be some glitches along the way as it’s implemented. But the criticisms we’re hearing in the current budget fight are way off base.
By: Chad Stone, U. S. News and World Report, October 4, 2013
“Drunk And Disorderly”: Republican Extremists Are Shredding Every Principle The GOP Claims To Uphold
By Washington standards, the current government shutdown is an everyday disaster – of a kind we are gradually learning to expect whenever the Republican Party controls Congress. The impending breach of the nation’s credit, however, when those same Republicans refuse to raise the debt limit to cover the funds they have spent, threatens a singular catastrophe: unpredictable, global, yet entirely avoidable.
The blame for this disgrace seems to be apportioned properly by most Americans, according to the latest polling data. But the future of the country and the world may well rest on whether voters understand the roots of this crisis – in a party controlled by an extremist faction that is violating every public value that party has supposedly espoused for 30 years and more.
Republicans used to tell us, often with a self-righteous air, that they were the true upholders of constitutional order, the rule of law, fiscal probity, personal responsibility, majority rights, and market principles. In their unquenchable zeal to oppose President Obama and all his works, they have discarded every one of those ideals.
They have closed down the government, with all the costs and sorrows that has imposed on the American people, in order to save us all from the Affordable Care Act – a law duly passed under the Constitution and declared to be so by a majority of the Supreme Court, including its very conservative chief justice. (Following that decision, the Republicans spent the next year campaigning to defeat the president on a platform of repealing health care reform – and were soundly defeated by him instead.)
To measure just how grossly the current attempts to obstruct Obamacare violate their supposed devotion to “law and order,” just imagine the Republican reaction if House Democrats had shut down government to force George W. Bush to repeal his beloved tax cuts.
Such hypocrisy is business as usual. But what about the substance of the Republican complaint against health care reform? To anyone aware of the law’s historical context, the fanatical Republican opposition simply seems bizarre. Here, after all, is a market-based system, originally conceived and promoted at the ultra-conservative Heritage Foundation as an alternative to Democratic plans for universal coverage. Its fundamental premises are individual responsibility and the power of competition to control costs and stop waste. Its first proven success occurred in a state governed by a Republican business executive — whom they later nominated for president.
Nevertheless, the Tea Party Republicans remain so determined to eradicate Obamacare that they are willing to jeopardize the economic recovery and the nation’s future prospects. They justify these outrages in the name of the budget, which they insist will be ruined by the costs of subsidizing health care for the country’s uninsured millions. But there is nothing fiscally responsible about shutting down government, an act that costs the U.S. economy at least $300 million each day – not including the additional burdens likely to arise from cancelled food inspections, disease monitoring, flu vaccinations, and weather reporting, to mention a few vital services that actually save enormous amounts of money and prevent untold suffering.
Should they continue to foment anarchy by causing a debt default, the ultimate costs are totally unpredictable – except that they will be very large. Even the threat of a shutdown in 2011 caused an immediate slowdown and an increase in unemployment. What will the real thing do? Nobody knows for certain, but the resulting market chaos and economic downturn will cause deeper fiscal problems as well as enormous public pain – at a time when deficits are falling faster than at any time in the past seven decades.
That is why the president and Senate Democrats are right to reject the House leadership’s demand for “negotiations.” Encouraging the destructive strategies of the extremists would convey precisely the wrong message to them and to the world. No doubt many Republicans, appalled at the shame that the Tea Party has brought upon their once Grand Old Party, are quietly applauding the president’s newfound firmness.
By: Joe Conason, The National Memo, October 3, 2013
“The Power Of Personality”: “ObamaCares” And The Tea Party Doesn’t
Does anybody care that millions of Americans can’t afford health care? Does anyone care that before health care reform, insurance companies had the power to screw their customers royally? Does anyone care that Americans spend more per person on health care than people anywhere else in the world but are not nearly as healthy as the citizens of nations which provide comprehensive health care coverage to their residents?
Barack Obama does and the tea party doesn’t.
The most important stat that I saw in the 2012 National Election Day Exit Poll was the power of personality in the presidential race. A majority of the voters who looked for leadership, vision and shared values in 2012 supported Mitt Romney. The only other personal dimension measured by the exit poll was caring. The voters who sought compassion in their president supported Barack Obama by an overwhelming margin. The president’s advantage on empathy was so big that it overwhelmed the support that Mitt Romney had on the other three personality dimensions.
Compassion brings us to the Affordable Care Act or, as I like to call it, ObamaCares.
Many Americans who oppose ObamaCares also dislike the mean spirited nature of the tea party. You can talk about issues until the cows come home, but Americans vote for people, not issues. Voters use the candidates’ positions on issues to make personal judgments about their character. Many Americans may have philosophical reservations about the Affordable Care Act, but more than anything else they resent the tea party’s blind opposition to any proposal that improves the quality of health care available to the public. The tea party has demonstrated its indifference to the suffering of millions of Americans by its failure to offer its own plan to improve the floundering system of health care that undermines the health, wealth and well being of the United States
Politics is full of irony, which is what makes Washington so interesting. Republicans pushed hard on the budget because they wanted to use the threat of a shutdown as leverage against ACA. But on the same day that the wacko birds forced the federal government to close with dismal reviews, enrollment in Obamacare began with such a big demand that it overwhelmed computer systems. My guess is the wingnuts don’t see the irony, but do see a lot of red.
The early returns on the shutdown should worry Republicans. A CBS News survey conducted since the federal government closed for business early Tuesday morning indicates that a large majority (72 percent) of Americans oppose the shutdown over Obamacare. The tea party doesn’t seem to care about its electoral fortunes any more than it does about the well being of the working families who make this country great. The party’s indifference to people and politics will cost it dearly next year in the midterm elections.
By: Brad Bannon, U. S. News and World Report, October 3, 2013
“Obamacare Swallowed Conservatism Whole”: What Happens To Conservatism When The Obamacare War Is Over?
When we look back decades from now, one of the keys to understanding this period in our political history will be the story of how a set of market-based health insurance reforms that started as a proposal from the Heritage Foundation and then were successfully implemented by a Republican governor who later became the GOP presidential nominee, ended up being viewed by virtually all conservatives as not just an abomination but the very essence of statist oppression. Liberals have often expressed wonder or exasperation about the way conservatives changed their opinions about this particular brand of reform. But now that it’s driving a government shutdown (and soon a potential default on the debt), we have to acknowledge that it’s more than just a policy conservatives hate. The Affordable Care Act is far, far bigger than that. It has become the most important definer of conservatism in America circa 2013. It isn’t that conservatives don’t still want to cut taxes for the wealthy, or slash the social safety net, or liberate corporations from pesky regulations on worker safety and the environment, or make it impossible for women to get abortions, because they still want all those things. But Obamacare has swallowed conservatism whole.
Since the health-care exchanges opened yesterday, some have suggested that the increased attention brought to the fact of their opening by the shutdown has done the administration a favor, informing more people that open enrollment has begun than the Department of Health and Human Services could possibly have managed on its own. That’s probably true. This controversy has also served to remind conservatives that there is nothing more important than fighting Obamacare. Every Republican politician has to prove that their hatred of the law is as great as that of the angriest Tea Partier. Every conservative everywhere is being told that this is what it means to be a conservative, this is so important to their beliefs and the future prospects of their party and their ideological movement that it is worth laying waste to the government and even the economy itself. If you’re a conservative and you aren’t willing to risk everything on even the smallest chance to toss your spear into this foul beast’s heart, then you’re not really a conservative at all.
Let’s fast-forward a couple of years from now, after this crisis ends without the ACA being defunded or delayed. The law is all rolled out, and while it’s far from perfect, things are going pretty well. We don’t have universal coverage, but the vast majority of Americans now have insurance, including millions who didn’t have it before. It’s not dirt cheap, but the trends that are evident today—a slowdown in the overall health-care spending growth rate, mirrored by a slowdown in premium increases—are continuing. More states have put aside their ideological objections and accepted the expansion of Medicaid to cover all their poor citizens, even if there are a few straggler states left. What with “pre-existing conditions” and “job lock” things of the past, even the most doctrinaire Tea Partier admits that there’s no more question about whether Obamacare can be repealed. Its tendrils have reached too many people who now benefit from it and would react angrily if you tried to take it away.
Ted Cruz admitted to Sean Hannity back in July that “If we don’t [defund Obamacare] now, in all likelihood, Obamacare will never, ever be repealed. Why is that? Because on January 1, the exchanges kick in, the subsidies kick in,” and they’ll be unable to take away something people are benefiting from. And he’s surely not the only Republican who gets this, which is part of the explanation for the ferocity with which they’re fighting now. But in our future scenario, the fight over the law will be basically over. There might be some debates about adjusting parts of the law, as Democrats will want to do, but that won’t concern Republicans too much. Once there’s no possibility left that it can be killed, they’ll likely lose interest.
I think that’s the most plausible picture of what things will be like in, say, 2015. The question is, if eventually they have no choice but to accept that the argument over the ACA is settled, what on earth will Republicans do with themselves? Because over the last four years, opposition to Obamacare has taken on such an extraordinary power within the movement that all other issues have paled before it.
Sure, they could revert to the old standbys—Cut taxes! Cut regulations! Strong defense! But those are just positions you can take. Obamacare was a war to be fought. And nothing galvanizes, energizes, and defines us like our wars. That’s particularly true of the zealots who are driving the Republican party and form such a key part of its base. And if they aren’t fighting Obamacare, who will they be?
By: Paul Waldman, Contributing Editor, The American Prospect, October 2, 2013
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 