Health-care act’s bugs transcend politics
Wednesday April 9, 2014 6:24 AM
I continue to be frustrated by individuals who politicize the facts surrounding the Affordable Care Act. Add columnist E.J. Dionne to that list (“In spite of doom and gloom, Obamacare is working,” op-ed, Friday’s Dispatch).
I don’t care what political polls say, as outlined by Dionne. We have our first marketplace realities to review with recent figures. The goal of an initial 7 million enrollees was set before 6.5 million to 7.5 million Americans lost their health-insurance policies in 2013. That happened because their policies did not meet the requirements set by the act. It is only logical to factor those who lost their insurance into the goal.
The revised goal by any logical standard should be 13.5 million at the low end. We should have expected 13.5 million people to sign up (6.5 million who lost the coverage and the 7 million set by Health and Human Services).
If 7.2 million signed up as stated by the Obama administration, that was a 53 percent achievement of the goal. Not impressive. That says that fewer than 700,000 of the enrollees were from the group of noninsured whom the administration established as a group that must have health-care coverage.
We have been told countless times that there are approximately 40 million people uninsured. We are at 2 percent of that goal.
Come on, with four years of preparation, countless executive-order revisions, a bad mix of young insured to old that makes the plan more expensive, questions about premium payments, etc., and countless other issues, this does not turn out to be a conservative-vs.-liberal problem, this is an American problem. I expect my government to fix it before the Affordable Care Act does nothing more than add to a spiraling debt.
M VALLEY (JIMVALLEY)
Geoff claims that “this does not turn out to be a conservative-vs.-liberal problem”, yet even referring to the ACA as a “problem” adopts the right-wing line on the issue. Considering that this entire letter consists of whiny complaining and the rote recitation of numerous familiar conservative talking points, I conclude that (a) no, Geoff, this IS a left-right issue, just like evolution and climate change have become; and (b) Geoff is a conservative.
RALPH HUMPHREY (RALPH-FROM-MARENGO)
When is your Savior going to report how many people have actually PAID for instead of enrolled in, ACA.. Not holding my breath as we all know how embarrassed Obummer would be if that was announced….. Keep drinking the kool aid guys.. Then again, nothing of truth has come out of this administration so who cares what they have to say other than you three jokers!
MARK DILLON (MRSMD1HUSBAND)
Reconcile, you might want to ask Rae Roca-Picket, the Senior national communications manager of the “Young Invincibles”, who wrote another letter whining about the legislature changing the age folks can stay on their parent’s insurance from 28 to 26 that question. Americans became such babies when they started feeling entitled to someone else taking care of them from cradle to grave and expecting to be rewarded just for being here. The ACA is a problem. It was badly written, rushed to a vote, and since it became a law it has been changed three dozen times. Well written laws do not need so many makeovers and unfortunately the changes that were made were for purely political reasons. There might be some good parts to the ACA but on the whole the law is a disaster. It should be repealed and then rewritten with input from industry experts instead of lawyers (which is what most of Congress is comprised of) to make it a workable piece of legislation instead of the train wreck it is now. I don’t care if you’re on the right or the left, the ACA hurts everybody.
Pelosi suggests Gibbs’s Obamacare comments are due to his business ties
Since departing the White House in 2011, Gibbs has taken a path familiar to other former White House officials who use their ties to a president to enrich themselves and establish a new career. Shortly after stepping down as White House press secretary, Gibbs sign a lucrative contributor contract with NBC News and MSNBC, hired the Harry Walker Agency to help him secure paid speaking appearances and co-founded The Incite Agency, a consulting and media relations firm that advises Fortune 500 companies, including health-care firms.
3:52 PM EST
Pelosi said, “We have to pass the bill to see what is in it.” Period. The airhead of central Ca. opened her mouth and inserted her Jimmy Choo.
3:59 PM EST
How many people, under oath, can say they “saw what’s in it”???…i.e., read the WHOLE 2500 page monstrosity.
4:16 PM EST
Looks like anyone with a brain cell has scooted out from under the Obama umbrella…
3:30 PM EST
Pelosi’s comments have been misrepresented, and the poster here does it again. She did not say “we”, she said passing the bill will allow *you* (meaning the public) to understand it. This is obviously true, a complex program needs to be implemented before it can be appreciated. “Passing” the bill does nothing, a poor choice of words on her part. She should have said “implement.” But her meaning was clear – except to conservatives intent on misrejjlj
3:33 PM EST
so NO MATTER WHAT THEY SAY, it’s ONLY WHAT THEY MEANT…. E.G. “if you like your doctor” Where do we find the secret decoder?
3:49 PM EST
Dems have been reading to much Orwell. All are created equal, just Dems are more equal than Repubs.
2:58 PM EST
Two immediate data points that could tell the story of success or failure: 1. How many uninsured today? 2. Total cost of roll out divided by 7 million Doesn’t the public deserve this?
3:11 PM EST [Edited]
You are myopic. The purpose of Obamacare is not to enroll 7 million people in 2014. The strategy is to steadily bring down the uninsured population over the coming decade. A meaningful individual mandate doesn’t kick-in for two years. We’re just at the start of this endeavor. Perhaps 25M will have coverage in 4 years. The startup costs bring long term benefits. If you want to boost those numbers, work on the Republicans who are spitefully and cruelly blocking medicaid expansion in states with large poor populations. BTW, why is poverty concentrated in states controlled by Republicans?
4/6/2014 6:19 PM EST [Edited]
Why are conservatives fixated on the employer mandate? I bet not one in ten of you have any opinion on whether it is a good idea. If Obama wanted to strengthen the employer mandate, you’d howl in protest. You’re angry when he delays it. And I see some of you are mad that it may never get implemented. You are balls of directionless, free-floating anger. I agree with Gibbs, although this may be wishful thinking, the employer mandate causes far more harm than good and should be eliminated entirely.
4/6/2014 6:47 PM EST
Math is not Obama’s friend, regardless of what he or Pelosi said or meant to say.
4/6/2014 6:09 PM EST
“Democrats say White House won’t delay Obamacare employer mandate again” Well, given that the Obammunists have lied 100% of the time about everything they’ve said about Obamacare so far, this is an absolute guarantee that they WILL in fact delay the employer mandate some more!
pietro piraino wrote:
4/6/2014 5:09 PM EST
Pelosi said “you have to pass the bill to see what is in it away from the fog of controversy”. Liberal or democrat, you can’t hide from the video of her actually saying it. Why is she so mad at Gibbs comments? Because when another democrat strays from the party line it means another light being turned on so people can see the truth.
4/6/2014 6:24 PM EST
your quote is wrong.
Health Care Without End
SO you think it’s finished? So you think now that enrollment has hit seven million, now that the president has declared the debate over repeal “over,” now that Republican predictions of a swift Obamacare unraveling look a bit like Republican predictions of a Romney landslide, we’re going to stop arguing about health care, stop having the issue dominate the conversation, and turn at last to some other debate instead?
You think it’s over? It’s never over.
Dawn Prevete Atlanta12 hours ago
Healthcare delivery and costs in the United States will remain a problem until we begin to address the vast difference in costs in the US as compared to other developed countries. One of the biggest flaws in the ACA is that it institutionalizes certain theories about what drives disproportionate healthcare costs in the US, putting the blame on “overuse by consumers” and “too much testing” rather than the inflated costs for treatment. We need to examine and review how to limit the fees hospitals – and doctors – can charge for procedures, whether through government intervention or market pressure. It’s time to place blame where it’s deserved.
Pvolkov Burlington, Ontario13 hours ago
Your concerns are valid, Mr. Douthat. I am a U.S. citizen living in Canada as a permanent resident and receive full medical coverage as well as my family in this country. How come Canada can accomplish this feat without bankrupting the nation? And do it at a fraction of the cost of the U.S. with better quality coverage? Simple. Our taxes which are more progressive cover the costs and there are no private for profit insurance companies or private medical conglomerates involved and hospitals are regulated with costs for medical care included in our coverage and no one’s care is tied to their jobs.Until and unless the health care needs for citizens are removed from the private sector, any form of Obamacare or other coverage will become an albatross for the nation and force medical needs to offer less and less help for the people.
Simple? We will have to have a financial and political revolution in my birth country before sanity will prevail and not only in the health care sector. It is depressing to witness what is happening and what the future holds. I am indeed fortunate to be living in Canada at this point in time.
Louis Howe Springfield, Il 13 hours ago
Obamacare is NOT health care reform but for-profit health insurance reform. The money poured into that leaky bucket will be an endless process as Douthat explains. The question is …How long will Americans continue to pay a $1.00 into a health care delivery process that the Germans and Canadians pay 53 cents, the British 40 cents and the Japanese 38 cents? When will Americans finally recognize that we need to fix the bucket before pouring in more resources?
Jane New Jersey14 hours ago
Thank you Mr. Douthat. You forgot to mention that what WILL change is the fact that the country will continue to lose primary care physicians. That as long as we make it harder for doctors to stay in practice, med students will continue to only specialize. They will work for hospitals only while the established will continue to sell out to the hospitals to strengthen their positions. I think we can expect doctors unions and strikes like that in Israel. We can expect a two tier system like that of Great Britain where we will be paying far more privately for quality care since the government cannot provide it. And we will see the dumbing down of medicine like that of Russia where their doctors have been trained fewer years with less knowledge/depth like that of PA’s. And finally let’s not forget that more doctors will continue to drop insurance altogether in order to practice REAL medicine and not that which is dictated by government intervention.
Yes, Mr Douhat, the American public has no idea what they are in for. Many delude themselves that socialized medicine is better. Those are the ignorant. “The grass always looks greener.” Watch out.
Elizabeth Renant New Mexico14 hours ago
Universal health care works across the developed world: it is underfunded in the UK, but works beautifully in Switzerland (a hotbed of socialism), Holland, France, Denmark, and reasonably well in Canada.We don’t know how it would work here not because it can’t, with the same kinds of taxes that support it in Switzerland and France, but because the wealthy CEOs of the health insurance industry have no intention of giving up a system that has done so well by them – they take home tens of millions annually in compensation, however badly it has done for the US’s middle-class.
There are lots of options. It’s not that we haven’t figured out how it could be paid for: it doesn’t matter. Our government is a wholly owned subsidiary of K Street, and large corporate interests are the patrons of K Street, not the middle-class.In the meantime, Mr. Douthat, the going rate for six months of treatment (that is, six rounds of the four-drug cocktail recommended to successfully treat a Stage I HER2 breast cancer) costs about $300,000 as my 60 year old sister recently found; she has a $62,000 job, no children, has been a dutiful citizen and taxpayer, saved for retirement . . . and is now $10,000 in debt for what her employer paid health insurance didn’t cover. She will be paying that $10,000 off for ten years rather than purchasing goods and services and thus creating jobs.
At this point, a step in any direction would be a step in the right direction.
Drindl NY 11 hours ago
I wonder if conservatives ever get tired of whining? It seems like all they do. And this outrage over middle-class access to healthcare is so Romneyesque… he lost, Douhat, and there’s a reason.
Rachel Kreier Port Jefferson 11 hours ago
When even Douthat talks about price controls as inevitable, I start to feel some hope!
Sara NY11 hours ago
Current “secularizing trends” are the cause of people consuming more healthcare? Which is a bad thing? The healthcare “problem” is all about greedy oldies wanting to live? That is a seriously selfish take on the issue, Douthat. You’re pretty bold to put it out there like that since it makes you sound exactly like self absorbed, pro-life-except-where-it’s-inconvenient hypocrite I’ve come to expect. Send your grandma my way when she needs some help…I don’t want you to make feel like she’s a burden.
Alan Chaprack New York, NY 11 hours ago
The debate on the ACa will end with Congress passing and a president signing into law a single-payer system. I wish you a long life, Mr. Douthat, so you can see one debate end and yet another begin.
NOVEMBER 9, 2013 4:00 AM
Obama’s Massive Fraud
If he were a CEO in the private sector, he’d be prosecuted for such deception.
By Andrew C. McCarthy
Ms. Stewart, naturally, was fearful that truthful statements would send the stock price plummeting. Obama, by comparison, was not lying merely to prevent a company from losing value. His fraud was, first, to induce passage of a plan designed gradually to destroy the private health-insurance market — a plan that barely passed and never would have been enacted if he’d been honest. And later, his fraud was to procure his reelection and the guaranteed implementation of Obamacare; had he been honest, he would have been defeated and Obamacare forestalled.
Barack Obama is guilty of fraud — serial fraud — that is orders of magnitude more serious than frauds the Justice Department routinely prosecutes, and that courts punish harshly. The victims will be out billions of dollars, quite apart from other anxiety and disruption that will befall them.
The president will not be prosecuted, of course, but that is immaterial. As discussed here before, the remedy for profound presidential corruption is political, not legal. It is impeachment and removal. “High crimes and misdemeanors” — the Constitution’s predicate for impeachment — need not be indictable offenses under the criminal code. “They relate chiefly,” Hamilton explained in FederalistNo. 65, “to injuries done immediately to the society itself.” They involve scandalous breaches of the public trust by officials in whom solemn fiduciary duties are reposed — like a president who looks Americans in the eye and declares, repeatedly, that they can keep their health insurance plans…even as he studiously orchestrates the regulatory termination of those plans; even as he shifts blame to the insurance companies for his malfeasance — just as he shifted blame to a hapless video producer for his shocking dereliction of duty during the Benghazi massacre.
It is highly unlikely that Barack Obama will ever be impeached. It is certain that he will never again be trusted. Republicans and sensible Democrats take heed: The nation may not have the stomach to remove a charlatan, but the nation knows he is a charlatan. The American people will not think twice about taking out their frustration and mounting anger on those who collaborate in his schemes.
Can Obamacare survive an enraged middle class?
By Robert Wargas US politics Last updated: November 13th, 2013
The middle class: the first ones slandered as bigots and louts and the first ones billed for all the latest schemes. Too rich to be poor, too poor to be rich. Too little power to rewrite laws in their favour, too much power to be gushed over by champagne socialists and metropolitan editorial boards.
So far, millions of Americans have lost their health-insurance coverage thanks to Obamacare. Those most affected are younger, healthy citizens as well as the middle class. Yes, this middle class includes many liberals. ProPublica has published an article describing the plight of two liberal Democrats who lost their coverage because their comprehensive plan still “did not meet the requirements of the Affordable Care Act”. The couple now must pay exorbitant rates for worse coverage. Since they are of the middle class, they make too much money to qualify for subsidies to help defray the cost of a new plan. (If you are single, the cut-off for subsidies is a salary of $46,000 a year. The cut-off for a family of four is $94,000 a year.)
Now, no nation does anger like the United States. Unlike most government programmes, which conduct their wealth-siphoning out of the public eye, the effects of Obamacare are starkly visible, especially to those it needs to exploit the most. You can complain about welfare and affirmative action all you want; still, to most people, those programmes are abstractions that don’t alter everyday life in any substantial way.
But there really is nothing quite like being a hard-working, tax-paying, law-abiding citizen and receiving a letter in the mail from your health insurance company saying you’ve been dropped – thanks to a law you were told would help you. The letter instantiates, to that upstanding citizen, the fact that he is now merely a sacrificial tax lamb. Millions of little tax lambs have received such letters, and even the most capable spin doctors can’t hide this nasty fact. In fact, the more creative they get with their spin, the more the victims of Obamacare will become enraged that their hardship is being trivialised. Obama is at least smart enough to have learned this, which is why he has offered a very late apology to the tax lambs on NBC News.
It’s a good thing, for him at least, that he’s shifting the tone. Obamacare supporters have used several stock arguments to the cancellation letters, and these have only made things worse. One is to say that it’s the insurance companies’ fault for terminating your coverage, since nothing in the so-called Affordable Care Act mandates dropping coverage. Obama himself used this talking point recently.
But the companies have terminated the plans due to the costs imposed by the law itself. The US government, you see, is using the insurance companies as middleman proxies in its wealth-redistribution scheme. By forcing these companies (among other things) to cover people who are certain losses, the government has effected a massive cost shift onto the pool of less risky customers, as well as to those too “wealthy” (i.e. $47,000 a year) to qualify for help.
Imagine if the US government passed a law mandating that every restaurant in the nation give away a certain number of free meals per day. Then imagine that when the restaurant owners raised prices on other meals to cover the guaranteed losses, the government claimed it was an innocent bystander in the affair. How dare those greedy owners not want to give away free merchandise! We didn’t mandate they raise prices!
Or imagine if the government raised the minimum wage to $50 an hour, and then claimed the ensuing mass unemployment was the fault of greedy shop owners. After all, nothing in the minimum wage law mandates firing employees.
The other reply, equally arrogant, is to say that the terminated coverage was “substandard”. Substandard to whom? As you can see from reading the ProPublica piece, the liberal author admits the cancelled plan was damn fine coverage by any standard.
The point is that Obamacare will continue to enrage people if the law’s supporters persist in using such dismissive talking points. People do not want to be talked about as though they were the eggs in the government omelette. Nor do they want to be told to stop their whining and take their bumps in the name of some abstract “equality,” when the concrete effects of that “equality” are higher costs and worse health coverage for them. If Obamacare is ever repealed, it will be because the American middle class finally stands up for itself.
The sinking ship of Obamacare
By Kathleen Parker, Published: November 15
Let’s recap: If you like your insurance policy, you can keep it. No, wait. If you liked your policy, it was probably worthless anyway. Scratch that. If your junk policy was canceled and you still want it, you can keep it. Er, get it back.
So now President Obama has apologized for real. On Thursday, he told Americans, “I hear you loud and clear” (Do I hear an echo?) and announced that insurance companies can ignore the law for a year. The several million Americans whose policies were canceled, or were scheduled to be canceled, can keep them — or get them back — assuming state regulators and insurance companies comply.
It isn’t clear whether insurers can, or will, based on the assurances of someone whose credibility isn’t exactly soaring. Meanwhile, the newest promise dovetails with another earlier delay granted to businesses with at least 50 employees (just 3.6 percent of employers), which were given another year to comply with the Affordable Care Act (ACA).
With the computer-crash rollout preventing people from signing up, businesses temporarily exempted from compliance and policyholders either reinstated or facing yet another broken promise (for which the insurance companies will be blamed), is there anyone left to love Obamacare?
In the wake of Obama’s latest tweak, two salient questions have emerged: Can the ACA survive? Can the president even do what he just did, legally?
Though brilliant minds may differ, the president is probably within bounds, according to a compelling argument by Simon Lazarus , senior counsel at the Constitutional Accountability Center. The relevant constitutional text, he writes for the Atlantic, requires that the president “take care that the laws be faithfully executed,” a broad-enough concept to allow for judgment in the execution.
The only prohibition is that the president not fail to execute the law owing to his opposition to a policy. Obviously, this is not the case here. As a political matter, it is also obvious that Obama is merely trying to right his own sinking ship, especially after Bill Clinton’s undoubtedly heartfelt advice (you just know), as well as to preempt a new House bill to aid canceled policyholders that passed Friday with bipartisan support, including 39 Democrats.
Cynics on the left insist that Republicans have no real interest in helping Obamacare. And, of course, they are correct. Do Republicans just want to make sure Obama fails? Yes, but not for reasons sometimes suggested. Oprah recently intoned that many Americans disrespect Obama because he is African American. Even if that were remotely true, it is not the reason half the country opposes Obamacare and many more now doubt its efficacy.
Similarly, when Senate Minority Leader Mitch McConnell of Kentucky notoriously said that his job was to make sure Obama was a one-term president, it wasn’t because of race, nor was it immediate to the president’s election. McConnell made his remark in October 2010, on the eve of the midterm elections, and after Obamacare passed without a single Republican vote.
In other words, Republicans oppose Obama’s policies, not the man, because they believe the president will so inexorably change the structure of our social and economic system by mandating and punishing human behavior that nothing less than individual freedom is at stake. Under present circumstances, this hardly seems delusional. Does anyone really believe that subsidized policyholders with preexisting conditions won’t eventually face other mandates and penalties related to their lifestyle choices?
Finally, Democrats incessantly seize upon their prize trophy: The U.S. Supreme Court validated Obamacare. True-ish. The high court didn’t endorse Obamacare as a good idea. It didn’t even find the individual mandate constitutional. It ruled that the mandate/penalty is constitutional only if the penalty is viewed as a “tax.” If one were to examine this gift horse’s mouth, one would have to note that, funny, but throughout the health-care debate and oral arguments, and even now, Democrats have insisted that the penalty is not a tax. Paging George Orwell.
Whether the ACA survives the new timetable remains an open question. The plan sinks or swims on the basis of young, healthy people signing up, which, for now, they cannot do except in dribs and drabs. Further, the ACA clearly needed the canceled policyholders to buy new, more expensive policies to underwrite subsidies and preexisting conditions.
Given the season, the timing of these un-glad tidings could not be worse. Soon enough, Americans will figure out whether Obamacare is the gift Democrats promised — or if Obama is the Grinch who stole, you know, the holiday season.
How we got Obamacare to work
(BRIAN SNYDER/REUTERS) – Liz Carlson, a self-employed student, attends a health care enrolment fair co-sponsored by Planned Parenthood of Northern New England and the State Employees Association at Great Bay Community College in Portsmouth, New Hampshire November 9, 2013. Carlson was unable to create a user account on the Affordable Care Act website, HealthCare.gov, and left with a paper application.
By Jay Inslee, Steve Beshear and Dannel P. Malloy, Published: November 17
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.
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.
Obamacare credibility going up in smoke: Our view
The Editorial Board, USATODAY8:26 p.m. EST November 13, 2013
New HealthCare.gov data show just how broken it is.
The health insurance sign-up numbers the White House released Wednesday afternoon were deeply disappointing, though not particularly surprising.
Everyone knows that the HealthCare.gov website has been performing abysmally, and the actual numbers confirmed what everyone could only guess at until now because the White House had withheld the data.
Overall, only about one-fifth of the people the White House expected to sign up for insurance in the first month actually did so: 106,185 against a forecast of 500,000. That’s just slightly less than a capacity crowd at Penn State’s Beaver Stadium. And of those who signed up, only 26,794 did so on the federally run exchanges in 36 states. The rest enrolled on state-run exchanges.
The White House was pre-spinning the numbers weeks ago, as soon as it was clear that the website, which it had three-and-a-half years to make ready, was dysfunctional. Aides also pointed out that Massachusetts had similarly low sign-up rates when it first rolled out its universal health coverage plan. True, it’s human nature to wait until the last minute to do something, especially when that something involves paying money. And the number of people visiting the online marketplaces (26.9 million) does show potentially strong demand for the policies being offered.
But when the White House isn’t cluelessly advising people whose health insurance policies are being canceled to go shop at its barely functional website, it’s acting as if there’s plenty of time for people to sign up because the open enrollment period doesn’t end until March 31. Tell that to millions of would-be enrollees who don’t have the luxury of waiting that long because their insurance expires at the end of this year.
Administration troubleshooter Jeffrey Zients promised the website would be working smoothly for most users by the end of this month. Even if the exchanges begin to work well by then — a big if — that will leave people whose insurance policies run out at the end of the year little time to sign up for insurance that kicks in on New Year’s Day. The deadline for signing up for insurance that begins Jan. 1 is Dec. 15.
That’s frightening for two reasons. One is that the White House has next to no credibility left when it comes to promises about its website. The other is that the administration’s disastrous incompetence is panicking Democrats, emboldening Republicans and threatening to unravel health reform.
That would be a sickening outcome, but with each passing day, there is more to do and less time to do it.
President Obama and former President Bill Clinton in September. Mr. Clinton urged the president on Tuesday to change the health care law to let all Americans keep their current policies.
Does the health-care fumble mean game over for Obama?
Obamacare and Character
ByCHARLES M. BLOW
Published: November 13, 2013
The president’s job approval numbers have hit new lows. That’s actually not the worst news in a new round of polling. The worst news — or what the White House should find most worrisome — is that the president’s character has taken a hit.
For most of the Obama presidency, the majority of Americans have viewed many of his character traits positively, even if they didn’t agree with his politics.
They may have disapproved of his vision for the country and his ability to manage it, but they often simultaneously said that they thought him honest and trustworthy and a strong and decisive leader.
It was a way for some of his most vociferous detractors to say: It’s not personal; it’s political. It’s the Washington version of damning with faint praise.
Now, even that is being diminished. The sloppy rollout of the HealthCare.gov website and the president’s having promised something — “you can keep it” — that turned out not to be true for some is giving license to more Americans to dispense with their character defenses.
According to a Gallup report released Wednesday, the percentage of people judging the president as honest and trustworthy had been around 60 percent for most of his time in office. Now that number stands at 50 percent.
The results of a Quinnipiac University poll released Tuesday were even more troubling. It found: “For the first time today, American voters say 52 – 44 percent that Obama is not honest and trustworthy.”
The sad part here is that there is merit to people’s dissatisfaction.
The administration has left itself open on the health care law, and its opponents are attacking at every opportunity. At its most noble, politics is the exercise of a government in the interest of people. But at its most practical — and petty — it’s a blood sport.
This is a moment in our politics when the latter dominates.
The White House is now feeling the consequences of floundering, a failure and a fallacy.
These are made-for-media story lines: the mighty, tech-savvy Obama-bots brought to heel by a tech snafu, and the well-spoken president being undone by a “misspoken” promise. A comeuppance for the too-cool commander in chief.
In politics — and pop culture — the news media likes stories that follow a well-worn trajectory: rise, fall and resurrection. Some see this as a fall — or possibly the fall — moment for the Obama administration. And even if it’s not, they will treat it as such for page views and cable ratings.
This is not to say that the administration can’t recover. It can. In fact, in all likelihood it will. And when it does, that too will be deemed news — the resurrection. But in this moment, the administration must take some lumps as it attempts to limp out of this mess, correct its problems and regain its footing.
That won’t be easy. Now Democrats — some nervous, some simply needling — are lining up with the Republicans to demand changes to the health care law.
In an interview published this week, former President Clinton said: “I personally believe, even if it takes a change in the law, the president should honor the commitment the federal government made to these people and let them keep what they got.”
Obama had already signaled that he was open to changes to the law without specifying which ones. But Clinton’s comment went further, specifying a change without acknowledging the difficulty of making such a change now that many of the cancellations have already gone out.
Clinton’s comments have given cover for other Democrats who want to avoid being associated with the Health Care Problem.
Friends to the end (of fair weather).
I have no doubt that the website will eventually be fixed. The only question is whether it will be fixed by the end of November, as the administration has aimed for. A report this week in The Washington Post said:
“Software problems with the federal online health insurance marketplace, especially in handling high volumes, are proving so stubborn that the system is unlikely to work fully by the end of the month as the White House has promised, according to an official with knowledge of the project.”
Exceeding that date would blow yet another hole in people’s confidence that the administration has a handle on the problem and is capable of fixing it. And that crisis of confidence is what is hurting the president at this moment.
Winston Churchill is credited with saying: “Success is not final, failure is not fatal: it is the courage to continue that counts.”
But in politics, the confidence of the public also counts. The White House can’t afford to lose more of it.
For Obama, loss of trust over health-care law poses major problems for his agenda, legacy
Is Obama up to saving his health law?
By Scot Lehigh / Globe Columnist / November 14, 2013
WHAT’S NEEDED to save Obamacare from the Obama administration’s fumbling?
Let’s put it this way: a lot more than what the president offered on Thursday.
The Affordable Care Act is now in serious, if not critical, condition. On a conceptual level, the pieces still make sense. But if the mechanics don’t start working soon, political support will flat-line. Nervous Democrats are already looking for cover — and Republicans are renewing their efforts to swing the wrecking ball. The law may not survive another serious body blow.
And honestly, Obama’s Thursday announcement that insurance companies can continue substandard plans for current policyholders for another year looks as much like deflection as it does correction. What the president has done is swat the bungled ball into the insurance companies’ court. Expect confusion to ensue as companies and customers scramble to make decisions about how to proceed.
Meanwhile, Obama’s one-year reprieve underlined another trust-eroding reality. It’s now apparent that the ACA cannot deliver on the president’s oft-repeated promise that anyone who likes his or her health insurance can keep it. Not on a permanent basis, anyway.
“I don’t think there is anything to do here to fix that,” says MIT economist Jonathan Gruber, who helped in the design of both Romneycare and Obamacare.
Why not? Because the price of the health plans offered on the exchange assumes that millions of people with substandard plans will upgrade to insurance that meets the ACA’s coverage standards. But if healthier people stay out of the more comprehensive plans while sicker people flock to them, those premiums will necessarily rise.
“Allowing the continuation of truly substandard policies while opening up the choice of much richer benefits would attract the sicker people into the new, larger risk pools, and that would therefore raise rates,” notes Jon Kingsdale, who ran the Massachusetts Health Connector for four years. Queried on risk pools and rate impacts during a conference call Thursday, White House officials talked vaguely about adjustment based on “risk corridors,” apparently a way of suggesting the government could help offset financial shortfalls insurers experience because of Obama’s new policy.
As for the president, he again expressed his regret and frustration, repeating “that’s on me” several times when speaking of the snafus. And yet his was such a low-energy performance that at times it bordered on the phlegmatic.
The president needs to tackle this head on, in a high-profile way, rather that acting as though these are mere bumps in the road. He needs to start by apologizing, fully and sincerely and with no qualifications, for leading people down the primrose path. Not at a rally. Not at a press conference.
In a prime-time address.
There, he needs to do something that this administration has failed to do in a clear, sustained, persuasive way: Explain why, despite the rocky roll-out, the false promise, the ongoing problems, this law should be a very good thing for the country.
That must include outlining why the parts of the law that people don’t like are inextricably linked to the parts that they most appreciate. Years into this debate, too many still don’t understand that you can’t guarantee that people can get high-quality coverage despite any pre-existing conditions without also requiring that everyone buy insurance. Why not? Because if you have the guarantee of access to coverage without also mandating that everyone carry insurance, some will wait until they develop a serious illness before purchasing coverage. That obviously sets the entire notion of insurance on its ear. Premiums would skyrocket.
He should also make it clear that those who end up paying higher premiums will also be getting better policies and protections, protections that could save them crippling debt or even bankruptcy if they develop serious illnesses.
At a time when his own polling numbers are sinking and his signature law is under siege, the president needs to move beyond his no-drama Obama mode. This is not business as usual.
Ideally, he would demonstrate the kind of compelling, high-energy leadership that could help reverse this frustrating narrative.
Failing that, it would nice if he could at least show more of a pulse.
Letter to the editor: Coping with Obamacare is preferable to what we were doing
Nov. 11, 2013
Kristin Failor’s Iowa View commentary [Nov. 9] on the unintended consequences of the Affordable Care Act deserves a response. After the government’s very successful, efficient operation of programs like Social Security and Medicare, her observation that “There was never any reason to believe the federal government could handle one-sixth of the biggest economy on Earth” is simply baseless.
Business interests have demonstrated their lack of confidence in our economy and contributed to slow growth by cutting back employment opportunities, refusing to raise wages, limiting investments and embracing the current system of health insurance controlled by a few powerful private companies. They apparently have no problem with their workers experiencing ever-increasing premiums and have no concern about the millions of workers without a health care safety net.
The rollout of the Affordable Care Act has been fraught with problems that should have been anticipated, and these need to be corrected as quickly as possible. Also, there may be provisions of the legislation that could and should be improved, but coping with implementation difficulties is preferable to doing nothing.
Of course, the very best choice for this country would be transitioning to a universal, single-payer system patterned after Medicare. Perhaps someday this country will have the political courage and maturity to make this move.
— Dean R. Prestemon, Ames
Stop digging. Start over.
This political salvage mission by the White House is roiling Americans’ health coverage.
November 15, 2013
As Friday dawns, here’s what a health insurance crisis looks like to many millions of Americans: Barely six weeks shy of 2014, they do not know whether they will have medical coverage Jan. 1. Or which hospitals and doctors they might patronize. Or what they may pay to protect themselves and their families against the chance of medical and financial catastrophe. How much, that is, they may pay in order to satisfy the Democratic politicians and federal bureaucrats who are worsening a metastasizing health coverage fiasco.
For perhaps 5 million of those Americans thus far — estimates vary — the Washington-ordered cancellation of their policies is especially maddening. In the past these people took responsibility for their coverage and bought policies that balanced their needs, finances and personal choices. Congress and President Barack Obama, by enacting the Affordable Care Act, in effect ordered insurers to dismantle many of those individual plans — and cancel those policies.
The Americans manhandled by this exercise in government arrogance now find themselves divided into warring tribes: Those with chronic ailments who have found new plans on Obamacare exchanges and are pleased. Those who don’t want or can’t afford the replacement policies Obamacare offers them. Those whose new policies block them from using the health providers who have treated them for many years. The estimated 23 million to 41 million people whose employer-sponsored plans are the next to be imperiled. And on and on.
Most of these tribes people only wish their big problem was a slipshod Obamacare website. On Thursday, their plight grew more frightful. With even Democratic members of Congress storming the White House over the cancellations, Obama declared — by what legal authority is unclear — that he would overrule the law he signed in 2010 and allow insurers to extend those canceled policies for a year.
If, that is, insurance regulators of the 50 states permit this potential distortion to risk pools inside and outside of Obamacare. The regulators, including those in Illinois, had better put protection ahead of politics: Within two hours of Obama’s announcement, Mike Kreidler, insurance commissioner of Washington, a Democrat-leaning state, rejected the president’s notion, citing “its potential impact on the overall stability of our health insurance market. … We will not be allowing insurance companies to extend their policies.”
Note that these are the same insurance companies that have done what Obamacare demanded of them, while they often were being vilified by politicians and bureaucrats who haven’t done what Obamacare demanded of them: Create workable, economically sustainable, insurance markets. A spokesman for America’s Health Insurance Plans, an industry group, said Thursday that Obama’s decree could further drive up prices: “Premiums were set based on assumptions about people transitioning to the (Obamacare) marketplaces,” Robert Zirkelbach told The Washington Post. “Changing the rules in the middle of the game could dramatically change who actually signs up. If the exchanges become nothing more than a high-risk pool, that’s going to result in massive premium increases for consumers.”
So, what Obama presented Thursday as a favor looks like one more mess for state governments, insurers and… American citizens. Under the policy Obama articulated, the states and insurers aren’t required to do anything. The American citizens? Under Obamacare, they’re still required to have health insurance. Or pay a government fine.
Note that the president’s intent to enable the extension of policies his administration deems inferior also contradicts a key tenet of Obamacare: the guarantee that (almost) every private health plan in the nation must offer a lengthy list of mandated benefits.
On some level, then, the president plainly agrees with critics of Obamacare, this page included, that the law needs to be rewritten: He and his administration keep rewriting its major components — remember the mandate that sizable employers offer coverage in 2014? — as practicalities and politics demand.
But in this country we don’t change bad laws by presidential fiat. We change them by having Congress rewrite them or by starting from scratch. Obama doesn’t want to reopen this law for fear that Republicans and some Democrats will substantially rewrite it. But that’s what has to happen.
We understand why the president and leaders of his party want to rescue whatever they can of Obamacare. On their watch, official Washington has blown the launch of a new entitlement program … under the schedule they alone set in early 2010.
What we don’t understand is their reluctance to give that failure more than lip service. Many of the Americans who heard their president say Thursday that “we fumbled the rollout of this health care law” would have been pleased to hear him add: So we’re admitting it. This law is a bust. We’re starting over.
It’s the campaign strategist’s favorite play: No matter how bad my candidate is, the other guy is worse. When Democrats soured on the Iraq war, President Bush called them the party of “cut and run.” Now Republicans are the party of “you’re on your own.” But in government, unlike campaigns, you can’t go negative forever. Sooner or later, you have to deliver.
Opinion: A Doctor’s Opinion Of Obamacare
July 9, 2012 8:41 AM
Last evening as I was just about to watch the local fireworks in our Chicago-area community, I ended up talking to two pro-Obamacare persons. As I recall, I didn’t bring up the topic. The pro Obamacare people did.
As diplomatic as I could, I started by saying that there are good points and bad points to the law, and I was disappointed that the Supreme Court wasn’t more discretionary in what they allowed to become the law of the land and what they didn’t allow to pass.
The main argument of the persons defending Obama’s health care reform was that we’re paying for it already – so why not do it this way, via Obamacare. I maintained that there’s nothing wrong with helping people who actually need assistance who can’t afford it in our society, but too many people are getting away with abusing the system. I feel that Obamacare makes it even easier for people to abuse the system. People abusing the government’s “handouts” are not the people I want my – or anyone else’s – hard-earned taxes going toward.
When those oral “fireworks” ended, it was time to regroup to watch the Fourth of July fireworks. As luck would have it, I ended up within earshot of a well-respected physician from the area.
I couldn’t help but ask him: “In a word, what do you think of Obamacare, Doctor? Good, bad, or indifferent?”
The doctor thought for a moment and hesitantly – nearly reluctantly said, in a very unenthusiastic tone: “It’s – it’s just OK.”
Hoping he’d explain, he did. He went on to say that something has to be done about the insurance companies and the prescription companies. Of course, he meant the horrendous profits the two are making at the expense of American citizens in need of medical insurance and medications.
He went on to say that, basically, the many other things related to the system aren’t positive. In fact, they are negative. He knows that if he continues to service Medicaid patients, he is going to be swamped. While he says he scarcely has enough time to see all of the patients he has to see now, the number of patients he now services is practically nothing to what the future holds for him – should he decide to continue servicing Medicaid patients. And, he sincerely hopes to continue helping this sector of society. The doctor indicated that he knows there are many people in his profession who simply will not deal with Medicaid patients from here on out due to the Obama legislation.
This, of course, is what many in the medical profession have said all along and which the pro-Obamacare government has ignored.
The doctor and I compared what’s happening to doctors and others in the medical profession to what has happened to persons in the teaching and related-educational fields. Through the years, the government’s role has messed things up to the point where good people who care about other people are being convinced that teaching isn’t a very good profession to enter anymore. It’s a travesty that “born teachers” are being led to feel this way via constantly growing governmental intrusions.
Professionals who have been honorable in helping other people throughout our nation’s history have – and are – being dishonored as the government demands more of these good people while expecting them to achieve less and less of their personal American dream.
Why dishonored? It’s all negative publicity for teachers and their pensions right now. But why are the pensions in such disarray? It’s because of the government – not because of the teachers. Teachers put into the system loyally for decades while the government – yes the state and federal governments – “borrowed” the money for other things. Call it theft if you choose. Yet, teachers are blamed for the horrendous pension plans throughout the country now when it’s the elected officials who spent that money on other things.
Be forewarned, now that government is taking over the health profession, disaster lurks for that profession in many ways as well.
By having government regulate the jobs of the people who do the extreme good for society more and more, those good people of the past are saying “forget it”. They are saying that they will do something else with their time and effort to get a decent living out of it. It’s to the point that the only ones who are happy with the government’s intervention of their jobs are the politicians. They set their pay, their health care plans, their guaranteed pensions and more. They go through the hell of a political campaign to keep their government jobs. Why wouldn’t they? They love their jobs – they’ve got it made. After all, they get to dictate what the people with necessary jobs in society should do and how they should be compensated for what they do. Politicians have it all.
Good people are running away from the necessary jobs in society – primarily health care and teaching – as the government controls them more and more with their requirements and laws.
Yes, they are very good people – often the best our society has. But when given the option to invest their skills, talents, and training in a job in the private sector or one being strangled by the government, these professionals are often making the right choice for themselves and their families – the choice of getting out of a governmentally-controlled field.
Good, hard-working Americans shouldn’t be forced to contemplate leaving their chosen profession as they are with federal laws such as Obamacare. But they are.
That slippery slope that the media keeps talking about these days is going to be crowded with lots of health care professionals very soon – slipping away from their government-controlled jobs – just as we have seen people turn away from teaching in recent decades. The government is to blame for it. The U.S. needs to stop giving the federal government controls over our most-needed and most-honored professions.
Lack Of Competition Might Hamper Health Exchanges
Opinion About Obamacare