Smile! You’ve Got Socialized Healthcare!
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- Start date
Latinos are smiling over Obamacare:
Obamacare enrollment push needs to target Latinos, experts say
One of the great successes of Obamacare was in the surge of Latinos newly insured under the law. The uninsured rate among Latinos dropped from 36 percent to 23 percent from the summer of 2013 to spring of 2014. But with open enrollment for 2015 open now through mid-February, activists see a great deal of room for improvement. That's because nearly a quarter of the Latino population is still uninsured, and because there are still barriers to getting them enrolled.
But that reflects another barrier to getting insurance to this population: Texas and Florida—the two states with the highest uninsured rates—also didn't expand Medicaid. That immediately cuts about 1 million Latinos out of coverage. The heavy focus by the administration in those states does intend to try to reach the largest populations of uninsured people to get them coverage, but it is partly political. It's shining a light on how many people are still left out because of the refusal by Republican lawmakers to help their constituents.
Obamacare enrollment push needs to target Latinos, experts say
One of the great successes of Obamacare was in the surge of Latinos newly insured under the law. The uninsured rate among Latinos dropped from 36 percent to 23 percent from the summer of 2013 to spring of 2014. But with open enrollment for 2015 open now through mid-February, activists see a great deal of room for improvement. That's because nearly a quarter of the Latino population is still uninsured, and because there are still barriers to getting them enrolled.
“When you have a community where a third of the people didn’t have health insurance, the process of informing people about their options and the choices they need to make requires more time,” said Jane Delgado, CEO of the National Alliance for Hispanic Health. She pointed out that health insurance is confusing to most people, even those who have had it for a long time. "It's the nuances that make it complicated. It’s not like buying a television, where a TV’s a TV and there are some fine differences based on their choice," she said. "These are matters of life and death."
In addition some Hispanic people have expressed a belief that they don’t need health insurance, Delgado said.
For instance, in a 2013 survey by the Urban Institute, fewer than half the Hispanics polled disagreed with the statement “I’m healthy enough and I don’t really need health insurance,” compared with 64 percent of whites—implying that Hispanics were more likely to go without insurance.
"Our response to people is, ‘Can you afford not to have it?'" Delgado said.
The issue of health insurance being confusing certainly isn't limited to any single group—not even to just the uninsured—because it is a confusing process for everyone. But that confusion is compounded by language barriers. One of the issues for the 2014 enrollment period was that there just weren't enough Spanish-language resources available to do the kind of outreach and education needed. The parallel Spanish-language federal website was even buggier and more problematic than Healthcare.gov. The White House has focused on Latino outreach in the opening days of the 2015 enrollment season, with HHS Secretary Sylvia Mathews Burwell doing a Google hangout with Latino bloggers and interviews on Univision and Telemundo. Additionally, La Raza and the National Alliance are working with Spanish-language broadcasters and with community-based organizations around the country to get word out. Administration officials are also in Texas and Florida, focusing on enrollment efforts in those states with high Latino populations.In addition some Hispanic people have expressed a belief that they don’t need health insurance, Delgado said.
For instance, in a 2013 survey by the Urban Institute, fewer than half the Hispanics polled disagreed with the statement “I’m healthy enough and I don’t really need health insurance,” compared with 64 percent of whites—implying that Hispanics were more likely to go without insurance.
"Our response to people is, ‘Can you afford not to have it?'" Delgado said.
But that reflects another barrier to getting insurance to this population: Texas and Florida—the two states with the highest uninsured rates—also didn't expand Medicaid. That immediately cuts about 1 million Latinos out of coverage. The heavy focus by the administration in those states does intend to try to reach the largest populations of uninsured people to get them coverage, but it is partly political. It's shining a light on how many people are still left out because of the refusal by Republican lawmakers to help their constituents.
Republican state of Wyoming expands Medicaid:
http://www.nytimes.com/2014/11/27/u...&contentCollection=Recommended&pgtype=article
With a plan released Wednesday by the administration of Gov. Matt Mead, a Republican, Wyoming has become the latest state seeking to expand Medicaid.
The plan would provide Medicaid coverage to an additional 18,000 low-income people, according to the state’s health department. If it wins federal and state legislative approval, Wyoming will join 27 states that have expanded the program under the Affordable Care Act, including nine with Republican leadership.
As several other Republican governors have done, Mr. Mead wants to require some people who receive coverage under the expansion to pay something toward the cost. Under his plan, those earning 100 to 138 percent of the federal poverty level — for a single person, $11,670 to $16,105 a year — would have to pay monthly premiums. The premiums could range from about $20 to $50 a month, depending on household size and income, according to a summary of the plan.
Health care shoppers signed up for insurance on the first day of open enrollment for the Affordable Care Act at the Evergreen Health Center in Manassas, Va., earlier this month.In First Week, More Than a Million Apply for Health Insurance on Federal Website NOV. 26, 2014
Luis Orellana signed his family up for health insurance at a Los Angeles high school on Saturday.Some Hiccups, but Federal Health Exchange Website Is in Good HealthNOV. 16, 2014
Cost of Coverage Under Affordable Care Act to Increase in 2015NOV. 14, 2014
For Many New Medicaid Enrollees, Care Is Hard to Find, Report SaysSEPT. 27, 2014
The Obama administration has to sign off on the plan because it deviates from regular Medicaid expansion under the federal health care law.
People earning less than 100 percent of the poverty level would not have to pay monthly premiums. But they could owe small co-payments for certain services, as could the higher-income group. Those deemed “medically frail” would get Medicaid, which has a slightly more comprehensive benefits package, said Kim Deti, a spokeswoman for the Wyoming Department of Health.
The expansion plan would also require approval from the State Legislature, which is controlled by Republicans. If lawmakers approve the plan, it will most likely take effect in 2016. The Legislature has already rejected several bills that would have expanded traditional Medicaid. But earlier this year it authorized Mr. Mead to negotiate with the Obama administration on a modified version.
“We have done the work and we have a plan,” Mr. Mead said in a statement. “I believe it is the most favorable plan for Wyoming, and it addresses the needs of those who fall in the gap.”
Wyoming officials considered the “private option” alternative that Arkansas adopted, which uses federal Medicaid expansion funds to buy private coverage for low-income residents through the state’s health insurance exchange. But they decided it would cost too much, according to a report detailing the proposal, because exchange plans in Wyoming are among the most expensive in the nation.
Under the terms of the Affordable Care Act, the federal government pays the entire cost of Medicaid expansion through 2015, and at least 90 percent of the cost in later years. The Wyoming plan includes a provision that would terminate Medicaid expansion there if the federal share ever dropped below 90 percent.
At least three other Republican governors — Mike Pence of Indiana, Bill Haslam of Tennessee and Gary R. Herbert of Utah — are negotiating with the federal government on alternative forms of Medicaid expansion.
More Republicans to benefit from "socialized" medicine.
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http://www.nytimes.com/2014/11/27/u...&contentCollection=Recommended&pgtype=article
With a plan released Wednesday by the administration of Gov. Matt Mead, a Republican, Wyoming has become the latest state seeking to expand Medicaid.
The plan would provide Medicaid coverage to an additional 18,000 low-income people, according to the state’s health department. If it wins federal and state legislative approval, Wyoming will join 27 states that have expanded the program under the Affordable Care Act, including nine with Republican leadership.
As several other Republican governors have done, Mr. Mead wants to require some people who receive coverage under the expansion to pay something toward the cost. Under his plan, those earning 100 to 138 percent of the federal poverty level — for a single person, $11,670 to $16,105 a year — would have to pay monthly premiums. The premiums could range from about $20 to $50 a month, depending on household size and income, according to a summary of the plan.
Health care shoppers signed up for insurance on the first day of open enrollment for the Affordable Care Act at the Evergreen Health Center in Manassas, Va., earlier this month.In First Week, More Than a Million Apply for Health Insurance on Federal Website NOV. 26, 2014
Luis Orellana signed his family up for health insurance at a Los Angeles high school on Saturday.Some Hiccups, but Federal Health Exchange Website Is in Good HealthNOV. 16, 2014
Cost of Coverage Under Affordable Care Act to Increase in 2015NOV. 14, 2014
For Many New Medicaid Enrollees, Care Is Hard to Find, Report SaysSEPT. 27, 2014
The Obama administration has to sign off on the plan because it deviates from regular Medicaid expansion under the federal health care law.
People earning less than 100 percent of the poverty level would not have to pay monthly premiums. But they could owe small co-payments for certain services, as could the higher-income group. Those deemed “medically frail” would get Medicaid, which has a slightly more comprehensive benefits package, said Kim Deti, a spokeswoman for the Wyoming Department of Health.
The expansion plan would also require approval from the State Legislature, which is controlled by Republicans. If lawmakers approve the plan, it will most likely take effect in 2016. The Legislature has already rejected several bills that would have expanded traditional Medicaid. But earlier this year it authorized Mr. Mead to negotiate with the Obama administration on a modified version.
“We have done the work and we have a plan,” Mr. Mead said in a statement. “I believe it is the most favorable plan for Wyoming, and it addresses the needs of those who fall in the gap.”
Wyoming officials considered the “private option” alternative that Arkansas adopted, which uses federal Medicaid expansion funds to buy private coverage for low-income residents through the state’s health insurance exchange. But they decided it would cost too much, according to a report detailing the proposal, because exchange plans in Wyoming are among the most expensive in the nation.
Under the terms of the Affordable Care Act, the federal government pays the entire cost of Medicaid expansion through 2015, and at least 90 percent of the cost in later years. The Wyoming plan includes a provision that would terminate Medicaid expansion there if the federal share ever dropped below 90 percent.
At least three other Republican governors — Mike Pence of Indiana, Bill Haslam of Tennessee and Gary R. Herbert of Utah — are negotiating with the federal government on alternative forms of Medicaid expansion.
More Republicans to benefit from "socialized" medicine.
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Regret is a very sad emotion. The saddest words in the English language are "what might have been."
Consider the case of Democratic Senator Tom Harkins who was one of the sponsors of the Obamacare legislation. He's full of heartbreak and regret today. Perhaps that's because he knows that the worst is yet to come. Judge for yourselves:
"Retiring Sen. Tom Harkin (D-IA), who helped oversee the drafting of the Affordable Care Act, lamented in a recent interview that the law had become compromised amid the political turmoil that surrounded its passage.
He also expressed regret that the law didn't include liberal policies like a single-payer health care system or a public health insurance plan, as many had hoped it would in the early stages.
“We had the votes in ’09. We had a huge majority in the House, we had 60 votes in the Senate," Harkin told The Hill, saying that the first Congress of President Barack Obama's administration should have passed “single-payer right from the get go or at least put a public option (which) would have simplified a lot.”
“We had the votes to do that and we blew it,” he said. He decried that the law as it exists is "really complicated" and benefits the insurance companies, though he praised its prevention health funding.
“We had the power to do it in a way that would have simplified health care, made it more efficient and made it less costly and we didn’t do it,” Harkin told The Hill. “So I look back and say we should have either done it the correct way or not done anything at all.
The latter comment reflects those made recently by Sen. Chuck Schumer (D-NY), who said that health care reform "should have come later" after Democrats took control of Congress and the White House in 2009."
Harkin: O-Care Should Have Been Single-Payer But 'We Blew It'
Consider the case of Democratic Senator Tom Harkins who was one of the sponsors of the Obamacare legislation. He's full of heartbreak and regret today. Perhaps that's because he knows that the worst is yet to come. Judge for yourselves:
"Retiring Sen. Tom Harkin (D-IA), who helped oversee the drafting of the Affordable Care Act, lamented in a recent interview that the law had become compromised amid the political turmoil that surrounded its passage.
He also expressed regret that the law didn't include liberal policies like a single-payer health care system or a public health insurance plan, as many had hoped it would in the early stages.
“We had the votes in ’09. We had a huge majority in the House, we had 60 votes in the Senate," Harkin told The Hill, saying that the first Congress of President Barack Obama's administration should have passed “single-payer right from the get go or at least put a public option (which) would have simplified a lot.”
“We had the votes to do that and we blew it,” he said. He decried that the law as it exists is "really complicated" and benefits the insurance companies, though he praised its prevention health funding.
“We had the power to do it in a way that would have simplified health care, made it more efficient and made it less costly and we didn’t do it,” Harkin told The Hill. “So I look back and say we should have either done it the correct way or not done anything at all.
The latter comment reflects those made recently by Sen. Chuck Schumer (D-NY), who said that health care reform "should have come later" after Democrats took control of Congress and the White House in 2009."
Harkin: O-Care Should Have Been Single-Payer But 'We Blew It'
Another GOP Governor Flips For Medicaid Expansion
Another GOP Governor Flips For Medicaid Expansion
Posted: 12/03/2014
One year after rejecting federal funds to expand Medicaid coverage under the Affordable Care Act, Wyoming Gov. Matt Mead (R) is pushing the state’s Republican legislature to approve a new plan set forth by the state Department of Health last week.
During a press conference Monday, Mead, who signed onto a federal lawsuit opposing the Affordable Care Act in 2011, urged Republican lawmakers to "be realistic" and accept Obamacare as the "law of the land."
"I agree it is not a good piece of legislation, but as I see where we are, I think we have to be realistic and say, 'This is the current law of the land and we need to either go forward with this' or if the Legislature wants to come up with a different plan, I certainly would be open to that," Mead said, according to the Casper Star-Tribune. "But I don’t think we can say to those people in Wyoming who are working who cannot get insurance that we’re not going to do anything."
To expand Medicaid, Mead's proposal seeks a federal waiver that will allow the state to charge low-income participants who make 101 to 138 percent of the federal poverty level -- that’s $11,670 to $16,105 annually for a single person -- co-payments and a monthly premium. Those earning below 101 percent of the poverty level would not pay premiums but could be responsible for certain co-payments. However, the ACA's Medicaid provisions guarantee coverage for eligible low-income residents without cost-sharing, so the Obama administration would have to approve Wyoming's modified Medicaid expansion.
The plan would also have to clear the state legislature, which has rejected several Medicaid-related bills in the past year alone.
According to the Wyoming Department of Health, the Strategy for Health, Access, Responsibility and Employment -- or SHARE plan -- would grant health care access to an estimated 17,600 low-income residents. Two-thirds of them fall in the coverage gap, meaning they are ineligible for both Medicaid and federal tax subsidies through the federal health care marketplace.
If Mead’s proposal is approved, he would become the 10th GOP governor to expand Medicaid under the Affordable Care Act. Several other Republican-led states, including Indiana, Tennessee and Utah, have considered similar options but have yet to advance legislation to address the issue. To date, 27 states and the District of Columbia have opted to expand Medicaid coverage under the Affordable Care Act.
Smart Republican!
Another GOP Governor Flips For Medicaid Expansion
Posted: 12/03/2014
One year after rejecting federal funds to expand Medicaid coverage under the Affordable Care Act, Wyoming Gov. Matt Mead (R) is pushing the state’s Republican legislature to approve a new plan set forth by the state Department of Health last week.
During a press conference Monday, Mead, who signed onto a federal lawsuit opposing the Affordable Care Act in 2011, urged Republican lawmakers to "be realistic" and accept Obamacare as the "law of the land."
"I agree it is not a good piece of legislation, but as I see where we are, I think we have to be realistic and say, 'This is the current law of the land and we need to either go forward with this' or if the Legislature wants to come up with a different plan, I certainly would be open to that," Mead said, according to the Casper Star-Tribune. "But I don’t think we can say to those people in Wyoming who are working who cannot get insurance that we’re not going to do anything."
To expand Medicaid, Mead's proposal seeks a federal waiver that will allow the state to charge low-income participants who make 101 to 138 percent of the federal poverty level -- that’s $11,670 to $16,105 annually for a single person -- co-payments and a monthly premium. Those earning below 101 percent of the poverty level would not pay premiums but could be responsible for certain co-payments. However, the ACA's Medicaid provisions guarantee coverage for eligible low-income residents without cost-sharing, so the Obama administration would have to approve Wyoming's modified Medicaid expansion.
The plan would also have to clear the state legislature, which has rejected several Medicaid-related bills in the past year alone.
According to the Wyoming Department of Health, the Strategy for Health, Access, Responsibility and Employment -- or SHARE plan -- would grant health care access to an estimated 17,600 low-income residents. Two-thirds of them fall in the coverage gap, meaning they are ineligible for both Medicaid and federal tax subsidies through the federal health care marketplace.
If Mead’s proposal is approved, he would become the 10th GOP governor to expand Medicaid under the Affordable Care Act. Several other Republican-led states, including Indiana, Tennessee and Utah, have considered similar options but have yet to advance legislation to address the issue. To date, 27 states and the District of Columbia have opted to expand Medicaid coverage under the Affordable Care Act.
Smart Republican!
Health Spending Has Lowest Rate Increase on Record
Source: U.S. News and World Report
The U.S. is spending more on health care every year, but last year the growth rate in medical spending was the lowest on record, a change government researchers are attributing both to the economy and to various health care policy implementations, including Obamacare.
The Office of the Actuary at the Centers for Medicare and Medicaid Services presented the findings at a Health Affairs event Wednesday at the National Press Club in the nation's capital. The increase in spending on health care in 2013 was at 3.6 percent, lower than it has ever been since 1960, when the government began tracking the figure. Total spending on health care increased to $2.9 trillion, or $9,255 per person.
The government researchers found that health care spending slowed by half a percentage point from 2012 to 2013 – a change they attribute to a slower growth in private health insurance and Medicare spending. Slower growth in spending for hospital care, investments in medical structures and equipment, and spending for doctors and clinical care also contributed to the low overall increase, states the Health Affairs report.
Still, the economy played a significant part in the outcomes, which even before reaching the lowest record last year did not grow above 4.1 percent from 2009 to 2013. The low rate of health spending falls in concert with slow overall economic growth since 2009, or what is considered to be the end of the great recession. In fact, that year showed the next-lowest increase in health spending, at 3.8 percent. Since that time, share of gross domestic product on health care has remained at 17.4 percent.
Health Spending Has Lowest Rate Increase on Record - US News
ACA - working better than ever!
Source: U.S. News and World Report
The U.S. is spending more on health care every year, but last year the growth rate in medical spending was the lowest on record, a change government researchers are attributing both to the economy and to various health care policy implementations, including Obamacare.
The Office of the Actuary at the Centers for Medicare and Medicaid Services presented the findings at a Health Affairs event Wednesday at the National Press Club in the nation's capital. The increase in spending on health care in 2013 was at 3.6 percent, lower than it has ever been since 1960, when the government began tracking the figure. Total spending on health care increased to $2.9 trillion, or $9,255 per person.
The government researchers found that health care spending slowed by half a percentage point from 2012 to 2013 – a change they attribute to a slower growth in private health insurance and Medicare spending. Slower growth in spending for hospital care, investments in medical structures and equipment, and spending for doctors and clinical care also contributed to the low overall increase, states the Health Affairs report.
Still, the economy played a significant part in the outcomes, which even before reaching the lowest record last year did not grow above 4.1 percent from 2009 to 2013. The low rate of health spending falls in concert with slow overall economic growth since 2009, or what is considered to be the end of the great recession. In fact, that year showed the next-lowest increase in health spending, at 3.8 percent. Since that time, share of gross domestic product on health care has remained at 17.4 percent.
Health Spending Has Lowest Rate Increase on Record - US News
ACA - working better than ever!
4 New Studies Show Obamacare Is Working Incredibly Well
4 New Studies: Obamacare Working Incredibly Well -- NYMag
A week ago, Sen. Charles Schumer said his party made a political mistake by passing the Affordable Care Act rather than some unspecified economic measure. Put aside the dubious political logic (in reality, Congress’s appetite for additional stimulus had been completely exhausted with the passage of the original version). Also put aside the brutally cold moral logic (that politicians should prioritize keeping power over enacting positive change).
Schumer’s comments, announced at the National Press Club, sanctify a hardened perception among the general public, which has encroached into the Democratic Party itself, that Obamacare was not worth the trouble. The law is a bugaboo upon which every criticism of Obama has attached itself — he is too economically elitist, or too partisan, or too complex. Left-of-center analyst Thomas Edsall recently went so far as to suggest Obamacare was “destroying the Democratic Party.” What makes this wave of regret — not even taking into account the unmitigated hostility from the political right — so strange is that Obamacare is actually working. Indeed, evidence continues to mount that the law is working extremely, even shockingly, well.
The overall goal of the law was to gradually reverse the two most perverse facts about the U.S. health-care system: Its overall cost has exploded, and it denies access to tens of millions of people. Four major new sources of information have come out this week, all of which have further demonstrated the law’s success.
1. Increasing access to the uninsured. The law was never going to ensure that every single American had insurance. President Obama promised, in the face of political pressure, not to extend its coverage to non-citizens, who make up about one fifth of the uninsured population. Five* Supreme Court Justices decided to allow states to boycott the law’s Medicaid expansion, adding some 4 million more to the ranks of the uninsured. Also, any new law takes years to ramp up participation and public awareness.
Conservatives widely denied that the law would even succeed at its basic goal of increasing access to health insurance. Obamacare “created more uninsured people than it gave insurance to. And it promises to create even more,” argued National Review’s Jonah Goldberg. Fox News panelist Charles Krauthammer proclaimed the law would result in “essentially the same number of uninsured.”
Every serious method of measuring has shown the law effecting significant reductions in the uninsured rate. The latest, a report by the Urban Institute yesterday, shows that the uninsured rate has fallen nationally by 30 percent:
That rate is 36 percent in states participating in the Medicaid expansion. The states whose Republican governors or legislators have boycotted the expansion have seen their uninsured rates fall by just 24 percent, dragging down the average.
2. Reducing overall health-care costs. Obamacare actually had two different fiscal responsibility goals. The first was simply to offset the cost of new coverage with a combination of spending cuts and higher taxes — which, according to the Congressional Budget Office, it did. The second, more ambitious goal was to change the incentives that made doctors and hospitals eager to charge more money regardless of its effect, and that gave people who pay for that insurance little means to shop for better deals. Obamacare’s architects hoped that, on top of merely paying for the cost of new coverage, they could “bend the cost curve” downward.
When the law passed, conservatives insisted it would increase rather than decrease health-insurance costs. (Esteemed conservative intellectual Yuval Levin, in 2010, insisted it “completely fails” to reduce overall health-care spending.) Since the law passed, health-care inflation has fallen to historically low levels. Conservatives have repeatedly insisted this was a blip that would soon be reversed, and seized upon any apparent evidence for this case. When health-care spending spiked in the first quarter of 2014, Megan McArdle announced vindication: “After all the speculation that Obamacare might be bending the cost curve, we now know that so far, it isn’t.” (It turned out the first-quarter spike in health-care spending was a preliminary miscount that has since been corrected.)
Also yesterday, the Centers for Medicare and Medicaid reported that health inflation in 2013 not only remained in, it fell to the lowest level since the federal government began keeping track:
3. Hospital errors. Obamacare has a wide variety of reforms designed to bend the cost curve. One of them is a new payment system that encourages hospitals to avoid readmissions. The old Medicare system reimbursed hospitals for every procedure. This meant they had a perverse incentive to do a bad job taking care of their patients — a patient who developed an infection, or needed readmission, would produce a second stream of revenue for the hospital. Obamcare’s payment reforms changed that incentive. A new report finds that hospital-acquired medical conditions has fallen by 17 percent since 2010. (This has not only saved huge amounts of money, it has also saved 50,000 lives.)
4. Insurance competition. Obamacare is based on an old Republican plan, developed by the Heritage Foundation and first tried by Mitt Romney, whose central feature was market competition. The animating premise was that forcing insurance companies to lure customers on an open, regulated marketplace would bring prices down.
In all fairness, liberals did not place much faith in this dynamic. They didn’t accept a health-care plan that gave insurance companies a central role out of ideological conviction, but out of necessity — appeasing the industry, they calculated, offered them the only viable way to pass a bill through Congress. But the dynamic has turned out to work much better than expected. (The most natural ideological allies of the market function, conservatives, all committed themselves to the Republican Party’s totalistic opposition to every facet of the law.)
A new Kaiser Health News analysis released this week finds:
A surge in health insurer competition appears to be helping restrain premium increases in hundreds of counties next year, with prices dropping in many places where newcomers are offering the least expensive plans … In counties that are adding at least one insurer next year, premiums for the least expensive silver plan are rising 1 percent on average. Where the number of insurers is not changing, premiums are growing 7 percent on average.
The downside is that the lower prices require consumers to actively shop on the exchanges. Customers who automatically renew their existing plan without comparison shopping will miss out.
Obamacare’s bitter opponents on the right have increasingly trained their focus on measures of public opinion. It is true: Polling on the health-care law remains dismal as ever despite its success. Obamacare’s opponents have won a public-relations struggle. They have not won an argument.
*Edit: Seven justices actually voted for the ruling, which gave states the right to opt-out of Medicaid. Many legal observers believe, but of course cannot prove, that the support of two Democratic appointees for this measure was a form of horse-trading to preserve the law's overall framework, which John Roberts nearly decided to overturn completely. The actual decision to make Medicaid voluntary was likely made by five Republican-appointed justices, but formally the decision was endorsed by seven.
But again, all these truths are of no value if the idiot Democrats run away from rather than highlighting them in the campaigns.
4 New Studies: Obamacare Working Incredibly Well -- NYMag
A week ago, Sen. Charles Schumer said his party made a political mistake by passing the Affordable Care Act rather than some unspecified economic measure. Put aside the dubious political logic (in reality, Congress’s appetite for additional stimulus had been completely exhausted with the passage of the original version). Also put aside the brutally cold moral logic (that politicians should prioritize keeping power over enacting positive change).
Schumer’s comments, announced at the National Press Club, sanctify a hardened perception among the general public, which has encroached into the Democratic Party itself, that Obamacare was not worth the trouble. The law is a bugaboo upon which every criticism of Obama has attached itself — he is too economically elitist, or too partisan, or too complex. Left-of-center analyst Thomas Edsall recently went so far as to suggest Obamacare was “destroying the Democratic Party.” What makes this wave of regret — not even taking into account the unmitigated hostility from the political right — so strange is that Obamacare is actually working. Indeed, evidence continues to mount that the law is working extremely, even shockingly, well.
The overall goal of the law was to gradually reverse the two most perverse facts about the U.S. health-care system: Its overall cost has exploded, and it denies access to tens of millions of people. Four major new sources of information have come out this week, all of which have further demonstrated the law’s success.
1. Increasing access to the uninsured. The law was never going to ensure that every single American had insurance. President Obama promised, in the face of political pressure, not to extend its coverage to non-citizens, who make up about one fifth of the uninsured population. Five* Supreme Court Justices decided to allow states to boycott the law’s Medicaid expansion, adding some 4 million more to the ranks of the uninsured. Also, any new law takes years to ramp up participation and public awareness.
Conservatives widely denied that the law would even succeed at its basic goal of increasing access to health insurance. Obamacare “created more uninsured people than it gave insurance to. And it promises to create even more,” argued National Review’s Jonah Goldberg. Fox News panelist Charles Krauthammer proclaimed the law would result in “essentially the same number of uninsured.”
Every serious method of measuring has shown the law effecting significant reductions in the uninsured rate. The latest, a report by the Urban Institute yesterday, shows that the uninsured rate has fallen nationally by 30 percent:
That rate is 36 percent in states participating in the Medicaid expansion. The states whose Republican governors or legislators have boycotted the expansion have seen their uninsured rates fall by just 24 percent, dragging down the average.
2. Reducing overall health-care costs. Obamacare actually had two different fiscal responsibility goals. The first was simply to offset the cost of new coverage with a combination of spending cuts and higher taxes — which, according to the Congressional Budget Office, it did. The second, more ambitious goal was to change the incentives that made doctors and hospitals eager to charge more money regardless of its effect, and that gave people who pay for that insurance little means to shop for better deals. Obamacare’s architects hoped that, on top of merely paying for the cost of new coverage, they could “bend the cost curve” downward.
When the law passed, conservatives insisted it would increase rather than decrease health-insurance costs. (Esteemed conservative intellectual Yuval Levin, in 2010, insisted it “completely fails” to reduce overall health-care spending.) Since the law passed, health-care inflation has fallen to historically low levels. Conservatives have repeatedly insisted this was a blip that would soon be reversed, and seized upon any apparent evidence for this case. When health-care spending spiked in the first quarter of 2014, Megan McArdle announced vindication: “After all the speculation that Obamacare might be bending the cost curve, we now know that so far, it isn’t.” (It turned out the first-quarter spike in health-care spending was a preliminary miscount that has since been corrected.)
Also yesterday, the Centers for Medicare and Medicaid reported that health inflation in 2013 not only remained in, it fell to the lowest level since the federal government began keeping track:
3. Hospital errors. Obamacare has a wide variety of reforms designed to bend the cost curve. One of them is a new payment system that encourages hospitals to avoid readmissions. The old Medicare system reimbursed hospitals for every procedure. This meant they had a perverse incentive to do a bad job taking care of their patients — a patient who developed an infection, or needed readmission, would produce a second stream of revenue for the hospital. Obamcare’s payment reforms changed that incentive. A new report finds that hospital-acquired medical conditions has fallen by 17 percent since 2010. (This has not only saved huge amounts of money, it has also saved 50,000 lives.)
4. Insurance competition. Obamacare is based on an old Republican plan, developed by the Heritage Foundation and first tried by Mitt Romney, whose central feature was market competition. The animating premise was that forcing insurance companies to lure customers on an open, regulated marketplace would bring prices down.
In all fairness, liberals did not place much faith in this dynamic. They didn’t accept a health-care plan that gave insurance companies a central role out of ideological conviction, but out of necessity — appeasing the industry, they calculated, offered them the only viable way to pass a bill through Congress. But the dynamic has turned out to work much better than expected. (The most natural ideological allies of the market function, conservatives, all committed themselves to the Republican Party’s totalistic opposition to every facet of the law.)
A new Kaiser Health News analysis released this week finds:
A surge in health insurer competition appears to be helping restrain premium increases in hundreds of counties next year, with prices dropping in many places where newcomers are offering the least expensive plans … In counties that are adding at least one insurer next year, premiums for the least expensive silver plan are rising 1 percent on average. Where the number of insurers is not changing, premiums are growing 7 percent on average.
The downside is that the lower prices require consumers to actively shop on the exchanges. Customers who automatically renew their existing plan without comparison shopping will miss out.
Obamacare’s bitter opponents on the right have increasingly trained their focus on measures of public opinion. It is true: Polling on the health-care law remains dismal as ever despite its success. Obamacare’s opponents have won a public-relations struggle. They have not won an argument.
*Edit: Seven justices actually voted for the ruling, which gave states the right to opt-out of Medicaid. Many legal observers believe, but of course cannot prove, that the support of two Democratic appointees for this measure was a form of horse-trading to preserve the law's overall framework, which John Roberts nearly decided to overturn completely. The actual decision to make Medicaid voluntary was likely made by five Republican-appointed justices, but formally the decision was endorsed by seven.
But again, all these truths are of no value if the idiot Democrats run away from rather than highlighting them in the campaigns.
Not in the least bit.
Gruber being grilled on the Hill.
Elijah Cummings Savages Gruber: 'Absolutely Stupid,' 'Incredibly Disrespectful' | National Review Online
Congressman Cummings... I know you are mad but Gruber hit the nail on the head.