Doing a quick read through the New York Times reporting on the Obamacare tweak proposed today and it is basically the Landrieu plan with even less damage to the underlying risk pools of the Exchanges. Here are the major points:
- Administrative change only
- Health insurers have the option of keeping the old plans in operation (Landrieu required the old plans to stay open)
- No new enrollments, only exisiting members
- Plans would be considered “grandfathered” for mandate purposes if in effect on Oct. 1, 2013.
Minimal damage to the risk pools, and this is a viable political solution to a political problem.
Baud
Thanks, Richard. Too many opinions out there, most of them ranging from half-assed to full-moon.
? Martin
And again the states have asked ‘If we have declared a policy to be out of state compliance, are the feds asserting that they can overrule the states and keep the plan running?’
I don’t know how many states this impacts, but it definitely affects CA. I don’t dispute the political prudence of the move, but my guess is that this will have no effect in CA, that the state will assert its authority to cancel all of those plans, and the wails of Marxism will continue unabated.
taylormattd
@Baud:
^^^^^^^
negative 1
He seemed to indicate in the WaPo transcript that it would force the insurers to own it if they were going to jack up your premiums (which seems to make sense to me). Now let’s see if that message will get through.
Also in the bundle of good from the transcript — the President pointing out that there was always a grandfather clause in the ACA. If only we had some kind of media whose job it was to inform members of the public about things that affect them so that rampant speculation and baseless complaining wouldn’t defeat every single idea that everyone had…
nastybrutishntall
Nothingburger today, nothingburger tomorrow, nothingburger forevvvahhhh!
EconWatcher
Richard, what do you make of reports that state insurance regulators are expressing concern about the fix? Thanks.
Gypsy Howell
Thanks Richard. After your post clarifying the Landrieu proposal yesterday, I was pretty happy to hear Obama lay this out today.
So, does this mean the Landrieu bill is now a moot point and will be withdrawn, or will the Senate go forward with it anyway?
Not that any of this will stop the screeching and caterwauling in the media. Damn, it makes you pray for some kind of disaster to come along to divert their attention.
Gypsy Howell
@EconWatcher:
Not to mention the pushback from the insurers (which I can only take to mean this is a GOOD thing). Do they have any legitimate gripe? Not that I give a rat’s ass about the insurers.
Yatsuno
@Gypsy Howell: I think it goes forward if for no other reason than it shows Landrieu is working on something. It also gives cover to the wingnuts in the House to do nothing. Of course at this point that is their standard modus operandi, so they should be good with that.
Fair Economist
Politically it’s good, but, honestly, I’d prefer he’d go farther. Grandfathering existing plans has *no* effect on the long-term status of the exchanges, because they’ll all be gone in a few years anyway. It means less disruption to the existing insured, at the cost of somewhat higher subsidies. On the whole, I think that’s a good idea, especially given the very tight timeline for a relatively large number of cancelees to get an exchange policy. In retrospect, *at least* the Obama administrative change should have been part of the plan; you should never get rid of an old critical system until you *know* the replacement is working.
? Martin
@negative 1:
Right, but the grandfather didn’t supersede the authority of the states. If a state decided independently of ACA to declare a previously approved product as no longer compliant with state regulation, they could shut down the policy regardless of the grandfather clause. It only applied when the policy remained compliant with the state but fell out of compliance with the feds – it existed not to benefit Vermont or Mass, but Alabama. So what happened in CA, the state aligned CA regulation more closely with Fed, knocked everything out of compliance, and largely killed the grandfather clause. So, is Obama saying that the policy is now okay, even if it’s out of compliance with CA regulation? Not clear. If the states still can regulate, then this is nice, but it’s a lot of political theater because there’s almost no policies being canceled for the reasons that this addresses. The policies are either being cancelled because the state wanted them gone, or because the insurer wanted them gone. In CA, both parties were in rough agreement on this, but we have a much more competitive market than most states. A monopoly insurer would want to keep their old policies as it gives them flexibility – they always have the right to cancel the policy, so there’s no risk. In CA Kaiser and others didn’t want to have to compete on the exchange with these old policies being offered by other insurers, so they lobbied the state to level the playing field and put everything into the exchanges.
I don’t think this rule will do any particular harm – CA will dig in because we have a governor who just LOVES to fight the feds (usually for good reasons). But I also don’t think it will solve much of anything. It’s action for the sake of claiming action.
Baud
EconWatcher
@Gypsy Howell:
We’re getting hit hard. TPM cites to polling showing both PBO and ACA taking a big hit to popularity. Most concerning, they cited something the other day with 52% saying they did not think of Obama as honest and trustworthy. Personal likeability has always been a big strength for him, so I did not like seeing that at all.
As I said yesterday, things really need to be in better shape by the time the debt ceiling comes up again, or the alignment of forces and public perception could be very different next time.
This seems to me a very dangerous situation. The combo of bad website roll out and cancellations/”you can keep your plan” created a perfect storm.
Second terms are rarely glorious. But we need to get out of this rut, pronto.
Hal
In the end, isn’t this all for optics? I just wonder once the folks out their who would be affected by this change see what their other options are, aren’t they just going to switch if the plan is better while they’ll end up paying the same, a little more, or less money?
Also, after all the bitching republicans did about those poor people losing their great plans I wonder if they’ll even support this change?
piratedan
@Fair Economist: well tbh, this is one of those situations where the insurance companies knew that they were getting a decent deal, some cost control at the behest of them being unable to gouge their existing client base with more of a percentage payout going to overhead costs, you know, they get to exist and still be profitable and more Americans get affordable coverage and there’s some cost containment built in. Wouldn’t you know it, that simply wasn’t profitable enough for the insurance companies, they had to find a way to scare people that used to have wafer thin coverage into more expensive plans that they would promote via fear and misinformation and neglect to inform mr. consumer that there were now other bidders for his business.
Time like this, that I do wish that there was the possibility of taking a few CEO’s out and making an example of them for fucking over people just because you can. Just nationalize the whole thing, we’ll hire the workers at those companies, they’re now government employees, the business management people, go fuck yourselves, find another job or maybe just grab your ill gotten gains and leave the country. Assholes like these make me distrust the business community and that’s really unfair because there are plenty of folks out there that just want to make good products and provide good services without becoming greedy arseholes.
IowaOldLady
Sometimes when I hear the hysterical outcries over nothing, what I really want to ask is “Don’t you people have work to do?”
? Martin
@Gypsy Howell:
They do. Insurance is not a rapid industry. Testing a new product for market takes ~2 years. The actuarial work is non-trivial. Declaring this rule 6 weeks from when plans were set to be cancelled (and some of your risk pool has already left because you told them you were canceling their plan) is a legitimate gripe. You may have already started unwinding contracts with providers with the expectation that the plan would be gone, and now it may not be. Those aren’t huge issues because the insurer was already expecting the plan to go away and appears to still have the option to end it. They’re not obligated to keep the plan running.
But understanding how you’re going to compete against these plans, which you had previously expected would go away is another legitimate gripe. Every person that gets to stay on an old plan is a person not going onto the exchange. Like I said above, CA insurers had worked toward a much faster transition, and part of that transition was not grandfathering these plans:
I was somewhat mistaken above. The State Insurance Commissioner and the legislature didn’t support this move, but the agency that runs the state exchange did. So, if you want on the exchange, you can’t grandfather anything. If you aren’t on the exchange, you still can. The insurers on the exchange might feel a little fucked over right now, but it looks like the exchange can work out whether or not to fight this with the insurers.
Short Bus Bully
How am I supposed to shit my pants in fear of the coming Sharia Law when Obama keeps acting so reasonable?
Betty Cracker
@Gypsy Howell: I found the howls of the insurance companies comforting too. One “insider” interviewed by Buzzfeed said this fix is just a ploy so the admin could make the insurance companies the bad guy when policies stay cancelled. Good. They ARE the fucking bad guy.
Jeremy
@EconWatcher: What do you expect when you have GOP shills in the media attacking him daily. He is getting attacked from all sides. I think part of it is racism and the hatred the media and a number of people have for this man. I know they hate him because he is a dem but a lot of these people are deranged.
IowaOldLady
@Jeremy: They’re deranged because they work one another up and feed off one another. It’s a kind of mob effect. And I’m talking about the press here.
Jeremy
@Jeremy: Actually I would say a large part of it is about race. Stop the first minority president at all costs, ruin his image so that another one doesn’t come up.
Belafon
@EconWatcher:
Not really. It wasn’t Obama’s likeability that got us through the last showdown. It was the Republicans shutting down the government that screwed them. They’re not going to be able to suddenly shut down the government again because of a website or whatever else with the ACA.
Yatsuno
@Betty Cracker: SQUEAL LIKE A PIG!
Jeremy
@IowaOldLady: Yep. This event reminds me of the Rev. Wright incident. The media tried everything they could to tarnish Obama’s image going on and on about a few things his pastor said.
Johnnybuck
@EconWatcher: Well, Joshua tends to be a bit excitable.
It’s the media’s job to exaggerate, conflate, and misinform. it’s how they roll. One need only watch the local news to understand this. The repeal and replacers are on the wrong side of this issue, and they’ll pay a price ultimately.
Frankensteinbeck
@EconWatcher:
In two, three months when millions of people have health insurance for the first time and millions more have insurance vastly cheaper AND better than they had before, nobody will even remember this.
Alex S.
@EconWatcher:
Yep, with the NSA revelations and the ACA roll-out Obama is in a serious crisis. His likeability and his image as a technocrat are in serious danger. I understand why his approval is at a record low at the moment.
Jim, Foolish Literalist
@Jeremy: To say nothing of Democrats and self-styled liberals piling on, from neo-cons like Feinstein to knob-polishers like Bill Maher. Bush was given four years to fuck up Iraq, and its still considered impolite to point out (and John McCain and Lindsey Graham are still considered Very Serious). Obama’s presidency is being declared “over”, after less than six weeks of a bad website.
Gene108
@Hal:
Met with an attorney today. His partner got one of these cancellation notices. New plan will cost the guy 6k more a year.
The poor getting screwed by Medicaid not being expanded in their state will be ignored. Angry self employed upper middle class folks will be able to make some noise.
With a major assist from the MSM and Republicans angry middle class guys are getting the lions share of attention, while any winners under Obamacare are being ignored.
I have some hope the Democrats are going to show some spine on this and bit go along with Republican efforts to actually undermine the law.
Sure there will be some tweaks but no one is trying to gut the rules that will extend coverage to every one the way Republicans are doing with their “reforms”.
The big issue is going to be if any reporting will be done on the winners under Obamacare in the coming year, when the plan goes into effect. If not we may be screwed despite everything, because people will just get discouraged.
JPL
@Jeremy: The Republicans, the party that brings out the racism in people.
pseudonymous in nc
A victory for Spoilt Bastard America and a media that doesn’t do its fucking job.
This is why we can’t have nice things.
jl
TPM says some insurance companies and state regulators are skeptical that the fix can be implemented. But their objections seems vague to me, and mostly consist of repeating ‘uncertainty’ and ‘late date’.
I don’t have much sympathy for any AHIP objections, since it is some of their members who tried to hoover up some short term dough for mostly poor plans at another ‘late date’, but I would like better info on what their objections really are.
I am of the Dean Baker school of thought on this issue, and wonder whether to satisfy the whiners, Obama would need to announce a take-over of the private insurance industry and dictate to companies that they continue plans that are losing money. Some of these plans are going to be cancelled if some people decide to leave and consider the ACA approved plans, regardless of tinkering with the grandfather clause, right?
Will The Obamacare ‘Fix’ Actually Accomplish Anything?
TPM blog
http://talkingpointsmemo.com/dc/obamacare-fix-what-is-it-good-for
pseudonymous in nc
@Gene108:
Fuck those people. The White House will have to spoonfeed this to them, and hope that they don’t spit it out because they’re spoilt bastards.
pseudonymous in nc
@Alex S.: herp derp a derp. Get a new script.
Jim, Foolish Literalist
Andrew Sullivan is comparing this to Iran-Contra, which probably strikes most villagers as spot on, very few as a little over the top, and probably a number you could count on one hand as morally bankrupt.
Chyron HR
@pseudonymous in nc:
But, but, but the tyrant Obama personally controls every IP packet that flows through our once-free internet. Also, too, his website doesn’t work right.
IowaOldLady
@Jim, Foolish Literalist: Wait. What? Iran-Contra broke the law. How can Sullivan possibly claim this is similar?
jl
I am also tired of supposed experts in something or other saying that healthy of any age, and healthy young, are a separate market for insurance than the older and sicker, and that the ACA is an imposition on them, making them buy a new Caddy when a used Ford would do just as well.
That is standard ‘cash in my pocket equals penneis from heaven” BS US style policy economics. It would only be true if the currently young and/or healthy are a permanently distinct population that stays that way. But they don’t. The risks of being able to get individual policies later is not independent of what you do now, and whether you have health insurance now. Since many people do not get health insurance through employment, the sad fact that every one gets old and dies sooner or later, and most people get sick and many do so without a stable long term employment policy is one of the main reasons for decreasing prevalence of health insurance coverage in the past, and why public health insurance policies like Medicaid and CHIPS have been expanded.
Am I missing something, or am I right but working through the apparently obscure and complex logic and existing empirical evidence that everyone ages and dies is too hard for the media pundits? Maybe some of these glibertarians and glib policy and political pundits have uploaded themselves into their computers and have not told us?
The Raven on the Hill
I worry that this will become a long-term norm and that the cost problems will not be addressed for years to come.
Thanks, Obama.
Hill Dweller
@Gene108: Was that the price the insurance company quoted him/her? If so, he/she should shop on the exchange.
Baud
@Gene108:
$500/month more? What state? I’m skeptical.
Joel
I’m giving this at least another month before getting concerned.
IowaOldLady
@jl: Someone on here the other day applied the same kind of logic to old folks complaining they don’t need maternity care. OK, then. Let’s put everyone past childbearing years into the same group. Do you think your rates would go up or down?
Jeremy
@Jim, Foolish Literalist: Well you have some on the left that hate Obama as much as the beltway press and the GOP. The professional left pundits have attacked him and the media plays it up in order to create division and help the GOP.
Gypsy Howell
@Gene108:
And I just had a conversation on FB with a friend of mine who enrolled through the website and will SAVE $6000 a year. True story. And I highly doubt she’s getting any subsidies.
ETA: and she says its for a better policy
jl
@IowaOldLady: Yes., Several commenters here have made very good points along that line. And the real question should be about what happens to these lucky young and/or healthy now people as they degrade (as we all do) or eventually have a bad accident, and they either still have a crummy policy or no policy at all anymore (either because they moved and it changed things that they didn’t want to keep it, or they dropped it, or the insurance company dropped the line or made changes the enrollee did not like).
The person runs up bills, and is subsidized by the taxpayer, the provider ERs and hospitals, and serious distortions occur in the health care and insuance market. So, are the costs imposed by the ACA to solve that problem reasonable?
But I never here that in the news. I hear goofball stuff like ‘OK, there you go, big gummit making some poor sap buy more stuff than he or she needs!’ That might be a simple and reasonable objection to a policy that requires everyone to buy top quality organic baby lettuces for their salad, but not health insurance.
But, we could repeal all the federal and state regulations requiring provision of emergency care, I guess. Funny I never hear about that alternative..
GHayduke (formerly lojasmo)
Meep meep, muthafuckas.
sparrow
@Jim, Foolish Literalist: Yeah it’s beyond ridiculous. ALL OF YOU STOP WATCHING NATIONAL NEWS. Seriously, it’s like meth – screws you up in the head.
Patricia Kayden
@Gypsy Howell: I just heard Landrieu (on Martin Bashir’s show) say she’s going forward with a bill. She also hinted that President Obama could take executive action on his own although she didn’t go into any specifics.
chopper
@Jim, Foolish Literalist:
i’m thinking it’s more like the holocaust, but yeah, that’ll do also.
pseudonymous in nc
@jl:
US per capita health spending is $8,000 ish. A small chunk of that’s admin and skimmers and inflated costs, but a large chunk of that is actual medical shit. Either you want a country where people aren’t routinely ruined by medical bills or forego treatment because of cost, in which case that comes with a bill — or you want a country where that happens (ideally just to other people) in which case fuck you.
pseudonymous in nc
@jl:
US per capita health spending is $8,000 ish. A small chunk of that’s admin and skimmers and inflated costs, but a large chunk of that is actual medical shit. Either you want a country where people aren’t routinely ruined by medical bills or forego treatment because of cost, in which case that comes with a bill — or you want a country where that happens (ideally just to other people) in which case fuck you.
Gypsy Howell
@Patricia Kayden:
I just called my senator and encouraged him to support it if it was put up for a vote (fat chance, but whatever)
Betty Cracker
@pseudonymous in nc: Actually, about 30% of US “healthcare” spending goes to skimmers and admin, which is one reason the ACA is a good thing: It does something to limit that shit. Not enough, but it’s a start.
jl
@pseudonymous in nc:
I don’t want people denied care or no mandated emergency care, I was just expressing my frustration with the misleading and unhelpful stuff I hear in the media. Edit: and I think the reason the option of eliminating distortions in the health care provider and insurance market through denying any emergency or compassionate care is never discussed, is that most people would find it a disgusting and immoral national and state policy. And I agree. But those provisions do have costs and consequences, so if we want to keep them, the question is how to do that with the least cost. But the pundits seem oblivious to those issues.
My only quibble is that I would say ” but a large chunk of that is actual medical shit.” that is sold at grossly inflated prices compared to other high income industrial economies.
jl
@Betty Cracker: The best estimates I’ve seen are from
Accounting for the Cost of Health Care in the United States.(2007) McKinsey Global Institute
Which says about 40 percent of the excess cost goes to higher reimbursement for specialist doctors, surgeons, skilled nurses, hospital inpatient services, medical equipment, tests and drugs. About 20 percent goes to identifiable excess administrative costs. About 8 to 10 percent is due to higher number of nonclinical personnel for per capita compared to similar economies.
Not sure how much of that higher ratio of nonclinical personnel is people fighting over bills and money, So, probably higher than 20 percent, but 30 percent seems high. I don’t think anyone really knows.
Chris
@Alex S.:
The mainstream media’s been cutting loose with a non-stop blitz of fake scandals for well over a year. I suppose it was inevitable that one of them would finally stick.
And it makes sense that it’s this one. “Benghazigate.” Nobody cares. “IRSgate.” Nobody cares. “APgate.” Nobody cares. “NSAgate.” Despite the collective gasp and shock of the chattering classes, I don’t think most people really gave a shit. “Obamacare is rolling out and your health care plans are being canceled.” Now, people give a shit.
With all the previous stories, it’s not that they were bullshit, so much as they just didn’t trip John Q. Citizen’s “why should I care?” wire. John Q. Citizen is not a diplomat or living overseas. John Q. Citizen is not a political activist trying to pass himself off as a charitable organization. John Q. Citizen might be alarmed at the notion of The Gub’mint going through his emails, but it’s really theoretical until a Man In Black shows up on his doorstep and “would like to ask a few questions.” On the other hand, John Q. Citizen does have a health insurance plan and the notion that he might lose it is both real and the kind of thing that can easily send him into freakout mode, justified or not.
Remains to be seen whether it’ll last or just be a temporary glitch. Obama’s been pronounced dead before. I wouldn’t be too sure it’ll be true this time either.
Citizen_X
@IowaOldLady:
I’m starting to get real pissed off at middle-aged & old people complaining about “damn moochers I gotta subsidize.” No, you idiot, you’re not subsidizing the young and healthy, they’re subsidizing you.
shelly
Well. just found out yesterday that my insurance plan is being canceled. And believe me, this is NOT a junk plan. Comparble to any Gold plan on the exchanges. Don’t know if Obama’s announcements will make any difference. Just wonder what the heck’s going on. Of course they give no reason.
MomSense
@jl:
I’ll be really interested to see how bundling of Medicare reimbursements will change the cost of specialists.
MomSense
@shelly:
Spandan C talks about why this is at thepeoplesview.net
Insurance companies want the subsidies from the exchanges.
Here’s a link.
http://www.thepeoplesview.net/2013/11/president-obamas-check-mate-to-health.html
Go check it out. He has been on fire over there.
Baud
@shelly:
What’s the price difference between your plan and the Gold plan? I would expect insurance companies will generally try to move all of their business over to the exchanges — why have two separate products?
@MomSense:
Good link.
NR
@Gene108:
The insurance companies? I guess someone could do a feature on how the CEO of Aetna was able to buy a third yacht thanks to all the money that the government forced people to give him. Might be interesting, in a “Lifestyles of the Rich and Famous” kind of way.
PopeRatzo
@Chris: In 2009, when some of us were saying what a stupid plan this was, Rahm Emmanuel was calling us “retards”.
If Obama had one time suggested that maybe, you know, a public option or single-payer system might actually be a good thing, I might still have a shred of respect left for him. If he had even spent a penny of political capital on it.
Today, he looked like a total chadrool. When I said 6 weeks ago that he would end up delaying the individual mandate for a year, I was attacked and called an “emoprog” or “firetard” or some shit, and now that Obama actually proposes such a delay, it’s “practical”. Oh wait, “concern troll”: that was my favorite. Because I wasn’t clapping loud enough.
This is not going to save the public exchanges, it’s just going to draw out this fiery wreck for another year, until the employer mandate kicks in and millions more policies are cancelled. With the 2016 elections around the corner.
It’s a good thing Obama was smart enough to delay the rollout to October of 2013, because if this had happened in October of 2012, he never would have been reelected and Mitch McConnell would be majority leader. How do you respect a guy who has to delay his landmark legislation until after the election just to save his own ass?
It’s a little bit disgraceful that so many are still trying to pretend that just a “few tweaks” are going to save this mess. They’re going to go down with the ship and then act surprised in 2014 and 2016.
And to Citizen_X above: I am happy to subsidize others. I am not happy about subsidizing insurance companies and pharmaceutical companies and the HMO megacorps.
Chris
@Citizen_X:
Our entire political sense is upside fucking down, in a way that would be considered too ridiculous even for a TOS planet-of-the-week.
Old people who consume the most in terms of health care are considered solid and honest citizens, the young who subsidize them despite typically needing less health care are the “entitled” deadbeats.
States that take in more money than they give are considered “rugged individualists,” states that give more than they take in are considered moochers and leeches’ paradises.
People making minimum wage are derided as fat cat union thugs, while people making $250,000 a year are sold as being needy and barely keeping afloat.
People whose business model is entirely based on destroying jobs are labeled, literally, “job creators.”
A media that fires Helen Thomas while protecting Richard Cohen, that fires Dan Rather while protecting Lara Logan, and that sold the Iraq War and the Bush tax cuts but couldn’t be bothered to fact-check something as blatant as “death panels,” is widely reviled as “liberally biased.”
A financial system that rewards bankers with obscenely profitable “golden parachutes” even after they’ve fucked the economy worse than anyone in several generations, is attacked as “creating uncertainty for the markets.” And the politicians who allow it are labeled “anti-business.”
Too much bullshit. Just… way too much bullshit.
shelly
@Baud:
I’m not saying I couldn’t find a more reasonable plan thru Obamacare, I’ve already been researching it. (As a self-employed single i’ve been paying over 800 a month) Just curious why they’re canceling a plan where, at least to me, it seems there getting a good chunk of change every month.
Baud
@shelly:
That’s good to hear. I don’t know for certain, but as stated above, it’s likely that they want to get you in the same pool as other people in the exchange.
NR
And then they’ll find a way to blame liberals for it. If only we hadn’t talked about what a shitty piece of legislation the ACA was, nobody would have noticed!
Dee Loralei
@Chris: righteous rant dude! I want that tatooed on the face of every political reporter and pundit!
pseudonymous in nc
@shelly:
It’s the pool. It’s all about whoever else was paying $800/mo into the same pot you were in.
@jl:
My comment wasn’t aimed at you, so mea culpa if you read it that way.
I’m talking about the basic disconnect that you see in people’s belief that everybody can somehow pay $100/mo for “catastrophic” coverage and out-of-pocket for the rest whenever it happens, and perhaps plan on paying $200/mo when they start getting aches and pains, and that will somehow cover the bill, even if you constrain costs on skimmers and inflated fee-for-service costs.
Gene108
@Jim, Foolish Literalist:
I saw a montage on CNN awhile back about Presidential apologies, just after Obama said sorry about plans getting cancelled.
They had Nixon in 1977 about Watergate, Reagan about Iran-Contra and Clinton about. cheating on Hillary.
They really do equate all these because Obama said sorry too.
As much of a smarmy asshole move that it seemed that Bush, Jr never admitted to mistakes, I’m thinking it might not be as bad an idea as I thought as it seems the media is like a bunch of sharks who react to any public sign of “weakness” as a shark does to blood in the water.
PopeRatzo
@Gene108: You believe President Obama had no idea that plans would be cancelled and the resultant uncertainty would get people upset? Or that the people who would get most upset could be some of the biggest supporters of health care reform?
Why would anyone, after seeing how badly this whole thing has been cocked-up, thing we can convince people that the best solution would be single-payer, universal health care. The one thing the ACA had to do was make things better for most people. Now we’re learning that after the full implementation of Obamacare, there will still be 30million uninsured American citizen (down from 40million). That’s the CBO saying that, not the Weekly Standard.
This isn’t just some news-cycle dust-up. It’s going to be the headline until next November. If Democrats don’t find constructive ways to run away from Obamacare, we’re looking at losing a lot of ground next year, Senate and House (and more state legislatures). And I hope to christ Howard Dean has it in him to run in 2016. Nobody with Obama-taint is going to survive – not Biden or Clinton, certainly. I doubt anyone like Feingold wants to face the hostility that’s coming. Before he’s done, Obama will have set back the most important progressive causes by a decade or more.
Chris
@Gene108:
Kind of obscene that they equate Watergate and Iran-contra with an affair, too.
FlipYrWhig
@PopeRatzo: Yeah, there’d be hardly ANY complaints in the media about a system that involved 100% of the public getting used to a new method of health insurance and health care delivery!
Gypsy Howell
@shelly:
Oh for christ sakes, I don’t know how long you’ve been in the individual market, but I’ve been in it for over 15 years, and every fuckin year, my insurer would come up with some new variation on my plan, essentially “canceling” my previous plan, and at the same time jacking up my rates by 12%, 15% or more.
This is the first year in 15 years I’ve actually had any CHOICE about what I can buy (being middle aged and having a few very minor pre-existing conditions) and I am damn happy about it. My insurer sent me the rates for my new “equivalent plans” this year, and when I went on the exchange, I found I could get essentially the same exact thing FROM THE SAME INSURER for a few hundred dollars less a month.
schrodinger's cat
Richard@top
What did you think of Gottlieb’s whiny rant about the ACA in NYT, earlier this week.
MomSense
@schrodinger’s cat:
Check out boomantribune on that. He flat out called her a liar and went on the CA exchange to prove it.
Chris
@PopeRatzo:
The main value of coming out clearly for single payer, IMO, is that even if he didn’t have a chance of actually getting it, and the current plan is the best he could get, every problem and glitch in the current plan could’ve been answered with “remember this isn’t what we wanted; this is what we accepted because nothing else could go through. Now you going to listen?” Not much change for the moment, but some more elbow room for future improvement, IMHO.
Yatsuno
@PopeRatzo:
I call bullshit. Changing the attitude of health care being a right as opposed to a privilege is fucking huge and a major progressive leap forward. And no country has gone from total private to single-payer (or equivalent) all at once, because it is actually a huge disruption. ACA is a transition law, it is not the endgame.
NR
@Yatsuno:
We don’t have a total private system. We already have Medicare, an incredibly popular government program. All the Democrats had to do was expand it to cover everyone.
They didn’t do it, because they were more interested in empowering and enriching the private insurance companies than they were in improving the U.S. healthcare system.
DTOzone
@PopeRatzo
I don’t think we can convince people the best solution would be single-payer and I don’t think we could have even before ACA. It’s a HUGE change, and spare me the crap poll about how people actually supported single-payer, asking people “do you support a plan that covers all Americans” is about as vague as “do you support ice cream?” At the end of the day, even if we could have passed such a massive undertaking, doing so, including actually shutting down entire corporations and moving the entire nation onto a program run by an entity that they hate (government) would not play very well in the process.
As has every Democrat who came before him, what’s your point?
Hill Dweller
@NR: Pelosi couldn’t get lowering the medicare age to 55 through the House. When the Senate Dems were talking about doing it, Lieberman, who ran for reelection on a platform of lowering the medicare age, said he was against it.
PO was never getting single payer nor anything close to it through congress.
VDT34
@NR:
Do people actually KNOW it’s a government program?
VDT34
@PopeRatzo:
When did he do this?
Uncle Ebeneezer
@Chris: But that assumes that the ACA would have still passed. Like it or not single-payer and public option both are incredibly loaded terms that simply with their invoking cause wingnut voters, Foxnoise and the MSM to go into hissy fits. Considering the fact that there were several Dem Senators who were already timid about giving their support and looking to distance themselves from any accusations of creeping Socialism, steering clear of that terminology (knowing the votes for single-payer weren’t there even in the best case scenario) may have been the only way to get the bill passed.
slightly_peeved
@Hill Dweller:
Given single-payer would have involved kicking everyone off their current insurance, the idea that this particular mess would have been avoided if Obama had pushed for single-payer boggles the mind.
“Yeah – this mess that’s happening now, we didn’t want that. Actually we wanted that to happen to many more people.”
FlipYrWhig
@slightly_peeved:
I’m at literal SMH levels over this shit in the blogosphere. This hissy fit we’re in right now is being thrown by, what, 4% of the public and their media enablers? And so the answer to “what would have worried people less and gone more smoothly?” is… confuse 25 times more people and convulse a multi-billion-dollar industry? I mean, just listen to what the fuck these people are proposing in political terms. Not in policy terms; we’re not idiots; we know how these things work. But the solution to a problem of political perception is probably not to mess with more people faster.
FlipYrWhig
@Uncle Ebeneezer:
And unless you’re a particularly precocious not-quite-4-year-old, you have the capacity to remember WHAT ACTUALLY HAPPENED when the whole thing was being debated. And it was that a fuckload OF DEMOCRATS didn’t want to go very far at all. This wasn’t that long ago, ya know. We can name, in excruciating detail, actual political figures who didn’t support going farther than the final ACA went. The reason why it wasn’t a better law is because making it _this good_ took years of hard work and just barely happened at all.
Richard Mayhew
@VDT34: agreed…he is proposing to extend grandfather’s status for a small segment for a short time .
gwangung
@NR: You need to remember that the political process is not subject to Green Lantern power rings. Willing it to happen is not enough; you need to count votes, particularly on your own side.
Its not clear that you’ve even thought of the concept, let alone the tedious nuts and bolts of making it happen.
gene108
@PopeRatzo:
The goal is universal health care. How we get there is, i.e. single-payer uber-alles, should not be as important. Secondly, if the SCOTUS had not allowed the Medicaid. opt-out and a Republican state governments weren’t such dicks (or cunts for the ones run by women governors), a lot more people would be covered.
It’s also not the end of the world.
The good out weighs the bad, with regards to this law.
Medical inflation is already slowing down and from managing benefits for my employer, the past three years is the first time in over a decade, we have not been hit with double digit premium increases. There was a time in the middle of the 00’s that I was told that a 10% increase was the least you could expect, if your plan ran as expected, i.e. the insurance provider did not pay out more than you paid in premiums because medical inflation was driving costs up by that much.
Democratic politicians are smart enough to figure out how to handle their own re-election prospects and still not totally fuck this law up.
Landrieu’s done it with her proposed fix.
I was watching CNN at lunch and Mark Begich (D-Sen, Alaska) was on and the lead up to him was about how Obama was offering his patch and how House Democrats may have to vote for a bad Republican House “fix” to Obamacare and how the law would totally hurt Begich in his tough re-election campaign in Alaska.
After the host tried to keep baiting Begich to say a “gotcha” comment about sticking a knife in the back of Obama and this law. Begich acknowledged the 4,000 Alaskans, who lost coverage was an issue and they needed a fix, preferrably a legislative fix over an Executive directive.
The host smelled blood in the water and kept trying to goad Begich to say something about repealing Obamacare, or delaying it, but Begich had an emphatic retort, “prior to the Obamacare 34% of Alaskans were denied insurance on the individual market each year, today 0% (with his hand up outlining a zero for the camera) are going to be denied individual plans because of this law” (paraphrased a bit, but close enough),
He went on to talk about how great it would be for President Obama to come to Alaska, so he could show him how useful opening up ANWR would be for his state, i.e. he wasn’t scared that he his opponent would run ads showing him on the same planet as Obama.
As much as the media is going to try to hang this law and President Obama’s current unpopularity around Democrats, I think many Democrats in conservative states know how to handle their re-election prospects.
Yatsuno
@gene108: The Democrat is within six points of the idiot wingnut who will most likely win the primary in South Dakota. That is a workable deficit twelve months out, especially if we can get money there and the wingnut shoots himself in the dick. Repeatedly.
The Art of Compromise
@Chris: absolutely righteous. even c-span is showing it’s truthiness with their right wing slant on everything and their constant love affair with politico.
DTOzone
Interesting to note that only one Democratic senator in a blue state has lost reelection this century so far.
Russ Feingold.
Matt McIrvin
So Ed Kilgore at Washington Monthly had this ominous link:
Ohmygod, even the liberal insurance commissioner in Washington State has turned against Obama! But it turns out the commissioner is rejecting it from the left, saying the state will continue to prevent the substandard plans from continuing:
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/14/the-backlash-to-the-obamacare-fix-has-already-started/?wpisrc=nl_wnkpm
That’s a bit different from what I imagined it would be.
NR
@gwangung:
No “power rings” were necessary. The Democrats controlled the House, the Senate, and the White House. It was within their power to pass anything they wanted.
The only reason we didn’t get Medicare for all is because the Democrats didn’t want to pass it.
DTOzone
Yes. Some did. Not nearly enough of them. No one denies this. Your point being what exactly?