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Showing posts with label Patient Protection and Affordable Care Act. Show all posts
Showing posts with label Patient Protection and Affordable Care Act. Show all posts

Thursday, January 02, 2014

What Will 2014 Bring?

It's always fun at the beginning of a new year to predict what may happen. I've enjoyed reading all the partisan predictions for 2014 over the last few days that have ranged from the likely to the absurd so I figured I should throw out a few of my own.

Barring some outlying incident, the economy will continue to improve and unemployment will drop to below 6 percent. GDP will be steady at 3-4 percent for each of the four quarters. This will be the number one factor in the 2014 elections. For those of you inside the right wing bubble, our country is facing imminent economic collapse because of the liberals so nothing really new here.

The Affordable Care Act will be a 2014 campaign issue but not in the way the GOP would like it to be. The hundreds of thousands of Americans who will be benefiting from this law will dwarf those who are complaining about it and turn out to vote. The nervous and hyperventilating Democrats will suddenly become calm and happily stamp the ACA to their foreheads:)

After primary season is over in the Spring, GOP House members will pass comprehensive immigration reform. The new law will largely be the same one that was authored by Marco Rubio, Republican Senator from Florida. Political reality will become quite stark for Republicans this year in terms of the Latino vote and they will have no choice.

Failing to extend unemployment insurance for the long term unemployed will erase the political capital gained from the poor rollout of the Affordable Care Act. The Right's failure to address the issue of inequality with anything other than failed economic ideas and bloviating platitudes will take larger chunks out of the electorate for them.

There will be another school shooting and the Gun Cult will scream about Hitler coming to take their guns away, stomp down the hallway to their rooms, and act like belligerent adolescents.

The settled science of climate change will continue to be on display throughout the year. The Right will scream about Stalin coming to take their freedoms away, stomp down the hallway to their rooms, and act like belligerent adolescents.

President Obama's approval ratings will come back up again (they are already) and his 89th political death will quickly be forgotten.

For the 2014 election, the House will largely remain unchanged with either party picking up or losing a few seats. In the Senate, we can say goodbye to Mitch McConnell, Mary Landrieu, the Democratic seats in Montana, South Dakota, and West Virginia. That's a net loss of three seats which would put the Dems at 50 + Bernie Sanders and Angus King who caucus with them. Of course, that's how it looks now without the possible surprise retirement of Susan Collins or the GOP deciding to run far right candidates in the states they should easily pick up. Throw in some more Todd Akins and Richard Murdocks into the mix and nothing in the Senate really changes with the Democrats still holding the majority.

The most interesting races of the 2014 will be the governor's races. Governors Brewer, Heineman and Perry are all retiring. Rick Scott, Tom Corbett, Rick Snyder, and Scott Walker are going to have tough reelection fights. I see the Democrats taking most of these seats and holding on to the very blue states where they are running for reelection. The only one I really see holding on is Scott Walker in Wisconsin. I could be wrong because the state where I grew up really hasn't improved since he took office but I just don't see Kathy Burke beating him. He has moderated his language and criticized the crazies in his own party just enough to win the middle and set himself up for a presidential run.

Well, those are my predictions. What are yours?

Saturday, December 21, 2013

Hmm...

So, now we like Politifact, do we? I guess when it says things we like, we likey. When it doesn't, we don't likey, are shouty about it being liberally biased, and are all angwee and stuff. Hmm...there's a word for that and it rhymes with Schmadolessent.

For the record, I think Politifact's Lie of the Year was a fine choice. They do a great job of calling people on their bullshit regardless of what side of the aisle they are on.

Friday, December 20, 2013

The GOP Conundrum

This recent exchange illustrates the conundrum the GOP faces next year in the elections.

Albright doesn’t want the Affordable Care Act repealed, which Stutzman and the Republican-controlled House have voted to do numerous times. Albright told his congressman that his monthly payment for family health coverage will drop from $3,800 to $1,700 by enrolling in a plan offered through the much-maligned law. 

Albright said most of his dozen employees also are enrolling in Affordable Care Act plans and will have coverage for the first time. “If the Republican Party thinks they’re going to kill Obamacare, you guys need to realize that those nine people that I add on, are they going to vote Republican ever again if you take their health care from them?” 

Stutzman responded: “No, probably not.”

If I were in charge of strategy for the GOP in the 2014 elections, I would find out how many voters in those key swing districts and states are signing up for health care for the first time and compare that number to how many voters are being "screwed over by Obamacare." 

Monday, December 16, 2013

A Tale of Two Governors

Now that the hysterical hyperventilation over the Affordable Care Act has passed, we are starting to hear about the more positive ways in which the law is being implemented. It's very interesting to note how two red states, Nevada and Kentucky, have chosen to tackle the rollout.

As noted in this piece, Governor Sandoval (R-Nevada), is all in.

Sandoval is the only Republican governor whose state is both running its own health insurance exchange this year and expanding its Medicaid program under the health law. He’s arguably doing more to put the Democrats’ signature law into place than any other Republican.

Why?

“I opposed the Affordable Care Act from its inception,” he wrote in an email. But he’s a former federal judge and in his view, once the Supreme Court upheld the legislation, “the Affordable Care Act became the law of the land.” 

Apparently, his constituents appreciate his adult behavior.

Even after sticking his neck out on Obamacare — which few others in his party would consider amid fear of a conservative backlash — Sandoval is overwhelmingly popular in Nevada. State lawmakers backed his Obamacare approach on a bipartisan basis, and he’s cruising toward reelection next year with no formidable opponent in sight. 

Huh. So, moderating and actually accomplishing the business of government works. So does "stamping Obamacare to his forehead." Whoda thunk it? Well, considering the ACA was a Republican idea in the first place...

Governor Steve Beshear, a Democrat in the (not much longer now) red state of Kentucky has also fully embraced the ACA.

The way Beshear tells it, “this” is enrolling 69,000 Kentuckians in newly available health coverage programs, a number that has grown steadily and that the Democrat expects to “surge” in the final weeks of the year. As the only governor of a Southern state who has both set up a state insurance exchange and green-lighted an expansion of the Medicaid program, Beshear represents a painfully rare bright spot in the landscape of Obamacare implementation. The state exchange, dubbed Kynect, has been a model of smooth enrollment compared to the federal government’s version, and has absorbed 550,000 web visitors and 180,000 phone inquiries so far. 

Hoo boy...so much for the boiling pit of sewage. Governor Beshear has even been calling out folks like Mitch McConnell on all the lying over the ACA.

“I have a U.S. senator who keeps saying Kentuckians don’t want this,” Beshear said. “Well, the facts don’t prove that out. There’s about 550,000 on our website right now who want it — and some 65,000 to 69,000 that have signed up. So Kentuckians do want it.” 

"I want to publicly invite our entire federal delegation to come back to Kentucky as [Democratic Rep.] John Yarmuth does all the time and come over to our center, our nerve center where we’re running this program and see for yourself what is going on,” said Beshear. “When you see that, I think you’ll quit saying this will not work and Kentuckians don’t want it.”

Governor Beshear also notes that the issue of the ACA is going to come back and haunt McConnell in his already tough reelection battle next year. I agree. In fact, I'm going to predict right now that McConnell loses that race because the far right in Kentucky is pissed off at him and won't turn out. Heck, he might not even make it out of the primary. Alison Lundergan Grimes is a very popular, moderate Democrat currently serving as Secretary of State for Kentucky. She will pull GOP voters to her side, given the Kentuckian embrace of the ACA.

Republican governors and Democrats in southern red states embracing the Affordable Care Act? All this bipartisanship makes me warm and fuzzy. I wonder how it makes the Tea Party feel these days...:)

Saturday, December 14, 2013

Who is John Galt?

Or, in this case, Jon Gault? 

Well, he is a man who is very grateful for the Affordable Care Act.

Some nights, when Jon Gault felt his worst, he wondered if he would live long enough to see his 17-year-old son go to college or to walk his daughter, now 8, down the aisle.

Although many have reported problems with the federal HealthCare.gov site, Gault says Washington’s site was surprisingly easy to navigate and he was quickly approved. The price came as a pleasant surprise also. Thanks to federal subsidies, Gault will not have to pay for his coverage.

“I went from being denied health insurance several years ago to actually having it now,” Gault says. 

“It’s kind of nice.”Many of his Republican friends have dismissed his newfound hope, and he has stopped trying to argue with them. They are not seeing the bigger picture, he says. It’s not about how much it will cost; it’s about those it will help. Everyone will benefit at least indirectly, because people they love and care about will benefit. 

As for him, he says he no longer has to choose between providing for his family or taking care of himself. 

Oh, the sweet, sweet irony!

Tuesday, December 10, 2013

Monday, December 09, 2013

The Metric of Success

A commenter recently asked what my metric for success was in terms of the Affordable Care Act. I've answered this question many times in posts and comments and one need only click here to peruse my answers over the last couple of years. In fact, I recently highlighted one such quantification that bounced off the bubble into outer space. Oh well.

Yet, unlike my conservative colleagues, I strive to be reflective. So, it is in that spirit that we start today with a new tag called "health care success." Today, I will highlight two main metrics of quantitative success that will be integral in judging the effectiveness of the ACA. As the numbers start to come in showing increased enrollment in health care insurance, we will be able to see the number of people insured in this country rise. Right now we stand at 84.6 percent insured. So, the first metric of success is to get as many of that 15.4 percent uninsured to have coverage. If we can have a total of 95 percent of the nation covered with health insurance by 2016, I'd say it was successful. That's about three quarters of that 15 percent or 30 million people. We may not be able to know this for certain until the next census (2020) but I think there will be plenty of data by the next presidential election to give us a clearer picture.

But what about that last five percent? Well, that's where my second metric comes into play. Those that don't get insurance will have to pay a fee which will offset the costs of the program. Will that fee and all the newly insured people be able to achieve the overall goal of the ACA in reducing the amount of money we spend on health care? Currently we each spend $8,233 per year and the U.S. health care costs now eat up 17.6 percent of GDP.  How does that compare with other countries?












































Terrible. Just terrible. This is why we had to have health care reform. Obviously, the goal here is to control growth, as I noted the other day, and the ACA is already doing that. Now we have to look at the goal numbers in terms of dollars spent per person and our GDP (adjusted for inflation, of course). A minor success would be for us to spend $8,232 per person-1 dollar less than we are now. A major one would be for us to spend as much as Norway does at $5,388 per person. I'm going to set the goal of $6,700 dollars per person which falls right in between as my measure of success. With GDP, a minor success would be to get it to 16 percent. A major success would be 11.5 percent, putting us right in the middle of many European countries. I'll set the goal here at 14 percent of GDP. \

Of course, quantifying health care success is only one piece of the puzzle. What about quality of care? We could meet these goals but what if the care level falls? In the coming months, I'll be discussing other metrics that will indicate success in terms of our new health care law. Look for the tag "health care success!"

Saturday, December 07, 2013

Anecdata

Remember all those Obamacare horror stories? Not looking so bad now.

Oh, really? Why? Well, read the piece. But how did this happen?

The failure of the exchanges created an information vacuum as far as Obamacare successes went; in rushed the individual stories of those who claimed to have been hurt by the changes to the market. It didn't matter that these stories are, even without enrollment numbers from the exchanges, demonstrably unrepresentative! 

In steps...anecdata!

Statisticians dismiss the practice of using personal stories to argue about an objective reality as "anecdata", but it might be more accurate to call the "Obamacare horror stories" that have taken over social media "urban legends". There are urban legends about a lot of things – from spiders in hairdos to red velvet cake. Some are funny, some feature a satisfying come-uppance, but folklorists agree that the stickiest of them, the ones that last for generations and resist debunking are the ones that live off ignorance and feed off fear. As one researcher put it: "It's a lack of information coupled with these fears that tends to give rise to new legends. When demand exceeds supply, people will fill in the gaps with their own information … they'll just make it up."

I can't think of a better description of the conservative media ecosystem at the moment. 

Neither can I.  I quite enjoyed the torpedoeing of some of the more prominent "horror" stories. 

Thursday, December 05, 2013

Completely Inconsolable

I've had some rather lengthy discussions with my conservative friends of late that have led me to the same conclusion as Jamelle Bouie: No matter the facts, the GOP is committed to the message that Obamacare has failed.

The Republican complaints of two months ago were purely opportunistic. For them, it just doesn’t matter if Healthcare.gov is working, since Obamacare is destined to fail, reality be damned! At most, the broken website was useful fodder for attacks on the administration. Now that it’s made progress, the GOP will revert to its usual declarations that the Affordable Care Act is a hopeless disaster. Meanwhile, hundreds of thousands of Americans have gained access to health insurance thanks to the Medicaid expansion or the exchanges, and many more will join their ranks as the deadline for coverage approaches. 

They are completely inconsolable and it seems they want to stay that way. 

Saturday, November 30, 2013

Then What?

Brian Beutler reveals a very interesting conundrum for right wing extremists in his latest piece over at Salon.com. When Healthcare.gov actually starts working, GOP will have to choose between politics or their constituents' health. With the bugs being ironed out at healthcare.gov, Beutler points out what the future holds.

A working site that can service nearly a million people a day destroys that excuse. Some conservative groups have been craven and reckless enough to actively discourage people from enrolling in Affordable Care Act coverage. Elected Republicans have generally used their influence more subtly, by drawing attention to the hassles and supposed dangers of using Healthcare.gov. Manipulation vs. direct appeal. They’ve also maligned an administrative solution President Obama devised that will allow carriers in some states to reissue canceled policies.

But the real fix for 70 percent (or so) of people whose policies have been canceled is to get new, subsidized coverage through exchanges, or to enroll in Medicaid. Once Healthcare.gov is working at high capacity, they’ll owe people with canceled coverage more than just the play-acting they’ve offered for the past month. Democrats will be helping these people find such coverage. Will Republicans?

No, they won't. And that's why I say we should take Reince Preibus's advice: Stamp the ACA right to our foreheads and run proudly on it in 2014. That's exactly what I would do if I was up for reelection next year.

Sunday, November 24, 2013

Math Doesn't Lie

The main goal of the Affordable Care Act was to reduce the growth of health care costs and guess what? It's doing just that.

Take a look at the chart below.





















According to the report, the overall inflation rate for medical goods and services is at historic lows. The link above also has some very interesting information about readmission rates.

The conclusion?

The majority of experts now believe Obamacare is at least partly responsible for the slowdown. They think it is encouraging permanent, structural changes in medical care—the kind that will generate more and more savings over time. The slowdown's effects are largely invisible. They take the form of premium and tax increases that people will never have to pay. But the effects seem very real—and, if so, they constitute a bona fide policy success, the kind that even many experts once doubted was possible. It may not show up in the polls. But it will show up in people's wallets. 

And this would be exactly why Democrats should take Reince Priebus's advice and stamp Obamacare right to their forehead. 

Thursday, November 21, 2013

Wednesday, November 20, 2013

Good Words

The most common fallacy of journalism, and one of the most common fallacies of the human brain in general, is the assumption that whatever is happening at the moment will continue to happen forever. That has been the implicit assumption of the hyperventilating coverage of the miserable Obamacare rollout. (Jonathan Chait, New York Magazine Online).

A great companion piece to the Begala post from ealier today and one which has inspired a new tag-"Hyperventilating Media."

Of course, this is more than just a fallacy of journalism as Chait aptly notes. It is indeed a fallacy of the human brain that plays perfectly into the adolescent taunting of the Right. Fallacy is their bedrock after all so Democrats need to remember this and simply be patient. Long term, nearly all of the items on the Democratic wish list will end up as the law of the land as reality will dictate necessity.

And it will be with the help of Republicans!

Dudes, Paul Says Take A Chill Pill

Paul Begala's recent piece on the Affordable Care Act woes is very sound advice. He also takes a certain group of people to the mat who are very deserving.

Yet despite the bed-wetting from Beltway Chicken Littles, the President's problems are eminently fixable. The Affordable Care Act isn't collapsing. The Obama presidency isn't imploding. And the ninnies making those sweeping and stupid predictions will one day look like the Washington pundit who boldly declared of the Clinton presidency, "This week we can talk about 'Is the presidency over?' " He asked that question 11 days after Bill Clinton's inaugural. His first inaugural. Clinton's presidency was not over for another 2,911 days.

And look where President Clinton is now...hallowed in the ranks with Reagan, Lincoln and Roosevelt.

So, take a chill pill, folks and feel free to "stamp Obamacare to your forehead" as Reince Priebus suggests. In the long run, it's going to work out quite well. The party that tried to fix health care and ran into some snags will be viewed more favorably than the party that had nothing and against everything.

Monday, November 18, 2013

Obama's Poll Numbers

Most of the major polling places show the president dropping in the polls to the low 40s. Understandable, considering that he is responsible for the fumbled roll out of the Affordable Care Act web site and registration. So why does Rasmussen, a conservative polling operation, show him dropping only a few points and staying in the mid 40s?

My thought is that Americans aren't as upset with the president as the political media is making it out to be. We haven't heard any stories about the people finding better policies, only stories that are negative. Of course, that is what is popular right now:)

Friday, November 15, 2013

He's Right

Michael Tomasky is absolutely right when the says that the Democrats need to to stop freaking out and take charge. They tend to get sucked in to the news cycle panic of the moment and forget about the the long term picture. In the final analysis, this is where we are at.

The current situation is serious. But I remember a lot of other times when it was supposedly curtains for Obama, too, because inside the Beltway, the more disciplined Republicans, who after all are in the luxurious position of just sitting back and firing away, have an easier time winning news cycles. But out beyond the Beltway, the party that shut down the government for three weeks and killed immigration reform and wants to decimate food stamps and can’t even pass its own spending bills doesn’t look very appealing to most people. The fate of Obamacare can be changed. The DNA of the GOP cannot.


How To Admit Fault

I challenge any conservative to show me a Republican that is this reflective and honest.

 

The Barack Obama they hate simply doesn't exist.

Friday, November 08, 2013

Mea Culpa Is Just Fine

The president apologized yesterday for his mistake in saying, "If you like your insurance, you get to keep it," several times during his campaign to pass the ACA. This is quite illustrative of the type of man he is: someone willing to admit mistakes and work to fix them. And that's just what he is going to do. Notice as well that he is taking the high ground and not blaming the insurance companies which he would be well within his purview to do as it is the truth.

This is quite a bit more than his opponents would do. They never admit error (see: Apocalypse), always blame others, and are actively working to destroy the structures of this country because they are essentially babies who can't accept defeat and any sort of authority in their lives. At election time next year, the problems with the ACA will be fixed (the real ones and not the fake ones made up in bubbleland) and the benefits are going to vastly outweigh the costs.

More importantly, we have seen an improving economy this week. GDP was 2.8 percent for the 3rd quarter and hiring in October exceeded expectations, clocking in over 200k jobs. Revisions were made for August and September, adding in an extra 60K jobs. Imagine how much stronger these numbers would have been had there not been a shutdown. The economy is what really matters to voters in elections and it's pretty clear which party is working to improve it and which one is rooting for it to fail.

Wednesday, November 06, 2013

Other Shoe=Dropped

I was wondering when the other shoe would drop in terms of the hysteria over "If you like your insurance, you get to keep it." It looks like it has.

"If you're an insurance company, you're trying to hang onto the consumers you have at the highest price you can get them," Laura Etherton, a health policy analyst at the U.S. Public Interest Research Group, told TPM. "You can take advantage of the confusion about what people get to have now. It's a new world. It's disappointing that insurance companies are sending confusing letters to consumers to take advantage of that confusion. The reality is that this could do real harm."

It never ceases to amaze me how folks like Mika Brzezenski get sucked in to the faux outrage. Why are they so insecure? Ah well, I used to be like that so maybe she will learn and become like Juan Williams over at Fox someday.

You should be blaming your insurance company because they have not been providing you with coverage that meets the minimum basic standards for health care. Let me put it more bluntly: your insurance companies have been taking advantage of you and the Affordable Care Act puts in place consumer protection and tells them to stop abusing people. The government did not “force” insurance companies to cancel their own substandard policies.The insurance companies chose to do that rather than do what is right and bring the policies up to code. This would be like saying the government “forces” chemical companies to dispose of toxic waste safely rather than dumping it in the river.

People should be angry that their insurance companies were not paying for these humane, common sense benefits all along. It baffles me that people are directing their anger at the ACA which rights these terrible wrongs.

There's nothing baffling about it. Our country is filled with adolescents who have problem with authority figures and would never think to blame insurance companies because they are filled with wealthy people who, by their very nature, are perfect and should be worshiped. Just blame the government...it's easy!!

So, what does happen to those people whose policies are "cancelled?"

Yeah, you'll have to excuse me if I don't fall for their bullshit again.

Tuesday, November 05, 2013

Hmm..

Yesterday on "Morning Joe," Zeke Emmanuel said that anyone who had an insurance policy in place before March 23rd, 2010 and has since not had any alterations to that plan, got to keep it. Is this true?