Coverage Of The Success of Obamacare And Debunking Republican Lies

Obamacare Winning

Reading liberal versus conservative columnists give entirely different views of the Affordable Care Act. Liberals have been writing about its success while conservatives continue to spread misinformation. Here’s a few examples of liberal views on the topic (which are the fact-based articles):

Tim Dickenson of Rolling Stone (source for the above graphic) writes that Obamacare is working. Instead of the fake conservative horror stories, he linked to stories which show how the Affordable Care Act is helping people. He described the successes, and pointed out that “Republican Party sabotage has also impeded enrollment.” Rather than back away  from calling a lie a lie as many journalists will, Dickenson directly addressed Republican lies as lies as he debunked them:

GOP LIE No. 1: THE NUMBERS DON’T MEAN ANYTHING
Over the course of the open-enrollment period, Republicans labored to argue that Obamacare did far less good than advertised because an estimated 4.7 million Americans received letters in the fall warning that their current policies could not be renewed, as they failed to comply with new coverage requirements. They point to these “cancellations” to argue that few of the folks being counted as ACA enrollees previously lacked insurance.

There are three glaring flaws to this argument. First: Many if not most of those whose plans were canceled were automatically transferred into similar policies that complied with the new law. One of the nation’s largest for-profit insurers told House investigators that it had issued fewer than 2,000 outright cancellations.

Second: Through executive orders, Obama gave roughly half of those who received a letter – 2.35 million – the chance to stay in their existing coverage. CBO estimates suggest that just 1.5 million actually continued in their grandfathered plans, as many could find cheaper and/or better coverage on a subsidized exchange or qualify for Medicaid. It’s telling that the Michigan leukemia patient featured in Koch-funded ads intended to convey the horror of these cancellations has found a compliant poicy on the exchange that still covers her oncologist and cut her monthly premium in half.

Giving the Republican argument every benefit of the doubt, this would leave a potential pool of about 3 million people who changed, rather than gained, insurance. This leads to the third flaw in the argument: Obamacare sign-ups were always going to include millions of people who already had insurance. In its latest estimate, the CBO showed just two-thirds (4 million of 6 million) of exchange enrollments coming from people who were previously uncovered. And the limited hard data available from the states suggests the CBO is closer to the mark than the GOP: In New York, nearly 60 percent of buyers were previously uninsured. In Kentucky, it’s even higher: 75 percent.

GOP LIE No. 2: THEY HAVEN’T PAID THEIR PREMIUMS YET
GOP critics point out that the administration hasn’t tracked how many enrollees are actually paying their insurance bills. The complaint about transparency is fair, but the concern is misplaced. Figures from state exchanges and insurers themselves show that between 80 and 95 percent of enrollees are paying their bills.

GOP LIE No. 3: OBAMACARE WILL COLLAPSE UNDER ITS OWN WEIGHT
One legitimate concern as Obamacare ramped up was that it could enter a “death spiral.” This would happen if the number of older, sicker people on the exchanges far outnumbered the young and the healthy. Premiums would spike, year over year, with each increase driving more healthy folks out of the pool – making the exchange unsustainable. While reaching 7 million enrollees is a huge win politically, it doesn’t ensure Obamacare’s viability as an insurance program. “I do think there’s too much focus on the overall number,” Karen Ignagni, a top insurance-industry lobbyist, told reporters. What matters far more, she said, is the insurance pools’ “distribution of healthy to unhealthy.”

The administration wanted 18- to 34-year-olds to make up nearly 40 percent of enrollees. By March, however, only 25 percent of the mix was under 35. That sounds dire. Yet even pools with just 25 percent of younger people would not create a tailspin, forcing premiums to rise by just 2.4 percent, according to the Kaiser Family Foundation.

Additionally, the convoluted structure of Obamacare eliminates systemic risk. Even the 27 states that relied entirely on the federal exchange will end up with state-specific insurance pools. What this means is that if a death spiral were to develop in, say, Ohio, that failure would not pull down neighboring states. What’s more, safeguards within the ACA mean states don’t have to get the mix right in Year One. For the first three years, ACA has shock absorbers to prevent premium spikes in states with problematic pools. Over that same period, the penalties for not buying insurance step up – which should drive younger, healthier people into the market, balancing the risk profile. We lack hard data to get a clear picture of all state pools. But private insurers are sending optimistic signals to investors that all is well. Case in point: Insurance giant WellPoint just raised its earnings forecast.

GOP LIE No. 4: “OBAMACARE IS THE NUMBER-ONE JOB KILLER IN AMERICA”
That’s what Texas Sen. Ted Cruz told a Tea Party convention in Dallas last summer. Since then, the GOP has been making two ACA-connected job-loss claims, both demonstrably false. First, they twisted a February CBO report to claim that Obamacare will cause 2.5 million Americans to lose their jobs. What the CBO actually found is that Americans will be able to work a little less thanks to lower health-care costs, voluntarily scaling back work hours between 1.5 and 2 percent through 2024, or the output of 2.5 million full-time workers. The other GOP lie is that Obamacare is causing employers – who will be responsible for insuring employees who work more than 30 hours a week – to either scale back the hours of full-time employees or hire only part-time workers. This, too, is hogwash. While the share of part-time employment remains historically high, it has actually been in decline since 2010, when Obama­care became law.

I have discussed many of the above points, with links to the evidence, in previous posts on health care reform.

I was also happy to see that he concluded with the same opinion I have expressed that Democrats must take the offensive on health care:

House Republicans have learned the hard way that even nibbling around the edges of Obamacare can backfire. In February, the GOP pushed a bill to tweak the mandate that businesses offer health care to all employees working more than 30 hours. Switching to the GOP’s preferred 40-hour standard, it turns out, would add $74 billion to the deficit by 2024 and cause nearly 1 million Americans to lose coverage. That’s the kind of move that would play right into Democratic hands. Says Greenberg, “Democrats do very well when they hit back at Republicans on what people lose.”

Until recently, Greenberg had been advising Democrats to move beyond Obamacare and turn to bread-and-butter issues like jobs and the minimum wage. “The strongest attack on Republicans,” he says, “is that they’re obsessed with Obamacare instead of critical issues like dealing with the economy.” But his new poll has Greenberg rethinking that counsel. “Until now, this is an issue where the intensity has been on the other side,” he says. But defending Obamacare, he adds, has emerged as “a values argument for our base.” Greenberg now believes Democrats “ought to lean much more strongly” to campaign on the virtues of Obamacare as a means of boosting progressive turnout. “Not apologizing for Obamacare and embracing it actually wins the argument nationally,” he says. “And it produces much more engagement of Democratic voters. That’s a critical thing in off-year elections.”

Eugene Robinson also wrote about the success of Obamacare:

A new report by the nonpartisan Congressional Budget Office estimates that, despite all the problems with the HealthCare.gov Web site launch, 12 million people who previously lacked insurance will obtain coverage this year. By 2017, the year Obama leaves office, the CBO predicts that an additional 14 million uninsured will have managed to get coverage .

Why was the Affordable Care Act so desperately needed? Because without it, 54 million Americans would currently have no health insurance. Within three years, according to the CBO, Obamacare will have slashed the problem nearly in half.

We should do better, and perhaps someday we will. Most industrialized countries have some kind of single-payer system offering truly universal coverage. But if you have to work within the framework of the existing U.S. health-care system — which involves private health insurance companies and fee-for-service care — the Affordable Care Act reforms are a tremendous advance.

Many Republican critics of Obamacare know, but refuse to acknowledge, that the reforms are here to stay. Does the GOP propose to let insurance companies deny coverage because of preexisting conditions, as they could before the ACA? Does the party want to reimpose lifetime caps on the amount an insurer will pay? Tell young adults they can no longer be covered under their parents’ policies?

He concluded by also recommending that Democratic candidates take advantage of the success of Obamacare:

To do well in the fall, Democrats have to infuse their most loyal voters with similar enthusiasm. The success of Obamacare will help. Already, polls are showing upticks in support for embattled Democratic incumbent senators in Louisiana, Arkansas and Alaska. Democrats control their own destiny in November: If they can get their voters to the polls, they’ll win.

In the long run, no matter what happens in the election, I’m more convinced than ever that the Affordable Care Act will be seen as landmark legislation. With minimal immediate impact, the ACA does two tremendously important things.

First, it shifts the incentive structure in the health-care industry in ways that promise to hold down rising costs. And second, it establishes the principle that health care should be considered a right, not a privilege.

Of course it’s not perfect. It’s a thing of beauty anyway. We have liftoff. It’s working.

Paul Krugman described Obamacare as the unknown ideal:

The current state of public opinion on health reform is really peculiar. If you’ve been following the issue at all closely, you know that the Affordable Care Act is one of the great comeback stories of public policy: after a terrible start, it has dramatically exceeded expectations. But hardly anyone seems to know that.

He blamed Fox and Rush Limbaugh for all the misinformation they have spread, the Obama administration for doing a “lackluster job so far in getting the word out,” and “a persistent anti-ACA tilt in news coverage.” He pointed out how factual stories on the success of Obamacare are often buried in the back pages of newspapers.

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A Response To Obama’s Critics On Ukraine

There’s nothing like a crisis to show how intellectually bankrupt the right wing has become. I won’t waste more time with the nutty right wing, such as those who think the Russian invasion of Ukraine means that Palin had some actual insights into foreign policy when she mentioned Ukraine or Russia during the 2008 campaign. The supposedly more sensible portion of the right wing over at The Washington Post does some classic right wing projection in claiming that President Obama’s foreign policy is based on fantasy. The gist is that Obama should do something, but they don’t actually say what he can or should do. This looks like more of the same lack of understanding of the real world seen with Fred Hyatt’s previous support for Bush’s invasion of Iraq.

Among the best commentary I’ve seen (to add to that I linked to yesterday from David Remnick) came from Michael Cohen at The Guardian. He began with pointing out several more instances of absurd commentary from the right and then wrote:

As in practically every international crisis, the pundit class seems able to view events solely through the prism of US actions, which best explains Edward Luce in the Financial Times writing that Obama needs to convince Putin “he will not be outfoxed”, or Scott Wilson at the Washington Post intimating that this is all a result of America pulling back from military adventurism. Shocking as it may seem, sometimes countries take actions based on how they view their interests, irrespective of who the US did or did not bomb.

Missing from this “analysis” about how Obama should respond is why Obama should respond. After all, the US has few strategic interests in the former Soviet Union and little ability to affect Russian decision-making.

Our interests lie in a stable Europe, and that’s why the US and its European allies created a containment structure that will ensure Russia’s territorial ambitions will remain quite limited. (It’s called Nato.) Even if the Russian military wasn’t a hollow shell of the once formidable Red Army, it’s not about to mess with a Nato country.

The US concerns vis-à-vis Russia are the concerns that affect actual US interests. Concerns like nuclear non-proliferation, or containing the Syrian civil war, or stopping Iran’s nuclear ambitions. Those are all areas where Moscow has played an occasionally useful role.

So while Obama may utilize political capital to ratify the Start treaty with Russia, he’s not going to extend it so save the Crimea. The territorial integrity of Ukraine is not nothing, but it’s hardly in the top tier of US policy concerns.

What is America’s problem is ensuring that Russia pays a price for violating international law and the global norm against inter-state war. The formal suspension of a G8 summit in Sochi is a good first step. If Putin’s recalcitrance grows – and if he further escalates the crisis – then that pressure can be ratcheted up.

But this crisis is Putin’s Waterloo, not ours.

Which brings us to perhaps the most bizarre element of watching the Crimean situation unfold through a US-centric lens: the iron-clad certainty of the pundit class that Putin is winning and Obama is losing. The exact opposite is true.

Putin has initiated a conflict that will, quite obviously, result in greater diplomatic and political isolation as well as the potential for economic sanction. He’s compounded his loss of a key ally in Kiev by further enflaming Ukrainian nationalism, and his provocations could have a cascading effect in Europe by pushing countries that rely on Russia’s natural gas exports to look elsewhere for their energy needs. Putin is the leader of a country with a weak military, an under-performing economy and a host of social, environmental and health-related challenges. Seizing the Crimea will only make the problems facing Russia that much greater.

For Obama and the US, sure, there might be less Russian help on Syria going forward – not that there was much to begin with – and it could perhaps affect negotiations on Iran. But those issues are manageable. Meanwhile, Twitter and the opinion pages and the Sunday shows and too many blog posts that could be informative have been filled with an over-the-top notion: that failure to respond to Russia’s action will weaken America’s credibility with its key allies. To which I would ask: where are they gonna go? If anything, America’s key European allies are likely to fold the quickest, because, you know, gas. And why would any US ally in the Far East want Obama wasting his time on the Crimea anyway?

You don’t have to listen to the “do something” crowd. These are the same people who brought you the wars in Iraq and Afghanistan, among other greatest hits. These are armchair “experts” convinced that every international problem is a vital interest of the US; that the maintenance of “credibility” and “strength” is essential, and that any demonstration of “weakness” is a slippery slope to global anarchy and American obsolescence; and that being wrong and/or needlessly alarmist never loses one a seat at the table.

The funny thing is, these are often the same people who bemoan the lack of public support for a more muscular American foreign policy. Gee, I wonder why.

Cross posted at The Moderate Voice

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Fake Right Wing Claims Of Losers Under The Affordable Care Act

Last week I looked at the right wing’s inability to present losers under Obamacare. There certainly are some losers in a major overhaul of the healthcare system, however they just don’t help the Republicans with their line of attack. The losers, i.e. people paying more in premiums, are affluent Americans who don’t qualify for subsidies but, as I pointed out in the previous post, we still receive significant improvements in coverage to offset higher premiums which we can afford to pay. The types of people the Republicans portray as losers to gain sympathy for their argument have repeatedly been shown to not be losers under Obamacare once the facts are revealed. Anybody with serious medical problems such as cancer is far better off since the Affordable Care Act was passed, regardless of how the Republicans try to twist the facts.

Paul Krugman revisited this issue today, comparing the false claims of losers under the Affordable Care Act to the right wing claims of non-wealthy people being losers under the “death tax.” Krugman wrote:

I’m not sure whether conservatives realize yet that their Plan A on health reform — wait for Obamacare’s inevitable collapse, and reap the political rewards — isn’t working. But it isn’t. Enrollments have recovered strongly from the law’s disastrous start-up; in California, which had a working website from the beginning, enrollment has already exceeded first-year projections. The mix of people signed up so far is older than planners had hoped, but not enough so to cause big premium hikes, let alone the often-predicted “death spiral.”

And conservatives don’t really have a Plan B — in their world, nobody even dares mention the possibility that health reform might actually prove workable. Still, you can already see some on the right groping toward a new strategy, one that relies on highlighting examples of the terrible harm Obamacare does. There’s only one problem: they haven’t managed to come up with any real examples. Consider several recent ventures on the right:

■ In the official G.O.P. response to the State of the Union address, Representative Cathy McMorris Rodgers alluded to the case of “Bette in Spokane,” who supposedly lost her good health insurance coverage and was forced to pay nearly $700 more a month in premiums. Local reporters located the real Bette, and found that the story was completely misleading: her original policy provided very little protection, and she could get a much better plan for much less than the claimed cost.

■ In Louisiana, the AstroTurf (fake grass-roots) group Americans for Prosperity — the group appears to be largely financed and controlled by the Koch brothers and other wealthy donors — has been running ads targeting Senator Mary Landrieu. In these ads, we see what appear to be ordinary Louisiana residents receiving notices telling them that their insurance policies have been canceled because of Obamacare. But the people in the ads are, in fact, paid actors, and the scenes they play aren’t re-enactments of real events — they’re “emblematic,” says a spokesman for the group.

■ In Michigan, Americans for Prosperity is running an ad that does feature a real person. But is she telling a real story? In the ad, Julia Boonstra, who is suffering from leukemia, declares that her insurance has been canceled, that the new policy will have unaffordable out-of-pocket costs, and that “If I do not receive my medication, I will die.” But Glenn Kessler of The Washington Post tried to check the facts, and learned that thanks to lower premiums she will almost surely save nearly as much if not more than she will be paying in higher out-of-pocket costs. A spokesman for Americans for Prosperity responded to questions about the numbers with bluster and double-talk — this is about “a real person suffering from blood cancer, not some neat and tidy White House PowerPoint.”

Even supporters of health reform are somewhat surprised by the right’s apparent inability to come up with real cases of hardship. Surely there must be some people somewhere actually being hurt by a reform that affects millions of Americans. Why can’t the right find these people and exploit them?

The most likely answer is that the true losers from Obamacare generally aren’t very sympathetic. For the most part, they’re either very affluent people affected by the special taxes that help finance reform, or at least moderately well-off young men in very good health who can no longer buy cheap, minimalist plans. Neither group would play well in tear-jerker ads.

No, what the right wants are struggling average Americans, preferably women, facing financial devastation from health reform. So those are the tales they’re telling, even though they haven’t been able to come up with any real examples.

Even the healthy young people are able to buy catastrophic insurance policies which, once subsidies are considered, will often cost less then their current minimalist plans.

Cross posted at The Moderate Voice

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With Success, Obamacare Problems Are Quickly Turning Into Meaningless Old Memories

With enrollment picking up under the Affordable Care Act, there is increasing attention being paid to the make up of those newly enrolled in insurance plans. Eugene Robinson at The Washington Post looked at this:

Oh dear. The Republican Party’s worst nightmare is coming true. Obamacare is working.

The news that nearly 1.2 million people signed up last month for insurance through the Affordable Care Act exchanges is highly inconvenient for GOP candidates nationwide. It looks as if the party’s two-word strategy for the fall election — bash Obamacare — will need to be revised.

Wednesday’s status report on the health-insurance reforms was by far the best news for Democrats and the Obama administration since the program’s incompetent launch. January was the first month when new enrollments surpassed expectations, as the balky HealthCare.gov Web site began functioning more or less as intended.

Cumulatively, 3.3 million people had chosen insurance plans through the state and federal exchanges by the end of January. That is fewer than the administration had originally hoped but well above the predictions of critics who believed — or hoped — that the program would never succeed. The Congressional Budget Office projects that 6 million people will have chosen plans through Obamacare when the initial enrollment period ends March 31, down from a pre-launch estimate of 7 million. Not bad at all.

The numbers are even more encouraging when you look more closely. The proportion of young people — from 18 and 34 — who chose insurance plans through the exchanges increased slightly to 27 percent, compared with an average of 24 percent in previous months. This is important because premiums would have to rise if not enough young, healthy people enrolled.

The administration had hoped the percentage of young enrollees would reach about 40 percent. But the January figure — and the rising trend — should put to rest any notion that the whole program could go down the drain in an actuarial “death spiral.” Administration officials are convinced this won’t happen.

According to the January report, about 80 percent of those signing up for Obamacare are eligible for subsidies to help them pay for insurance. The administration believes, but does not have the data to prove, that most of the new enrollees were previously uninsured.

Despite all the good recent good news, Robinson knows that conservatives will continue to attack. After all, that is all they really know how to do:

Bashing Obamacare will always have resonance for the GOP’s conservative base. But if you’re trying to win the votes of independents, it’s more profitable to target a failed program than a successful one.

Critics will doubtless try to blame Obamacare for anything bad that happens to anyone’s health insurance before the November election. But all of this is just noise without the central narrative of a “failed program.”

Attack ads against vulnerable Democratic senators, such as Kay Hagan of North Carolina and Mary Landrieu of Louisiana, are already trying to paint Obamacare as a character defect — the president and his supporters “lied” when they said everyone could keep their insurance. The response from Democrats should be to shift the focus to the actual program and its impact. Imperiled incumbents can point to constituents who are benefiting from the Affordable Care Act in life-changing ways.

If you assume that Affordable Care Act enrollment remains on its current trajectory, the February numbers should look even better. Polls consistently show that even if voters have mixed views about the health-care reforms, most do not want to see them repealed. By the fall, the whole Obamacare-is-a-disaster line of attack could sound stale and irrelevant.

Republicans may even have to take the drastic step of saying what they advocate, rather than harping on what they oppose. Is there a GOP plan to cover those with preexisting conditions? To cover the working poor? Is expanding access to health insurance really such an awful thing?

That’s the problem for conservatives. Knocking government programs in a debating society is one thing. To threaten to repeal the Affordable Care Act is a different matter. Doing so would hurt real people–millions of us. The old individual market for private insurance was a disaster we cannot go back to. Even some Republicans now love Obamacare.

Repealing Obamacare is also bad for the economy and bad for the country when you consider how the Affordable Care Act will help reduce the deficit, reduce unemployment, and promote more entrepreneurs now that people are no longer tied to their employer for health care coverage.

Conservatives will continue to make noise about everything that really is wrong about the Affordable Care Act, along with continuing to make up plenty of lies about things which are not really wrong. Republican might have voted forty-seven times for repeal, but that is not going to happen. That ship has sailed. The Affordable Care Act is the law of the land and it is pointless for Republicans to continue to demand repeal as opposed to working responsibly with Democrats on improving the program.

Bloomberg also looked at enrollment by the young, as well as the continuing debate:

The only debate worth having is how to improve enrollment. If not enough people sign up, or the mix of beneficiaries isn’t quite right, it could lead to higher premiums down the road, pushing people away from buying coverage and making the law less effective.

In other words, what matters now is how to persuade more young people, especially young men, to sign up for health insurance before March 31. What has the administration learned in the first fourth months of open enrollment? What works and what doesn’t? Everything else is beside the point.

The administration is already pushing hard, and its efforts have come in for a fair amount of ridicule: ads featuring cats, for example, to get more women to sign up, and the much-maligned “pajama boy,” whose appeal was to … actually it’s not clear who he was trying to appeal to. At any rate, a little ridicule is a small price to pay if these attempts result in higher enrollment. Republican state officials might also do more to promote the law, futile as it may be to point that out.

Contrary to what you may have read, enrollment numbers for Obamacare aren’t some referendum on the president’s popularity or lack thereof. They’re the best way to tell whether the law is working as planned — and how to adjust if it isn’t.

It looks like the goals will be met for enrolling more young people, but what if we they aren’t?  Kaiser ran the numbers back in December, when meeting the goal was more in doubt.

If enrollment among young adults falls short, then the total amount of premiums collected by insurers will be less than the total health care expenses of enrollees plus administrative overhead and profit. And, if insurers believe that those enrollment patterns will continue into 2015, then they may raise premiums higher to compensate for the loss.

However, because premiums are still allowed to vary substantially based on age, the financial consequences of lower enrollment among young adults are not as great as conventional wisdom might suggest.

We simulated the effects of two scenarios:3

Scenario 1: Young adults age 18-34 enroll at a 25% lower rate than other individuals relative to the potential market. Under this scenario, young adults would represent 33% of individual market enrollees instead of 40% as in the potential market. Taking into account the allowed three-to-one variation in premiums due to age, we find that costs (health care expenses plus overhead and profits) would be about 1.1% higher than premium revenues.

Scenario 2: Young adults age 18-34 enroll at a 50% lower rate than other individuals relative to the potential market. Under this scenario, young adults would represent 25% of enrollees, substantially less than their share of the potential market. It is roughly comparable to what Covered California reported for October and November (the first two months of open enrollment), with 21% of all enrollees who picked a plan in the 18-34 age range. However, this is likely a worst-case scenario, since the expectation is that older and sicker individuals are more likely to buy first and that younger and healthier people will tend to wait until towards the end of the open enrollment period (which concludes March 31, 2014). In fact, our recent survey of people in California who are uninsured found that 58% of young adults said they planned to get coverage in 2014. But, if this more extreme assumption of low enrollment among young adults holds, overall costs in individual market plans would be about 2.4% higher than premium revenues.

Insurers typically set their premiums to achieve a 3-4% profit margin, so a shortfall due to skewed enrollment by age could reduce the profit margin of insurers substantially in 2014. But, even in the worst case, insurers would still be expected to earn profits, and would then likely raise premiums in 2015 to make up the shortfall, However, a one to two percent premium increase would be well below the level that would trigger a “death spiral,” which would occur if insurers needed to increase premiums substantially, in turn further discouraging young and healthy people from enrolling.

There’s no real risk of death spirals and the Affordable Care Act is here to stay. Over the next year or two, the early computer problems will be seen as distant memories, sort of like the Y2K computer problems, while we enjoy the benefits of Obamacare. People will no longer care about letters about cancelled insurance plans when most are in more comprehensive plans at a lower cost. Conservatives will continue to point out every fault but there is only one real point in this: so that we know what to fix next and get it working better. Plus the better we get it working, the harder it will be for conservatives to continue to scare people with all the additional “problems” they have made up.

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The Past Week In Conservative Stupidity

Over a year ago Bobby Jindal warned that Republicans “must stop being the stupid party.” They have not been doing particularly well at following his advice. To extrapolate this to the conservative movement, this week provided two more examples of what can only be labeled as stupidity dominating conservative conversation–the intentional misinterpretation of the Congressional Budget Office report on the Affordable Care Act and reaction to Olympic coverage from Russia.

This is not to say that all conservatives believe these things or are stupid. However, the prevalence of stupidity does seem to have increased tremendously in the conservative movement and Republican Party in recent years. Even ignoring the easy targets such as Sarah Palin and Michele Bachmann, the caliber of conservative discourse generally seen today is far different from what came from past conservatives such as William F. Buckely, Jr., who also fought to keep the Birchers and other predecessors of today’s Tea Party out of the GOP. Barry Goldwater might have many views which liberals find objectionable, but he also warned about what would happen if the religious right took control of the Republican Party. Even Ronald Reagan was not so foolish as to oppose any tax increase or to prevent increases in the debt ceiling to allow the Unites States to honor its debts.

It is understandable that some conservatives might have been misled by the initial headlines on the report from the non-partisan Congressional Budget Office. Many journalists, overly influenced by conservative arguments and lacking adequate understanding of health care policy, initially were inaccurate in their coverage. Once the report was more fully evaluated, it was clear that the CBO report actually showed that there is no evidence of an increase in unemployment due to the Affordable Care Act as Republicans had been predicting would occur.  Instead the portions of the report on employment showed that Obamacare was projected to be successful in one of its goals--saving people from the “insurance trap.”

Until the Affordable Care Act came into effect many people continued in jobs they did not want because they would be unable to obtain health insurance if they left their current job. Under the Affordable Care Act, health insurance is no longer tied to employment. Now people are free to retire at an earlier age if they desire, instead of waiting until age 65 when they qualify for Medicare. They are also free to leave large corporations to work for small businesses, or perhaps even start a business of their own. The Robert Wood Johnson Foundation wrote about projections for an increase in entrepreneurship and self-employment last May. The CBO report confirms that they were correct. This can help boost the economy.

While an initial mistake regarding this might have been unintentional, there has subsequently been many corrections. Glenn Kessler of The Washington Post,  corrected errors in reporting in writing, “No, CBO did not say Obamacare will kill 2 million jobs”.  Kessler concluded with saying, “we award Three Pinocchios to anyone who deliberately gets this wrong.” Factcheck.org also corrected the misconceptions.

As some people leave jobs they no longer want or need, their jobs can open up for others. In testimony before the House Budget Committee, CBO Director Douglas Elmendorf confirmed that the CBO report suggests the Affordable Care Act will reduce unemployment. Even Paul Ryan corrected fellow Republicans on this point. Besides reducing unemployment, the CBO report showed that, while Republicans had been demanding an end to the risk corridors in order to agree to an increase in the debt limit, the risk corridors actually wind up saving the government eight billion dollars. The CBO projects a deficit of $514 billion in 2014, representing three percent of the Gross Domestic Product. This is down from 2009 when deficit was at 10.1 percent of GDP, and more in line with the average size of the deficit compared to GDP over the past forty years.

Conservatives are rarely willing to give up on their criticism of the Affordable Care Act even when contradicted by the facts. They continue to repeat fallacious arguments about death panels or their false claim that Obamacare constitutes a government takeover of health care. Finding that those who received cancellation notices from insurance companies generally received better coverage at a lower price under the Affordable Care Act did not end their claims of people supposedly losing their insurance under Obamacare.

Conservatives remain unwilling to give up the argument about people leaving their jobs, spinning it to suggest that the Affordable Care Act encourages people to be lazy parasites on society instead of working, ignoring the actual types of people this is likely to affect. Conservatives have been presenting “horror stories” of people allegedly harmed by the Affordable Care Act which typically turn out to be untrue once the details are examined. Finally we are seeing newspaper reports emphasizing the positive aspect of freeing people from the “insurance trap.”

While conservative columnists such as Ross Douthat fear that Obamacare will lead to a “strong work disincentive while looking at a population of childless, able-bodied, mostly working-class adults,” these are not the type of people I am seeing as benefiting by freedom from the “insurance trap.” If the health care debate is turning into one of anecdotal cases, I’m thinking of an affluent friend who, because of health history, cannot obtain insurance on the individual market so his wife has been working full time in a job purely for the health insurance, even though they have no need for the income beyond the benefits. I have a patient who was left without insurance when her husband retired in his early sixties and then struggled to pay her medical bills. As of January she finally has comprehensive coverage she can afford. These are the types of people who are benefiting from the supposed disincentive to work under Obamacare.

In theory there is a risk that “able-bodied, mostly working-class adults” might have less incentive to work, but I hardly think that providing affordable health care is enough to do this on a widespread level. Far more able-bodied adults are not working because jobs are not available. Besides making more jobs available, the Affordable Care Act can help relieve this problem in another way. In addition to freeing people to retire in their early sixties or leave jobs held solely for the insurance, people will be able to start small businesses without losing health insurance. In Republican-speak, this should also be beneficial to the economy due to making more “job creators.” The Robert Wood Johnson Foundation wrote about projections for an increase in entrepreneurship and self-employment last May. The CBO report confirms that they were correct, and to a greater degree than previously projected.

Conservatives were wrong about this argument, and now appear stupid, and dishonest, when they continue to repeat the same mistakes. I spent more space on this first example than intended, but in retrospect this is an important point which deserves repeated explanations as long as conservatives are claiming that this positive aspect of the Affordable Care Act is somehow undesirable.

The second example is bizarre outrage from the right wing over the video below which comes from NBC’s coverage of the Olympic games:

Their objection is to this line: “The empire that ascended to affirm a colossal footprint; the revolution that birthed one of modern history’s pivotal experiments.”

This is being spun by right wing bloggers as praise for Communism, including by FoxMarco Rubio, along with other conservatives commenting, does not appear to understand what pivotal means. The word refers to points which are critical or vitally important. The Russian Revolution was a pivotal point in their history, along with the history of the world. Similarly, Hitler’s rise to power was a pivotal moment. Both 9/11 and Katrina were pivotal moments during the Bush years.  The computer problems during the first month of the exchanges has unfortunately become a pivotal moment for the Obama administration. The word pivotal says nothing about whether the events were good or bad.

This was one line in a video narrated by Peter Dinklage as introduction to NBC’s sports coverage of the Olympics. If this was a political documentary we would expect information on the horrors of communism. This is unnecessary, and probably out of place, in sports coverage, especially if they desire to be polite and avoid criticism of the host country over a political system which has been overthrown (even if the current regime is repeating many of the same mistakes as under Communism).

I suspect this is outrage is partially motivated by the desire of conservatives to falsely paint liberals as socialists or Communists, such as with the absurd claims that a moderate such as Barack Obama is a socialist. To the conservative mind, the mainstream media represents liberals, especially when they fail to differentiate the evening commentary shows on MSNBC from the rest of NBC. There are rare examples, such as the absurd argument I noted a couple of weeks ago at Salon to nationalize the news media, but putting aside such outliers, there no meaningful interest in Marxist-style socialism or Communism on the left. In contrast, I would think that today’s Republicans would love modern Russia. Between its homophobia and substitution of a plutocracy for a working market economy, Russia has become an example of the end-result of the Republican platform.

Cross posted at The Moderate Voice

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The CBO Report On The Success Of The Affordable Care Act

The Congressional Budget Office report released yesterday showed that the Affordable Care Act is getting off to a tremendous success despite the early computer problems in the exchanges. The report showed that millions of additional people are receiving coverage, the law results in a reduction in the deficit, and frees workers from the “insurance trap.”

The report also turned out to be both a test of the understanding of health care policy by reporters and of the dishonesty of conservative news sources. Health care policy is quite complicated and it is not unusual for reporters to make mistakes in the coverage of a report such as this. Many misunderstood the predictions of people leaving the work force leading to some rather untrue headlines yesterday. Needless to say, the conservative media continues to make the same false claims, ignoring the actual meaning of the CBO report, and will continue to spread this misinformation.

I was pleased to see  Glenn Kessler of The Washington Post, who has made some major mistakes on health care policy coverage in the past, got it right on this one.  His fact-checker article was entitled “No, CBO did not say Obamacare will kill 2 million jobs”. I think it helped that he specifically wrote about what the CBO report really said, as opposed to getting into the more complicated details of health care policy. Kessler concluded with saying, “we award Three Pinocchios to anyone who deliberately gets this wrong.”

The word deliberately is important as unfortunately some people are going to be misled by the initial incorrect headlines and by the conservative media which will continue to make this false claim.  The reduction in employment described in the report is one of the positive aspects of the Affordable Care Act. Up until now, many people continued in jobs they did not want because they would be unable to obtain health insurance if they left their jobs.  I know affluent people whose spouses work purely for the health insurance as this was the only way they could obtain this. This change frees people in their 60′s to retire early if they choose. People who would prefer to change jobs will be able to do so without losing their insurance. People will also be able to start small businesses without losing health insurance, which will also probably turn out to be beneficial to the economy. The Robert Wood Johnson Foundation wrote about projections for an increase in entrepreneurship and self-employment last May. The CBO report confirms that they were correct.

On a related issue, the ability to keep affordable health insurance after losing a job means that people who develop a serious illness and become too sick to continue working will no longer lose their insurance. This was a common cause of bankruptcy in the past.

The New York Times looked at the benefits described by the CBO in an editorial today:

The report estimated that — thanks to an increase in insurance coverage under the act and the availability of subsidies to help pay the premiums — many workers who felt obliged to stay in a job that provided health benefits would now be able to leave those jobs or choose to work fewer hours than they otherwise would have. In other words, the report is about the choices workers can make when they are no longer tethered to an employer because of health benefits. The cumulative effect on the labor supply is the equivalent of 2.5 million fewer full-time workers by 2024.

Some workers may have had a pre-existing condition and will now be able to leave work because insurers must accept all applicants without regard to health status and charge premiums unrelated to health status. Some may have felt they needed to keep working to pay for health insurance, but now new government subsidies will help pay premiums, making it more possible for them to leave their jobs.

The report clearly stated that health reform would not produce an increase in unemployment (workers unable to find jobs) or underemployment (part-time workers who would prefer to work more hours per week). It also found “no compelling evidence” that, as of now, part-time employment has increased as a result of the reform law, a frequent claim of critics. Whether that will hold up after a mandate that requires employers to provide coverage, which was delayed until 2015, kicks in is uncertain.

The report also verified that millions more people will be covered by health insurance due to the Affordable Care Act:

Given the rocky start, 14 million additional Americans covered by insurance through the exchanges and Medicaid is sound progress; and the budget office projects a sharp increase in enrollment in 2015 and 2016 and a bigger net reduction in the number of uninsured. Its projections for subsequent years remain essentially unchanged. In 2017, it predicts 12 million more in Medicaid and 24 million more in private coverage through the exchanges.

Update: CBO Director States Affordable Care Act Will Reduce Unemployment; Paul Ryan Corrects Republican Misinformation

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Edward Snowden, Whistle-Blower And American Hero

The New York Times had an editorial today on how the United States should respond to the revelations on NSA surveillance exposed by Edward Snowden:

Seven months ago, the world began to learn the vast scope of the National Security Agency’s reach into the lives of hundreds of millions of people in the United States and around the globe, as it collects information about their phone calls, their email messages, their friends and contacts, how they spend their days and where they spend their nights. The public learned in great detail how the agency has exceeded its mandate and abused its authority, prompting outrage at kitchen tables and at the desks of Congress, which may finally begin to limit these practices.

The revelations have already prompted two federal judges to accuse the N.S.A. of violating the Constitution (although a third, unfortunately, found the dragnet surveillance to be legal). A panel appointed by President Obama issued a powerful indictment of the agency’s invasions of privacy and called for a major overhaul of its operations.

All of this is entirely because of information provided to journalists by Edward Snowden, the former N.S.A. contractor who stole a trove of highly classified documents after he became disillusioned with the agency’s voraciousness. Mr. Snowden is now living in Russia, on the run from American charges of espionage and theft, and he faces the prospect of spending the rest of his life looking over his shoulder.

Considering the enormous value of the information he has revealed, and the abuses he has exposed, Mr. Snowden deserves better than a life of permanent exile, fear and flight. He may have committed a crime to do so, but he has done his country a great service. It is time for the United States to offer Mr. Snowden a plea bargain or some form of clemency that would allow him to return home, face at least substantially reduced punishment in light of his role as a whistle-blower, and have the hope of a life advocating for greater privacy and far stronger oversight of the runaway intelligence community.

While Snowden’s actions were illegal, there are times when illegal action is necessary to preserve our liberties. This is especially true when it has been the government which as been breaking the law. Providing a reduced sentence would not be enough. Rather than punishing Edward Snowden, he deserves a full pardon and the United States should be considering the most appropriate means of thanking him and honoring him for his service to his country. While this will probably never happen officially, Americans should treat Snowden in the same way as important whistle blowers of the past such as Daniel Ellsberg, who exposed how the government was lying to the American people about the war in Viet Nam.

After further discussion, including how there was no other way for the abuses exposed by Edward Snowden to be acted upon, the editorial concluded with a list of some of the illegal activity on the part of the government which Snowden has exposed:

In retrospect, Mr. Snowden was clearly justified in believing that the only way to blow the whistle on this kind of intelligence-gathering was to expose it to the public and let the resulting furor do the work his superiors would not. Beyond the mass collection of phone and Internet data, consider just a few of the violations he revealed or the legal actions he provoked:

■ The N.S.A. broke federal privacy laws, or exceeded its authority, thousands of times per year, according to the agency’s own internal auditor.

■ The agency broke into the communications links of major data centers around the world, allowing it to spy on hundreds of millions of user accounts and infuriating the Internet companies that own the centers. Many of those companies are now scrambling to install systems that the N.S.A. cannot yet penetrate.

■ The N.S.A. systematically undermined the basic encryption systems of the Internet, making it impossible to know if sensitive banking or medical data is truly private, damaging businesses that depended on this trust.

■ His leaks revealed that James Clapper Jr., the director of national intelligence, lied to Congress when testifying in March that the N.S.A. was not collecting data on millions of Americans. (There has been no discussion of punishment for that lie.)

■ The Foreign Intelligence Surveillance Court rebuked the N.S.A. for repeatedly providing misleading information about its surveillance practices, according to a ruling made public because of the Snowden documents. One of the practices violated the Constitution, according to the chief judge of the court.

■ A federal district judge ruled earlier this month that the phone-records-collection program probably violates the Fourth Amendment of the Constitution. He called the program “almost Orwellian” and said there was no evidence that it stopped any imminent act of terror.

The shrill brigade of his critics say Mr. Snowden has done profound damage to intelligence operations of the United States, but none has presented the slightest proof that his disclosures really hurt the nation’s security. Many of the mass-collection programs Mr. Snowden exposed would work just as well if they were reduced in scope and brought under strict outside oversight, as the presidential panel recommended.

When someone reveals that government officials have routinely and deliberately broken the law, that person should not face life in prison at the hands of the same government. That’s why Rick Ledgett, who leads the N.S.A.’s task force on the Snowden leaks, recently told CBS News that he would consider amnesty if Mr. Snowden would stop any additional leaks. And it’s why President Obama should tell his aides to begin finding a way to end Mr. Snowden’s vilification and give him an incentive to return home.

Without Edward Snowden, we would not know about any of this. It is unlikely that the entire discussion which is now underway to reevaluate the practices of the National Security Agency  would be taking place. The national debate over this topic we are now engaging in would certainly not be anywhere near as informative and fact-based, if such a debate were to have happened at all.

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Three Senators Call For Reforming NSA Surveillance

Three Senators, Senators Ron Wyden (D-Ore), Mark Udall (D-Colo), and Martin Heinrich (D-N.M), have proposed legislation to help restore  Fourth Amendment privacy protections following recent revelations regarding NSA surveillance. They have an op-ed in The New York Times which explains their position and their opposition to currently proposed legislation form the Senate intelligence committee which would codify current surveillance without providing privacy protections. Their op-ed begins:

End the N.S.A. Dragnet, Now

THE framers of the Constitution declared that government officials had no power to seize the records of individual Americans without evidence of wrongdoing, and they embedded this principle in the Fourth Amendment. The bulk collection of Americans’ telephone records — so-called metadata — by the National Security Agency is, in our view, a clear case of a general warrant that violates the spirit of the framers’ intentions. This intrusive program was authorized under a secret legal process by the Foreign Intelligence Surveillance Court, so for years American citizens did not have the knowledge needed to challenge the infringement of their privacy rights.

Our first priority is to keep Americans safe from the threat of terrorism. If government agencies identify a suspected terrorist, they should absolutely go to the relevant phone companies to get that person’s phone records. But this can be done without collecting the records of millions of law-abiding Americans. We recall Benjamin Franklin’s famous admonition that those who would give up essential liberty in the pursuit of temporary safety will lose both and deserve neither.

The usefulness of the bulk collection program has been greatly exaggerated. We have yet to see any proof that it provides real, unique value in protecting national security. In spite of our repeated requests, the N.S.A. has not provided evidence of any instance when the agency used this program to review phone records that could not have been obtained using a regular court order or emergency authorization.

Despite this, the surveillance reform bill recently ratified by the Senate Intelligence Committee would explicitly permit the government to engage in dragnet collection as long as there were rules about when officials could look at these phone records. It would also give intelligence agencies wide latitude to conduct warrantless searches for Americans’ phone calls and emails.

This is not the true reform that poll after poll has shown the American people want. It is preserving business as usual. When the Bill of Rights was adopted, it established that Americans’ papers and effects should be seized only when there was specific evidence of suspicious activity. It did not permit government agencies to issue general warrants as long as records seized were reviewed with the permission of senior officials.

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Republican False Narrative On The Failure Of The Affordable Care Act

Timothy Egan wrote about the South’s new lost cause. He started with how Abraham Lincoln lied in his inaugural address of 1861, essentially telling the South that if they liked their slaves they could keep them:

The comparisons of President Obama to Lincoln fade with every day of the shrinking modern presidency. As for the broken-promise scale: Lincoln said an entire section of the country could continue to enslave more than one in three of its people. Obama wrongly assured about five million people that they could keep their bare-bones health plans if they liked them (later amended when it turned not to be true).

As inapt as those comparisons are, what is distressingly similar today is how the South is once again committed to taking a backward path. By refusing to expand health care for the working poor through Medicaid, which is paid for by the federal government under Obamacare, most of the old Confederacy is committed to keeping millions of its own fellow citizens in poverty and poor health. They are dooming themselves, further, as the Left-Behind States.

And they are doing it out of spite. Elsewhere, the expansion of Medicaid, the health care program for the poor, has been one of the few success stories of Obamacare. It may be too complicated for the one-dimensional Beltway press. Either that, or it doesn’t fit the narrative of failure.

Of course conservatives cherry pick facts to support their narrative, and ignore all those which contradict their views. For example. how do problems with a web site (which are being fixed) have any impact as to whether we should be concerned about providing affordable health care to all Americans?

Russell Simmons wonders about the same thing. First he described the Republican view:

I know where Republicans stand. They have voted 47 times to repeal the Affordable Care Act, so their stance is clear. If you get sick, you’re on your own. If you can’t pay for your medical expenses, declare bankruptcy. If you have a pre-existing condition, they’ll send you a get well card when you’re on your death-bed. Whatever President Obama stands for, they stand for the opposite. Even if it goes against every principle they have advocated for in the past, they would rather destroy our country, than see President Obama pass policy that is good for ALL Americans.

He next criticized Democrats who are backing down in fear, listening to the Republican narrative of failure, and argued that the web site will be fixed:

I run websites. I have built websites. I certainly understand the complications of servers and load times and 404 errors. THIS CAN ALL BE FIXED! And it will be fixed. But what cannot be fixed, is the fact that for over 100 years we have tried to reform our healthcare system, and EVERY President before Barack Obama FAILED! Yes, we initially wanted single payer, and we had to compromise back in 2009 for the Affordable Care Act. But, it is a damn good piece of legislation that has already saved hundreds of thousands, if not millions of lives. So, let us not give up now.  (**addendum: After getting attacked by the right wing blogs yesterday for my comments, let me remind them that Obamacare did not start with the website on October 1st.  It started when it was passed in 2009.  And since that time, 2.5 MILLION more young people have health insurance because they can stay on their parent’s plan until they are 26.  And since 2010, health insurance companies could no longer deny health insurance to children because of a pre-existing condition. That has been the law before the website even launched.)

Conservative sites are further spreading misinformation by citing how United Health Care has been dropping patients and doctors as if this is an argument against Obamacare. United Health Care has engaged in such practices for years. Their actions are not an argument against Obamacare. They are examples as to why the Affordable Care Act is needed.

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A Taft On How Modern Republicans Have Fallen To Nihilism And McCarthyism

John G. Taft on how the modern Republican Party would not be recognized by his ancestors, and the Democrats have become the agents of fiscal responsibility:

As I write, a photograph of my grandfather, Senator Robert Alphonso Taft, looks across at me from the wall of my office. He led the Republican Party in the United States Senate in the 1940s and early 1950s, ran for the Republican nomination for president three times and was known as “Mr. Republican.” If he were alive today, I can assure you he wouldn’t even recognize the modern Republican Party, which has repeatedly brought the United States of America to the edge of a fiscal cliff — seemingly with every intention of pushing us off the edge.

Throughout my family’s more than 170-year legacy of public service, Republicans have represented the voice of fiscal conservatism. Republicans have been the adults in the room. Yet somehow the current generation of party activists has managed to do what no previous Republicans have been able to do — position the Democratic Party as the agents of fiscal responsibility.

Speaking through the night, Senator Ted Cruz, with heavy-lidded, sleep-deprived eyes, conveyed not the libertarian element in Republican philosophy that advocates for smaller government and less intrusion into the personal lives of citizens, but a new, virulent strain of empty nihilism: “blow it up if we can’t get what we want.”

This recent display of bomb-throwing obstructionism by Republicans in Congress evokes another painful, historically embarrassing chapter in the Republican Party — that of Senator Joseph McCarthy, chairman of the Senate Permanent Subcommittee on Investigations, whose anti-Communist crusade was allowed by Republican elders to expand unchecked, unnecessarily and unfairly tarnishing the reputations of thousands of people with “Red Scare” accusations of Communist affiliation. Finally Senator McCarthy was brought up short during the questioning of the United States Army’s chief counsel, Joseph N. Welch, who at one point demanded the senator’s attention, then said: “Until this moment, Senator, I think I never really gauged your cruelty or your recklessness.” He later added: “Have you no sense of decency, sir? At long last, have you left no sense of decency?”

Watching the Republican Party use the full faith and credit of the United States to try to roll back Obamacare, watching its members threaten not to raise the debt limit — which Warren Buffett rightly called a “political weapon of mass destruction” — to repeal a tax on medical devices, I so wanted to ask a similar question: “Have you no sense of responsibility? At long last, have you left no sense of responsibility?”

There is more than a passing similarity between Joseph McCarthy and Ted Cruz, between McCarthyism and the Tea Party movement. The Republican Party survived McCarthyism because, ultimately, its excesses caused it to burn out. And eventually party elders in the mold of my grandfather were able to realign the party with its brand promise: The Republican Party is (or should be) the Stewardship Party. The Republican brand is (or should be) about responsible behavior. The Republican party is (or should be) at long last, about decency.

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