Why Many People In The Middle Now Identify With The Left

While the country has become more liberal in some ways, the Republican Party has moved to the extreme right, and the Democratic Party has filled in the vacuum in the middle by also moving to the right on many issues. As a consequence, many people who previously considered themselves in the middle are finding that the current views of the left are closer to their views. Thomas Ricks, who wrote Fiasco, and excellent look at the Iraq War, described why he moved to the left at Politico:

Disappointment in the American government over the last 10 years. Our wars in Afghanistan and Iraq were the first big shocks. I thought that invading Afghanistan was the right response to the 9/11 attacks, but I never expected the U.S. military leadership would be so inept in fighting there and in Iraq, running the wars in ways that made more enemies than were stopped. I believe that the invasion of Iraq was wrong, not only launched on false premises but also strategically foolish in that ultimately it has increased Iran’s power in the Middle East.

Torture. I never expected my country to endorse torture. I know that torture has existed in all wars, but to my knowledge, its use, under the chilling term “enhanced interrogation,” was never official U.S. policy until this century. In fact, until our recent wars, the American military had a proud heritage of handling its prisoners better than most. During the Revolutionary War, Gen. George Washington reminded his men of the need to “Treat [captives] with humanity, and Let them have no reason to complain of our Copying the brutal example of the British army.”

How we fought. I never thought that an American government would employ mercenaries in a war. And yet we did this in Iraq by hiring thousands of armed “security contractors” who in practice were subject neither to local law nor to the American military justice system, and so could and often did treat Iraqis badly. In September 2007, I remember, American officers, who by then understood the need to treat Iraqi civilians well, were outraged when Blackwater employees shot 37 Iraqis in Baghdad’s Nisour Square—the rough equivalent of opening up on the lunch crowd in Dupont Circle. Yet to my knowledge, the U.S. government has not studied how the use of mercenaries poisoned the conduct of the war. Indeed, it gives every indication of planning to operate the same way in the future.

Intelligence officials run amok. I think that American intelligence officials have shown a contempt for the way our democracy is supposed to work in turning a vast and unaccountable apparatus on the citizens it is supposed to be protecting. I remain wary of Edward Snowden’s motivations and connections, yet still am worried by the intrusive surveillance by the National Security Agency he has unveiled. At the very least, in a democracy, we should be able to be informed about the actions that have eroded our privacy but supposedly were taken in our name.

Growing income inequality. I also have been dismayed by the transfer of massive amounts of wealth to the richest people in the country, a policy supported over the last 35 years by successive administrations of both parties. Apparently income redistribution downward is dangerously radical, but redistribution upward is just business as usual. The middle class used at least to get lip service from the rich—“backbone of the country” and such. Now it is often treated like a bunch of saps not aware enough to evade their taxes.

This led to a lengthy discussion at The Moderate Voice, where I also blog. Many of the bloggers and regular commentators there are in a similar position, thinking of themselves as moderates but finding their views are now more in line with the left, especially on social issues. While Ricks didn’t mention social issues, the desire to keep government out of the private lives of individuals has led many people to abandon the Republicans and the conservative movement.

Opposition to the Iraq War and related issues has generally been the defining issue for the formation of the liberal “netroots” and this dominates Ricks’ reasons. Republicans typically use fear and distort Democratic views, such as with the misquotation of Obama as the theme of the last Republican convention, to falsely paint liberals as being for socialism. There are no such economic views listed by Ricks, and the same is typical of many liberals. There is a far greater variation in views on the left than on the right, but the center of gravity has moved rightwards on economic issues. Liberals tend to be  more pragmatists and closer to Eisenhower Republicans than anything close to socialist (by its classic meaning).

If the word conservative really meant anything, in many ways today’s liberals are the conservatives who want to preserve our market economy, while eliminating its abuses, while Republicans are the radicals who want to destroy the system and make our economy more like a banana republic. It is the Republicans who are irresponsible fiscally, financing their policies on credit (while Democrats are more likely to include financing for their policies), caring more about tax cuts for the rich as opposed to cutting the deficit, and rigging the system to redistribute wealth from the middle class to the rich. Besides the ethical problems with this, destroying the middle class is horrible for the economy, and in the long run doesn’t even benefit the rich either, unless you want to live in a banana republic. On top of this we have the Republicans engaging in irresponsible action such as shutting down the government and making an issue out of increasing the debt ceiling, resulting in a lowering of the country’s credit rating.

The Affordable Care Act is a good example of how both parties have moved to the right on health care. Obamacare is quite close to Richard Nixon’s health care plan, the GOP counter-proposal to HillaryCare in the 90′s, and Mitt Romney’s plan. Republicans used to push for mandates, exchanges, and recommended high deductible plans tied to medical savings accounts. Once Obama pushed for all of this, as opposed to previous more liberal health care proposals, the Republicans suddenly claimed that everything they supported in the past is socialism and amounts to a government takeover of health care. (Of course part of the Republican opposition is because Obamacare does differ from the old Republican proposals in including regulations to keep insurance companies from ripping off consumers while pushing to increase use of private insurance companies.)

Conservatives are likely to misinterpret the inclusion of concerns about income inequality by Ricks, as well as myself  in this post, as indicating support for socialism. Concern about the deleterious effects of  the concentration of wealth to our economy is not an exclusively liberal viewpoint–see the works of Kevin Phillips on this. Nor does this mean that socialism is being advocated as the solution.

Nicholas Kristof has an op-ed on income inequality which is worth reviewing:

First, economic inequality has worsened significantly in the United States and some other countries. The richest 1 percent in the United States now own more wealth than the bottom 90 percent. Oxfam estimates that the richest 85 people in the world own half of all wealth.

The situation might be tolerable if a rising tide were lifting all boats. But it’s lifting mostly the yachts. In 2010, 93 percent of the additional income created in America went to the top 1 percent.

Second, inequality in America is destabilizing. Some inequality is essential to create incentives, but we seem to have reached the point where inequality actually becomes an impediment to economic growth.

Certainly, the nation grew more quickly in periods when we were more equal, including in the golden decades after World War II when growth was strong and inequality actually diminished. Likewise, a major research paper from the International Monetary Fund in April found that more equitable societies tend to enjoy more rapid economic growth.

Indeed, even Lloyd Blankfein, the chief executive of Goldman Sachs, warns that “too much … has gone to too few” and that inequality in America is now “very destabilizing.”

Inequality causes problems by creating fissures in societies, leaving those at the bottom feeling marginalized or disenfranchised. That has been a classic problem in “banana republic” countries in Latin America, and the United States now has a Gini coefficient (a standard measure of inequality) approaching some traditionally poor and dysfunctional Latin countries.

Third, disparities reflect not just the invisible hand of the market but also manipulation of markets. Joseph Stiglitz, the Nobel Prize-winning economist, wrote a terrific book two years ago, “The Price of Inequality,” which is a shorter and easier read than Piketty’s book. In it, he notes: “Much of America’s inequality is the result of market distortions, with incentives directed not at creating new wealth but at taking it from others.”

For example, financiers are wealthy partly because they’re highly educated and hardworking — and also because they’ve successfully lobbied for the carried interest tax loophole that lets their pay be taxed at much lower rates than other people’s.

Likewise, if you’re a pharmaceutical executive, one way to create profits is to generate new products. Another is to lobby Congress to bar the government’s Medicare program from bargaining for drug prices. That

Fourth, inequality doesn’t necessarily even benefit the rich as much as we think. At some point, extra incomes don’t go to sate desires but to attempt to buy status through “positional goods” — like the hottest car on the block.

The problem is that there can only be one hottest car on the block. So the lawyer who buys a Porsche is foiled by the C.E.O. who buys a Ferrari, who in turn is foiled by the hedge fund manager who buys a Lamborghini. This arms race leaves these desires unsated; there’s still only one at the top of the heap.

Fifth, progressives probably talk too much about “inequality” and not enough about “opportunity.” Some voters are turned off by tirades about inequality because they say it connotes envy of the rich; there is more consensus on bringing everyone to the same starting line.

Unfortunately, equal opportunity is now a mirage. Indeed, researchers find that there is less economic mobility in America than in class-conscious Europe.

We know some of the tools, including job incentives and better schools, that can reduce this opportunity gap. But the United States is one of the few advanced countries that spends less educating the average poor child than the average rich one. As an escalator of mobility, the American education system is broken.

Cross posted at The Moderate Voice

Update: Norm Ornstein On The Republican Battle Between The Conservatives And Lunatic Radicals

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Thoughts on Democrats Winning The House And Republicans Winning The Senate

The conventional wisdom is that the Democrats have no chance to take control of the House, and the Senate is up for grabs. Is there any chance for a better outcome?Since winning the presidency, Obama acted quickly to prevent the full fledged depression which George Bush’s economic policies were pushing us towards. Since then we have seen record corporate earnings and stock prices while unemployment, along with the Bush deficit, have fallen considerably. Those who continue to suffer in this economy due so because of Republican obstructionism. Obamacare has turned into an even greater success than its supporters dreamed while all the Republican predictions of doom failed to come about. Events in Iraq demonstrate the folly of Republican policy on Iraq while most Americans agree with Obama on keeping American troops from getting in the middle of a war between different factions in the middle east. Republicans are also out of step with the views of Americans on social issues as Republicans push for greater government intrusion in the private lives of individuals.

Unfortunately our system leads to a situation in which a majority of people can vote for Democrats in both House and Senate elections but Republicans can potentially still wind up controlling both Houses of Congress. With Republican policies being both unpopular and failures, the Democrats might take control of the House if not for factors such as gerrymandering, a concentration of Democrats in urban districts, and Republican domination of a “news” media which is increasingly being used as a right wing propaganda machine. If there is any hope that we will see a sane outcome this fall,  Bill Scher at The Week suggests one possible way the Democrats could take control of the House.

Everyone assumes that Republicans will easily hold the House in November. The dominant storyline among the chattering classes centers instead on the possibility that Republicans could seize control of the Senate from Democrats. But the rapidly escalating immigration face-off between President Barack Obama and House Republicans raises the possibility that Democrats could win back the House — even if Republicans do take the Senate

How is that possible? It’s simple: There are more competitive House races than Senate races in areas with significant Latino populations.

Last year, David Damore, a polling analyst for the firm Latino Decisions, found that there are 44 congressional districts with Republican incumbents that could be ousted if their Latino constituents flex their electoral muscle. “This includes districts where the Latino voting-age population exceeds the 2012 margin of victory or swing districts won in 2012 by President Obama and the House Republican candidate that also have notable Latino populations,” he wrote…

Immigration will probably have less of an impact in Senate races. Every competitive 2014 Senate race, with the exception of Colorado, is in a state where the Latino eligible voter population is less than five percent. Of course, in any nail-biter race, even a constituency of three percent can play an outsized role. But with so many of these races occurring in red states, embattled Senate Democrats will likely want to avoid the potential for right-wing anti-immigrant backlash. That explains why the Senate Democrats’ “Fair Shot” 2014 agenda touts raising the minimum wage, promoting equal pay, investing in manufacturing jobs, and protecting Medicare — but nothing about immigration.

In other words, the House Democratic campaign strategy and the Senate Democratic campaign strategy may run along separate tracks, one driving immigration, the other pushing the economy. One strategy could work while the other flops. That creates the possibility, however unlikely, for something completely unprecedented: a midterm election where Democrats and Republicans trade control of each congressional branch.

It is far more likely that the Republicans will take control of the Senate than the Democrats will take control of the House, with Republicans having a real chance of controlling both Houses of Congress. Republicans benefit from factors including receiving the same number of Senators from the small states which favor them as the large states which favor Democrats, along with Democrats being forced to defend several Senate seats this year which they picked up six years ago in red states.

Republican control of the Senate would be a disaster in terms of appointments, but could also wind up being harmful to the Republicans politically, as Dana Milbank pointed out:

The prevailing view is that a Republican Senate would only compound Obama’s woes by bottling up confirmations, doubling the number of investigations and chipping away at Obamacare and other legislative achievements.

Yet there’s a chance that having an all-Republican Congress would help Obama — and even some White House officials have wondered privately whether a unified Republican Congress would be better than the current environment. Republicans, without Harry Reid to blame, would own Congress — a body that inspires a high level of confidence in just 7 percent of Americans, according to a Gallup survey last month finding Congress at a new low and at the bottom of all institutions tested.

There would be no more excuses for Republicans’ failure to put forward their own health-care plan, immigration proposals, specific cuts to popular government programs, and pet causes involving abortion, birth control and gay rights. This would set up real clashes with Obama — who could employ the veto pen he hasn’t used a single time since Republicans gained control of the House in 2010 — and sharp contrasts that would put him on the winning side of public opinion.

It is not hard to imagine a Republican takeover of the Senate causing conservatives in both chambers to overreach. House Republicans would get more pressure from their base to take a swing at impeachment, because the odds of convicting Obama in the Senate would be better (if still prohibitive). Alternatively, Republican leaders, recognizing that the public will hold them responsible now that they have complete control of Congress, might try to compromise with Obama.

In the first scenario, marauding conservatives drive Republicans to oblivion in 2016 and beyond, putting Hillary Clinton in the White House. In the second scenario, Obama actually accomplishes something in his last two years.

The biggest danger to Republicans is that more voters might figure out what they are doing and what they stand for. At present only 40 percent of Americans are even aware of which party controls which House of Congress. With Republicans in control of both Houses of Congress, what they believe would be far more apparent to voters if they are allowed to pass their agenda and Obama could veto their legislation. Perhaps then more Americans would realize that the Republican economic agenda is to use government to rig the rules to transfer more wealth to the ultra-wealthy, while it is Democrats who are far more likely to support a true market economy in which people are rewarded for their work, or that Republican health care policies would once again allow insurance companies to increase their profits by denying health coverage when people are sick. Democracy would provide a solution for Republican extremism if more people were aware of what the Republicans are trying to do.

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Unclipping Hillary Clinton’s Hawkish Wings

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Barack Obama recently described his views on the use of military force at West Point. E.J. Dionne pointed out that military “restraint makes us stronger” and praised “the more measured approach to military intervention practiced during the presidencies of both George H.W. Bush and Bill Clinton.” Obama said, “a strategy that involves invading every country that harbors terrorist networks is naïve and unsustainable.” This was described by Andy Borowitz as meaning”Obama Defends Controversial Policy of Not Invading Countries for No Reason.”

Conservative critics were taken aback by Obama’s speech, which was riddled with incendiary remarks about only using military force for a clearly identified and rational purpose.

Obama did not shy away from employing polarizing rhetoric, often using words such as “responsible” and “sensible” to underscore his message.

Harland Dorrinson, a fellow at the conservative think tank the Center for Global Intervention, said that he was “stunned” to see Obama “defend his failure to engage the United States in impulsive and random military adventures.”

“History tells us that the best way to earn respect around the world is by using your military in a totally unpredictable and reckless manner,” he said. “Today, President Obama showed once again that he doesn’t get it.”

Even beyond Borowitz’s satirical take on the speech, this is a clear change from past years. The apparently inevitable nomination of Hillary Clinton for the 2016 presidential nomination has some on the left concerned. An article on Clinton in The Wall Street Journal will not help to reassure anyone worried about Clinton’s more hawkish views. We must keep in mind the Republican bias of the source, which leads me to question some of the assessments in the article that Clinton was ineffective. I doubt that they would have reason to exaggerate Clinton’s hawkishness, and their assessment on this is consistent with the views of many others.

The article describes her as a “hawk with clipped wings.”  It argues that, “She was often more hawkish than the White House she served, and at some key moments was ineffectual at swinging policy her way.” Despite the article’s description of Clinton as someone who did not push her views, I often had the opinion that Clinton was one of the forces pulling Obama more to the right. Syria was given as an example where the two did disagree:

“… she was more comfortable than Mr. Obama with the use of military force and saw it as an important complement to diplomacy, present and former administration aides say.
“In the debates that we had, she generally was someone who came down in favor of military action,” says Ben Rhodes, a deputy national security adviser. “She had a comfort with U.S. military action.”

Syria was a test case. The civil war exposed a divide in the administration, with Mr. Obama hesitant to commit military force and Mrs. Clinton pushing to arm secular rebels who might help oust Syrian leader Bashar al-Assad.”

It would certainly be ironic if Rand Paul manages to win the Republican nomination, leaving the Democrats with the far more hawkish candidate who would take over without Barack Obama in the White House to counter her more hawkish tendencies.

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Mitch McConnell Backs Kentucky State Exchange While Calling For Obamacare Repeal

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Now that people are experiencing the advantages of the Affordable Care Act it is becoming harder for Republicans to call for repeal. While people might tell pollsters they dislike Obamacare, they also oppose the consequences of repeal. In Kentucky, people might say they dislike Obamacare, but they certainly do like Kynect, their highly successful insurance exchange. This is resulting in problems for Mitch McConnell who has been calling for the repeal of Obamacare and is now up for reelection.

McConnell has been trying to express support for Kynect while continuing to oppose Obamacare. It is necessary for one to be either dishonest or quite ignorant about the Affordable Care Act to make claims such as the ones McConnell is making:

“If Obamacare is repealed, Kentucky should decide for itself whether to keep Kynect or set up a different marketplace,” McConnell campaign spokeswoman Allison Moore told WFPL.

“But Kentuckians shouldn’t have been forced to lose the plans they had and liked, shouldn’t have seen their premiums skyrocket, shouldn’t have had their Medicare cut, and shouldn’t have had their taxes raised because of President Obama and his friends in Washington forced it down their throats.”​

McConnell is being dishonest with his claims that premiums are skyrocking and Medicare is being cut. One reason people in Kentucky support Kynect is that it is allowing them to obtain health insurance at a lower cost. Republicans are resorting to scare tactics with claims of Medicare cuts.

The Kentucky Herald-Leader had this editorial criticizing McConnell for attempting this deception:

Nothing could be more connected — or should be more important to Kentucky’s senior senator — than the fates of the more than 400,000 Kentuckians who are getting health insurance, many for the first time, and the federal Affordable Care Act, which is making that possible.

Repeal the federal law, which McConnell calls “Obamacare,” and the state exchange would collapse.

Kynect could not survive without the ACA’s insurance reforms, including no longer allowing insurance companies to cancel policies when people get sick or deny them coverage because of pre-existing conditions, as well as the provision ending lifetime limits on benefit payments. (Kentucky tried to enact such reforms in the 1990s and found out we were too small a market to do it alone.)

Kentucky’s exchange also could not survive without the federal funding and tax credits that are helping 300,000 previously uninsured Kentuckians gain access to regular preventive medicine, including colonoscopies, mammograms and birth control without co-pays.

As a result of a law that McConnell wants to repeal, one in 10 of his constituents no longer have to worry that an illness or injury will drive them into personal bankruptcy or a premature grave.

Repealing the federal law would also end the Medicaid expansion that is enabling Kentucky to expand desperately needed drug treatment and mental health services.

Kynect is the Affordable Care Act is Obamacare — even if Kentuckians are confused about which is which.

The Louisville Eccentric Observer also responded to McConnell:

Just for the record, McConnell saying that Kynect can survive the repeal of Obamacare is like saying that the Oklahoma City Thunder can trade Kevin Durant, but keep his jump shot.

The Kynect website and call center was paid for with federal money from the ACA, specifically $252 million in federal grants. Without the ACA, Kentucky foots the bill for a website that is worthless.

Over 300,000 Kentuckians gained Medicaid coverage because the ACA expanded Medicaid eligibility and Kentucky did not opt out, and that coverage is 100 percent paid for by federal money under the ACA, until it becomes 90 percent after a few years. Without the ACA they are no longer eligible, unless Kentucky changes their state law and pays through nose to cover these new people (that is not happening).

Most of the 82,795 Kentuckians who bought private insurance through Kynect were able to do so with the help of federal subsidies only made possible by the ACA. Without the ACA, those plans that have strong consumer protections on preexisting conditions, not being dropped from coverage for getting sick, and spending caps are no longer mandatory, so they’re gone. Gone as well is the requirement that children must be covered under their parents plans through the age of 25. Without the ACA many of these people won’t find someone to insure them, and many are forced to go back to junk plans that are worthless when you have a medical emergency or plans that are unaffordable without federal ACA subsidies.

Without the ACA, Kynect is nothing but a worthless website that would soon go dark, and roughly 400,000 Kentuckians will lose their coverage and the consumer protections it provides, and will therefore be thrown back into the old healthcare system that had failed them beforehand.

What McConnell is hoping to do with this strategy is deceive Kentucky voters who like what Kynect is doing but have a negative perception of the Affordable Care Act, and hope that the media here will do lazy “He said, She said” reporting that does not explicitly point out that what McConnell is saying is flatly false. He might turn out to be successful on that front, but this might also be a good opportunity for Alison Lundergan Grimes to get off of the sidelines and actually talk about health care with the media and voters so they know exactly what McConnell is trying to do, and have an honest conversation about what she would do. Or, she can continue staying out of this fight, and just hope for the best. Your call, Alison.

This should make it easier for McConnell’s opponent, Alison Lundergan Grimes, to defend Obamacare. Instead it looks like she is trying to play it safe. Greg Sargent discussed how Grimes is talking about the Affordable Care Act:

Now the Grimes campaign is finally hitting McConnell over his gyrations on the issue, accusing him of “voting to destroy Kynect.” From Grimes senior adviser Jonathan Hurst:

Mitch McConnell has been in the fantasyland that is Washington for so long that he cannot tell the difference between fact and fiction. McConnell has voted to destroy Kynect — and he has said he will do it again. In the U.S. Senate, Alison Lundergan Grimes will fix the law to ensure it is working for all Kentuckians.

This seems somewhat defensive. It again leans heavily on a vow to “fix” the law, and doesn’t state flatly that Kynect is a policy success. Some Dems, such as Rep. John Yarmuth and pollster Celinda Lake, have suggested Grimes go further. Lake told me the other day that her polling has showed that Kynect polls positively in Kentucky, even as the law known as “Obamacare” or the “Affordable Care Act” remains under water.

Lake suggests this to Grimes:  “She could say, `In Kentucky, we got it right. I’ll take Kentucky values to Washington.”

The idea would be to focus people on something they like — the state exchange — separating it from the hated Obummercare, localizing the contrast between the two candidates’ positions. Her statement today does not mention Obamacare, signaling again that Kynect is far more popular in the state, and that it’s now somewhat safe to make an issue at least out of the state exchange. Indeed, elsewhere Grimes has said: “I am not and will not be for taking away insurance that 400,000 Kentuckians just recently got access to.”

Still, given the tentativeness of Grimes’ statement, clearly she is still not prepared to cross over into seriously making an issue out of that contrast, and it just won’t be a central point she makes. As noted here before, I understand all the reasons for Grimes’ reluctance.

While it is understandable that Democrats would show some reluctance to being associated with Obamacare, failure to speak out probably guarantees their defeat. Democrats need to go on the offensive and take credit for the benefits of the law their party passed. Trying to distance themselves will not work. Everyone knows that this is a policy passed by the Democrats. Acting scared only reinforces the negative views and makes Democrats look weak. As long as Democrats remain afraid to forcibly speak out about the benefits of Obamacare and explain its benefits, voters will fall for the type of deception Mitch McConnell is practicing. Voters do want the benefits of Obamacare, and the popularity of Kynect gives Grimes the perfect opportunity to speak out in its defense.

Update: Glenn Kessler reviewed the facts regarding the above issue.

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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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