Success Of Obamacare Might Translate Into Political Success

The number of people signing up for private insurance coverage under the Affordable Care Act has now reached eight million. While primarily symbolic, it does represent a victory after initial projections of seven million were reduced to six million due to the problems when the exchanges opened. We know that if they failed to meet these projections, Republicans would be making a big deal of them. In addition, late enrollees included a high percentage of young people.

Good news means more positive head lines, such as National Journal writing that Obamacare is on a Winning Streak. The political climate is changing, with some Democrats now being more willing to run on its success.  I think it is essential that they do this to reduce the risk of the loss of a large number of seats this November. The evidence shows that Obamacare is a success but if Democrats don’t defend it, voters will only hear Republican attacks. Hiding from Obamacare will only make Democrats look weaker, and will not protect them from voters who vote against Democrats based upon Republican misinformation.

Ezra Klein writes that the right suffers from Obamacare Derangement Syndrome, being unable to admit that it is working:

Republicans used to talk about Bush Derangement Syndrome. Washington Post columnist Charles Krauthammer defined it as “the acute onset of paranoia in otherwise normal people in reaction to the policies, the presidency — nay — the very existence of George W. Bush.” Republicans like Krauthammer understood that BDS helped the Bush administration in two ways: it fired up their supporters and it distracted liberals from more modest, but effective, critiques.

Today, the right struggles with Obamacare Derangement Syndrome: the acute inability to see Obamacare as anything but a catastrophic failure that the American people will soon reject. For those suffering from ODS, all bad Obamacare news is good news, and all good Obamacare news is spin. In this world, delays of minor provisions in the law prove that the entire structure is collapsing, while surges of millions of people enrolling in insurance don’t prove anything at all…

But it’s coming at a moment when Obamacare’s successes are getting tougher and tougher to deny. The law signed up more than 7.5 million people in the exchanges, more than 3.5 million people in Medicaid, and it led millions more to get health care through their employers or directly through insurers. Premiums are lower than the Congressional Budget Office predicted when the law passed, and insurers are already thinking about how to compete for applicants in 2015. The White House has a much better story to tell than anyone — including me — thought possible in December.

For Republican pundits it might not matter that Obamacare is a success. Republicans show more intensity in their views, and very little concern for the truth. Campaigning against Obamacare might still motivate Republicans to get out and vote.

Andrew Sullivan might be a bit overly optimistic about the political effects of the success of Obamacare, but I hope he is right:

There’s simply no denying that the law has been rescued by an impressive post-fiasco operation that did to ACA-opponents what the Obama campaign did to the Clintons in 2008 and to Romney in 2012. Obama out-muscled the nay-sayers on the ground. I have a feeling that this has yet to fully sink in with the public, and when it does, the politics of this might change. (Since the law was pummeled at the get-go as something beyond the skills of the federal government to implement, its subsequent successful implementation would seem to me to do a lot to reverse the damage.) There are some signs that this is happening. A new Reuters/Ipsos poll finds the following:

Nearly one-third of respondents in the online survey released on Tuesday said they prefer Democrats’ plan, policy or approach to healthcare, compared to just 18 percent for Republicans. This marks both an uptick in support for Democrats and a slide for Republicans since a similar poll in February.

That’s mainly because of renewed confidence and support from previously demoralized Democrats. But it’s also a reflection, it seems to me, of the political vulnerability of Republicans who have failed to present a viable alternative to the law, and indeed seem set, in the eyes of most voters, merely to repeal ACA provisions that are individually popular. And this bad position is very likely to endure because of the intensity of the loathing for Obama/Obamacare among the Medicare recipients in the GOP base. It seems to me that right now, the GOP cannot offer an alternative that keeps the more popular parts of Obamacare without the air fast leaking out of their mid-term election balloon. And so by the fall, the political dynamics of this may shift some more in Obama’s direction. By 2016, that could be even more dramatic. One party – the GOP – will be offering unnerving change back to the status quo ante, and the other will be proposing incremental reform of the ACA. The only thing more likely to propel Hillary Clinton’s candidacy would be a Republican House and Senate next January.

It’s that long game thing again, isn’t it? Like the civil rights revolution of the Obama years, it seemed a close-to-impossible effort to start with, and then was gradually, skillfully ground out. It also seems true to me that the non-event of the ACA for many, many people will likely undermine some of the hysteria on the right. The ACA-opponents may be in danger of seeming to cry wolf over something that isn’t that big a deal. Yes, they may have premium hikes to tout as evidence of the alleged disaster. And every single piece of bad news on the healthcare front will be attributed to the ACA, fairly or not. But the public will still want to know how premiums can go down without people with pre-existing conditions being kicked out of the system, or without kids being kicked off their parents’ plan, and so on. I think, in other words, that the GOP’s position made a lot of short-term political sense in 2010 and even 2012. But it’s a much tougher sell in 2014, let alone 2016. Once again, they have substituted tactics for strategy. Every time they have done that with Obama, they have failed.

Sullivan described how he has benefited from the Affordable Care Act and concluded, “Yes, I am just one tiny, and rare example. But for me, at least, Obamacare has over-delivered and over-performed. If my experience is replicated more widely, then I suspect the polling and politics will shift yet again.”

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Insurance Companies Plan To Increase Policies Offered On Exchanges Following 2014 Success, And Other Health Care News

The first year of enrollment for insurance under the exchanges is largely for first getting our feet wet, with more people projected to sign up in the future. It certainly exposed problems in the computer system and allowed for them to be fixed (although further testing before October was clearly needed). Insurance companies got to see whether this was a profitable market they would want to enter. In the past one or two insurance companies dominated in most areas on the individual market. One of the benefits of selling coverage through the exchanges was the hope that multiple companies would now begin to offer coverage.

Even conservatives who oppose the Affordable Care Act should agree with the benefits of having more companies offer insurance, including the likelihood of competition leading to lower prices. Actually exchanges, along with mandates, were originally supported by Republicans until they opposed the plan when supported by Barack Obama.

So far we are receiving good news following the initial IT problems. The Affordable Care Act now looks like a good policy which just got off to a rocky start. Enrollment is estimated at 7.5 million, exceeding predictions made even before they were adjusted downward with the early computer problems, with more healthy young people signing up at the last minute. Politico reports that insurance companies are happy with what they are seeing and want to get in:

Health insurers got their first taste of Obamacare this year. And they want seconds.

Insurers saw disaster in the fall when Obamacare’s rollout flopped and HealthCare.gov was a mess. But a strong March enrollment surge, along with indications that younger and healthier people had begun signing up, has changed their attitude. Around the country, insurers are considering expanding their stake in the Obamacare exchanges next year, bringing their business to more states and counties. Some health plans that skipped the new marketplaces altogether this year are ready to dive in next year.

At least two major national insurers intend to expand their offerings, although a handful of big players like Aetna, Humana and Cigna, are keeping their cards close for now. None of the big-name insurers have signaled plans to shrink their presence or bail altogether after the first rocky year. And a slew of smaller health plans are already making moves to join more states or get into the Obamacare business for the first time.

“[W]e see 2014 as just the beginning for exchanges,” said Tyler Mason, a spokesman for UnitedHealth Group, one of the nations’ largest insurers. “As the economics, sustainability and dynamics of exchanges continue to become clearer, we believe exchanges have the potential to be a growth market with much to offer UnitedHealthcare and other insurers and consumers.”

Nurturing this growth and health plan participation will be one of the first tasks of Sylvia Mathews Burwell, assuming she is confirmed to succeed Kathleen Sebelius as secretary of Health and Human Services.

The article reviewed plans by many of the larger insurance companies and also noted that several smaller companies now want to start selling insurance. Being able to offer their plans on the same computer site as the larger companies will allow small companies to compete for sales more easily than in the past, further increasing choice for consumers.

It is not only insurance companies which see the Affordable Care Act as succeeding. The latest Reuters/Ipsos poll shows the number of people who prefer Democrats over Republicans on health care has increased:

Americans increasingly think Democrats have a better plan for healthcare than Republicans, according to a Reuters/Ipsos poll conducted after the White House announced that more people than expected had signed up for the “Obamacare” health plan.

Nearly one-third of respondents in the online survey released on Tuesday said they prefer Democrats’ plan, policy or approach to healthcare, compared to just 18 percent for Republicans. This marks both an uptick in support for Democrats and a slide for Republicans since a similar poll in February.

Not surprisingly, Gallup has found a greater decrease in the uninsured in states which have embraced the Affordable Care Act, such as by setting up their own exchanges and taking advantage of the expanded Medicaid program.

Having Gallup survey the number of uninsured is of value as the Census Bureau is changing how it is surveying the uninsured, with Gallup providing a second set of numbers for comparison. Many Republicans see a conspiracy to make Obamacare look good. Actually this looks like a change to get more accurate results, which might actually show a greater number of uninsured. The changes also started with 2013 so we will still be able to compare the year prior to the exchanges to subsequent years. Sarah Kliff explained further at Vox.

Cross posted at The Moderate Voice

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Gallup Finds Number Of Uninsured Continues To Fall

Percent Uninsured

New figures from Gallup show a further decrease in the number saying they are uninsured. The number of uninsured decreased to 15.6 percent in the first quarter of this year, a 1.5 percent decrease from the fourth quarter of 2013. This is the lowest recorded level since late 2008 and suggests that the Affordable Care Act is successful in providing insurance to the previously uninsured. This also shows a further decrease from a similar survey conducted last month.

The uninsured rate has been falling since the fourth quarter of 2013, after hitting an all-time high of 18.0% in the third quarter — a sign that the Affordable Care Act, commonly referred to as “Obamacare,” appears to be accomplishing its goal of increasing the percentage of Americans with health insurance coverage. Even within this year’s first quarter, the uninsured rate fell consistently, from 16.2% in January to 15.6% in February to 15.0% in March. And within March, the rate dropped more than a point, from 15.8% in the first half of the month to 14.7% in the second half — indicating that enrollment through the healthcare exchanges increased as the March 31 deadline approached.

This report is consistent with The Urban Institute’s Health Reform Monitoring Survey (HRMS) which estimated that the number of uninsured adults had fallen by 5. 4 million before the surge in enrollment in March . Another study performed prior to the late March surge in enrollment showed that at least 9.5 million new people received insurance.

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Lack Of Information And Misinformation Suppressing Enrollment In Insurance Plans

Recent polls are showing some of the obstacles to extending coverage among the uninsured. A study published Monday by the National Academy of Sciences showed that a substantial number of consumers lack basic knowledge of how insurance works which would be necessary to intelligently purchase coverage. A new Kaiser Health Tracking Poll shows lack of knowledge of the deadline for obtaining coverage and widespread belief in many of the false claims being spread by opponents of the Affordable Care Act.

Many are unaware of next week’s deadline to obtain coverage and avoid potential tax penalties:

A third of those who lack coverage as of mid-March are unaware that the law requires nearly all Americans to have health insurance or pay a fine. When it comes to the specifics, four in ten of the uninsured (39 percent) are aware that the deadline to sign up for coverage is at the end of March, leaving about six in ten unaware of the March deadline.

When reminded of the mandate and the deadline, half of those without coverage as of mid-March say they think they will remain uninsured, while four in ten expect to obtain coverage and one in ten are unsure.

Many plan to not obtain coverage due to cost concerns, unaware of financial assistance available:

While some report trying to get coverage from new options available under the ACA, large shares of the uninsured remain unaware of two of the law’s key provisions that could help them get coverage. About half the uninsured are unaware that the ACA gives states the option of expanding their Medicaid programs, and more than four in ten don’t know that it provides financial help to low- and moderate-income individuals to help them purchase coverage.

The Kaiser poll showed a reduction in the gap between those who see the law unfavorably as opposed to favorably. While more now have a favorable opinion than previously, the majority continue to have an unfavorable opinion. Much of the opposition is based upon misinformation spread by opponents:

“It’s too expensive for regular people.”
“it’s costing too much money. It’s supposed to help people with low incomes and it’s not.”
“Because it’s a financial hardship on the U.S.”

The first two are based upon lack of knowledge of the assistance available which does make coverage more affordable. The third has been shown by the recent non-partisan report from the Congressional Budget Office to be false. Among its other benefits, the Affordable Care Act will reduce the deficit, reduce unemployment, and help stimulate the economy by freeing people from the insurance trap, enabling more people to work for and start small businesses

Opposition also includes a belief that the individual mandate is unconstitutional despite a Supreme Court ruling upholding the law. Some expressed the false belief that the ACA gives government more control over personal health care choices, echoing further scare stories from the right wing as to what the law does.

Despite unfavorable views about the law, a majority still would prefer to see improvement to the law as opposed to repeal or a Republican alternative:

Perhaps reflecting this sense that the debate has gone on long enough, more of the public would like to see Congress keep the law in place and work to improve it (49 percent) or keep it as is (10 percent) rather than repeal it and replace it with a Republican-sponsored alternative (11 percent) or repeal it outright (18 percent).

The poll found that many aspects of the law are popular, even if many people are unaware of these and other benefits:

As previous Kaiser tracking polls have found, many of the ACA’s major provisions continue to be quite popular, including across party lines. For example, large shares of Americans – including at least seven in ten overall and at least six in ten Democrats, Republicans, and independents – have a favorable view of the fact that the law allows young adults to stay on their parents’ insurance plans up to age 26, closes the Medicare “doughnut hole” for prescription drug coverage, provides subsidies to low- and moderate-income Americans to help them purchase coverage, eliminates cost-sharing for preventive services, gives states the option of expanding Medicaid, and prohibits insurance companies from denying coverage based on pre-existing conditions. Nearly as many (including a majority across parties) have a favorable view of the “medical loss ratio” provision that requires insurance companies to give their customers a rebate if they spend too little money on services and too much on administration and profits. Somewhat more divisive is the law’s Medicare payroll tax on earnings for upper-income Americans, which is viewed favorably by about three-quarters of Democrats and just over half of independents, but just a third of Republicans.

The individual mandate remains highly unpopular. Anticipation of this is one of the reasons I opposed the individual mandate prior to passage of the Affordable Care Act, preferring an alternate system to provide incentives to purchase coverage and penalize those who try to game the system by waiting until sick to purchase insurance.

Much of the opposition to the ACA is based upon beliefs about the law which are untrue:

Misperceptions also persist about things the ACA does not actually do. For example, nearly half the public (46 percent) think the law allows undocumented immigrants to receive financial help from the government to buy health insurance, and another two in ten (22 percent) are unsure whether it does. A third of the public (34 percent, including 32 percent of seniors) believe the law establishes a government panel to make decisions about end-of-life care for people on Medicare, with another quarter saying they are unsure (23 percent of the public, 25 percent of seniors).

Unfortunately both lack of information and intentional misinformation being spread by opponents of the Affordable Care Act is likely to cause a substantial number of people to go without coverage this year. The deadline is fast approaching for purchasing coverage on the exchanges. There is no deadline for those who qualify for coverage due to Medicaid expansion, but Republicans in many states are also denying this benefit to residents of their states even though the federal government picks up almost all of the cost.

Cross posted at The Moderate Voice

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Don’t Panic Because Nate Silver Predicts Republicans Will Take Senate

I was traveling yesterday and when I finally got on line saw a lot of panic over Nate Silver predicting that the Republicans were favored to take control of the Senate. I don’t find this terribly significant.

We already knew that there was a real possibility that the Republicans could take control of the Senate and Silver’s prediction does not provide any new information. Silver making the prediction does not mean it is any more likely to occur than it was last week. He was way off in predicting a 61 percent chance the Republicans would take control of the Senate in 2012. I hope he is wrong again.

As I noted recently, Nate Silver’s predictions in the 2012 presidential election were similar to those from other sources (ignoring the Republicans who made predictions contrary to polling results). His predictions for the Senate in 2012 were also comparable to predictions being made by others at that point. His prediction for the Senate in 2014 is comparable to predictions already made by others.

There is real reason to fear that the Republicans will take control of the Senate is year, but the news of Nate Silver predicting this does not alter what we knew before he made this prediction and does not mean that it is any more likely to occur.

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Lying About Obamacare Not Working Out That Well For Republicans

Republicans, lacking any real policies they can campaign on,  have been relying on ads based upon lies about the Affordable Care Act. One ad which has received a lot of attention in the Michigan Senate race centered around a cancer patient who claimed her health insurance was unaffordable under Obamacare.  Several fact-checkers found that her new policy through the Affordable Care Act was actually saving her at least $1200 per year. The Koch brothers have been funding a number of similarly dishonest ads through Americans for Prosperity. They may have been wasting their money. A new poll has Democrat Gary Peters with a narrow lead over Republican Terri Lynn Land despite a barrage of dishonest ads from Americans for Prosperity.

Talking Points Memo ran a story earlier today claiming that Americans for Prosperity is giving up on these ads but later in the day a spokesman for AFP denied a shift in strategy:

“We are currently on-air with many different types of ads, including personal testimony of Obamacare impact,” AFP spokesman Levi Russell told TPM. “This is the same strategy we’ve been using for 6 months. This does not represent a shift in strategy.”

I’m not surprised. Take away the lies, and the right wing has no argument left. The old system was such as disaster, harming both millions of people and causing harm to the economy. The Republicans have no meaningful alternative. Claims made by the right wing are repeatedly being shown to be false, as with the ads from Americans for Prosperity.

The Affordable Care Act is turning into a major success, providing millions with health insurance coverage and ending the ability of insurance companies to abuse the system by finding ways to sell policies and then avoid paying out. Five million Americans have purchased health coverage through the exchanges, and this number will continue to increase. Millions more are purchasing higher quality coverage directly from insurance companies, benefiting from the expansion of Medicaid, or are now able to be covered on their parents’ insurance until age 26. No longer are people denied coverage, or have their coverage taken away, due to becoming sick or losing their jobs. In addition,  Obamacare frees people from the “insurance trap” which forced people who otherwise do not need to work to continue working for insurance coverage, along with other overall benefits to the economy. The Congressional Budget Office Report, frequently distorted by Republicans, showed that the Affordable Care Act will reduce unemployment, help decrease the deficit, and allow more people to leave large corporations to start small businesses, further stimulating the economy.

Cross posted at The Moderate Voice

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Republicans, White Working Class Voters, And Race

White working class males present a particular frustration for Democratic strategists. Most independent economists agree that Republican economic policies have increasingly led to redistribution of  wealth to the ultra-wealthy at the expense of the middle class yet Republicans obtain the majority of votes from low-information white voters who are hurt the most by Republican policies.  Last week I looked at attempts by Democrats to regain the votes of white males. This is hindered by low-information voters being misled by Republican misinformation (while better educated white male voters are more likely to vote Democratic). Many vote contrary to their economic self-interest based upon social issues. This is all reinforced by the Republican southern strategy which enhances economic insecurity by playing on racial fears.

Thomas B. Edsall has an op-ed in The New York Times on How Democrats Can Compete for the White Working Class. His analysis actually leaves many reasons for Democrats to remain gloomy about these prospects. He began with some differences in attitudes between these less-educated white voters and the general population in surveys conducted by Democracy Corps:

Democracy Corps found that less well-educated whites agree, by a huge 46.2 percentage point margin, with the statement “When something is run by the government, it is usually inefficient and wasteful.” This is 11.6 points more than all voters.

Similarly, the general public agrees that “It is the responsibility of the government to take care of people who can’t take care of themselves” by a 19.5 percentage point margin, while whites who did not go to college agree by half that.

He also cited a survey by the Public Religion Research Institute from September 2012 entitled “Beyond Guns and God: Understanding the Complexities of the White Working Class in America.” This also showed that working class whites tend to be more conservative on social issues but also that this was far more the case in the south. Grouping these numbers nationally made these voters appear more conservative on social issues than is actually the case:

…while working-class whites in the South opposed same-sex marriage by 61-32 in the P.R.R.I. survey, in the Northeast they favored it 57-37; in the West they were split 47-45; and in the Midwest they were modestly opposed, 44-49. In the case of abortion, majorities of non-college whites outside of the South believe the practice should be legal, while those in the South were opposed 54-42.

In general, the findings of the P.R.R.I. study suggest that outside the South, Democrats should be able to make significant inroads among working-class whites – and, in fact, they have. In 2008, when Obama was losing nationally by 18 points among noncollege whites, in Michigan he carried these voters 52-46; in Illinois, 53-46; and in Connecticut, 51-47.

There remains another huge stumbling block to Democrats winning these white votes–race:

The P.R.R.I. study did point to one Democratic stumbling block: affirmative action and “reverse discrimination.”

Three out of five working-class whites believe “that discrimination against whites has become as big a problem as discrimination against blacks and other minorities.” This view is strongest in the South, at 69 percent, but it is the majority conviction of working-class whites in all regions of the country, where it is never lower than 55 percent.

In another key measure of white working-class racial resentment, the P.R.R.I. survey found that by a margin of three percentage points, the white working class agreed “that the government has paid too much attention to the problems of minorities.” White noncollege voters were split down the middle on this issue in the Northeast and Midwest. In the South, 58 percent agreed.

Thirty years ago, in the aftermath of the 1984 presidential election in which Ronald Reagan crushed Walter Mondale, Democrats were deeply alarmed over the defection of blue-collar voters.

Stan Greenberg, the Democratic pollster, conducted focus groups in 1985 in the white working-class suburbs of Detroit and found that “these white Democratic defectors express a profound distaste for blacks, a sentiment that pervades almost everything they think about government and politics.”

The perception of reverse discrimination was an even more acute source of anger: “The special status of blacks is perceived by almost all these individuals as a serious obstacle to their personal advancement. Indeed, discrimination against whites has become a well-assimilated and ready explanation for their status, vulnerability and failures.”

A separate study that year, financed by the Democratic National Committee, found that white working-class voters were convinced that “the Democratic Party has not stood with them as they moved from the working to the middle class. They have a whole set of middle-class economic problems today, and their party is not helping them. Instead, it is helping the blacks, Hispanics and the poor. They feel betrayed.”

While these attitudes are stronger in the south, I fear that Democrats will continue to face serious obstacles to attracting white low-information voters in other regions. That does not mean I disagree with Democratic attempts to  try to pick up votes. There are white working class voters who are less conservative and less motivated by race than those in the south and some might be convinced to vote more along economic interests. Even if Democrats continue to win a minority of these voters, increasing their share could still add to Democratic margins.

This strategy has also begun to backfire against Republicans nationally. The realization that Republicans have based their electoral strategy to such a considerable degree on stroking racial fears has been one reason why they have been so unsuccessful in obtaining Jewish votes, and why Republican use of racial fears on immigration issues is hurting their long term prospects due to the loss of Latino voters.

Among other measures, Democrats have attempted to improve the economic conditions of millions of workers by pushing for an increase in the minimum wage. Now Obama has escalated this with an executive order which will provide overtime pay to millions of Americans who have been denied this:

President Obama this week will seek to force American businesses to pay more overtime to millions of workers, the latest move by his administration to confront corporations that have had soaring profits even as wages have stagnated.

On Thursday, the president will direct the Labor Department to revamp its regulations to require overtime pay for several million additional fast-food managers, loan officers, computer technicians and others whom many businesses currently classify as “executive or professional” employees to avoid paying them overtime, according to White House officials briefed on the announcement.

Mr. Obama’s decision to use his executive authority to change the nation’s overtime rules is likely to be seen as a challenge to Republicans in Congress, who have already blocked most of the president’s economic agenda and have said they intend to fight his proposal to raise the federal minimum wage to $10.10 per hour from $7.25…

Under the new rules that Mr. Obama is seeking, fewer salaried employees could be blocked from receiving overtime, a move that would potentially shift billions of dollars’ worth of corporate income into the pockets of workers. Currently, employers are prohibited from denying time-and-a-half overtime pay to any salaried worker who makes less than $455 per week. Mr. Obama’s directive would significantly increase that salary level.

In addition, Mr. Obama will try to change rules that allow employers to define which workers are exempt from receiving overtime based on the kind of work they perform. Under current rules, if an employer declares that an employee’s primary responsibility is executive, such as overseeing a cleanup crew, then that worker can be exempted from overtime.

White House officials said those rules were sometimes abused by employers in an attempt to avoid paying overtime. The new rules could require that employees perform a minimum percentage of “executive” work before they can be exempted from qualifying for overtime pay.

“Under current rules, it literally means that you can spend 95 percent of the time sweeping floors and stocking shelves, and if you’re responsible for supervising people 5 percent of the time, you can then be considered executive and be exempt,” said Ross Eisenbrey, a vice president of the Economic Policy Institute, a liberal research organization in Washington.

Conservatives are likely to protest the use of an executive order here, ignoring the fact that Obama is just reversing a previous executive order by George W. Bush in 2004. Think Progress has more on the economic effects of this executive order. Jared Bernstein, former executive director of the White House Task Force on the Middle Class, also predicts that “a potential side effect is that you may see more hiring in order to avoid overtime costs, which would be an awfully good thing right about now.”

The question remains whether low-information white working class voters will realize that they are benefiting from such policy differences between the parties or whether they will continue to fall for right wing talking points on the economy, and allow the Republicans to continue to scare them with the prospect of blacks and immigrants challenging them for jobs.

Cross posted at The Moderate Voice

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Number Of Uninsured Continues To Decrease

Gallup reports a continued decrease in the percentage of Americans without health insurance, including a drop in uninsured young people:

Percent Uninsured

The percentage of Americans without health insurance continues to fall, measuring 15.9% so far in 2014 compared with 17.1% in the fourth quarter of 2013.

These data are based on more than 28,000 interviews with Americans from Jan. 2-Feb. 28, 2014, as part of the Gallup-Healthways Well-Being Index. With only a few weeks remaining in the first quarter, the uninsured rate is on track to be the lowest quarterly level that Gallup and Healthways have measured since 2008.

The uninsured rate has been declining since the fourth quarter of 2013, after hitting an all-time high of 18.0% in the third quarter. The uninsured rate for the first quarter of 2014 so far includes a 16.2% reading for January and 15.6% for February.

Uninsured Rate Declines Most Among Lower-Income and Black Americans

The uninsured rate for almost every major demographic group has dropped in 2014 so far. The percentage of uninsured Americans with an annual household income of less than $36,000 has dropped the most — by 2.8 percentage points — to 27.9% since the fourth quarter of 2013, while the percentage of uninsured blacks has fallen 2.6 points to 18.3%. Hispanics remain the subgroup most likely to lack health insurance, with an uninsured rate of 37.9%.

The percentage of uninsured has declined across all age groups this year, except for those aged 65 and older. The uninsured rate for that group has likely remained stable because most Americans aged 65 and older have Medicare.

The uninsured rate among 26- to 34-year olds and 35- to 64-year olds continues to decline — now at 26.6% and 16.3%, respectively. The February Enrollment Report released by the Department of Health and Human Services (HHS) highlighted no significant changes in young adults’ enrollment in the health exchanges since its December report, with the cumulative total enrollment rate among 18- to 34-year-olds hovering at 25%…

Implications

The uninsured rate continues to decline after the requirement to have health insurance went into effect on Jan. 1, 2014. This drop could be a result of the ACA, which aims to provide healthcare coverage to more Americans through multiple provisions, including federal and state healthcare marketplaces where Americans can purchase health insurance coverage at competitive rates.

At the end of February, HHS reported 4 million people have signed up for health insurance coverage through the marketplaces established under the ACA. With the open enrollment period scheduled to close on March 31, the uninsured rate in the U.S. will likely continue to fall. Additionally, healthcare aides in the Obama administration announced on Wednesday that Americans will be able to renew old health insurance plans for up to three years, even if the plans do not comply with ACA policies. Other provisions of the healthcare law have not yet gone into effect, such as the requirement for employers to provide health insurance to their employees by 2015 or 2016. These provisions also may affect the uninsured rate over time.

These numbers remain lower than ultimately desired but do show a significant improvement, and further enrollment in the exchanges is expected during March, after the period of this survey. Further enrollment by young, healthy adults would be advantageous, but with enrollment at current numbers the Affordable Care Act would remain viable. Some states also had delayed implementation of Medicaid expansion due to initial political opposition by Republicans (with some states continuing to refuse to expand Medicaid). For example, Michigan is not accepting applications for the expanded Medicaid program until after April 15, 2014, which should further add to the newly insured.

Most likely enrollment will also continue to increase substantially in future years. Initial implementation of the original Medicare program and Medicare Advantage plans were also hampered by problems and took time to get established. This year enrollment under policies provided under through the exchanges was hindered by additional factors including the initial computer problems and a campaign by opponents of the law to dissuade the uninsured from enrolling.

Numbers regarding reduction in the number of uninsured would provide one parameter regarding the success of the Affordable Care Act, but there are many other numbers to look at. This includes no longer having people lose their insurance due to developing serious medical problems or losing their job, no longer having people denied health care coverage due to pre-existing conditions, no longer having people declaring bankruptcy because of losing insurance, the number of people who no longer having caps on health care coverage, the number freed from the “insurance trap” forcing people who otherwise do not need to work to continue working for insurance coverage, along with the overall benefits to the economy. The Congressional Budget Office Report, frequently distorted by Republicans, shows that the Affordable Care Act will reduce unemployment, help decrease the deficit, and allow more people to leave large corporations to start small businesses.

Cross posted at The Moderate Voice

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Are Many Conservatives Really Liberals?

Liberal or conservative, opposite signs

Polls have generally showed self-identified conservatives outnumbering liberals, with a recent slight increase in the number of liberals. I have often speculated that this is largely due to the success the right wing noise machine has had in demonizing the word liberal. Americans come out more liberal than would be expected by these poll findings when we look at individual issues.

While the pendulum swings both ways, the trend has been toward more liberal policies over the years. Most people wouldn’t think of returning to the days of child labor. Medicare and Social Security are deeply entrenched, to the point that even when Republicans vote for ending Medicare as we know it they realize they have to hide what they are doing. Recent polls show increases in the number of people who support legalization of same-sex marriage and legalization of marijuana. A majority even supports the individual components of Obamacare when asked without identifying the policy as Obamacare.

John Sides reviewed a recent book to argue that many conservatives are really liberals:

In Ideology in America, Christopher Ellis and James Stimson describe a striking disjuncture. When identifying themselves in a word, Americans choose “conservative” far more than “liberal.” In fact they have done so for 70 years, and increasingly so since the early 1960s.

But when it comes to saying what the government should actually do, the public appears more liberal than conservative. Ellis and Stimson gathered 7,000 survey questions dating back to 1956 that asked some variant of whether the government should do more, less, or the same in lots of different policy areas.  On average, liberal responses were more common than conservative responses. This has been true in nearly every year since 1956, even as the relative liberalism of the public has trended up and down.  For decades now there has been a consistent discrepancy between what Ellis and Stimson call symbolic ideology (how we label ourselves) and operational ideology (what we really think about the size of government).

Looked at this way, almost 30 percent of Americans are “consistent liberals” — people who call themselves liberals and have liberal politics.  Only 15 percent are “consistent conservatives” — people who call themselves conservative and have conservative politics.  Nearly 30 percent are people who identify as conservative but actually express liberal views.  The United States appears to be a center-right nation in name only.

This raises the question: why are so many people identifying as conservative while simultaneously preferring more government?  For some conservatives, it is because they associate the label with religion, culture or lifestyle.  In essence, when they identify as “conservative,” they are thinking about conservatism in terms of family structure, raising children, or interpreting the Bible. Conservatism is about their personal lives, not their politics.

But other self-identified conservatives, though, are conservative in terms of neither religion and culture nor the size of government.  These are the truly “conflicted conservatives,” say Ellis and Stimson, who locate their origins in a different factor: how conservatives and liberals have traditionally talked about politics.  Conservatives, they argue, talk about politics in terms of symbols and the general value of “conservatism” — and news coverage, they find, usually frames the label “conservative” in positive terms.  Liberals talk about policy in terms of the goals it will serve — a cleaner environment, a stronger safety net, and so on — which are also good things for many people.  As a result, some people internalize both messages and end up calling themselves conservative but having liberal views on policy.

Ideology has two faces: the labels people choose and the actual content of their beliefs.  For liberals, these are mostly aligned.  For conservatives, they are not.  American conservatism means different things to different people.  For many, what it doesn’t mean is less government.

This idea that nearly 30 percent of self-identified conservative are really liberals would explain the increased support for liberal positions despite a majority identifying themselves as conservatives.

There are some limitations to this, largely due to problems with these labels. It seems to use a simplistic definition of liberals as being for more government and conservatives being for less, but that does not really explain the differences. There are many areas where I am for less government. There is nowhere that I support more government for the sake of more government.

I supported the Affordable Care Act because financing of health care is an area where the market has failed, as insurance companies found it more profitable to find ways to collect increased premiums while finding ways to avoid paying out claims. Conservatives opposed the Affordable Care Act based upon greatly-exaggerated arguments that it is more government (ignoring its similarities to health plans previously advocated by conservatives). Republicans widely supported an individual mandate to buy health insurance until this became part of the plan supported by Barack Obama (who ran against Hillary Clinton opposing the individual mandate). Similarly, conservatives previously supported ideas comparable to the health care exchanges.

On the other hand, conservatives support more big government when it comes to military spending, mandatory vaginal probes, and other intrusions into the private lives of individuals. Even Ron Paul, who voted no on virtually any spending by the federal government, would allow for far greater government restrictions on individual liberties if it came from the state or local level.

Republicans in office generally perform different than their rhetoric would, with big increases in the size of government under Ronald Reagan and George W. Bush. This has been described as being “ideologically conservative, but operationally liberal.” If we just go by their effects on the size of government, Reagan and Bush were the liberals while Barack Obama has been the most conservative president since Dwight Eisenhower. Part of this is because Republican rhetoric is incompatible with actually governing, leading Reagan and Bush to promote far more government spending than would be expected by their rhetoric. Many conservatives realize they didn’t get what they wanted from Bush, but continue to buy the myth of Ronald Reagan as a supporter of small government.

Another problem is a concentration on economic issues and the size of government, as misleading as those issues can be in assigning labels. How would they classify someone who wants to ban abortion, limit access to contraception, opposes same-sex marriage, and supports everyone carrying a concealed weapon, but doesn’t follow the entire Republican line on economic policy? I bet a lot of self-identified conservatives would have no real opposition to a modest tax increase on the wealthy and increasing some government economic regulations (especially if they don’t affect them personally) while holding a number of other conservative positions.

Today many are self-identified conservatives based upon social issues. This didn’t always identify conservatism. Barry Goldwater was a strong opponent of the religious right. He sure called it right in 1994:

Mark my word, if and when these preachers get control of the [Republican] party, and they’re sure trying to do so, it’s going to be a terrible damn problem. Frankly, these people frighten me. Politics and governing demand compromise. But these Christians believe they are acting in the name of God, so they can’t and won’t compromise. I know, I’ve tried to deal with them.

Or maybe they just like being members of the club.  They like to listen to people like Glenn Beck and agree with what they say. However Beck has previously described himself as “a rodeo clown” and conceded, “If you take what I say as gospel, you’re an idiot.”

Cross posted at The Moderate Voice

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Support For Same Sex Marriage Increases (Except Among The Tea Party)

Support for legalization of same sex marriage has reached a new high according to a new Washington Post-ABC News poll:

Half of all Americans believe that gay men and lesbians have a constitutional right to marry, according to a new Washington Post-ABC News poll in which a large majority also said businesses should not be able to deny serving gays for religious reasons.

Fifty percent say the U.S. Constitution’s guarantee of equal protection gives gays the right to marry, while 41 percent say it does not.

Beyond the constitutional questions, a record-high 59 percent say they support same-sex marriage, while 34 percent are opposed, the widest margin tracked in Post-ABC polling

According to the poll, public opinion is more unified on recent proposals that would allow businesses to refuse serving gays and others based on the religious convictions of the business owner. Nearly seven in 10 respondents say businesses should not be allowed to refuse service to gays. On this question, majorities across partisan lines said businesses should not be allowed to deny service.  Last week, Arizona Gov. Jan Brewer (R) vetoed a measure that would have allowed businesses to refuse service to customers based on religious grounds.

The breakdown of supporters includes little that is surprising:

Despite the changing views, deep chasms remain along religious, generational and political lines. Six in 10 evangelical Protestants oppose same-sex marriage, while about six in 10 Catholics, non-evangelical Protestants and eight in 10 with no religious affiliation support it. Three-quarters of Americans younger than 30 support same-sex marriage, while less than half of seniors say the same.

Although support for such unions has grown to clear majorities among Democrats (70 percent) and independents (61 percent), Republicans have moved at a slower pace. Fifty-four percent of Republicans oppose same-sex marriage in the new poll, while 40 percent approve of it.

“I just don’t believe in the marriage thing; the Bible says that isn’t right,” said Musser, who opposed the Arizona legislation on the religious rights of businesses.

Republicans are split along ideological and religious lines. Support for allowing same-sex marriage is lowest, below one-third or less, among conservatives and evangelical Protestants.

Greg Sargent has this comment on where much of the this Republican support for government intrusion in the private lives of individuals comes from:

Meanwhile, opposition to gay marriage among Republicans seems to be concentrated among the Tea Party. According to the Post polling team, Republicans and GOP-leaning independents who support the Tea Party oppose gay marriage by 54-38. By contrast, non-Tea Party Republicans and GOP-leaners support gay marriage by 57-36. Tea Party Republicans are often said to be more libertarian-leaning on social issues than other segments of the GOP base (such as evangelicals), but a majority of them still opposes same-sex marriage.

While the Tea Party often claims to be purely concentrated on economic matters,  as I have pointed out in the past, the Tea Party is often just a new name for the old religious right base of the Republican Party.

On the other hand, opposition to same sex marriage is declining among Catholics. A comparable change is also seen with the more liberal views coming from the Vatican under Pope Francis. While outright support for same sex marriage remains too liberal a position for him to adopt, Think Progress points out that he is open to the idea of civil unions:

In an interview published Wednesday, Pope Francis appeared to support governments that recognize civil unions to provide non-traditional couples with access to benefits:

On the question of marriage and civil unions, the Pope reaffirmed that “marriage is between a man and a woman”. States seek to justify civil unions “to regularize different situations of living together,” pushed by the need to regularize the economic aspects between people, such as, for example, to ensure health care, he said. “We have to look at the different cases and evaluate them in their variety”.

Over the last year, Francis has nudged the church in a more welcoming direction on issues like contraception, divorce, and marriage equality. Unlike Francis’ predecessor, Pope Benedict XVI — who sermonized that same-sex marriage is a “serious harm to justice and peace,” and a “manipulation of nature” — Francis has directed the church to become more inclusive. He has also instructed American Bishops to poll how everyday Catholics view same-sex marriage, divorce, and contraception. Last year, Francis himself welcomed gays priests, arguing, “who am I to judge?” Before becoming the Pope, Francis may have supported civil unions as an Argentina archbishop, though he was simultaneously condemning marriage equality as a product of the “father of lies” that was “destructive to the plan of God” and that would “gravely harm the family.” The Vatican continues to oppose same-sex unions and has had to deny past reports of Francis’ support as “paradoxical” and a “manipulation” of his words.

Francis also discussed plans to revisit the church’s position on birth control, saying “it is a matter of going into the issue in depth and bringing it about that the pastoral practice takes account of situations and of what is possible for persons.”

While this country is quickly moving beyond the idea of civil unions to full marriage equality, support for civil unions is a welcome move in the right direction from the Catholic Church.

Cross posted at The Moderate Voice

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