Conservative Publication Claims Obama To Back Warren Over Clinton

Conservative publications often report on a Bizarro World, fact-free version of the real world. I’m sure readers know about the general outlines of their alternate reality. In conservative publications Barack Obama is a Muslim Socialist born in Kenya, Republicans support limited government, and the generally accepted principles of science and economics do not exist. There are also lots of conspiracy theories and other stories which haven’t been repeated as often.

Generally their stories are pure fiction which is not worth paying any attention to. A story in The New York Post today realistically fits in that category, but in this case it differs from most of their claims in that I wish it was actually true:

President Obama has quietly promised Massachusetts Sen. Elizabeth Warren complete support if she runs for president — a stinging rebuke to his nemesis Hillary Clinton, sources tell me.

Publicly, Obama has remained noncommittal on the 2016 race, but privately he worries that Clinton would undo and undermine many of his policies. There’s also a personal animosity, especially with Bill Clinton, that dates from their tough race six years ago…

Obama has authorized his chief political adviser, Valerie Jarrett, to conduct a full-court press to convince Warren to throw her hat into the ring.

In the past several weeks, Jarrett has held a series of secret meetings with Warren. During these meetings, Jarrett has explained to Warren that Obama is worried that if Hillary succeeds him in the White House, she will undo many of his policies.

He believes that the populist Warren is the best person to convince the party faithful that Hillary is out of touch with poor Americans and the middle class. Warren, in his view, would carry on the Obama legacy after he leaves the White House.

If only they could have it right on this one.

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Republicans Plan Frivolous Law Suit Against Barack Obama’s Use of Executive Power

After over fifty votes to repeal the Affordable Care Act the Republicans are in the need for another gimmick. John Boehner believes he has come up with a new one in suing Barack Obama for doing what he supported when Bush was president. Republicans are giving up their claimed opposition to frivolous law suits to sue Barack Obama for issuing Executive Orders despite the fact that Obama has used issues far fewer executive orders and signing statements than other recent president such as George Bush. As Paul Waldman wrote:

It’s irresistible to charge Republicans with hypocrisy, especially given the fact that they were unconcerned when the Bush administration pushed so vigorously at the limits of presidential power. Bush and his staff regularly ignored laws they preferred not to follow, often with the thinnest of justifications, whether it was claiming executive privilege to ignore congressional subpoenas or issuing 1,200 signing statements declaring the president’s intention to disregard certain parts of duly passed laws. (They pushed the limits of vice presidential power, too—Dick Cheney famously argued that since the vice president is also president of the Senate, he was a member of both the executive and legislative branches, yet actually a member of neither and thus not subject to either’s legal constraints. Seriously, he actually believed that.)

It is certainly hypocritical for Republicans to object to abuse of executive power after they backed Dick Cheney and George Bush’s claims on the Unitary Executive with virtually unlimited power. It is also notable that the problem stems from Republican abuses in the Congress which are responsible for the current gridlock which necessitates executive action.

This flip flop on executive orders includes Speaker Boehner personally:

President Obama has issued about 180 executive orders — a power that has been utilized by every president since George Washington except for the brief-tenured William Henry Harrison — and taken other executive actions. A Boehner spokesman denounced these as “a clear record of ignoring the American people’s elected representatives and exceeding his constitutional authority, which has dangerous implications for both our system of government and our economy.”

But Boehner embraced the power of a Republican president to take action, even at times when he would circumvent Congress by doing so. President George W. Bush’s issued hundreds of orders of his own over his eight years in office. In 2001 and 2007, Boehner strongly supported unilateral actions by Bush to prevent embryonic stem-cell research involving new embryos, saying the 2001 decision “preserves the sanctity of life and allows limited research that could help millions of Americans suffering from life-threatening diseases.” He endorsed a 2008 Bush executive order to limit earmarks. In the final days of Bush’s second term, he even wrote to the president asking him to use an executive order to exempt a historic steamboat from safety regulations after Congress opted not to do so.

Boehner even pushed for administrative compliance with one of President Obama’s executive orders. In 2010, he asked Obama for a progress report on implementation of an executive order banning taxpayer funding for abortion in Obamacare. In a letter to then-Secretary of Health and Human Services Kathleen Sebelius, he noted that the order had “paved the way” for the law’s passage and that the lack of update on implementation “does little to diminish widespread skepticism about the administration’s commitment to enforcing the Executive Order and preventing the law law from increasing federal support for abortion.”

Most likely this comes about in response to demands from the far right wing base. It has cost the Republicans a fortune to block most Tea Party challenges in the primaries this year. In the process the establishment Republican Party has become almost as radical as the Tea Party and is forced to pull stunts such as this. It is largely a way to appease those who are demanding impeachment after the Republicans saw how that worked for them when they tried it against Bill Clinton. I imagine many Democrats would love to see the Republicans try impeachment. For now they will have to settle for this, already using the threatened law suit to raise money.

Democrats have been more successful than Republicans in raising money so far this year with small Democratic donors contributing more to the Democrats than people like the Koch Brothers are donating to the Republicans.  This is undoubtedly coming from a small percentage of the country which is more politically engaged. Ideally we would have a higher percentage of the voters outraged by the Republican tactics and abuse of the democratic process. This is unlikely to occur as the Democrats lack the ability to make an issue out of the ways in which the Republicans abuse the system. Of course it is harder to make voters aware of such problems in a country in which only 40 percent are aware of which party controls which house of Congress.

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Two Polls Give (Limited) Hope For A Democratic Upset In November

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There are two recent poll findings which you might think should help the Democrats in November but most likely will not. Gallup found that the Democratic Party had a favorable rating of 44 percent while the Republicans have a with 34 percent favorable rating.

Unfortunately this type of lead has not necessarily translated into election victories in the past. It also doesn’t help the Democrats that, while leading the Republicans, they are still under 50 percent.

Republicans also have an advantage in House elections due to gerrymandering, and due to the concentration of Democrats in urban areas, leading to a larger margin of victory in a smaller number of districts. Democrats are defending several Senate seats in red states where they would not enjoy this lead over Republicans.

Brendan Nyhan looked at a recent Washington Post-ABC News poll which showed that more people agree with the Democrats on the issues:

More Americans say they trust Democrats than Republicans on the “main problems the nation faces over the next few years” as well as a number of key policy issues, including the economy, health care and immigration. Members of the public also typically indicate that Democrats are closer to their opinion than Republicans on specific issues like abortion, same-sex marriage and raising the minimum wage.

This apparent political advantage is less important than it might seem, however. For instance, Democrats had greater advantages on several major issues at comparable points in the 1994 and 2010 electoral cycles, which both resulted in Republican landslides…

Why haven’t these issue advantages translated into electoral success? First, the midterm electorate is not representative of the American public. The public’s preferences for Democrats on the issues may diminish or disappear once you look at registered voters or those who claim they are “absolutely certain” to vote, as Jaime Fuller of The Washington Post has noted. The Democrats’ edge on the issues is likely to dissipate further among the older, whiter group of Americans most likely to vote in November.

In addition, the importance of the issues in congressional elections is typically overstated. Structural factors like presidential approval, the state of the economy, the type of election (midterm or presidential year) and the composition of the seats that are up for election tend to matter more.

Most likely, based upon fundamentals in a midterm election the Republicans should do better than the Democrats. However, if the Democrats are seeking to significantly beat historical expectations, they sure have a better chance at the upset if they are the party which a majority support than if they did not have this support. How they do will depend a lot on whether the Democrats can get more of their supporters out to vote than is typical in midterm election years.

While the Democrats face a difficult task in holding onto Senate seats in the red states, there is an advantage to incumbency which should allow some to win. This might be enough to allow the Democrats to maintain control of the Senate until 2016 when the fundamentals are in their favor, including having an election year electorate and it is the Republicans who will be defending Senate seats in several blue states.

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Vulnerable Democrat Takes Offensive On Obamacare

I have been writing for a while that Democrats need to take the offensive on the Affordable Care Act. As long as they fail to promote its significant accomplishments, voters will only hear the Republican misinformation. If Democrats act scared, people will assume they have something to be afraid of. I was happy to see this example of a Democrat in a tight race using Medicaid expansion in the Affordable Care Act to her benefit:

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A Closer Look At Insurance Cancellations Under The Affordable Care Act

Last fall opponents of the Affordable Care Act made noise way out of proportion to its actual meaning when insurance companies sent out cancellation letters to policy holders whose policies were not compliant with the law. A combination of the initial failings of healthcare.gov and exaggerated reports on cancellations led to much of the negative publicity about the Affordable Care Act which still has many Democrats reluctant to run on the party’s accomplishments. President Obama subsequently allowed these policies to be grandfathered in even if not meeting the initial qualifications for being grandfathered, but questions persist regarding winners and losers under Obamacare. A study in the current issue of Health Affairs provides some information on those whose policies were canceled.

The study’s key finding was that there is normally a high degree of turnover in policies on the individual market, and most of the people who received cancellation letters would have changed insurance even if there were no changes under the Affordable Care Act:

The Congressional Research Service has estimated that 10.8 million people had nongroup coverage in 2012.6 According to my estimates for the sample population, this suggests that 6.2 million Americans typically leave nongroup coverage each year. Presumably some of them do so voluntarily, because they qualify for Medicaid or start a new job with employer-sponsored coverage. Others lose coverage through inability to afford increased premiums, loss of income, or changes in health status that affect eligibility for nongroup insurance.

In this context, reports that recent cancellations of coverage may affect as many as 4.7 million adults (though precise estimates are lacking)6 are likely capturing a great deal of the normal turnover in this market. The findings presented here also suggest that overall coverage rates in the United States are unlikely to fall as a result of these cancellations: Most people who left nongroup coverage in this study acquired other insurance within twelve months, even before the ACA offered increased coverage via the Medicaid expansion and tax credits for Marketplace insurance.

Of course, the ACA’s regulations are presumably leading some people to lose nongroup coverage that they would prefer to keep. The results of this study indicate that certain subsets of people—in particular, those who are older than thirty-five, white, or self-employed—with nongroup insurance are likely to retain that coverage for three years or more. For some people who were covered by nongrandfathered plans, cancellations related to the ACA represent an unwanted change in coverage options that may be quite disruptive.

However, the ACA creates a range of new coverage alternatives via Medicaid and the Marketplaces. In addition, most insurance companies that are issuing cancellations are making efforts to enroll into alternative plans those customers receiving cancellation notices.19 Notably, 65 percent of the sample in this study had incomes below 400 percent of poverty. This suggests that many, if not most, of those who received cancellation notifications are now likely to be eligible for subsidized coverage that may be less expensive than their previous insurance.

This study’s findings are also relevant to the issue of premium “sticker shock”—which occurs when a person has to pay significantly more than in the past to remain covered by a plan—in the nongroup market. Some policy makers have expressed concern that the market reforms in the ACA are leading to significantly higher premiums for many healthy young adults (particularly men)20 and may lead people to drop their current coverage.

In this context, it is notable how rapid coverage turnover was among adults ages 19–35 in this study. Even before the ACA was implemented, nearly 80 percent of these adults experienced a change in coverage within two years. Undoubtedly, some adults in this age range with nongroup coverage will experience premium increases due to the ACA. However, most of them will qualify for lower premiums due to tax credits,21 and many of them will experience even larger declines in total out-of-pocket spending because of reduced cost-sharing requirements. Thus, true “sticker shock” is the exception rather than the rule for younger adults in this rapidly changing market.

While the study did find that most people would have changed insurance polices regardless of requirements under the Affordable Care Act, and the majority of people changing policies wound up paying lower premiums, there was a significant subset of older, white, self-employed individuals who received cancellation notices who otherwise might have kept the same insurance plan. Of this group, sixty-five percent qualified for subsidies.

The thirty-five percent of this group who wound up paying higher premiums might be consider “losers” because of the change, but it is not that simple. As I pointed out last month, one group of actual winners under Obamacare are the satisfied unsubsidized. Many people in this group, including myself, were offered alternative less expensive plans from our insurance companies but chose to purchase more expensive plans because of the added benefits of compliance with the regulations under the Affordable Care Act. These benefits include a cap on out of pocket expenses, coverage of preventative services with no copay or deductible, and, most importantly, being non-cancelable if there is a change in medical condition.

Policies sold in the past on the individual market were often less expensive as they were primarily sold to healthy individuals who the insurance companies did not anticipate having high medical expenses. A policy which must be sold to anyone, regardless of health status, is obviously going to cost more. Policies on the individual market often were severely limited in their coverage, with subscribers often unaware of the limitations unless they developed medical problems and found that their older plans did not cover them as well as they anticipated. For many people, it is to their benefit to replace older policies sold on the individual market with new policies which are compliant with the Affordable Care Act.

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Republican Extremism Gives Democrats The Edge

Jonathan Chait looked at demographic and political trends to consider whether the trend towards the Democratic Party is likely to continue. Much of what he wrote is a recap of the conventional wisdom these days, with some disagreeing. He considered multiple factors including the tendency of the young and minorities to vote Democratic. To some degree this could be offset by an increased trend for white voters to vote Republican out of a backlash against the increase in minorities. While Democrats are expected to dominate in presidential elections, there certainly can be exceptions if there is a major occurrence favoring Republicans as the party out of power. Plus Republicans should continue to maintain a sizable portion of Congress due to the higher turnout among Republicans in off year elections as well as structural advantages in each House. Republicans have an advantage in the House of Representatives due to gerrymandering and the greater concentration of Democrats in urban areas, giving Democrats victories by larger margins in a smaller number of states. Republicans have an advantage in the Senate due to smaller Republican states having the same number of Senators as the larger Democratic states. Republicans therefore have a reasonable chance of controlling each House, or come close as is now the case in the Senate, despite a larger number of people voting for Democrats to represent them.

The key point which gives us our status quo, and gives the Democrats the edge, is that the Republican Party is now firmly in the hands of a radical fringe which will always have difficulty winning a national election, but which is unlikely to change in the foreseeable future:

My belief, of which I obviously can’t be certain, is that conservatism as we know it is doomed. I believe this because the virulent opposition to the welfare state we see here is almost completely unique among major conservative parties across the world. In no other advanced country do leading figures of governing parties propose the denial of medical care to their citizens or take their ideological inspiration from crackpots like Ayn Rand. America’s unique brand of ideological anti-statism is historically inseparable (as I recently argued) from the legacy of slavery. Whatever form America’s polyglot majority ultimately takes, it is hard to see the basis for its attraction to an ideology sociologically rooted in white supremacy.

Jonathan Bernstein sees the United States as remaining more of a 50:50 nation as in 2000, also citing George Bush’s victory over John Kerry in 2004. However the Democratic advantage in the electoral college has increased tremendously since 2000 when George W. Bush was able to come in a close enough second to take the presidency due to irregularities in Florida and a friendly Supreme Court. This victory in 2000, along with the 9/11 attack, gave Bush, as an incumbent during time of war, an edge which future Republican candidates are unlikely to enjoy.

The current political divisions won’t last in their current form forever. At sometime there is likely to be a major event which shakes up the current divisions. Chait noted that this might have been the 9/11 attack if the Republicans hadn’t squandered their political advantages by their disastrous invasion of Iraq. I would add to that being on the wrong side of far too many other issues prevented the Republicans from becoming a long-term majority party.

Most likely at some point in the future the far right will lose their grasp on the Republican Party as those who actually want to be able to win an election eventually regain control. Perhaps this will come as a newer generation rejects the most extreme ideas of the current conservative movement. If the Republicans don’t change, eventually a third party might challenge them, as difficult as it is for third parties to compete in our current political system. We might also see the Republicans persisting in their current form as a southern regional party as others battle for political control in the rest of the country.

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Republicans Will Soon Regret Being The Party Of Repealing Obamacare

The Affordable Care Act has exceeded expectations where ever we have measurements, such as in people signing up, despite the Congressional Budget Office reducing their prediction after the computer problems in October. The Republican horror stories have been debunked whenever the facts have been examined. There are no death panels, and the Republican predictions of doctors refusing to see Obamacare patients or long waits have turned out to be false. Health insurance companies desire to increase participation in the exchanges, and premium increases are projected to be far less than Republicans have predicted. However, despite the success, the debate over Obamacare is unlikely to end soon. Far too many Republicans suffer from Obamacare Derangement Syndrome.

This includes a degree of short term memory loss. The individual mandate, selling insurance through exchanges, and high deductible plans to discourage spending are all conservative ideas which most Republicans supported up until the Affordable Care Act was nearing passage in Congress. This year Republicans will continue the attacks on Obamacare because of the intensity of opposition among Republican voters. Elections, especially off-year elections, have become far more about motivating the base to get out to vote as opposed to convincing undecided people to vote for your party. Repeating the same lies about the Affordable Care Act will motivate their voters to get out to vote. If Democrats, who at times are almost as inept at campaigning as Republicans are at governing (and predicting the effects of Obamacare), continue to cower in fear over their own accomplishments, there will be little to motivate as many Democrats to get out and vote.

However the realities will change over time, as First Read explained:

It’s easy to explain why the GOP doesn’t want to move on. Health care is the issue that fires up the base; it unites a party that’s divided on other issues; and the law remains mostly unpopular in most public-opinion polls. Obama even recognized this when he talked about possible bipartisan fixes to the health-care law during his news conference yesterday. “My suspicion is that probably will not happen until after November, because it seems as if this is the primary agenda item in the Republican political platform.”

That’s a short-term winner but a long-term problem

That political platform looks like a short-term winner in the upcoming midterm elections, with the GOP having an excellent opportunity of winning back the Senate. But it raises other long-term challenges. What do you do with the eight million Americans who now have insurance on the exchanges, and with the 24 million Americans who are projected to be on the exchanges by 2017 (the next time there’s the possibility of a GOP president)? What about the millions more who have insurance via expanded Medicaid or via their parents’ insurance? And how do you advocate repeal and replace when you don’t have a detailed legislative alternative (that’s scored by the Congressional Budget Office)? Come 2015 and 2016, Republican presidential candidates could very well find themselves in an unsustainable position — having to campaign on a repeal message in the primaries (because that’s what GOP voters want), but then having to face a general electorate that’s more hostile to the idea (because repeal doesn’t poll well outside the GOP).

Americans will not want to repeal Obamacare when they consider what this means. We cannot take away health insurance from millions, and place many more at risk of losing coverage should they become sick. In the near future, to argue to repeal Obamacare will sound as absurd as arguing to repeal Medicare. Of course those who think that Republicans have really moved beyond wanting to repeal Medicare haven’t paid enough attention to the Ryan budget which Republicans have repeatedly voted to support.

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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.”

Cross posted at The Moderate Voice

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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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Good News On Obamacare Enrollment Leading To More Favorable Coverage

Democrats have suffered damage from the Affordable Care Act far more from negative press than actual negative results. Of course they make the problem far worse by running away as opposed to standing up for the successes of the Affordable Care Act. Two stories last fall did the most harm–the failed roll out and news of people receiving cancellation letters. The computer problems were IT issues which have nothing to do with the benefits of the Affordable Care Act as policy. Now that we have some data on enrollment, we know that the initial IT problems did not decrease enrollment at all from initial projections. We also now know that most of the people who received cancellation letters received alternate coverage, frequently from the same company, with better coverage at a lower price.

Bad news tends to lead to more bad news but good news often leads to more good news, and hopefully the Democrats will show the ability to capitalize on it. Republicans who made claims of Obamacare leading to fewer people having coverage or failing to meet projections look as foolish as the Republicans who ignored the polls and projected a Romney victory in 2012. Instead of negative stories, we are seeing stories such as this from Politico: Obamacare critics: Homina, homina, homina:

Back in the fall, conservatives seized on the flubbed Obamacare rollout as proof that President Barack Obama’s brand of liberalism doesn’t work.

Now, the law’s opponents aren’t about to say that critique was wrong — but they’ve lost the best evidence they had.

On Tuesday, Obamacare sign-ups passed 7 million, six months after the launch of a federal website that could barely sign up anybody. There are still a lot of questions about how solid that figure is, but the idea that the law could even come close to the original goal after such a disastrous start would have been laughable even a few weeks ago.

It was also a wake-up call for Republicans and conservatives, and even the occasional liberal, who pushed the argument that the failed website challenges the idea at the heart of Obama’s agenda — that government can still solve big social problems.

Of course Fox and other right wing outlets are still running negative headlines, but otherwise success is leading to the rest of the media being more positive. While conservatives spread false stories of Obamacare nightmares, there are more stories on those who benefit under the Affordable Care Act. The New York Times has pointed out that many people have purchased insurance directly from insurance companies in addition to the over seven million purchasing through the exchanges:

Millions of newly insured people are hiding in plain sight.

They are the people who have bought new health insurance since the start of this year but have chosen for one reason or another to bypass the state and federal exchanges that opened last year under the Affordable Care Act. While the exact number is unknown, some health care experts estimate that it may be in the millions.

Politicians and policy makers have focused on the number of people who signed up through the exchanges — at nearly seven million and counting a day after the March 31 deadline — but they have largely overlooked the group that did not use the exchanges, even though it could have a major impact on the program’s financial success in the years ahead…

All individual health insurance plans offered after Jan. 1 must adhere to several new requirements, regardless of whether they are bought through the marketplaces. Insurers must offer more comprehensive coverage and charge healthy and sick people the same rates. And they can no longer turn people away if they have existing medical conditions.

It makes little difference to insurers how the new customers arrive at their door: What matters most is that they get there. Insurers must bring in enough new customers, including a significant number of healthy ones, to offset the higher costs of complying with the law.

Aaron Billger, a spokesman for Highmark, an insurer that offers plans in Delaware, Pennsylvania and West Virginia, said about 30 percent of the approximately 133,000 members that Highmark had enrolled as of mid-March had signed up outside the marketplaces. The large insurer WellPoint, which has said it expects to enroll about one million customers nationwide in new plans, has reported that about 20 percent of its sign-ups have occurred off the exchanges.

Some people are saving money by purchasing insurance from co-ops which are being set up in some states thanks to the Affordable Care Act as an alternative to the large insurance companies. It is too soon to tell whether they will really lower costs, but they do sound like a promising alternative:

The names of the big health insurance companies are familiar – Blue Cross, Aetna, United Healthcare. But what about CoOportunity Health, or Health Republic Insurance of New York?  These are among 23 new health insurance companies that started under the Affordable Care Act.  They’re all nonprofit, member-owned cooperatives, and the aim is to create more competition and drive prices down…

“In some states, co-ops are dominating the marketplace, with 80 percent of the enrollees going to the co-op,” he says.

That’s in Maine. Morrison says most co-ops are very happy with their enrollment numbers. Their rates are often the lowest available through an exchange.

“The co-op states have 8.4 percent lower premiums on average than the non-co-op states, across the marketplace,” says Morrison. “So co-ops are creating that competition. They’re keeping rates down in the states they’re operating in.”

The Los Angeles Times told the story of a cancer patient who benefited from Obamacare:

Robertson wrote a passionate account of his cancer and posted it on the White House website to illustrate how important insurance is even for younger people. Noting that he had paid just 1% of the $900,000 cost for five surgeries, radiation and chemo, he wrote, “Without that, I would have bankrupted my family just to stay alive.”

And without Obamacare’s guarantee that he could buy affordable insurance despite his preexisting medical condition, he wrote, “there’s no telling what life would have been like for us moving forward.”

A major benefit of the Affordable Care Act is to enable people to obtain coverage on the individual market who had difficulty obtaining coverage in the past, when most coverage outside of government programs came from large businesses. There have already been stories on some of the winnersPolitico reported on how Obamacare has helped self-employed artists and actors:

Abromaitis is among the hundreds of thousands of artists, musicians, dancers, actors and filmmakers around the country who especially stand to gain under Obamacare, either through the plans and premium subsidies available on its new insurance exchanges or from the plans employers must start offering.Typically a well-educated but lower-earning demographic — whose members are self-employed more often than not — these Americans have frequently struggled to buy insurance on their own. Some were able to afford union plans, but others paid for costly coverage on the individual market or went without it despite the risk.

A survey last year by The Actors Fund found that 43 percent of individuals working in the visual and performing arts lacked coverage, more than double the national uninsured rate. More than a third of those who had coverage said they got it on the individual market, compared with the 6 percent of Americans generally who turn there for health insurance.

Many are now flocking to Obamacare’s federal- and state-run exchanges, hoping for a way to get covered without breaking the bank. They’re finding both good and bad: more affordable plans but sometimes narrow provider networks and high deductibles.

The narrow provider networks and high deductibles did come as a surprise to some but this has actually been a characteristic of insurance sold through the individual market for a long time. When I purchased new coverage (directly from the insurance company, bypassing healthcare.gov), there was a choice of policies with more restrictive networks with a lower premium, along with choices without restrictive networks but with a higher premium. Most people who wind up in plans with the most restrictive network did so out of a choice to save money. The choices I saw were no different from the choices offered prior to the Affordable Care Act. The difference was that the coverage was far more comprehensive, had new limits on out of pocket expenses, and could never be canceled due to medical problems.

There is far  more good news this week on the Affordable Care Act. Hopefully the Democrats will finally stop being scared of negative and false attacks from Republicans and go on the offensive and develop a new message to take political advantage of the law they passed.

Cross posted at The Moderate Voice

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