Single Payer Coming?

It looks like we might be heading in the direction of a single payer health care system, but note in the way we wanted. Aetna is seeking to buy Humana. While this would not actually be single payer, it would further decrease competition in the insurance industry. There is also speculation that UnitedHealth is interested in purchasing Cigna and Aetna. Instead of a single=payer system modeled on Medicare, we could wind up with a more monopolistic system, which should please Republicans. These purchases would be subject to anti-trust review.

Aetna purchasing Humana would also give Aetna a much larger share in the Medicare Advantage market. So much for George Bush’s plan to supposedly increase competition and choice for Medicare patients. The plan has was more designed as a reward to the insurance industry for all the contributions they have made to the Republicans.

In related news, The New York Times repeated misleading information on health care rates which I previously discussed. Only plans desiring rates over ten percent are required to submit their requests. Insurance companies have multiple plans, and are only seeking increases on some plans, leaving less expensive choices for those who take advantage of the exchange to compare plans. Plus the requests for larger rate increases will not necessarily be granted.

However, should private insurance rates still be too high, single payer remains the most cost-effective means of providing health care coverage. This could turn into a major issue in Bernie Sanders’ favor.

Please Share

Two Liberal Decisions From A Conservative Court

Rainbow White House

It has been a good week for liberal decisions form a conservative court. Yesterday, as I was certain they would, they threw out the absurd case against the Affordable Care Act. I’m not sure that this really changes anything. Conservatives will continue to complain about the law, but lack any effective way to repeal it, and certainly have no alternative.

The case made no sense and if Roberts had wanted to destroy Obamacare he would have done so when they ruled on the individual mandate. In this case it isn’t so much that the Supreme Court has become more liberal, but that the Supreme Court is not willing to go along with every ridiculous case brought by conservatives. Earlier in the week, The New York Times showed that the court has made more liberal decisions this year. Brendan Nyhan followed this up discussing a reason why the court might appear more liberal when it is not:

In a 2009 article, the political scientists Kevin T. McGuire, Georg Vanberg, Charles E. Smith Jr. and Gregory A. Caldeira proposed a theory that provides an alternate explanation to liberal drift. They predicted that conservatives would press their luck to take advantage when they had a majority on the court, appealing more cases they lost in lower courts. (Conversely, liberals would be less likely to appeal cases because they were more likely to prefer lower-court decisions and to fear creating damaging precedents.) Mr. McGuire and his co-authors then showed empirically that this process increased the number of conservative reversals of lower-court rulings but also increased the number of cases in which a more liberal ruling was affirmed because litigants guessed wrong about how far the court was willing to go.

Their prediction seems to fit nicely with recent evidence. The court has reversed lower-court decisions and decided in favor of conservatives on high-profile cases concerning issues like campaign finance and voting rights. But Justice Kennedy and/or Chief Justice Roberts have joined the liberal wing to affirm more liberal lower-court rulings in cases like today’s decisions on health care and housing.

The case also did show a degree of sanity on the court in deciding against an argument which only bat-shit crazy conservatives(such as George Will) could accept. It also demonstrated that at least one justice was persuadable as it takes four justices to accept a case, and only three stuck with this argument in the end.

The decision in favor of same-sex marriage was also predictable but is far more significant. It really does change the status quo for those living in states where same-sex marriage has remained illegal. Andrew Sullivan returned to blogging to describe what this meant to him:

We are not disordered or sick or defective or evil – at least no more than our fellow humans in this vale of tears. We are born into family; we love; we marry; we take care of our children; we die. No civil institution is related to these deep human experiences more than civil marriage and the exclusion of gay people from this institution was a statement of our core inferiority not just as citizens but as human beings. It took courage to embrace this fact the way the Supreme Court did today…

I think of the gay kids in the future who, when they figure out they are different, will never know the deep psychic wound my generation – and every one before mine – lived through: the pain of knowing they could never be fully part of their own family, never be fully a citizen of their own country. I think, more acutely, of the decades and centuries of human shame and darkness and waste and terror that defined gay people’s lives for so long. And I think of all those who supported this movement who never lived to see this day, who died in the ashes from which this phoenix of a movement emerged. This momentous achievement is their victory too – for marriage, as Kennedy argued, endures past death.

This case also shows how the Republican Party has moved to the right while the nation has become more liberal on social issues. Compare the views of the Roberts Court with this year’s presidential candidates which are summarized at BuzzFeed. In 2004 Republicans successfully used proposals to ban same sex marriage to turn out the vote in their favor. While opposition might help some candidates in Republican primaries, it will also hurt them in the general election.

In 2013 I had posted a prediction from George Clooney which is far closer to coming true:

 

Please Share

CDC Reports On Decrease In Uninsured Under Affordable Care Act

The CDC reports the percent of uninsured showed the largest drop since they began reporting data on this, consistent with other measures of the decrease in uninsured under the Affordable Care Act such as the Gallup poll.

The share of working-age people without health insurance fell by more than 4 percentage points in 2014, the biggest drop since the U.S. Centers for Disease Control and Prevention began reporting the data in 1997.

Last year, 16.3 percent of adults under age 65, or about 31.7 million people, lacked medical coverage, according to a CDC survey published Tuesday. That’s down from 20.4 percent a year earlier.

Many people are able to receive coverage due to eliminating the ability of insurance companies to deny coverage based upon pre-existing conditions. Many also are assisted by the subsidies which help them pay for the insurance premiums under Obamacare.

We are now waiting to see how the Supreme Court rules on King v. Burwell. Even if the Supreme Court accepts this fallacious argument that the law only intended to provide subsidies for those purchasing insurance on the state exchanges, and not the federal exchange, I would expect some sort of fix to enable the subsides to continue. The Republican Congress would be under tremendous pressure to cooperate in making a slight revision to the Affordable Care Act to continue the subsidies. If they did not, I bet some way would be found to make versions of the federal exchange available to the states.

Of course we cannot underestimate the possibility of Republicans to deny health care coverage, as we saw with the expanded Medicaid program:

States that expanded Medicaid through Obamacare provisions had lowers rates of uninsured, the CDC said. In states that didn’t expand Medicaid, 19.3 percent of adults under 65 were uninsured, compared with 13.3 percent in states that did.

Most people 65 and over get coverage through Medicare, the U.S. government program to cover the elderly.

Texas and Oklahoma had the highest rate of uninsured at 21.5 percent; neither state expanded Medicaid under the Affordable Care Act. Hawaii had the lowest rate, with 2.5 percent uninsured last year.

Please Share

Don’t Believe The Latest Round Of Scare Stories On Health Insurance Premiums

health care reform

There have been a number of scare stories recently predicting huge increases in health insurance premiums for 2016 due to Obamacare. This year premiums went up much less than predicted and most likely the current predictions of doom will not come about. Two recent stories from NPR’s Morning Edition and The Hill provide a more realistic outlook:

The average insurance premium under ObamaCare is probably not headed toward a double-digit hike next year, according to new data.

Premiums for silver plans on the federal insurance exchanges are slated to increase an average of 5.8 percent in the eight states where all data is available, according to an analysis by Avalere Health. For the lowest-cost silver plans, that increase will be 4.5 percent, or an average of $378 per year.

That data, which includes Maryland and Michigan, comes after a string of headlines predicting steep cost increases for health insurance plans in 2016.

“While recent public attention has focused on a subset of plans that filed for premium increases of 10 percent or more, these data reveal that most plans are proposing more modest increases,” said the group’s senior vice president, Caroline Pearson.

Health insurance companies were required to file their rate increases by June 1, though under law, most are only required to seek approval for hikes of 10 percent or more — resulting in a skewed portrait of the increases.

That is an important point that the news is coming from those plans which are requesting the largest increases while the plans which desire lower increases do not make news. Morning Edition had more to put this in perspective.

The numbers released last week came out of a June 1 deadline, under the Affordable Care Act, that requires insurance companies to tell government regulators when they’re requesting price hikes of more than 10 percent. Some officials opposed to the law, like Sen. Steve Daines, a Republican from Montana, decried the increases.

“Blue Cross Blue Shield, which is Montana’s largest insurer, is asking for an average increase of 23 percent for Montanans enrolled in individual plans,” he told colleagues from the U.S. Senate floor last week.

While that sounds scary, it turns out that Blue Cross Blue Shield in Montana is actually asking for large price hikes on just two plans it wants to offers in the state. While it’s not yet public how many they’ll offer in 2016, they currently offer 50 plans.

Caroline Pearson, vice president for health reform at the consulting firm Avalere Health, has been digging into available numbers on insurance pricing across several states. She says such price hikes are not the norm. She’s not seeing anything like a 20 percent average increase in the price of monthly premiums.

“Those are not necessarily the plans that hold the bulk of enrollment,” she says. “So, while some of those plans may be going up a lot in price, that doesn’t mean a lot of enrollees are necessarily affected.”

In the handful of states where data is available (Connecticut, Maryland, Michigan, Oregon, Virginia, Vermont, Washington state and Washington, D.C.), Pearson says the majority of people buying health coverage on exchanges won’t face serious sticker shock.

“We have seen that about 6 percent average rate increases are expected for 2016,” Pearson says.

As Avalere looks at the less expensive plans, she says, “We’re seeing anywhere from a 5 percent increase for the lowest-cost plan available, to a 1 percent increase for the second-lowest-cost plan available. So we’re really looking at very modest increases — very consistent with what we saw from 2014 to 2015.”

With some plans planning large increases while other plans, including some from the same company, are only likely to have modest premium increases, my suspicion is that insurance companies are counting on some customers sticking with the same plan without shopping around. They will receive higher profits from those who stick with plans which jump the most in price, while consumers who take advantage of the exchange can switch to plans without huge premium increases.

Also note that these increases making the news are only requests. Another change under the Affordable Care Act is that it is possible that these larger premium increases will be denied.

As long as health care remains based upon private insurance companies we will continue to see premium increases. After all, double digit increases in premiums were extremely common before the Affordable Care Act was passed. While the ACA has expanded health care coverage and has resulted in some lower costs, the bulk of the proposed cost-containing provisions were stripped form the bill in order to achieve sixty votes to pass in the Senate. Some of the remaining provisions to lower costs are based more on long term changes in health care.

If cost control was the goal, then it would have made more sense to go for a single-payer plan as opposed to the far more modest bill which passed. Ironically Bill Kristol recently suggested, in an interview with Ezra Klein, that this is what the Democrats should have done:

Kristol’s perspective on this will be of some comfort to liberals. “I was never convinced that single-payer wouldn’t be more attractive than Obamacare,” he says. “I think there was some truth to the left-wing critique of Obamacare. You’re building this giant contraption, making people worried about disruption, but you’re helping a rather limited number of people. In a funny way, if you’re doing a middle-class entitlement, you should do a big middle-class entitlement.”

The problem is that there would have never been sixty votes to pass a single-payer plan. If ideas such as the public option and a buy-in to Medicare had to be dropped because of the opposition from Joe Lieberman and Ben Nelson, there is no way that sixty votes could have been obtained for a single-payer plan. The same article points out how Obamacare passed while Hillary Clinton’s more extensive plan from the 1990’s, which “would have upended the health insurance of most Americans” was easier for Republicans to defeat.

Please Share

Bernie Sanders Answers Questions And NBC Advises Not To Count Him Out

Bernie Sanders facebook

Bernie Sanders will be holding a rally in Vermont to kick off his campaign tonight. Sanders answered ten questions from MSNBC–almost as many questions Hillary Clinton has answered in her entire campaign to date. Some excerpts, which show that while on the left of our political spectrum, he is still not out to destroy our market system as conservatives are bound to claim.

HARWOOD: In the latter part of the 20th century, Ronald Reagan came along and there was a big pivot in our politics. It revolves around the idea that we need less government and more market forces. Do you think that basic pivot was wrong?

SANDERS: Let me answer it this way, John. I think there is obviously an enormously important role for the free market and for entrepreneurial activity. I worry how free the free market is. In sector after sector, you have a small number of companies controlling a large part of the sector.

Certainly, in my view, the major banks should be broken up. We want entrepreneurs and private businesses to create wealth. No problem. But what we’re living in now is what I would call—what Pope Francis calls—a casino-type capitalism, which is out of control, where the people on top have lost any sense of responsibility for the rest of the society. Where it’s just “It’s all me. It’s all me. And to heck with anybody else.” I want to see the result of that wealth go to the broad middle class of this country and not just to a handful of people.

HARWOOD: If the changes that you envision in tax policy, in finance, breaking up the banks, were to result in a more equitable distribution of income, but less economic growth, is that trade-off worth making?

SANDERS: Yes. If 99 percent of all the new income goes to the top 1 percent, you could triple it, it wouldn’t matter much to the average middle class person. The whole size of the economy and the GDP doesn’t matter if people continue to work longer hours for low wages and you have 45 million people living in poverty. You can’t just continue growth for the sake of growth in a world in which we are struggling with climate change and all kinds of environmental problems. All right? You don’t necessarily need a choice of 23 underarm spray deodorants or of 18 different pairs of sneakers when children are hungry in this country. I don’t think the media appreciates the kind of stress that ordinary Americans are working on. People scared to death about what happens tomorrow. Half the people in America have less than $10,000 in savings. How do you like that? That means you have an automobile accident, you have an illness, you’re broke. How do you retire if you have less than $10,000, and you don’t have much in the way of Social Security?

HARWOOD: It came out in disclosure forms the other day that Hillary Clinton and Bill Clinton, in the last 16 months, have made $30 million. [More on their disclosure here.] .What does that kind of money do to a politician’s perspective on the struggles you were just talking about? Does it make it difficult for recipients of that kind of income to take on the system?

SANDERS: Well, theoretically, you could be a multibillionaire and, in fact, be very concerned about the issues of working people. Theoretically, that’s true.

I think sometimes what can happen is that—it’s not just the Clintons—when you hustle money like that, you don’t sit in restaurants like this. You sit in restaurants where you’re spending—I don’t know what they spend—hundreds of dollars for dinner and so forth. That’s the world that you’re accustomed to, and that’s the world view that you adopt. You’re not worrying about a kid three blocks away from here whose mom can’t afford to feed him. So yes, I think that can isolate you—that type of wealth has the potential to isolate you from the reality of the world.

HARWOOD: I read an interview that you did about the corporate media. And you said the corporate media was reluctant to call out people for lying in public debates. You’re on corporate media right now. Who’s lying in our politics?

SANDERS: I’m the ranking member of the Budget Committee, OK? Leader of the opposition. The Republican budget does the following: It throws 27 million people off of health care by ending the Affordable Care Act and cutting Medicaid by $440 billion. Have you seen that in print? Have you seen that statement? There is a reality that goes on here. And you have many people who try to be, “Oh, I’ve got to be even-handed here and even-handed there. You got the Koch Brothers there, Bernie Sanders there.” That’s nonsense. And I think a lot of right-wing people get away with murder because the media doesn’t call them out on it.

Elsewhere at NBC, Steve Kornacki advised not to count Bernie Sanders out, although he was writing more in terms of Sanders winning enough delegates to shape the platform. That is hardly a satisfactory outcome if it still means Clinton wins the nomination. It is not as if a more liberal platform has any real bearing on what she will do if elected.

First Read has a slightly different, and more desirable, take:

For political historians out there, think of Sanders as a potential Eugene McCarthy. McCarthy’s ability to gain traction against LBJ drove LBJ out in 1968 and sparked more Dems to run. If Sanders gets enough traction to actually knock off Clinton in an early state, then Katie bar the door.

The closest political analogy would be the sitting Vice President winning on to win the nomination as Hubert Humphrey did in 1968. While Joe Biden is not my first choice, he would be far preferable to Clinton. He spent four years opposing Clinton’s more interventionist views when she was Secretary of State, and it was Biden who pushed Obama into announcing support for same-sex marriage. Knocking out Clinton could also result in other more liberal Democrats entering the race. Martin O’Malley, who will be announcing his candidacy later this week, is certainly seeing such a scenario as opening the way for him to win the nomination. I also wouldn’t rule out the chances of Sanders himself winning.

Update: Text of Sander’s speech here.

Please Share

Good News In Polls On Obamacare, Obama, And The Economy

Kaiser Health Tracking Poll April 2015

There is some favorable news in a couple polls out today. A Kaiser Health Tracking Poll shows that the number who view the Affordable Care Act favorably or unfavorably is now evenly split, with 43 percent having a favorable view and 42 percent unfavorable. This remains within the margin of error and, while still lower than it should be considering how well the law has worked, is an improvement over previous polls. Last month 43 percent viewed the law unfavorably and 41 percent favorably. A year ag0 46 percent viewed Obamacare unfavorably compared to 38 percent favorably. As expected, there was a large partisan difference in these findings. The poll also showed that few people realize that implementation of the Affordable Care Act has cost less than originally estimated.

A CNN/ORC poll shows an improved approval rating for President Obama, along with increased optimism about the economy:

For the first time since May of 2013, more Americans polled say they have a positive impression of how Obama is handling the presidency than a negative one: 48% approve of the way Obama is handling his job, while 47% disapprove…

Obama’s numbers are on the rise at the same time the public gives the economy the highest ratings of his presidency.

The poll finds 52% describe the U.S. economy as very or somewhat good, while 48% call it very or somewhat poor. That marks the first time since Obama took office that significantly more people describe the economy as “good” than “poor,” and only the second time since then that a majority has described the nation’s economy as “good.”

…Likewise, the public’s outlook for the country’s economic future is remarkably positive. Sixty percent say they expect the economy to be in good shape a year from now, while just 38% say they think it will be in poor shape. That’s the most positive outlook since the height of the 2012 election campaign. Such campaigns typically boost optimism about the economy as people on both sides of the ideological divide believe their candidate will win and ultimately turn things around.

But outside of that campaign, the last time optimism about the economy reached 60% was in April 2009, about three months into Obama’s time in office.

Please Share

Hillary Clinton Begins Campaign Hiding From Press & Marco Rubio Jumps In

Clinton Announcement Video Screen Grab

Hillary Clinton has started her campaign, and is already hiding from the press. From The Los Angeles Times:

Hillary Rodham Clinton shocked nobody in the media when she announced that she was running for president on Sunday – but her next move took reporters by surprise.

Clinton didn’t get on a campaign plane and head to Iowa. Instead, she and a small group of staff piled into what the candidate calls the Scooby van. They are road-tripping it to Iowa. The press was not invited.

Peter Beinart at The Atlantic was far more impressed with Clinton’s video announcing her campaign than I was, but his article might not be doing her any favors. Beinart reminded readers of all the conservative imagery in previous Clinton announcements and her long history of cultural conservatism:

Here are some of the phrases that appeared in Hillary’s 2000 senate announcement: “voluntary uniform rating system for movies and films,” “welfare,” “more police on the streets,” “teacher testing in the face of boycotts,” “I don’t believe government is the solution to all our problems” and “parents, all parents, must be responsible.” The message was pure Clintonism, as developed when Bill ran the Democratic Leadership Council in the early 1990s: To deserve government help, people must be morally responsible. And it came naturally to a senate candidate who, although caricatured as a sixties radical, was better described, by a former White House aide, as “a very judgmental Methodist from the Midwest.”

In 1993, Hillary had declared herself “not comfortable” with distributing condoms in schools. In 1994, she had endorsed “three strikes and you’re out” laws that expanded prison sentences.

In 1996, she had backed Bill’s decision to sign the anti-gay Defense of Marriage Act. And in the 2000 senate campaign, she supported parental notification laws for children seeking abortions, a position that placed her to the right of her initial Republican challenger, Rudy Giuliani.

I agree with Beinart that this year’s video displayed more liberal imagery, but it was just imagery. Nothing was said about actual political positions or plans upon taking office. Until she shows evidence otherwise, and there is a long way to go, this video is not enough to believe that she has really changed. In many ways Hillary Clinton has remained the same Goldwater Girl she was in the 1960’s (except that Barry Goldwater was more socially liberal than Clinton, and not much more hawkish).

At Salon, (better known in the blogosphere as just Digby) warned about the Dangers of a Hillary Clinton campaign: The disastrous centrism she desperately needs to avoid.

Barack Obama says that he and Hillary are friends (she is likable enough after all) but he won’t automatically endorse her. After all, “there are other people who are friends of of the president” who still might run. This must make the Draft Biden movement happy. Joe Biden has never been my top choice for president, but I sure wouldn’t mind seeing him get into the race against Clinton. Biden spent the first four years of the Obama administration opposing Clinton’s hawkish views, and I would like to see this explored during the campaign. Plus Biden gets points for the manner in which he pushed Obama to “evolve” on gay marriage, and for coming to the rescue in the vice presidential debate in 2012 after Obama bombed in the first debate.

In addition to the conservatives already in the race from both major parties, another has joined them. The best thing about Marco Rubio entering the race is that he cannot run for reelection in Florida, increasing the chances the Democrats can pick up the seat. He is gambling everything on winning the presidency, and he might be optimistic over only trailing Clinton by three points in the latest Public Policy Polling survey.

Brian Beutler says that Marco Rubio Is the Most Disingenuous Republican Running for President. Considering who he is up against, that is quite an accomplishment. Rubio claims Hillary Clinton’s Ideas ‘Will Not Help Everyday Americans’. That can be debated, once Clinton says what her positions are, but it is a safe bet that at least Clinton’s ideas won’t screw everyday Americans as Rubio’s ideas would.

If the Republicans plan to continue to run against Obamacare, they got more bad news. Gallup has found that the uninsured rate has continued to drop since the Affordable Care Act was passed, now down to 11.9 percent. If you got insurance thanks to Obamacare, don’t forget to turn out to vote for whoever wins the Democratic nomination.

Many more candidates will still be entering the race. Bill Kristol asks, If They Get To Nominate Hillary Clinton, Why Don’t We Get To Nominate Dick Cheney? Ok Bill, go ahead and nominate Dick Cheney, and see how the Republicans do with that.

There are many more elections besides the presidential elections in 2016. A group of liberal donors is stepping up to counter all the money the Koch Brothers and other conservatives have been spending to help Republicans win in statehouses.

Please Share

Affordable Care Act Contributed To Saving Around 50,000 Lives

Washington Post Fact Checker Glenn Kessler is often very quick to give out those Pinocchios, often hitting Obama when statements have exceptions which go beyond what would be expected to be included in a political speech. Therefore I was pleased to see that he gave a rare Geppetto Checkmark for Obama’s statement on the 5th anniversary of The Affordable Care Act that the ACE is “a major reason why we’ve seen 50,000 fewer preventable patient deaths in hospitals.”

I agree with Kessler’s overall view that The Affordable Care act has contributed to a decrease in preventable deaths from factors such as drug reactions and pressure ulcers and that other factors, some pre-dating the ACA, were also important. As Kessler wrote:

But officials say there is also little question that the half-billion dollars in ACA funding sparked significantly greater cooperation among thousands of hospitals. On pressure ulcers and adverse drug reactions, “we already had practices that we knew had worked,” another official said, but the Partnership for Patients took it to the next level by involving thousands of hospitals in a concerted effort to promote those practices. The law also created the CMS Innovation Center, which tests new ideas at participating hospitals for delivering better service without increasing costs.

HHS reports say more than 70 percent of general acute care hospitals in the United States, representing over 80 percent of admissions, were part of the networks in 2012-2013. The study showed year after year gains in preventing patient deaths, with 35,000 coming in 2013 alone. (One caveat: The figure for 2013 is considered an “interim number,” with the final figure not available until June, 2015.)

The upward trajectory suggests tens of thousands in additional patient lives may have been saved since 2013.

The president’s statement could have been a bit more precisely worded to reflect some of the uncertainty in the estimate: “likely a major reason why we’ve seen an estimated 50,000 fewer preventable patient deaths in hospitals.”

But that’s a relatively minor quibble. The numbers might seem large, but the research seems solid, according to experts we consulted, and it is based on a review of an extensive database. The results likely reflect work that predated the ACA but at the same time the ACA has spurred even greater cooperation among hospitals. Since the president is using a figure more than a year old, it is likely understated — unless, of course, the interim number for 2013 turns out to be overstated. We will keep a watch on that.

But in the meantime, the president’s claim appears worthy of the elusive Geppetto Checkmark.

Plus these numbers don’t include lives saved due to people who would otherwise be uninsured now receiving insurance.

Please Share

Affordable Care Act Helping To Create Jobs

Among the benefits of the Affordable Care, beyond expanding health care coverage and lowering costs, has been to create more jobs. Bloomberg News reports:

More than 90 new health-care companies employing as many as 6,200 people have been created in the U.S. since Obamacare became law, a level of entrepreneurial activity that participants say may be unprecedented for the industry.

Zenefits, which provides human-resources software and acts as a health-insurance broker for small employers, wouldn’t exist without the law, said Parker Conrad, the firm’s chief executive officer. Since the Affordable Care Act’s inception in April 2013, the San Francisco-based company has grown to more than 900 employees. That makes it the largest firm among dozens that have sprouted in the law’s wake, according to PricewaterhouseCoopers, which issued a report on the trend this week.

The health law, which took full effect in 2014, represents the most dramatic change to the U.S. health system in 50 years. Entrepreneurs, including some from within President Barack Obama’s administration, have founded companies that target employers, health insurers, hospitals, doctors and consumers looking to navigate new requirements and possibilities.

The article discussed this further. It also debunked the Republican claims that the law would be a jobs killer, as PolitiFact also did recently.

The Affordable Care Act can also increase jobs another way. By freeing people to leave their current jobs with large companies without fear of losing insurance coverage, more people can leave to create new companies.

Despite the many benefits of the Affordable Care Act, large numbers of people remain misinformed. Sara Kliff reviewed this at Vox, noting common misconceptions persisting about the cost of the law,many incorrectly believing that illegial immigrants can obtain coverage, and many still believing that there are death panels.

Update: The latest to benefit from Obamacare–Ted Cruz

Please Share

PolitiFact Shows Facts On Health Care Reform, Debunking Republican Claims

PolitiFact has looked at the data available so far on the Affordable Care Act. They confirm what I’ve said in many posts on health care reform. ObamaCare is leading to more people being insured, lower costs, and a reduction in the deficit. The various Republican predictions of doom have failed to come about. The one area in which the law failed to meet expectations was the number of people covered due to Republican-controlled states which do not participate in the expanded Medicaid program. Thank-you Republicans for once again showing that you are the anti-life party.

Here is a summary of what PolitiFact has reported:

In 2010 it was projected that by 2019 32 million people would gain insurance, leaving 23 million uninsured (with the uninsured including illegal immigrants who, despite that email from your crazy Republican uncle, are not covered under ObamaCare.) It is now projected that by 2019 27 million will gain insurance, leaving 26 million uninsured. This is largely due to those not receiving access to the expanded Medicaid program in Republican-controlled states.

In 2010 it was predicted that the Affordable Care Act would decrease the deficit by $143 billion between 2010-19. In 2014 the projection was updated to reducing the deficit by $152 billion between 2015-24.

In 2010 the cost was projected to be $710 billion between 2015-19. The updated projection is $571 billion. The lower estimate is due to both reductions in health care costs and decreased spending on the expanded Medicaid program.

PolitiFact debunked that Republican claims that the Affordable Care Act is a jobs-killer.

PolitiFact debunked the Republican predictions of a death spiral in which premiums would become more expensive and younger, healthier people would not purchase insurance: “About 28 percent of customers during the 2014 enrollment period were ages 18 to 34. And there were 70 more insurance companies participating in the 2015 marketplaces than the previous year…”

PolitiFact debunked Republican predictions of increasing premiums, noting a decrease in health care spending. It is not clear to what degree this can be attributed to the Affordable Care Act versus other factors. One aspect that is not measurable is the way in which the culture in health care has changed since Obama began speaking about health care reform, leading health care professionals to utilize resources more economically.

The Affordable Care Act was introduced as incremental legislation which would both increase access to care and reduce costs. It was never expected to lead to universal coverage without further expansion of the plan. PoltiFact looked at those projected to remain uninsured:

Who makes up this group of persistently uninsured? About 30 percent are illegal immigrants, which the law specifically does not apply to. But about 40 to 45 percent are people who will choose not to purchase insurance offered to them either through the marketplaces or through an employer, in many cases because they still can’t afford it. The law exempts people from paying a penalty who have incomes so low they don’t file tax returns.

There is also a coverage gap unintended by those who wrote the law: People who live in states that didn’t accept Medicaid expansion. The law essentially required states to expand eligibility and agreed to pay 100 percent of the expansion for the first three years, declining to 90 percent in 2020 and beyond.

One goal for the future is to provide assistance for those denied care due to living in Republican-controlled states. Further review of the law is needed regarding the 40 to 45 percent who are projected to remain uninsured due to choosing not to purchase insurance offered through the exchanges or employers. Some people are not obtaining coverage due to believing false information spread by Republicans and this problem will hopefully decline as more people see the success of the law. Some were unaware of the tax penalties as they will not experience them until paying taxes due this April 15. This might provide further motivation to obtain insurance.

The biggest concern are those who remain unable to purchase insurance due to the cost. As I previously noted, eighty-three percent of enrollees qualified for subsidies in 2013. Those who qualified payed an average of $82 per month in premiums. Those obtaining Silver plans paid an average of $69 per month. Those not obtaining coverage due to the cost are probably people at the upper income range for receiving subsidies and not receiving sufficient subsidies to afford insurance, or those who just miss out on qualifying. This situation might be improved with further reductions in costs but expansion of the subsidies might be needed to get closer to universal coverage.

Please Share