Wednesday, July 23, 2014

Just One Cup

Yesterday I fasted in anticipation of the wellness fair held at work where I got my insurance-required biometric assessment done.  That meant blood work, and although they didn’t require it, I held off eating or drinking anything more than water from midnight on.

BBWW Coffee MugThis fast meant forgoing my morning coffee.  I usually have one mug before work to get the day going and maybe one at the office.  Once the tests were over I had a light lunch and a regular dinner, but zonked out before dark.  When I got up this morning, I really needed the coffee to get going.  No, I didn’t have the shakes and symptoms associated with caffeine withdrawal, but it sure made a difference once I had that first couple of sips of Folger’s Black Silk.

By the way, all systems are functioning within normal parameters, but I still plan on getting in more exercise and losing some weight.

One For, One Against

Can’t we all just get along?

Two federal appeals court panels issued conflicting rulings Tuesday on whether the government could subsidize health insurance premiums for people in three dozen states that use the federal insurance exchange. The decisions are the latest in a series of legal challenges to central components of President Obama’s health care law.

The United States Court of Appeals for the Fourth Circuit, in Richmond, upheld the subsidies, saying that a rule issued by the Internal Revenue Service was “a permissible exercise of the agency’s discretion.”

The ruling came within hours of a 2-to-1 ruling by a panel of the United States Court of Appeals for the District of Columbia Circuit, which said that the government could not subsidize insurance for people in states that use the federal exchange.

The administration will ask for an en banc ruling from the court that ruled 2-1 against Obamacare.  That means the whole court — including the three judges who ruled today — will hear the case and overturn the first ruling.  For now, let the Republicans have their little moment of joy because it won’t last.

This ruling could also have political implications for Republican governors and legislators in states without the healthcare exchanges.  TPM reader HW explains:

…will they build a state health insurance exchange or allow the taxes of a large number of their citizens to go up (remember these are tax credits their middle class citizens are losing, not Medicaid benefits their poorest citizens are not getting in the first place). If you are Rick Scott (FL), Scott Walker (WI), John Kasich (OH), Rick Snyder (MI), or Tom Corbett (PA), all facing competitive races and important races for the long term balance in the House of Representatives, you are faced with a lose-lose proposition. If you say, “still no exchange,” you are basically forcing a large tax increase on health care- that strikes me as a pretty good issue for their Democratic opponents to run on in the fall. If you say, “ok, we’ll build an exchange,” you are alienating your base going into the fall- and, of course, this problem goes away for Americans in these states.

That leaves it up to the Democrats to push the issue: “Hey, voters, Republicans want to raise your taxes and take away your affordable health insurance.”  Run on that, get the policy and the law right, and win the election.

Tuesday, July 22, 2014

20 Million

The Republicans were sure that Obamacare would crater and that no one would sign up for it.

Guess what.

A report published last week in the esteemed New England Journal of Medicine provided an overview of Obamacare’s first year, its successes and the challenges ahead. It also offered a yet another estimate of the number of people covered by the law: 20 million.

The NEJM report pulled a wealth of information, much of it already known by those closely following the law’s implementation but presented together by the journal, from think tanks and government agencies. It covered a range of topics, including the number of people covered, 2015 premiums, and the adequacy of provider networks for plans offered through the law.

But its bottom line was that millions of people have become insured under Obamacare.

“Taking all existing coverage expansions together, we estimate that 20 million Americans have gained coverage as of May 1 under the ACA,” the authors wrote. “We do not know yet exactly how many of these people were previously uninsured, but it seems certain that many were.”

But we all know that the NEJM is just another liberal mouthpiece for Obamacare.

Friday, July 11, 2014

Thursday, May 8, 2014

That Didn’t Go Well

The best-laid traps…

Republicans struggled to land punches against ObamaCare in a hearing Wednesday, as responses from insurance companies deflated several lines of questioning.

Democratic lawmakers were emboldened to defend the Affordable Care Act with renewed vigor and levity, creating a dynamic rarely seen in the debate over ObamaCare.

Adding to the irregularity, exits on the Republican side at a subcommittee hearing led by Rep. Tim Murphy (R-Pa.) allowed multiple Democrats to speak in a row and let heavy Democratic criticism of Republicans go unanswered, a contrast with the heated exchanges of last fall.

The discussion was not always favorable to the healthcare law, as it touched on health plan cancellations, the potential for premium increases in 2015 and problems that still plague the back end of HealthCare.gov.

Witnesses from the insurance industry were also careful in their comments and promised to submit several answers to the committee at a later date.

But Republicans were visibly exasperated, as insurers failed to confirm certain claims about ObamaCare, such as the committee’s allegation that one-third of federal exchange enrollees have not paid their first premium.

And none of the witnesses knew a thing about Benghazi.

Wednesday, May 7, 2014

And Another Meme Bites The Dust

One of the straws being grasped at by the Republicans to prove that Obamacare is a failure is that while 8 million people may have signed up for it, they haven’t paid for it.

Wrong.

Most of the people choosing health plans under the Affordable Care Act — about 80 percent — are paying their initial premiums as required for coverage to take effect, several large insurers said Tuesday on the eve of a House hearing about the law.

[...]

In testimony prepared for a hearing of a panel of the House Energy and Commerce Committee on Wednesday, Mr. Pratt said, “Health insurers have been doing everything possible to encourage exchange enrollees to pay their premiums.”

Paul Wingle, the executive director of exchange operations and strategy at Aetna, said: “As of the third week of April, Aetna had over 600,000 members who had enrolled and roughly 500,000 members who had paid. For those who had reached their payment due date, the payment rate, though dynamic, has been in the low- to mid-80 percent range.”

That means if 8 million people have signed up — and allowing for duplicates — the numbers are still impressive: 6 million have paid their initial premium.

Next meme, please.

Tuesday, May 6, 2014

Again With The Hitler Schtick

What is it with right-wingers that they can’t seem to go a week without comparing Obamacare with the Holocaust or the Third Reich?

On Monday, a Tennessee state senator apparently likened Obamacare’s individual mandate to Nazi Germany’s slaughter of Jews.

A brief post published at the blog of state Sen. Stacey Campfield (R) read: “Democrats bragging about the number of mandatory sign ups for Obamacare is like Germans bragging about the number of manditory [sic] sign ups for ‘train rides’ for Jews in the 40s.”

Obviously this Mr. Campfield knows little more about the Holocaust than what he remembers from being dragged to see Schindler’s List in high school.  He trivializes the worst event of systemic brutality in modern history by making it a punchline in a blog post, which shows nothing but disrespect for what 6 million people went through.

On the face of it, though, it’s breathtakingly stupid: how in any way is providing access to healthcare for millions of people for the first time in any way comparable to the Third Reich?

Isn’t there anyone in Tennessee who can turn to this person and tell him he’s a blithering idiot and he’s just embarrassing himself?

Friday, May 2, 2014

One Million Floridians

Despite the best efforts of Gov. Rick Scott and the right-wing noise machine, nearly 1 million people in Florida signed up for Obamacare.  Via New Times:

The Department of Health and Human Services announced today that 983,775 Floridians signed up for Obamacare plans. That’s the second-highest number of any state behind only California.

Meanwhile, California had set up its own healthcare marketplace. Floridians had to rely on the initially glitchy HealthCare.gov website because Rick Scott and the Florida government declined to set up their own exchange.

“More than 983,775 Floridians signed up through the marketplace, demonstrating brisk demand for quality, affordable coverage,” said Kathleen Sebelius, secretary of health and human services.

More than half of those Florida enrollments came in March, just before the sign-up deadline. That surge was in thanks part to health care activists reaching out to the uninsured in the final month.

Thirty-one percent of Floridians to sign up were under 35, which Seblius touted as a sign that younger, healthier enrollees have take advantage of the act.

Nearly 91 percent of Floridians who signed up also received some sort of assistance to pay for their plans through things like tax credits.

The Republicans will claim that HHS is cooking the books and the numbers are skewed, but denial is the toughest phase to get through.

Someone’s going to have to explain to me how getting all these people to get decent health insurance is a bad thing.

Thursday, May 1, 2014

They Like It

Florida Gov. Rick Scott (R) went looking for some easy pickings about complaints about Obamacare at a senior center in South Florida the other day… but it went horribly wrong for him.

The 20 seniors assembled for a roundtable with Scott at the Volen Center were largely content with their Medicare coverage and didn’t have negative stories to recount.

And some praised Obamacare – a program that Scott frequently criticizes.

“I’m completely satisfied,” Harvey Eisen, 92, a West Boca resident, told Scott.

Eisen told the governor he wasn’t sure “if, as you say,” there are Obamacare-inspired cuts to Medicare. But even if there are, that would be OK. “I can’t expect that me as a senior citizen are going to get preferential treatment when other programs are also being cut.”

Ruthlyn Rubin, 66, of Boca Raton, told the governor that people who are too young for Medicare need the health coverage they get from Obamacare. If young people don’t have insurance, she said, everyone else ends up paying for their care when they get sick or injured and end up in the hospital.

Whoops.

Tuesday, April 22, 2014

Rubber The Wrong Way

Cardinal Timothy Dolan on where women can buy contraceptives:

“Is the ability to buy contraceptives, that are now widely available — my Lord, all you have to do is walk into a 7-11 or any shop on any street in America and have access to them — is that right to access those and have them paid for, is that such a towering good that it would suffocate the rights of conscience?” Dolan said in an exchange uploaded by Raw Story. “I don’t think so. I hope the Supreme Court agrees.”

This from a guy who, if he lives up to his vows, never bought a rubber in his life.

Or perhaps this is what he tells his priests when they’re getting ready for choir practice.

His Eminence was speaking on TV last Sunday about the Hobby Lobby case — he wants them to win — and getting just about everything wrong.  The case is not about having contraception paid for by Hobby Lobby, nor is it about over-the-counter methods like condoms.  It’s about a person’s right to have access to healthcare without the interference of holier-than-Christ employers.

The more women have access to birth control, the fewer abortions there will be.  I hear the Catholic Church has a view about that.

Monday, April 21, 2014

Run With It

The incomparable Charles P. Pierce has some advice for Democrats about campaigning on Obamacare.

It’s now becoming pat to say this, but Democratic politicians in this year’s elections should run on their support for the law — if, for no other reason, than the fact that the Republicans are going to hang the ACA around their necks anyway. They should hammer hard on the indecency of the Republican governors who, out of rancid ideological meanness, refuse FREE MONEY (!) to provide their poor people with health care, especially now that people are starting to die for the lack of it. There should be ad after ad of people who demonstrate the sheer relief of not having to worry about choose between sick children or hungry children. Those dozens of votes to repeal the ACA should be illustrated by dozens of people in commercials who have pre-existing conditions, or dozens of young people, looking for work in a bad economy, who can stay on their parents’s health plans until they get settled. This is the kind of things that disarmed the opposition to health-care reform in Massachusetts — a concerted advertising campaign to put a happy face on the new system, with a slogan that doubled its entendres just enough to appeal to a modern audience. “I got it,” said the guy on the bike. “I’m going to get it,” said the woman jogger. And everybody laughed and went back to watching the Sox game. What worked here can work in the country. And you’re going to have to defend it anyway, so you might as well have fun doing it.

Some of them — Mark Begich of Alaska, for instance — are already getting the message out there, and some are making sure that they tell their constituents that the Republicans were — and still are — against it.  They are framing it as “Why do the Republicans want to take away coverage for children?  Why do they want to take away insurance from people with pre-existing conditions like diabetes?  Why do they want the insurance companies to tell you where to work?”

The Republicans bet all their chips on the failure of Obamacare and it came up snake-eyes.  They’re on the record as having voted over fifty times to repeal it entirely and replace it with… [crickets].  When pressed, they say they want to keep all of the good things about the law but repeal the bad things, but they can’t really explain what those bad things are without sounding like fools.

They then follow that with desperate attempts to debunk the numbers cited by the administration as to how many people have signed up, how many have paid for it, and the number of people under 35 — crucial for the actuarial calculations — who have enrolled.  But there the numbers are against them.

The law is by no means perfect, and of course we’ll have the Death Panels and flat-earthers with us always, but even the most timid Democrat should embrace the law and let the people who benefit from it — the ones who actually got affordable care — cast the vote.

Up Denial River

George F. Will can be so darn cute sometimes.

Fox News contributor George Will on Sunday argued that the United States Supreme Court had inadvertently made President Barack Obama’s health care reform law unconstitutional when the justices ruled that it was not unconstitutional.

[...]

“On May 8, here in the second-most important court in the land — the D.C. Circuit Court of Appeals — there will be an argument that this is objectively a revenue measure,” Will explained. “The Supreme Court said as much, a tax measure.”

“It did not originate in the House. And under the standards of origination, the whole thing is unconstitutional,” he added. “So this argument, again, is far from over.”

Of course by “cute” I mean pathetically laughable.

Sunday, April 20, 2014

Sunday Reading

The Easy Part — Jonathan Chait in New York explains implementing Obamacare was the easy part.

For all the Sturm und Drang, implementing a successful health-care reform was not actually very hard, for the simple reason that the United States started with the worst-designed health-care system in the industrialized world. When you spend far more on health care than any country, and you’re also the only advanced democracy that denies people access to medical care, it’s incredibly easy to design a better system.

Obamacare has two basic goals. One is to reduce the explosive rate of medical inflation, and the other is to give all citizens access to medical care. Medical inflation is indeed falling much faster than anybody expected four years ago, to its lowest level in half a century. And affordable health insurance is now available — insurance companies can’t use medical underwriting to exclude or charge prohibitive rates to people who need medical care, and people with low incomes get subsidized. It would be great if lots of people took up the coverage, but the simple availability of it is the main goal.

The health-care system still has lots of problems, beginning with the 5 million poor Americans cruelly denied health care by red state Republicans. Compared to an ideal blue-sky health-care system, we still fall short. What’s beyond question is that Obamacare has effected a revolutionary improvement by its own standards.

If it’s so easy to massively improve health care, why didn’t it happen before? Because passing a health-care reform through Congress is incredibly hard. The system’s waste created an enormous class of beneficiaries with a vested interest in the status quo. And the insecurity of private insurance made Americans terrified of change (which was necessarily complex).

And this is what conservatives have never understood. They act as if reforming health care is a mere matter of drawing up a health-care plan on paper and rounding up the votes, something they could do anytime they really feel like getting around to it, rather than a Herculean political task. They further convinced themselves that administering the new law would prove devilish if not impossible. They had it backwards.

The triumphs of Obamacare were designing a plan that could acceptably compensate the losers and generating the resources to cover the uninsured without alienating those with insurance. Designing and passing Obamacare was a project requiring real policy and political genius. Implementing it was easy.

Segregation Is Still With Us — Ta-Nehisi Coates in The Atlantic.

A few weeks ago I wrote skeptically of the jaunty uplifting narrative that sees white supremacy’s inevitable defeat. One reason I was so skeptical was because I’d been reading the reporting of Nikole Hannah-Jones. If you haven’t read her coverage on housing segregation you should. And then you should read her piece from this month’s magazine on the return of segregation in America’s schools:

Schools in the South, once the most segregated in the country, had by the 1970s become the most integrated, typically as a result of federal court orders. But since 2000, judges have released hundreds of school districts, from Mississippi to Virginia, from court-enforced integration, and many of these districts have followed the same path as Tuscaloosa’s—back toward segregation. Black children across the South now attend majority-black schools at levels not seen in four decades. Nationally, the achievement gap between black and white students, which greatly narrowed during the era in which schools grew more integrated, widened as they became less so.

In recent years, a new term, apartheid schools—meaning schools whose white population is 1 percent or less, schools like Central—has entered the scholarly lexicon. While most of these schools are in the Northeast and Midwest, some 12 percent of black students in the South now attend such schools—a figure likely to rise as court oversight continues to wane. In 1972, due to strong federal enforcement, only about 25 percent of black students in the South attended schools in which at least nine out of 10 students were racial minorities. In districts released from desegregation orders between 1990 and 2011, 53 percent of black students now attend such schools, according to an analysis by ProPublica.

Hannah-Jones profiles the schools in Tuscaloosa where business leaders are alarmed to see their school system becoming more and more black, as white parents choose to send their kids to private (nearly) all-white academies or heavily white schools outside the city. It’s worth noting that the school at the center of Hannah-Jones’ reporting—Central High School—was not a bad school. On the contrary, it was renowned for its football team as well its debate team.

But this did very little to slow the flight of white parents out of the district. (This is beyond the scope of Hannah-Jones’s story, but I’d be very interested to hear more about the history of housing policy in the town.) Faced with the prospect of losing all, or most of their white families, Tuscaloosa effectively resegregated its schools.

There doesn’t seem to be much of a political solution here. It’s fairly clear that integration simply isn’t much of a priority to white people, and sometimes not even to black people. And Tuscaloosa is not alone. I suspect if you polled most white people in these towns they would honestly say that racism is awful, and many (if not most) would be sincere. At the same time they would generally be lukewarm to the idea of having to “do something” in order to end white supremacy.

Taking Nutsery Seriously — Elias Isquith in Salon on what Cliven Bundy tells us about democracy.

Needless to say, the prospect of responding to this melodramatic and messianic crankery with ridicule is extremely tempting. And when you consider the fact that the Nevada Constitution, which Bundy claims to hold sacred and well above its federal counterpart, explicitly demands its adherents recognize the supreme authority of the federal government, that temptation becomes more seductive still. But while it’d be fun to respond to the Bundy set by cracking jokes about black helicopters and Agenda 21, it’d be a mistake to dismiss the Cliven crew’s success thus far entirely. There’s a reason they’ve gotten so much attention and spurred so much enthusiasm, especially on the right. Their prescriptions are wrong, but in their limited way, they’ve recognized the disease.

That disease is a growing sense of distrust of the government, which according to Gallup is reaching levels unseen in nearly 20 years. Americans have always been famously suspicious of government, of course, but even for America, having eight out of 10 people say they rarely or never trust the end-result of the democratic system is bad. And one of the reasons this intensifying mistrust is so worrisome is that it’s so obviously justified. Indeed, anyone who’s lived through the past 15 years of American politics — with the secret spying, the secret incarcerations, the secret torture, the secret drone strikes, and the secret indifference to the economic fortunes of the 99 percent — and still trusts their government wouldn’t just be naïve. They’d be a fool.

Two developments this week offer a useful glimpse of how the cynicism animating Bundy-styled populism is supported by a thin rail of truth. One involves Larry Summers, the former treasury secretary, Harvard president, and presidential economic advisor who in so many ways embodies Washington, D.C., as it functions in the modern era. The other features a major new report from two academics — one from Princeton, the other from Northwestern — who tried to figure out who, exactly, calls the shots in the U.S. and whose policy wishes are listened to by the White House and Congress. Put both stories together, and you begin to see where today’s pervasive anti-government sentiment is coming from.

Doonesbury — Bought and paid for.

Friday, April 18, 2014

No Way Out

The Republicans were counting on Obamacare being unpopular as their way to winning the mid-term elections and possibly even the 2016 presidential race.  But if the experience of Rep. Dennis Ross (R-FL) is any guide, that plan may very well blow up in their faces.

A Florida voter had harsh words for Rep. Dennis Ross (R-FL) at a town hall Tuesday, admonishing the congressman for his repeated efforts to repeal Obamacare and its bevy of benefits. Ross conceded that his party should have worked to offer an alternative health reform policy to preserve benefits for newly insured Americans.

Noting that Ross and the Republican Party have now voted more than 50 times to repeal Obamacare, the constituent took the Florida GOPer to task. “Why do you think it is so good to deny seniors on Part D to make them pay more, about $4,000 more for medicine, and people with pre-existing conditions get denied insurance, have 26-year-olds have a harder time getting insurance because they can’t get on their parents’?” the voter asked. “Why do you think those are good ideas?”

Despite voting to roll back such protections, Ross said he doesn’t actually think doing so is a good idea. He went on to chastise his own party for not offering any replacement health care bill. “I think one of the most unfortunate things my party did the last three years was not offer an alternative to health care,” Ross said, calling the move “absurd.”

This is what happens when you let the clowns drive the car.  The GOP did nothing but call for repeal of the bill and had nothing to replace it with.  Now they’re stuck with being on the wrong side of both history and an increasing number of people who are finding out that the law is working and that they like it.

Mr. Ross is in the middle: he can’t run away from his party’s record of voting against the bill originally and the fifty times after to repeal it, nor can he switch sides because he’ll most certainly get a primary challenger from the Tea Party if he ever says anything nice about the Kenyan secret Muslim.

Wednesday, April 9, 2014

A Lot More

TPM has a report that says a lot more people have gotten health insurance than previously thought.

A study released Tuesday blows the door wide open in the never-ending parlor game to estimate how many uninsured Americans have gotten health coverage under Obamacare, suggesting that the number might be bigger than previously thought.

But at this point, nobody is quite sure what to make of it.

RAND Corp, a non-profit think tank, released the survey. Its eye-opening finding: 7.2 million previously uninsured people have gained health coverage through their employer since mid-September. That’s on top of those people who have purchased private coverage on Obamacare’s insurance marketplaces or enrolled in Medicaid or young adults who signed up through their parents’ plan.

Those three groups were the only people that many previous estimates of Obamacare’s impact had accounted for.

In other words, if you take the earlier estimates of 8.3 million to 9.5 million uninsured people who had gotten covered by marketplace plans, Medicaid and their parents’ policies — and then add some of the millions more who RAND found had gotten insured through their employer — then Obamacare could be responsible for reducing America’s uninsured ranks much more than the earlier estimates suggested.

But I thought Obamacare was in a death spiral and that nobody wanted it.

Wednesday, April 2, 2014

Haven’t Heard The Last Of It

Now that President Obama has done his victory lap in getting more than 7 million people to sign up for health insurance through Obamacare, that’s pretty much it for it being a campaign issue in November, right?  According to Rachel Maddow and a lot of other hope-filled Democrats, the numbers should put the kibosh on it.

You wish.  The Republicans will do whatever it takes to keep up the demonization for as long as they can.  They will find anecdotes of someone who refused to sign up because they hate the guvamint and now have chronic sinusitis and it’s all Obama’s fault, or they heard about someone’s aunt who was tortured by a death panel.  After all, these are the folks who brought you 24 hours a day of Benghazi! and Rand Paul is dredging up Monica Lewinsky, f’r Dog’s sake.

So if you think you’ve heard the last of GOP hating on Obamacare, you haven’t heard anything yet.

Tuesday, April 1, 2014

Getting To Like It

A Washington Post/ABC News poll shows that Americans are getting to like Obamacare.

Support among Democrats jumped from 65 percent in January to 76 percent in the new poll. Independents (44 percent support; 54 percent oppose; and Republicans (20 percent support; 78 percent) was more stable, according to the poll. Surprisingly, the poll found a significant shift in support for the law among conservatives, with 36 percent of them backing it now compared to 17 percent in November.

This is despite the glitches, the labored roll-out, and the natural hesitancy of the American public to like anything new.  Oh, and this is also in spite of the relentless attacks from the GOP and their mouthpiece Fox News.

Count on them to tell us that the polls are skewed, that the books have been cooked on the numbers, and that John Boehner will announce that the American people don’t want it.  Blather, rinse, repeat.

So why the shift?  Well, I’m no pollster but I would think it has something to do with the fact that people can now afford to get health insurance when they couldn’t before because of not being employed full-time, having a pre-existing condition, or just couldn’t afford it.  They like that, and that’s a lot of people.

Tuesday, March 18, 2014

Friday, March 14, 2014

Short Takes

Russia keeps rattling its sabre over Ukraine.

There may be a deal in the works to extend unemployment benefits.

Gov. Chris Christie (R-NJ) finally got asked tough questions about GWB at a town hall.

Attorney General Eric Holder calls for reduced drug case sentences.

Sign up now — The Obamacare deadline won’t get extended.

R.I.P. Reubin Askew, former Florida governor.