Margaret Davis of West L.A. voted for President Obama and appreciates the ideas behind the Affordable Care Act. She agrees that everyone should have access to healthcare and no one should be denied coverage because of pre-existing conditions.
But here’s the problem:
She knows firsthand, as the new law of the land rolls clumsily into being, that it’s not working out to everyone’s advantage.
“I’m a 55-year-old woman in excellent health and have a catastrophic health plan,” she wrote recently to Obama and California Sens. Dianne Feinstein and Barbara Boxer. “I am completely happy with my plan. I received notice that the plan is being canceled and that to stay with a “comparable” plan my premiums would increase 88%, or $200 extra per month. To add insult to injury, the plan is INFERIOR to my existing plan.”
It’s true, as many have pointed out, that the raw number of enrollees matters less than the composition of the risk pool. What’s most important is that the program attracts a critical mass of young and healthy individuals — estimated by the administration at 40 percent — to offset the costs of covering older and sicker Americans, particularly those with pre-existing conditions…
It’s also important to remember that for the program to be truly viable, exchanges not only have to hit that critical mass nationally, but each individual state must have the right balance of enrollees. If 40 percent of the enrollees are young/healthy nationwide, but they are concentrated in a small number of states, then the individual market could still collapse in the others.
According to HHS, about 52,000 people signing up for plans — or nearly half the national total — came from New York and California. By contrast, Texas, Florida and Illinois (which have roughly the same population when combined) had fewer than 8,000 signups. South Dakota and North Dakota had 58 and 42, respectively.
Persistent technology problems plaguing the Obamacare signup process has created further concern that the only individuals willing to go through the arduous process for buying insurance thus far are likely to be older and sicker participants and those with pre-existing conditions.
As I remember it, the Democrats on Capitol Hill got the bill they wanted. They were heady, back in the majority, with a new and popular president, and they didn’t much care about GOP support. They wanted the credit: It was their bill. They wrote it in a way no Republican could support. And they got no Republican support. When Paul Ryan, who had emerged as the Republican point man, attempted to come forward with ideas, he was rebuffed.
The new president—and this was a key historic moment—decided not to act on the accumulated presidential wisdom of the ages, which is: Get the other party in on all big things. Give them a stake in it, use them for cover, show you have bipartisan juice, that you are truly national and not only the leader of one party, show you can wield your mighty power across the aisles. Get them bragging they passed it, with your leadership. Make them co-own it so that when certain parts don’t work, and certain parts won’t, they have deep motives to help you fix it.
Instead, a perfect storm of misjudgment, immaturity and lack of historical perspective, and a perfect storm of shortsighted selfishness (it’s all ours, it’s not even a little bit yours) brought forth a perfect storm of a health-care disaster.
Given current firestorm over coverage drops, Upton bill is seductive. But it's impact would be to subvert ACA, not fix problem.
— David Axelrod (@davidaxelrod) November 13, 2013
Before the government shutdown in July, as the defund push from Senators Ted Cruz and Mike Lee was just starting to gain steam, Speaker John Boehner laid-out his preferred Obamacare strategy to House Republicans in a closed-door conference meeting, telling them the GOP could repeal the law with “targeted strikes that will ultimately dissolve the Obamacare coalition.”
This morning, in another conference meeting, Boehner reminded his colleagues about that strategy and explained how bringing the “keep your plan” bill introduced by Representative Fred Upton to the House floor Friday fits into it.
“Remember the strategy for stopping Obamacare we laid out to you back in July. It had two components: Aggressive, coordinated oversight, and targeted legislative strikes aimed at shattering the legislative coalition the president has used to force his law on the nation,” Boehner said, according to a person in the room.
To their credit, House Republicans – led by Energy and Commerce Committee chairman Fred Upton – are planning to pass a bill this week that has the potential to help millions of people who are now in the impossible position of holding soon-to-expire insurance with no good options for replacement coverage. And it would do so by providing an escape from Obamacare, not a fix for the fatally flawed legislation…
At the same, the Upton legislation is not a panacea. It provides no guarantees, and it certainly doesn’t try to force insurers to reopen cancelled plans like the bill sponsored by Democratic Senator Mary Landrieu. No matter what House Republicans do at this point, there will be some casualties from the Obamacare train wreck. But strong support for the Upton bill would show voters that Republicans are doing whatever they can to minimize the casualties.
The defenders of Obamacare know full well that the Upton legislation represents a serious threat to the viability of the law. It would provide a lifeline for a viable insurance market outside of Obamacare’s rules and suffocating structure. Millions of Americans would flock to a revitalized insurance marketplace that offered lower premium products with better coverage. The end result would be one more step toward fully reversing the catastrophic mistake of Obamacare.
As for Landrieu’s bill, if Republicans can’t successfully argue that Congress has no constitutional power to compel commerce (the basic point of the successful — in that vein — challenge to Obamacare under the Commerce Clause), if they can’t argue that Congress has no power to compel anyone to sell an insurance plan, or, by extension, to compel a doctor to see a patient, etc., then we’re in sad shape.
Obamacare made millions of people’s plans illegal. By passing the Upton bill, House Republicans would be striving to make them legal again for the next year. If insurers nevertheless choose to stop offering those plans, it will still be Obamacare that set that trend in motion. What’s more, the GOP would then be free to criticize those insurers and remind voters that, over the next decade, Obamacare would funnel a stunning $1 trillion from American taxpayers, via Washington, to insurers (according to the Congressional Budget Office). Meanwhile, Landrieu’s bill is more of the heavy-handed, coercive model of government that gave us Obamacare to begin with, and Republicans should say so.
Finally, Landrieu’s bill would undermine the Obamacare exchanges at least as much as Upton’s bill would. So the Democrats certainly don’t love it, and it’s highly unlikely they would ever pass it. But if they did, and if the House and Senate ended up reconciling Upton and Landrieu in conference, the clear loser would be Obamacare — whose exchange population would just have gotten older, sicker, and costlier.
And then around October 2014, all of those notices about losing your health plan because of Obamacare would start being mailed out again, just in time to help voters make an informed choice on November 4.
Without intending it, Kingsdale has, I think, identified a central source of Obamacare’s problems: The people who created the program had no idea how it would be put into effect. They just took it for granted that the law would be implemented and perform, more or less, as intended. This attitude blended carelessness, ignorance and arrogance, reflecting a broader problem in business and government.
There’s a class structure to huge public and private organizations. One class — usually the leaders of enterprises or departments — might be called the Pontificators. They enunciate broad, often-worthy goals and values. President Obama (indeed, almost any president) ranks as the Pontificator in Chief. In politics, elected officials and pundits (people like me) are lower down on the Pontificator scale. In business, these people cluster in the executive suites.
But most workers belong to the Plumber class. They’re the fix-it folks. They’re supposed to put the Pontificators’ pronouncements and commands into effect. Never mind that these demands are often impractical, inconsistent or uninformed because the Pontificators have only a sketchy notion of what the Plumbers do or what the real world requires.
Via Fox News.
“We have not just Obamacare unraveling, not just the Obama administration unraveling, not just the Democratic majority of the Senate [unraveling], but we could be looking at the collapse of American liberalism,” Krauthammer told Bill O’Reilly Tuesday. “Obamacare is the big thing for them. The biggest in a hundred years.”…
“This is a moment where we have to be calm. We have to understand what holds us together on the right. We have to watch and explain why the failure of the left is happening. And if we do that, we will win,” he said.
“To be completely honest with you, we had a difficult time booking Democrats to come on after those numbers were released, to have them come on and talk about fixing the problem.”