Thursday, April 17, 2014

Numbers

The White House
Office of the Press Secretary

FACT SHEET: Affordable Care Act by the Numbers

The Affordable Care Act is working.  It is giving millions of middle class Americans the health care security they deserve, it is slowing the growth of health care costs and it has brought transparency and competition to the Health Insurance Marketplace.
HEALTH CARE BY THE NUMBERS
  • 8 million people signed up for private insurance in the Health Insurance Marketplace. For states that have Federally-Facilitated Marketplaces, 35 percent of those who signed up are under 35 years old and 28 percent are between 18 and 34 years old, virtually the same youth percentage that signed up in Massachusetts in their first year of health reform.
  • 3 million young adults gained coverage thanks to the Affordable Care Act by being able to stay on their parents plan.
  • 3 million more people were enrolled in Medicaid and CHIP as of February, compared to before the Marketplaces opened. Medicaid and CHIP enrollment continues year-round.
  • 5 million people are enrolled in plans that meet ACA standards outside the Marketplace, according to a CBO estimate. When insurers set premiums for next year, they are required to look at everyone who enrolled in plans that meet ACA standards, both on and off the Marketplace.
  • 5.7 million people will be uninsured in 2016 because 24 States have not expanded Medicaid.
HEALTH CARE COST GROWTH IS LOWEST IN DECADES
  • Health care costs are growing at the slowest level on recordSince the law passed, real per capita health care spending is estimated to have grown at the lowest rate on record for any three-year period and less than one-third the long-term historical average stretching back to 1960. This slower growth in spending is reflected in Medicare, Medicaid, and private insurance. 
  • CBO projects the deficit will shrink more and premiums will be lower than expected: CBO previously estimated that the ACA will reduce the deficit by $1.7 trillion over two decades, and, just this week, CBO concluded that lower-than-expected Marketplace premiums and other recent developments will cut $104 billion from our deficit over the next ten years. The CBO report also projects that lower-than-expected premiums will help to save $5 billion this year, and that lower premiums will persist in the years ahead, remaining 15 percent below projections by 2016 (the only year in which CBO provides a precise estimate).
  • Medicare spending growth is down: Medicare per capita spending is growing at historically low rates.  This week, for the fifth straight year, the CBO reduced its projections for Medicare spending over the next 10 years – this time by $106 billion.  CBO projects that Medicare and Medicaid costs in 2020 will be $180 billion below its 2010 estimates.  Recent economic research suggests that the ACA’s reforms to Medicare may have “spillover effects” that reduce costs and improve quality across the health care system, not just in Medicare. 
 THE SECURITY OF HEALTH INSURANCE FOR MILLIONS OF MIDDLE CLASS FAMILIES
  • Up to 129 million Americans with pre-existing conditions – including up to 17 million children – no longer have to worry about being denied health coverage or charged higher premiums because of their health status.
  • 71 million Americans with private insurance have gained coverage for at least one free preventive health care service such as mammograms, birth control, or immunizations in 2011 and 2012.
  • In 2013, 37 million people with Medicare received at least one preventive service at no out of pocket cost.
  • Approximately 60 million Americans have gained expanded mental health and substance use disorder benefits and/or federal parity protections.
  • Since the health care law was enacted, almost 8 million seniors have saved nearly $10 billion on prescription drugs as the health care law closes Medicare’s “donut hole.”
  • 105 million Americans no longer have to worry about having their health benefits cut off after they reach a lifetime limit.

Thursday, April 10, 2014

Civil rights



President Obama speaking at the LBJ library in Austin, commemorating the 50th anniversary of the passage of the Civil Rights Act of 1964.

Tuesday, April 1, 2014

Seven million sign-ups


It's official. Obamacare hit its enrollment target! Proof that people actually want affordable health insurance. Who could  possibly be against that?


Monday, March 31, 2014

Obamacare deadline 3/31

Texas:

California:


Nevada:


Maryland:


 New Jersey:


Bar graphs



Who knew that 6 million is that much smaller than 7 million?

Thursday, March 27, 2014

Narratives

Karl Rove must be smiling to himself somewhere. Rove, remember, is the guy quoted as criticizing a reporter from what he called the "reality-based community." Rove explained to this reporter, who was old-fashioned enough to believe that answers should be based on empirical evidence, that "that's not the way the world really works anymore." It appears that journalists have really taken this message to heart, judging from a Washington Post column yesterday by Chris Cillizza. Cillizza mentioned two seemingly random events--one, that some Secret Service agents were sent home from Amsterdam (hey, it was Amsterdam!) for misbehavior, and two, that the Obama administration was loosening the March 31 deadline for signing up for Obamacare--which he said would be taken as evidence of President Obama's incompetence.

It's not that either of these events actually demonstrates the administration's incompetence. It's that they can be read to feed into a developing "narrative" or "storyline" of incompetence. Well, who creates these narratives anyway? Journalists must bear some responsibility for playing up stories that seem to confirm the narrative arc of conventional wisdom. Right now, that narrative portrays the administration's rollout of the Affordable Care Act as a botched effort, based on initial glitches in the healthcare.gov website. So even though the glitches have been fixed, and even though enrollment in Obamacare now exceeds 6 million sign-ups, which is in line with the administration's earlier projections, we are still hearing stories about the failure of Obamacare. Even though many thousands of people are saving substantial amounts of money on their new insurance policies, and even though the new healthcare law is already saving lives by offering coverage to people who previously could not obtain it, we are still hearing stories, which have to be debunked one by one, from people claiming to have been harmed by the new law.

From a reality-based point of view, this kind of coverage makes no sense. If critics of the law last fall were mocking the slow rate of sign-ups as proof that the law was a failure, then the flood of sign-ups currently taking place must be taken as proof of the law's success. Those critics should be eating their words right now.


I'm not holding my breath waiting for these retractions, however. Once narratives take hold, they are hard to change. People do not want to listen to evidence that challenges the initial narrative. They would rather cling to any tiny shreds of stories that confirm the conventional wisdom. If Cillizza is right, and people would rather conclude that the administration is incompetent based on a meaningless story about a couple of Secret Service agents who partied a little too hard in Amsterdam, than pay attention to the overwhelming evidence (SIX MILLION SIGN-UPS) of the administration's competence, then the reality-based community really has its work cut out for it. If Republican politicians want to feign outrage that the administration is allowing those who get in line by March 31 to obtain coverage even if they can't complete their paperwork on time, people should understand that they are only doing that to play into the prevailing narrative, and to distract from the overwhelming evidence in front of them, that by the critics' own criteria, is proving the success of the new healthcare law. The media might be fighting the tide at times, but they have a responsibility to point out the flaws in the failure narrative. They should not be helping that flawed narrative along.


Critics of Obamacare will never let go of their failure narrative. It's all they've got. And someday, when the Republicans eventually get back in power, they will tinker with the healthcare law a bit, and try to claim all the credit for fixing the botched law that that incompetent President Obama put into place. But at least my readers will know the truth.

Wednesday, March 26, 2014

Europe



If we hold firm to our principles, hope will overcome fear, and freedom will triumph over tyranny.

(transcript here)

Thursday, March 20, 2014

Incentives

Speaking of poor people having too much money, I saw a clip of Congressman Paul Ryan trying to explain his recent remarks on the lack of work ethic among inner city folks. There has been a lot of commentary about whether Ryan's statement was racist. I'm going to try to put that question aside and just focus on the Ryan's explanation that what he is disturbed at are incentives for poor people not to work.

I'm assuming what Ryan means by that is that if a family gets enough in food stamps to feed the children, they have less incentive to go out and find a job. Let's say that's true for some people. But by that logic, Ryan should also grant that food stamps also give families less incentive to steal or to mooch off their relatives or to let their children go hungry. And possibly, if they have the peace of mind that comes from being able to feed their families, parents might in some cases actually have a better chance of finding work. Anyway, let's give Ryan the benefit of the doubt and say that in addition to not questioning whether he's a racist, we'll also grant he is raising a legitimate question about whether payments such as food stamps or unemployment compensation reduce people's incentive to work.  

Still, even giving Ryan the benefit of every doubt, the question I would want to ask him is this: if it's so important for you to take food out of the mouths of hungry children to provide their parents with more incentive to find jobs, why don't we apply those some incentives to rich people? In the case of the well-to-do, Ryan and his Republican colleagues always make the argument that rich people, who by definition are already pretty well off, still need more government benefits to incentivize them to work. All of their tax deductions are precious and untouchable. Farm subsidies and oil depletion allowances must be preserved so the well-off can be persuaded to create more jobs. Though the top 1% have a larger share of the wealth than at any time since the 1920's, no attempt should be made to tax any more of that wealth lest the wealthy decide to drop out of the work force. Republicans believe we should even abolish inheritance taxes, even though inherited wealth for the most part goes to people who did not lift a finger to earn that money.

Whatever someone thinks about how economic incentives work, I would ask that we at least apply those beliefs equally to rich and poor. Let's not punish the poor and coddle the rich, both in the name of providing incentives. That makes no sense. Instead, if we're going to cut food stamp benefits, let's cut some tax loopholes also. Maybe that would get everybody working harder. Alternatively, if we're going to continue to be generous with the wealthiest among us, then we can afford to be generous to the poorest also. And maybe that would give everyone the proper incentives.

Or maybe Ryan and his ilk should just cut the crap about economic incentives, and admit that they are instead making a moral argument: they believe in every man for himself, and that it is just wrong for the government to try to help the least fortunate among us, or to demand anything more of the most successful. Admit that, and at least then you'll be honestly answering your constituents' questions.

Tuesday, March 18, 2014

Give war a chance.

William Kristol, in the Weekly Standard, writes that he hopes the Republican candidate in the next presidential election will awaken the country from its war-weariness. Seriously. He thinks the public needs to awakened and rallied, at the latest, by the time of the next presidential election. (Kristol is worried that might be too late.) Otherwise, what? We might get too used to peace? We might enjoy too much the fruits of reduced defense spending? We might not have the stomach to fight Iran or Russia, or whomever the war-mongers think we should choose as our next enemy?

I say cheers to Bill Kristol for his honesty. And if the Republicans want to rally the public to war by the time of the next election, I say they should go for it. They could borrow some campaign slogans from Orwell, the guy who came up with such classics as WAR IS PEACE.

Here are some other Republican campaign slogans I would suggest for the midterms, or the next presidential campaign:

WHO NEEDS HEALTH INSURANCE WHEN YOU CAN ALWAYS GO TO THE EMERGENCY ROOM?

THE PROBLEM WITH POOR PEOPLE IS THEY HAVE TOO MUCH MONEY!

Let's not have the kind of election campaign we had in the 2010 midterms, when the Republicans tried to blame President Obama for the deficit, forgetting it was mostly caused by the Bush recession. When they kept repeating the lie that the Obama stimulus failed, when every reputable economic study showed that it kept the country out of a much worse recession. And when they tried to scare seniors into thinking Democrats were robbing Medicare, ignoring the fact that they planned deep cuts in benefits, while the Democrats planned only cost savings.

Republicans, follow the shining example of William Kristol, and be honest about what your party stands for! Come right out and say you are for rallying the country for another war. That you don't think people should have the right to affordable health insurance. And that in this time of record economic inequality, you believe that the poor and middle class should get even less and the rich should keep more.

Wednesday, March 5, 2014

Cold War nostalgia

When President Reagan ordered the invasion of Grenada in 1983, in response to a coup on that island, most of the world condemned the action as a violation of international law. Most Americans supported the invasion, however. We had American students on the island to protect, and the coup leaders arguably represented a threat to national security and to democracy in the region. But whatever people might have thought about the justifications for the invasion, hardly anybody attributed it to weakness on the part of the Soviet Union. After all, what was taking place in Grenada was taking place in America's back yard. Most Americans felt it was nobody's business but our own. (When President Reagan was told that the UN General Assembly had condemned the US invasion of Grenada by a vote of 108-9, he stated that that did not upset his breakfast at all.)



So why, after the Russian invasion of the Crimea, do critics of the Obama administration insist on viewing this action solely as a reflection of the administration's actions? After all, the Russian military action is taking place in Russia's own backyard. It is a response to a popular uprising in the Ukraine, and it was taken arguably to protect the substantial Russian-speaking population in eastern Ukraine. I'm sure there was some consideration given in Moscow to the world's, and the US reaction to the invasion, but the Putin administration undoubtedly also had other priorities to consider. This is territory that once belonged to the Soviet Union, and that Russia still wants to influence.

The Ukraine basically sits on the border of Europe and Asia. It has been fought over by European and Asian nations for centuries. At the risk of over-simplifying the causes of the conflict in that country, it helps to understand that most of the people in the western regions of the Ukraine want to tilt politically and economically toward Europe, while most of the people in the east gravitate toward Russia. Of course the conflict in the Ukraine is of concern to the United States. It is perhaps of even more concern to Europe. Other nations should condemn violations of international law, and there should be consequences to Russia for actions that break the law and threaten the peace.

But to view Russia's military response solely as a response to US foreign policy actions reflects a nostalgia for the kind of flawed Cold War thinking that has been out of style for more than 20 years. Either that, or it's just politics: the kneejerk reaction on the right that whatever goes wrong must be Obama's fault. But everything that happens in the world is not about the US, and the US is not solely responsible for preventing every bad thing that happens anywhere in the world. President Obama's critics just look foolish for forgetting that.

(Wikimedia Commons)

Saturday, March 1, 2014

Ukraine

The White House
Office of the Press Secretary

For Immediate Release March 01, 2014
Readout of President Obama’s Call with President Putin

President Obama spoke for 90 minutes this afternoon with President Putin of Russia about the situation in Ukraine. President Obama expressed his deep concern over Russia’s clear violation of Ukrainian sovereignty and territorial integrity, which is a breach of international law, including Russia’s obligations under the UN Charter, and of its 1997 military basing agreement with Ukraine, and which is inconsistent with the 1994 Budapest Memorandum and the Helsinki Final Act. The United States condemns Russia’s military intervention into Ukrainian territory.

The United States calls on Russia to de-escalate tensions by withdrawing its forces back to bases in Crimea and to refrain from any interference elsewhere in Ukraine. We have consistently said that we recognize Russia’s deep historic and cultural ties to Ukraine and the need to protect the rights of ethnic Russian and minority populations within Ukraine.  The Ukrainian government has made clear its commitment to protect the rights of all Ukrainians and to abide by Ukraine’s international commitments, and we will continue to urge them to do so.

President Obama told President Putin that, if Russia has concerns about the treatment of ethnic Russian and minority populations in Ukraine, the appropriate way to address them is peacefully through direct engagement with the government of Ukraine and through the dispatch of international observers under the auspices of the United Nations Security Council or the Organization for Security and Cooperation in Europe (OSCE).  As a member of both organizations, Russia would be able to participate. President Obama urged an immediate effort to initiate a dialogue between Russia and the Ukrainian government, with international facilitation, as appropriate. The United States is prepared to participate.

President Obama made clear that Russia’s continued violation of Ukraine’s sovereignty and territorial integrity would negatively impact Russia’s standing in the international community. In the coming hours and days, the United States will urgently consult with allies and partners in the UN Security Council, the North Atlantic Council, the Organization for Security and Cooperation in Europe, and with the signatories of the Budapest Memorandum. The United States will suspend upcoming participation in preparatory meetings for the G-8. Going forward, Russia’s continued violation of international law will lead to greater political and economic isolation.

The people of Ukraine have the right to determine their own future. President Obama has directed his Administration to continue working urgently with international partners to provide support for the Ukrainian government, including urgent technical and financial assistance. Going forward, we will continue consulting closely with allies and partners, the Ukrainian government and the International Monetary Fund, to provide the new government with significant assistance to secure financial stability, to support needed reforms, to allow Ukraine to conduct successful elections, and to support Ukraine as it pursues a democratic future. 

Wednesday, February 26, 2014

Tuesday, February 18, 2014

Executive power abuse, part 2

I spent the weekend immersed in study of the machinations of power behind the scenes at the White House and the Capitol, and let me tell you, what's been going on over there is absolutely frightening. There is proof positive available, if only the journalists who have been silenced by this administration can finally bring it out, that the Executive Branch has been hijacked by people with little regard for the Constitution, or for basic standards of decency and ethics. There seems little doubt now that the administration has lied, cheated, murdered and stolen its way to power, and there doesn't seem to be much that the people can do about this usurpation.

I'm talking of course, about the chicanery of the fictional Vice President Frank Underwood, whose world became an alternate reality this past weekend for a lot of political geeks like myself. It's probably best to treat House of Cards merely as a guilty pleasure, but even though it probably won't bear the weight, I can't help wondering whether I can use it as a springboard for discussing some serious questions. I start with the 25th Amendment to the Constitution, the essential mechanism of Underwood's scheme to rise to the top of power. Recall that the 25th Amendment is a relatively recent addition to the Constitution, adopted only in 1967. It comes into play in the very unusual situation where a vacancy arises in the office of Vice-President, and it empowers the President to appoint a successor to fill such a vacancy. Before the adoption of the 25th Amendment, vacancies in the office of Vice-President were simply left unfilled until the next election. Perhaps that was a problem that needed fixing. But the people who drafted the 25th Amendment probably weren't thinking of the possibility that the vice-president might be tricked into resigning, or that the president could be tricked into appointing the very conniver who engineered that resignation, to fill that vacancy. And it doesn't spoil any of the surprises of the second season, for those who haven't finished watching it yet, to understand where anyone who can do those sorts of things is thinking of heading next.

Is such a situation so far-fetched that we shouldn't worry about the possibility of a corrupt and power-mad administration coming to power without being elected by the people? Perhaps, but the most amazing part of the history of the 25th Amendment is that it was actually invoked only a few years after it was adopted, almost as if the sponsors of the amendment knew we were going to need it to deal with the corrupt actions of the very next presidential administration, in a series of circumstances that no doubt inspired the writers of House of Cards. In 1973, Vice-President Agnew was forced to resign from office due to a bribery scandal arising from his term as Governor of Maryland. President Nixon was thus empowered by the nearly brand new 25th Amendment, to appoint House Minority Leader Gerald Ford to the vice-presidency. This happened while Nixon was already under suspicion of the crimes that led a House committee to vote impeachment charges the following year. After President Nixon resigned, new President Ford pardoned the predecessor who had appointed him. The pardon forever tainted the short-lived Ford administration. Ford had his own chance to take advantage of the 25th amendment, appointing Nelson Rockefeller to the vice-presidency, and saddling the country with both a president and a vice-president who were not elected to those offices. For those who believe in conspiracy theories, as well as those who believe that there are secret societies of the wealthy and powerful who are always really running things despite the trappings of democracy, we are talking about one of the authors of the Warren Commission report and one of the richest men in America both in power without an election. I happen to believe that both Ford and Rockefeller were decent people, but still, it didn't look good at all for a constitutional republic to sanction this result.

House of Cards tracks some of the Agnew-Nixon-Ford history pretty closely, using some of the same devices to propel the characters to their fates. It prompts the question whether the 25th Amendment was even a good idea, encouraging both in real life and in this fictional scenario the possibility of a tainted administration coming to power. We were preoccupied by other problems during the Nixon scandals, but maybe it's now finally time to re-think the idea of appointing vice-presidents--who have a tendency to become presidents--and devise another procedure, like a special election, instead.

As for the show, what might have been even scarier than echoing some of the events of the Nixon and Ford presidencies, would have been to try out another section of the 25th Amendment, one that has never been invoked in history. That is section 4, which allows the Vice-President and a majority of the cabinet to declare the President incapacitated and appoint the Vice-President as Acting President. (This section did come into play in the movie Air Force One, where Vice-President Glenn Close had to decide whether to declare President Harrison Ford incapacitated.) Imagine the possibilities of a scheming vice-president like Frank Underwood, who we know does not shrink from arranging for the demise or disappearance of characters who stand in his way, finding a way to incapacitate the sitting president who is his only obstacle to assuming the top level of power. But perhaps that would have been too diabolical even for Underwood.

Watergate haunts us still, from television dramas to the lesser scandals of people like Governor Chris Christie. Every time such a scandal arises, it's "here we go again" time. The investigative press hounds are again on the trail looking for blood. The suffix "gate" is attached. The officials in question are trying to maintain their denials, and suspected of cover-ups. Because of Nixon and Watergate, practically every subsequent president has been threatened with impeachment for both real and concocted scandals. Those felled by the last scandal are always looking for payback. Meanwhile, the public can't always tell the difference between politics as a real struggle of competing people and ideas, and politics as entertainment.

Tuesday, February 11, 2014

Year of Action