THERE is a lot of confusion AND a lot of misinformation and deception about +Obamacare and the cost of insurance for individuals and companies and the law in general. Those who are spreading the misinformation as part of their propaganda campaign to repeal the +Affordable Care Act are hurting many of the very people this law is supposed to help. By playing on the fears and reinforcing the voluntary ignorance and mistrust of government by many Americans these opponents of Obamacare may convince people not to sign up for programs that are part of the law that will in fact help them. Here are a series of articles from Ezra Klein's +Wonkbook column in the Washington Post, with links to sources to verify and provide more detailed information, on Obamacare, the Affordable Care Act. For those of you not familiar with Ezra Klein's reporting, he doesn't shy away from criticizing Pres Obama and his administration's policies, the Wonkbook doesn't even come close to being a liberal biased cheer leading column in the Washington Post. Since there is so much controversy right now on the issue of individual insurance premiums I am starting this post with the graph and article explaining the cost....
It comes from
a brand new report from Health and Human Services, which summarizes what we know, so far, about the cost of health insurance under the Affordable Care Act.
What you’re looking at here shows what insurance plans will charge for coverage that will cover 70 percent of a typical subscriber’s health-care costs. These are averages of the second-lowest cost plans that provide this level of coverage (silver plans, as they’re known under the health-care law):
What’s striking, to me at least, is that premiums look relatively similar despite wildly different rhetoric across the country. California and Ohio might be the best examples of this. When California
announced its rates, the Democrat-led state celebrated how affordable prices came in. When Ohio
released data, it derided how expensive health insurance would be under the federal reforms.
In actuality though, Ohioans and Californians will see pretty similar premiums on the new marketplaces. There’s a $16 difference between the two states.
One other important thing to keep in mind: These are the prices before federal tax subsidies, which will go out to many Americans between 138 and 400 percent of the federal poverty line (about $15,000 to $45,000 for an individual). These are, essentially, the maximum prices for people who earn above that threshold. Below the threshold, many will get a significant discount on these rates.
Read the full report from HHS on premiums under Obamacare right here.
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/07/18/heres-a-really-helpful-chart-on-premiums-under-obamacare/?wprss=rss_business&clsrd&wpisrc=nl_wonk_b
Wonkbook’s Number of the Day: 80 percent. That’s the so-called minimum
medical loss ratio required of health insurance plans by the Affordable Care Act.
Wonkbook’s Quotation of the Day: “I’ve even survived an earthquake with her,”
said economist Andrew Rose of Fed vice chairman Janet Yellen, referring to the severe 1989 Loma Prieta earthquake, which struck as the two were working together at Berkeley.
1) Top story: Obamacare trains are running on time. No wrecks.
Obama addresses health law’s implementation. “President Obama, slipping back into his episodic role as a vigorous campaigner for his new health care act, said Thursday that thanks to the law, more than 8.5 million Americans are getting rebates this summer from their insurance providers. Mr. Obama was joined by families who have benefited from a provision in the law, which requires health insurers to spend at least 80 percent of the revenue from premiums on medical care rather than on administrative costs. Insurers who fail to meet that benchmark must reimburse customers, a process that began in 2012.”
Mark Landler in The New York Times.
Top Treasury official: No more Obamacare delays looming. “J. Mark Iwry, Treasury’s deputy assistant secretary for retirement and health policy, told lawmakers that the employer mandate is the only policy that has been considered for deferral. ”We don’t have any specific provision that we’ve identified for which we would give some relief,” Iwry said in witness testimony.”
Elise Viebeck in The Hill.
Implementation puts his legacy on the line. “Transforming the nation's health-care system stands as Barack Obama's most crucial piece of unfinished business, with much of his presidential legacy riding on whether it is deemed to have succeeded or failed. While other presidents have managed to overcome intense opposition to major new social initiatives, Obama faces a degree of difficulty with health care that has no historic parallel.”
Karen Tumulty in The Washington Post.
@yeselon: Can’t get over the fact that Republicans just keep fighting the idea of universal health insurance, rooting for its failure. #newgop
Premiums under Obamacare lower than expected. “The Obama administration on Thursday highlighted lower-than-expected premiums for healthcare plans sold through ObamaCare’s new insurance marketplaces. In the 11 states that have released rates for next year, premiums for a middle-of-the-road plan are an average of 18 percent cheaper than the Congressional Budget Office had expected. The Health and Human Services Department highlighted the rate information in a new report Thursday, just as President Obama was set to deliver a speech highlighting the law’s savings to consumers.”
Sam Baker in The Hill.
Strategy: Sell big by talking small. “In a speech on Thursday, Obama got deep into the specifics of the sweeping health care law, from a rule that forces insurers to send rebate checks to some consumers to the price competition in its new health insurance marketplaces-- all provisions designed to save Americans money. The auditor-in-chief routine lets Obama tout how real people have pocketed savings, while steering clear of the many controversies swirling around the law, including a recent decision to extend a requirement for employers.”
David Nather in Politico.
Obamacare will never be a huge political success for Democrats. “I'd say stories about various problems in the implementation of Obamacare will be a net negative for Democrats in 2014, and after that, the program will cease to matter much politically at all -- even as it works pretty well, and the coverage it offers is pretty popular. The key thing to remember about how people will experience Obamacare is that most people won't experience it at all, and those who do experience it will never, ever experience a program named "Obamacare."”
Ezra Klein in The Washington Post.
The health-care law isn't all that popular. And that's not changing. “Obama shouldn't expect to blow through much of anything when it comes to health-care law, however. The Kaiser Family Foundation has been tracking the popularity -- or, perhaps better put, unpopularity of the bill-now-law for quite some time…Looking at the data, it's readily apparent that views about the law have cemented in place. When that sort of thing happens in public opinion, virtually no external event -- no matter how dramatic or seemingly important -- can change perceptions in any statistically meaningful way.”
Chris Cillizza in The Washington Post.
@pourmecoffee: GOP now responding to Obama with its plan for health care, which is telling the uninsured “May the odds be ever in your favor.”
10 million Latinos qualify for Obamacare. Is there funding to get the word out? “The Obama administration is counting on Latinos to help make the Affordable Care Act a success, but there may be troubles ahead: Hispanic health centers and community organizations say they don't have the funding or resources to carry out the complicated sign-up process for the 10 million Latinos who will be eligible for new public and subsidized health coverage options.”
Jenny Gold in The Washington Post.
The Obamacare provision that terrifies insurers. “[T]he medical loss ratio (described as the "80/20 rule" by the White House) is arguably one of the most effective tools the White House has to hold down premium costs. And it's the provision that the White House is homing in on, in arguing that the health-care law will make health care cheaper for American families…The medical loss ratio, in that context, is relatively easy: It's a firm requirement for insurers to spend more on medical care and less on administrative cost. It should be no surprise, then, that this is the provision that terrifies insurers.”
Sarah Kliff in The Washington Post.
@JohnJHarwood: Obama on Republicans and health care: “they’re just offering same old song and dance. We’re gonna blow through that stuff.”
COHN: Obamacare won’t be a train wreck. “The fact that premium bids seem to be coming in lower than CBO and other experts predicted is a pretty big deal--and not for reasons widely understood. For one thing, it means the overall price of Obamacare--the amount of money the government must spend, in order to make the law function--is going to be even lower than predicted. The reason is those subsidies.”
Jonathan Cohn in The New Republic.
Sarah Kliff and I have spent the last three months interviewing dozens of Obama administration officials, state-level implementers, outside experts, steadfast critics and pretty much anyone else we could think of who’s involved in setting up Obamacare. The full article going deep inside the effort to implement Obamacare is
here, but as a bit of a teaser, here are 10 of my takeaways from the reporting:
1) For the White House, it’s all about the marketplaces. The White House believes the line between success and failure is perfectly clear: It’s getting enough young and healthy people to sign up for the insurance marketplaces (or “exchanges”) so premiums remain low. If seven million people sign up for the marketplaces in 2014, as CBO expects, then they need 2.7 million younger, healthier folks. Getting those folks is the administration’s top priority. If they get that right, the rest of the law — including the Medicaid expansion — will more or less fall into place.
Anything required to meet that goal — like making the data architecture work — is a priority. Anything that distracts from it, or is unrelated to it — like the employer mandate — is expendable.
2) It’s a lot like the campaign. If you listen to the White House describe the task, it sounds just like the campaign. A majority of these younger, healthier adults are non-white. They skew male. One-of-three lives in Texas, California, or New York. They’re getting microtargeted and heat-mapped and modeled. The guy running this part of the effort is David Simas, the guy who ran polling and focus groups for the re-election campaign.
This gives Team Obama a lot of confidence that they’ve got this one. Key quote: "When I hear the conventional wisdom about Obamacare," said Jeanne Lambrew, deputy assistant to the president for health policy, "this is the difference between the Karl Roves who put their fingers to the wind and the Nate Silvers of the world who looked at the numbers."
But there’s one big way in which it’s not like the campaign: Voting is free. Buying health insurance isn’t.
3) Don’t forget IT. The biggest difference between the national conversation over Obamacare and the ground-level conversation over Obamacare is the degree to which the second focuses on the IT challenge.
Making the IT work is very, very hard. It means building a data hub that lets federal-government systems from different departments and agencies talk to archaic state Medicaid systems and new state exchange systems and so on. If that data hub doesn’t work then someone trying to sign up for Obamacare will be stopped by an error message. And if Obamacare loses too many of those people on their first try, it may not be able to get them back for a second.
4) No one knows how to model politics. If you look at the experience of Massachusetts, or you talk to the people who model the way people act when buying insurance, the Affordable Care Act should be fine. The numbers work out. But no one knows the degree to which the politics around the law will change the way consumers react to it.
5) But maybe the politics won’t really matter. It’s always worth remembering that everyone in Washington is really weird. Most of the country doesn’t care much about Obamacare. They don’t have particularly strong feelings about it. And they’re never going to come into contact with something called “Obamacare,’ anyway.
In California, it’s called “Covered California.” In Connecticut, it’s “Health Access CT.” In Washington, it’s “WA State HealthPlanFinder.” People signing up for Medicaid will be signing up for the program called Medicaid. People in Washington experience Obamacare as a political abstraction and project that onto the country. That act of projection might be a huge mistake.
6) There will be glitches. It doesn’t matter how good a job the administration or the states do. Things will go wrong. When they go wrong, the media will cover them. No major program has ever rolled out without glitches. Even if 2014 goes well for Obamacare, it’s not likely to go easily.
7) Glitches may not really matter. Take it from Mark McClellan, who led Medicare and Medicaid during the troubled implementation of Medicare Part D. "The memories didn't last that long. In the end, it comes down to how good the insurance coverage is."
Fun Medicare Part D fact: Months before it launched in 2006, Medicare Part D was less popular than today's Affordable Care Act: Only 21 percent of the public viewed it favorably.
8) Different states will have wildly different experiences. California accepted the Medicaid expansion, chose to build its own exchange, is spending state money to promote the law, and is generally doing everything in its power to make Obamacare work. Texas rejected the Medicaid expansion, left the exchange to the feds, and the state’s key politicians are out there talking down the law. It’s very possible Obamacare will be a success in states like California and a failure in states like Texas. How the politics of that shake out is anyone’s guess.
9) No one knows quite what to do in states that aren’t expanding Medicaid. In those states, the poorest residents will get no help but slightly less-poor residents will get lots of help. That’s confusing for everyone involved — and a real challenge to the people trying to sign folks up for the law. How do you tell someone they’re too poor to be eligible for subsidies?
Nor is anyone really certain what will happen to the hospital systems in those states, as they’re losing out on a lot of money they were counting on. The administration’s theory is that if the law is seen as relatively successful, the economics of participating in the Medicaid expansion are so overwhelmingly favorable to the states that they’ll fall in line. But no one really knows what’ll happen in that first year or two, nor who will be blamed for the resulting mess.
10) State regulators are exhausted. When you talk to the Obama administration, you get a serene confidence that Obamacare is going great. When you talk to the Obama administration’s critics, you get a serene confidence that the law is collapsing under its own weight. When you talk to the state bureaucrats, technical specialists, and assorted other implementers, you get a harried download on just how much there is to do.
"In 2011, there was this 'we're going to save the world' mentality," said Rebecca Pearce, executive director of the Maryland Health Benefit Exchange. "In 2013, it focuses more on how do we deliver on the requirements of the law."
To wrap up: Read the whole story. Really.
There’s much more there, including an update of Max Baucus’s famous “train wreck” quote…
Wonkbook’s Number of the Day: 50 percent. That’s how much
lower health insurance rates will be in New York in 2014, according to new approvals from state regulators.
Wonkbook’s Quotation of the Day: "This is about basic fairness,"
said Rep. John Boehner of an immigration policy proposal for children brought into the US illegally.
Wonkbook’s Top 5 Stories: 1) Obamacare enrollment; 2) what the Fed said; 3) nominees and the filibuster; 4) education policy coming; and 5) immigration reform’s direction.
1) Top story: How to sell Obamacare
Longread – Obama's last campaign: Inside the White House plan to sell Obamacare. “Deep inside the White House, in a bare room that the chief of staff uses for meetings, David Simas is still thinking about turnout. Turnout has been Simas's job for years now. As director of public-opinion research and polling for President Obama's reelection campaign, Simas was at the center of the effort to find and persuade young and minority voters to go to the polls like they did in 2008. Many doubted the Obama campaign's contention that it could recapture the 2008 electorate. Simas's data, however, convinced the campaign that was possible. And when the smoke cleared, young voters and minorities did show up to the polls, and Obama won. Now Simas, a sad-eyed Massachusetts native with a facility for PowerPoints, needs to reach those same groups again -- with a much harder ask. This time, he doesn't just need them to vote. He needs them to buy health insurance.”
Ezra Klein and Sarah Kliff in The Washington Post.
@CitizenCohn: Best thing about that Obamacare story I just tweeted — it captures complexity and uncertainty of the situation.
Despite temporary reprieve, business owners increasingly anxious as health-care law looms. “Despite a temporary reprieve from some of the new rules under the health care law, business owners are growing increasing anxious about its looming implementation at the end of the year, according to a pair of recent surveys. Only three out of every 10 small employers say they are prepared to comply with new regulations under the law, while seven in 10 say those regulations have made it more difficult to grow, according to a new survey from the U.S. Chamber of Commerce. Meanwhile, the percentage of firms expressing concerns over Obamacare have jumped by a double-digit margin since this time last year.”
J.D. Harrison in The Washington Post.
Health plan cost set to fall 50 percent in New York. “State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower.”
Roni Caryn Robin and Reed Abelson in The New York Times.
@MikeGrunwald: Obamacare cutting NY premiums in half will be good test of post-truth politics. Does it change the debate at all?
…And here's why health insurance premiums are tumbling in New York. “ New York has, for two decades now, had the highest individual market premiums in the country. A lot of it seems to trace back to a law passed in 1993, which required insurance plans to accept all applicants, regardless of how sick or healthy they were. That law did not, however, require everyone to sign up, as the Affordable Care Act does. New York has, for 20 years now, been a long-running experiment in what happens to universal coverage without an individual mandate… The result: a small insurance market with very high insurance premiums.”
Sarah Kliff in The Washington Post.
Obama to tout Affordable Care Act on Thursday. “With concerns mounting about the viability of his signature health-care law, President Obama
on Thursday is planning to highlight some of the more popular aspects of the Affordable Care Act with remarks at the White House. Obama is expected to focus on insurance company rebates that will be mailed to 8.5 million U.S. households this summer. The rebates, which average about $100 per family, are a result of a provision of the law that requires insurers to spend at least 80 percent of the premium dollars they collect on medical care, rather than executive salaries or marketing. ”
Sandhya Somashekhar in The Washington Post.
@markknoller: Tomorrow’s Obama speech on ObamaCare also meant as response to latest vote by House to delay implementation of ObamaCare.
HHS adds $33 million to Obamacare PR contract. “The Obama administration has added roughly $33 million to a contract with a public relations firm to help promote President Obama’s signature healthcare law. A spokesperson for the Centers for Medicare and Medicaid Services (CMS) said the extra money was added to a contract with the PR firm Weber Shandwick.”
Sam Baker in The Hill.
@mattyglesias: "Gee, John, what do you want to do today?" / "The same thing we do every day -- try to repeal ObamaCare!"
House votes on two bills to delay parts of Obamacare. “The Republican-controlled House yet again passed legislation Wednesday that aims to change the Affordable Care Act. This time Republicans called for one-year delays on two key provisions, one requiring nearly all Americans to buy health insurance and the other requiring businesses with more than 50 full-time employees to provide coverage. The Obama administration has already delayed the requirement for businesses. President Obama plans to veto the House's legislation, and Senate leaders have no plans to take similar action. This marked the 38th and 39th times that the House has voted to repeal or change all or part of the landmark Affordable Care Act.”
Jenna Johnson in The Washington Post.
@daveweigel: If the House holds an Obamacare repeal vote and the press doesn’t take it seriously, does it make a sound?
Obamacare privacy fears loom. “The biggest overhaul of the U.S. health-care system in 50 years has spawned one of the most complex computer projects in the government's history. Dubbed the Hub, the $267 million computer system built by a unit of UnitedHealth Group Inc. is one of the most important determiners of whether the Affordable Care Act succeeds. The hub ties together the databases of seven U.S. agencies, ranging from the Internal Revenue Service to the Peace Corps, to determine which Americans can buy medical coverage and get U.S. subsidies through the new government-run insurance exchanges.”
Alex Wayne in Bloomberg.
COHN: This Obamacare rate shock is good for you. “hat does this tell us about Obamacare in the rest of the country? On the one hand, we should expect premiums in New York to decline by more than they will in most states. That's because New York already has some of the Obamacare regulations that tend to make insurance more expensive…On the other hand, New York also seems to be reaping the benefits of a more competitive market. Based on the filings, it appears that some insurers are pricing very aggressively, trying to underbid competitors.”
Jonathan Cohn in The New Republic.
MILBANK: On Obamacare, Republicans test the definition of insanity. “Well, this is embarrassing. Republicans have made so many attempts to repeal "Obamacare" that the scorekeepers have lost count…All the tallies fall well short of the actual number of times Congress has voted to repeal all or part of Obamacare. It has done that -- are you sitting down? -- 67 times.”
Dana Milbank inThe Washington Post.
Mandela's cell on Robben Island. Photo by Brian Bahr/Getty Images.
