Affordable Care Act

A Supreme Court decision against Obamacare could cost states billions and billions of dollars

Washington Post ~ Greg Sargent

If you want a sense of just how far-reaching the impact of a Supreme Court decision gutting Obamacare subsidies could prove, new data on health care signups released this week provide a fresh way to game out such a ruling’s consequences.

The Department of Health and Human Services announced the other daythat some 11.4 million people have signed up for health plans through federal marketplaces. The new HHS data also provides a breakdown of the number of sign-ups in each of the three dozen states on the federal exchange — precisely the states that would no longer get subsidies if the Court invalidates tax credits to people in all federal exchange states.

This provides a way of approximating just how much money in tax credits each state could lose if the Court rules that way. We’re talking about enormous amounts of money: Florida could lose nearly half a billion dollars per month in subsidies to its constituents. Texas could lose a quarter of a billion dollars per month. North Carolina and Georgia could each lose over one hundred million per month.

Here it is in chart form (a note on methodology is below), detailing the impact of such a ruling on the 14 states that stand to lose the most:

The column on the left details the approximate total number of people in each state who qualify for subsidies. The middle column details the average amount in subsidies per person. And the column on the right details the approximate total number of dollars per month that are set to flow into each state — money that would presumably stop flowing if SCOTUS guts the subsidies.

This methodology was suggested to me by Larry Levitt, a senior vice president at the Kaiser Family Foundation who may know more about the Affordable Care Act than anyone else alive. He says one reasonable way of trying to calculate total subsidies per state is to take the total number of new signups in each state, and multiply that by the percentage in each state who qualify for tax credits, data that is also supplied by HHS. That produces the approximate total in each state who qualify for subsidies (the left column).  You then multiply that by HHS data detailing the average monthly subsidy payment in each state (the middle column), and it gives you the approximate total in monthly subsidies to each state (the right hand column).

A few caveats: First, these calculations are very rough and approximate. The data on the percentages who qualify for subsidies and on average monthly subsidies are a little bit older than the newest data on total signups (but they probably won’t change much). Also, not all of the people who signed up will end up paying, so these totals will likely drop somewhat, though it’s hard to know how much. Still, Levitt says this is a good way of trying to gain a rough sense of how much money in each state we’re talking about here.

“This a very reasonable approach to estimating the amount of federal subsidies people living in these states will receive,” Levitt says. “Billions of dollars are flowing to low and middle income people under the law, and most of those are going to people in states using This makes it very tangible: If the Supreme Court sides with the plaintiffs, states would be losing in some cases hundreds of millions in federal money per month.”

If defenders of the law get their way, numbers like these could end up having legal significance. A number of states have argued, in a brief filed for the government’s side, that the plain text of the ACA contains noexplicit threat to withdraw subsidies from states that fail to set up exchanges. Thus, they argue, if the Supreme Court guts subsidies, it would impose a “dramatic” hidden punishment on them and their residents for their decision not to set up an exchange, despite the fact that they had no clear warning of the consequences of that decision. This raises serious Constitutional concerns, and as a result, the states argue, the Supreme Court should opt for the interpretation of the statute that doesn’t raise those concerns — the government’s interpretation that subsidies are universal.

This federalism argument, which has been expanded upon by law professors Nicholas Bagley and Abbe Gluck, could potentially appeal to Anthony Kennedy or possibly to John Roberts. The fact that the states stand to lose such enormous amounts in subsidies to their residents could help underscore that case.

Indeed, all of this suggests that a SCOTUS ruling against the ACA could create real problems for GOP lawmakers in many states. Reuters reportsthat officials in some states are currently scrambling to figure out what to do in the event of such a ruling. Even state officials who want to respond by setting up their own exchanges — keeping subsidies flowing — tell Reuters they may not be able to do so for political and other logistical reasons, meaning they’d lose subsidies even if they don’t want to. In Ohio, for instance, GOP governor John Kasich has suggested he wants to come up with a fix but doesn’t seem clear on what. It’s perhaps not surprising, then, that relatively few red states have signed a brief in support of this lawsuit.

Meanwhile, Republicans in Congress are working hard to convey the impression that they might have a contingency plan in place — or even their own alternative health reform — for those who might lose subsidies and coverage. Such feints are probably just designed to persuade the Justices that the consequences of an anti-ACA ruling might somehow not prove so dire. But, taking those Republicans at their word, numbers such as the above provide a useful way to judge any such contingency plans or alternatives: Do they come anywhere close to covering the same numbers of people?

Conservatives might seize on these sums of money for their own purposes.Some on the right are arguing that, if SCOTUS does gut subsidies to millions, Republicans must not offer a fix that spends anything close to the same amount in subsidizing those people’s health care, and instead must advocate for a return to a pre-Obamacare baseline level of spending and propose “free market” solutions instead. These conservatives will likely argue that such huge expenditures as those detailed above underscore their point.

As I’ve repeatedly written, I think there’s a decent chance the Justices could side with the challengers. The massive amounts of money at stake underscore that if this does happen, a whole new political and policy story will unfold from there, with consequences that no one should pretend to be able to predict.

16 Times Fox News Claimed Obama “Diminished” The Presidency

I’ve come to the conclusion that the POTUS does not give a crap about what Fox News “analysts” think…at all!  To that, I say in today’s youth vernacular:  “Do you, Mr. President!”

Media Matters

Naturally, President Obama’s lighthearted appearance last week in a BuzzFeed video that promoted the deadline to sign up for health coverage through the Affordable Care Act triggered humorless responses from his conservative critics.

Like clockwork, conservative commentators, led by Fox News, swooped in. Assigning themselves the role of protocol police, they sternly announced that Obama had extinguished all “dignity” from the Oval Office. “I yearn for my president looking presidential and serious right now,” announced Fox News host Greta Van Susteren.

Sound familiar? It should. For six years now Fox News’ lineup of talkers and guests have been regurgitating the same condescending claim: Obama has “diminished” the office of the presidency and had done something unspeakable that’s “beneath” his lofty position. It’s part of an uglier, ongoing attack on Obama. It’s the Fox News suggestion that Obama’s not part of the American tradition, that he doesn’t understand our history and doesn’t know how conduct himself. Or, he’s so arrogant that he just doesn’t care.

But a review of the charges shows the alleged offenses have almost always been trivial and unimportant.

Here’s a collection of at least 16 times Fox News figures claimed, or certainly insinuated, that Obama had diminished the office or done something “beneath” it. Each quote (via Nexis) is followed by the alleged etiquette slight that prompted the habitual hand wringing.

*February 12, 2015: “Some people think this diminishes the presidency. I certainly hope so because I think the presidency, not this president but the office itself, is too much with us and far too grand and encrusted in royal trappings.” – George Will

Obama transgression: Appearing in the BuzzFeed video.

*January 21, 2015: “Does it diminish the office to be sort of showing the swagger?” — Megyn Kelly

Obama transgression: Being too confident during his State of the Union address following Democratic midterm losses.

*January 23, 2015: “For the people to say this is diminishing the dignity of the office, that happened a long time ago.” — Tucker Carlson

Obama transgression: Being interviewed by handful of YouTube stars.

*November 6, 2014: “I thought his news conference yesterday was beneath the office in a sense of pretending that this wasn’t a shellacking and just giving lip service to common ground.” — National Journal’s Ron Fournier appearing on Special Report With Bret Baier

Obama transgression: Not being humble enough at press conference following Democratic midterm losses.

*October 2, 2014: “So as we face down big, big, big problems in the world, skip the trash talk. It only diminishes the office of the president.” — Greta Van Susteren

Obama transgression: He criticized Fox News in a speech.

*March 11, 2014: “Yes, look, people sometimes will say, look, I disagree with the president, but I respect the office. It’d be nice if Obama respected the office. When he does things like this, it diminishes not just him but the office itself. People around the world are watching this, as you say, with all these international crises going. And you just see him and the office just shrinking day by day.” — Fox News contributor, Deroy Murdock

Obama transgression: He appeared on comedian Zach Galifianakis’ comedy interview show, “Between Two Ferns” to promote Obamacare.

*April 6, 2013: “I’m on Twitter a lot, and when I see some of the things that these guys say, it’s just beneath the office of the president.” — Kirsten Powers

Obama transgression: A Politico report that noted the president’s aides often find fault with Obama’s critics via Twitter.

*April 25, 2012: “Do you think it’s beneath the office of the president of the United States to go on ‘Jimmy Fallon’ and not only do an interview? I like that he did the interview, and we’ll play some of that. But the fact that he did this slow rap, this slow talk afterwards, does that make any sense to you? Do you think that that is something beneath the office?” — Brian Kilmeade (on Fox News Radio)

Obama transgression: Doing a few comedy bits on late-night television.

*April 25, 2012: “He’s diminishing the office, diminishing himself, seemingly petty.” — Sean Hannity

Obama transgression: Running a negative re-election campaign.

*May 2, 2012: “And the great asset the President has is the Oval Office, the presidency of the United States. He is diminishing that by using events which are national events as partisan events.” — Patrick Buchanan

Obama transgression: Trumpeting the death of Osama bin Laden for political gain.

*June 26, 2012: “Don’t you think it diminishes the office of the president, talking about condoms?” — Andrea Tantaros

Obam transgression: Addressing birth control.

*October 26, 2010: “The decisive — divisive rhetoric that he’s used seems to me beneath the office.” Dana Perino

Obama transgression: Criticizing Republicans while campaigning for Democrats.

*October 28, 2010: “One of it, it drives independents further into the Republican column and energizes the Republicans as well, and more importantly that diminishes the office that he’s been entrusted by the American people.” — Karl Rove

Obama transgression: Appearing on The Daily Show With Jon Stewart.

*July 27, 2010: “This pandering to the entertainment elites diminishes the office and it ends up further estranging him from the common man.” — Laura Ingraham

Obama transgression: Being too cozy with celebrities.

*June 18, 2009: “The president of United States should not be afraid of coming on Fox News, nor should the president of the United States diminish his office by seeming to engage in a petty fight with the — with the — with a network himself.” — Karl Rove

Obama transgression: Criticizing Fox News.

*April 6, 2009: “This diminishes him. This takes the presidency, the most powerful office in the world, and diminishes it.” — Karl Rove.

Obama transgression: “separating himself from the Bush administration,” according to Bill O’Reilly.

Sorry Fox News, but you know what does “diminish” the office of the presidency? Incessantly claiming the occupant isn’t worthy of respect.

The White House’s unlikely ally at the Supreme Court

A view of the Supreme Court, Jan. 16, 2015 in Washington, DC. (Photo by Drew Angerer/Getty)

A view of the Supreme Court, Jan. 16, 2015 in Washington, DC | Drew Angerer/Getty

MSNBC ~ Rachel Maddow Show

In recent years, one group has had more success at the Supreme Court than any other. It’s not Republicans. It’s also not conservatives, per se. It’s not the NRA, the Koch brothers, or the religious right movement.
In Justice John Roberts’ court, there’s been a lot for the right to like, but Big Business and Corporate America have consistently found a friendly ear among the majority of the sitting justices. With this in mind, Stephanie Mencimer’s report last night stood out as especially significant.
If getting rid of Obamacare is such a good idea, why isn’t corporate America getting behind King v. Burwell, the Supreme Court case designed to demolish the Affordable Care Act? More than 52 different parties have weighed in with briefs in advance of oral arguments on March 4…. But not a single business group – not the US Chamber of Commerce, not any of the health industry companies and trade groups that opposed the law when it was being drafted – has presented a brief endorsing this lawsuit.
These outfits are either backing the Obama administration’s attempt to defeat the suit or sitting out this case. Briefs in the case help explain why: Obamacare is working.
Mencimer pointed to a brief filed by the Hospital Corporation of America (HCA), the nation’s largest health care provider, which described the argument underpinning King v. Burwell as “absurd,” while also making the argument that the system at risk in this case is working quite well, both for the public and for America’s hospitals.
What’s more, it’s not just private medical institutions pushing against the ridiculous litigation. National Journal reported a couple of weeks ago that private insurers are doing the same thing.
In an amicus brief filed Wednesday, health insurers said a ruling against the subsidies would have widespread and severe ripple effects, potentially throwing states’ entire insurance markets into chaos.
Stopping the flow of subsidies “would create severely dysfunctional insurance markets” in 34 states, America’s Health Insurance Plans, the industry’s leading trade organization, said in its amicus brief. “It would leave consumers in those States with a more unstable market and far higher costs than if the ACA had not been enacted.” […]
AHIP … said the state and federal exchanges work the same as a practical issue. The subsidies and the law’s individual mandate are part of an interconnected series of policies designed to stabilize insurance markets, AHIP said – irrespective of who runs the exchange in any particular market.
We generally think of Big Business and Corporate America aligning themselves with Republicans, and for good reason; that’s usually true. But on the Affordable Care Act, which Republicans like to pretend is bad for the private sector, the usual partisan lines are blurred – the White House, insurance companies, hospitals, and even pharmaceutical companies are all telling the Supreme Court that this stupid case is genuinely dangerous, both to the American public and the American marketplace.
And that’s no small development. It’s quite easy to imagine Republicans on the Supreme Court ignoring the White House and deliberately gutting one of President Obama’s accomplishments, but it’s tougher to imagine those same justices blowing off private-sector leaders – the same corporate leaders hoping to avoid systemic chaos and shattered balance sheets.

The Case Against Obamacare May Fail One Of The Most Basic Tests Of A Lawsuit

Justice Anthony Kennedy | CREDIT: AP PHOTO/MATT SLOCUM

Think Progress

King v. Burwell, a Supreme Court case seeking to defund much of the Affordable Care Act and strip health insurance from as many as 13 million people, is a project of the Competitive Enterprise Institute (CEI), a conservative organization whose former chairman compared Obamacare to the Holocaust. CEI, does not hide this fact. To the contrary, its website announces that CEI is “coordinating and funding” the King litigation.

The Constitution, however, does not permit CEI to bring a lawsuit challenging Obamacare simply because they do not like the law. Rather, in order to invoke the jurisdiction of federal courts, CEI had to track down at least one plaintiff somewhere in the country who is actually injured in some way by the provisions of the Affordable Care Act CEI wishes to attack. Recent reporting by the Wall Street Journal and Mother Jones, however, indicate that CEI may have failed at this basic task when it assembled the four plaintiffs in King.

Article III of the Constitution requires plaintiffs challenging a federal law to show that they will actually be harmed in some way if the law remains in effect, a requirement known as “standing.” King challenges tax credits that help millions of individuals who purchased health insurance through health exchanges operated by the federal government afford their coverage. To establish standing, however, the lawyers behind this case offer a somewhat convoluted theory.

Although the Affordable Care Act requires most Americans to either carry health insurance or pay somewhat higher taxes, individuals are exempt from this requirement if the cost of the lowest-price coverage available to them exceeds 8 percent of their household income. The King plaintiffs claim that the cost of such a health plan is below 8 percent of their income if they are eligible for tax credits, but it is above 8 percent of their income if the tax credits are struck down. Thus, they claim, by rendering health care unaffordable for millions of Americans, they can also save themselves from complying with the law.

It’s not at all clear that the plaintiffs’ (and their attorneys’) math is correct, however, at least if one assumes that the claims that they made regarding their own finances are correct. According to a declaration filed by a senior official in the Department of Health and Human Services, two of the four plaintiffs are exempt from the consequences of not buying health insurance regardless of whether they receive a tax credit, because the cost of the cheapest plan will exceed 8 percent of their income even if they do receive a tax credit. Additionally, while plaintiff Brenda Levy projected that she would earn as much as $43,000 in 2014, reporting by the Wall Street Journal suggests that her income may actually be “less than $10,000.” If her income is this low, she would also be exempt from the law’s consequences for people who do not buy health insurance.

That leaves one more plaintiff, Douglas Hurst.

The Wall Street Journal also reports, however, that Mr. Hurst is a veteran and may be entitled to enroll in a veterans health plan. Federal regulations provide that several veterans health programs qualify as insurance coverage under the Affordable Care Act. So if Hurst qualifies for one of these programs, he does not have standing the challenge the tax credits even if he hasn’t actually enrolled in the veterans benefits he is entitled to. A plaintiffs’ decision not to claim benefits they are entitled to is their own choice, but that does not give a plaintiff a right to “complain about damage inflicted by its own hand.”

In an email to ThinkProgress, CEI’s general counsel Sam Kazman writes that, to CEI’s knowledge at the outset of the King litigation, “neither Mr. King nor Mr. Hurst was ever enrolled in any veterans health care program,” and he claims that their failure to enroll in veterans benefits means that “under the ACA and its regulations, neither was ‘eligible’ for such coverage.” To justify this counter-intuitive definition of the word “eligible,” Kazman points to a regulation establishing a “Special rule for coverage for veterans and other individuals.”

“CEI is wrong,” however, according to law professor and health policy expert Tim Jost. Jost explains that “there are two sets of regulations that discuss veterans benefits,” and the regulations Kazman cites to do not answer the question of who has complied with their obligation to obtain health insurance under the Affordable Care Act. Rather, the regulations Kazman cites gives veterans a choice — they can either enroll in a veterans program or obtain insurance through another means such as through the health insurance exchanges. But, once again, a plaintiff cannot root his standing to bring a lawsuit in his own choices.

So what all does this mean for the future of the King case? If all four plaintiffs lack standing, the Court must dismiss the case because the Constitution does not permit federal courts to decide cases where no plaintiff has standing. Based on what we know now, however, it would be premature for the Court to definitively hold that no party has standing. It is possible, for example, that Ms. Levy’s income is higher than news reports suggest, or that Mr. Hurst does not qualify for veterans benefits. These facts could only be determined with certainty if the case is sent back to a lower court to allow additional fact-finding.

One possibility is that the Supreme Court could dismiss the case as “improvidently granted,” a process that would allow the justices to wait for another case that presents a similar issue without also presenting the same doubts regarding whether the Court has jurisdiction to decide the matter in the first place. As a practical matter, however, it probably is not in the Justice Department’s interests to urge the justices to reach such a decision. If there are five votes who are inclined to reject this attack on Obamacare, then the best outcome for the Department — and for the millions of Americans who rely the law’s tax credits to afford insurance — is to have the justices reach the merits and uphold the law. If, on the other hand, there are five votes eager to gut the law, then they are unlikely to stay their hand due to doubts about the plaintiffs’ standing.

As the New York Times‘s Linda Greenhouse recently explained, the plaintiffs’ legal arguments in King aren’t just weak on the merits, they conflict with the previously stated views of all five of the Supreme Court’s conservatives. By taking CEI’s case, according to Greenhouse, the justices allowed themselves “to be recruited into the front lines of a partisan war.” And once a justice decides to take sides in such a war, it’s not likely that they are going to be deterred because CEI was less-than-diligent in recruiting plaintiffs.

Nevertheless, CEI’s trouble recruiting plaintiffs for this lawsuit who can claim, with certainty, that they were actually injured in some way by Obamacare says a great deal about the stakes in this litigation. During oral arguments before a federal appeals court that upheld the tax credits, Judge Andre Davis described what he thought the plaintiffs in this lawsuit were after — “You are asking us to kick millions of Americans off health insurance, just to save four people a few dollars.” As it turns out, the four King plaintiffs may have even less at stake than Judge Davis thought.

Disaster Looming For Republicans As Poll Finds 64% Want To Keep Obamacare Subsidies


President Obama | White House Photo


A new Kaiser Health Tracking Poll found that Congressional Republicans are living in a difference universe from most Americans. The poll found that 64% of Americans want to Congress to act to restore ACA subsidies if the Supreme Court rules against the health care law.

Via the Kaiser Family Foundation:


If the Supreme Court rules that financial assistance is only available in states with state-run marketplaces, nearly two-thirds of the public says that Congress should take action so that people in all states can be eligible for financial help to purchase health insurance. Majorities of Democrats and independents say they would support Congressional action while Republicans are more divided. And, although the Supreme Court’s decision would have significant implications for many people in states using the federal exchange, their views are similar to those of people living in states with their own marketplace.

A nightmare scenario for Republicans would unfold if the Supreme Court ruled the ACA subsidies unconstitutional in states that have not set up their own exchanges. Republicans are committed to killing the ACA. Their most ardent supporters want to kill the law. The problem is that nearly two-thirds of the American people want congressional Republicans to act to protect the subsidies if the Supreme Court rules them unconstitutional.

Millions of people will lose their health care if the subsidies go away. The fate of the subsidies would become a big issue in the 2016 presidential election, and the Republicans will be trapped between doing what a majority wants and what their right-wing ideological base wants. A Supreme Court ruling against the subsidies would be a disaster for the Republican Party. If Congressional Republicans refuse to act to restore, the subsidies voters will blame them for the loss of their health care.

The House has announced that they will vote to repeal the ACA next week. Only 32% of those polled in Kaiser poll want the law repealed. Congressional Republicans are completely out of touch with the majority of Americans on the issue of the ACA. If the Supreme Court rules against the subsidies, the conservative justices will be dropping a ticking time bomb into the laps of Republicans.

No matter how the Supreme Court rules, this won’t end well for the GOP.

GOP’s Stealth Blow To Obamacare Helps Claim Its First Victim


AP Photo/Cliff Owen


Part of the reason that the insurance commissioner took over the struggling insurer, and therefore part of the reason it is now being shut down after state officials determined it couldn’t be saved, is a provision that House Republicans inserted into the spending bill approved in December.

As TPM reported at the time, House GOP staff requested a change to Obamacare’s so-called risk-corridor program as part of the CRomnibus. The program, a favorite punching bag of Republicans, who have pushed for its repeal, is designed to help insurers in the law’s first few years. Companies estimate what their insurance pools will look like. If they turn out better than expected, then the companies pay money into the program. If they turn out worse, then companies are paid money by the program.

That helps lessen the risk for insurers as they take on a new population of Obamacare enrollees. But what the Republicans inserted into the CRomnibus was a requirement that the risk-corridor program effectively be revenue neutral. So if the program didn’t bring in enough money from overperforming companies, it wouldn’t be able to make payments to underperforming ones.

Experts told TPM at the time that bigger companies would likely be able to absorb any short-term losses that might come with the change, but that smaller insurers — like CoOpportunity Health, which covers about 68,000 people in Iowa and Nebraska — would be more vulnerable.

When Iowa insurance commissioner Gerhart petitioned to take over the company in December, he cited the uncertainty of the risk-corridor money as one reason for CoOpportunity Health’s struggles, stating that the CRomnibus provision had “placed in jeopardy” up to $60 million of the company’s projected assets.

Becky Blum, a senior official at the Iowa agency, confirmed to TPM in an email that the CRomnibus provision had been one of the factors in the company’s financial instability, though not the only one. The bottom line was that the insurer was paying out too much in claims and not bringing in enough revenue.

But that is exactly the problem that the risk-corridor program is designed to address and, because the revenue for CoOpportunity wasn’t guaranteed after the spending bill, it put the company’s long-term solvency further into doubt.

“The potential limitation on recouping the risk corridor money complicated the company’s ability to put forward a plan of viability,” Blum said.

That was the fallout that Obamacare supporters warned about when the CRominbus passed.

“The risk corridor program was established specifically to assist insurers, like the coops and other new entrants, who face difficulties in setting premiums accurately for the first couple of years of their existence because they lack previous experience,” Tim Jost, a health law professor at Washington and Lee University who supports the law, told TPM. “Congress should have realized that by limiting funding for the risk corridor program, it would likely be driving some insurers into insolvency.”

Poll: Americans hate Obamacare (until they use it)

America Blog

Oh America, you are adorable.

Back in 2010, a Newsweek poll showed that Americans “hate” Obamacare, but loved it component parts.

Even Republicans, who “loathe” Obamacare, overwhelmingly support most of the legislation’s key provisions.

Doc via Shutterstock

So it’s shouldn’t come as a surprise that a new Gallup poll shows Americans, yet again, hopping mad about Obamacare.

But as CNN notes, another Gallup poll shows that the actual people who use Obamacare, love it:

Over seven in 10 Americans who bought new health insurance policies through the government exchanges earlier this year rate the quality of their healthcare and their healthcare coverage as “excellent” or “good.” These positive evaluations are generally similar to the reviews that all insured Americans give to their health insurance.

The people who hate the Affordable Care Act are generally people who have no idea what it even does, and who aren’t affected by it at all.

There are a number of lessons here:

1. Democrats stink at messaging.

2. Republicans are awfully good at messaging.

3. Lying doesn’t tend to impede the success of the GOP message machine.

4. Americans are seldom shy about having a strong opinion on something they know nothing about.

In the end, I’d like to say ignore the polls, but the Republicans are so good at misrepresenting the truth, that even a lie — especially a lie — can do a lot of damage. I’ve said from day one that Democrats were doing a lousy job of selling their programs. Whether it was the stimulus that quite literally saved our country, or Obamacare, that wasn’t all we wanted, but it also wasn’t too shoddy either.

Unfortunately in life, and politics, doing good isn’t enough. You have to market what you’re selling, and continue to market it even after it’s sold. The bad guys won’t stop trying to shoot it down. And you should never cease defending it.

More Than 70 Percent Of Americans Like Their Obamacare Plans

Cathey Park from Cambridge, Mass. shows the words "I Love Obamacare" on her cast for her broken wrist as she waits for President Barack Obama to speak at Boston's historic Faneuil Hall about the federal health care law, Wednesday, Oct. 30, 2013.

Cathey Park from Cambridge, Mass. shows the words “I Love Obamacare” on her cast for her broken wrist as she waits for President Barack Obama to speak at Boston’s historic Faneuil Hall about the federal health care law, Wednesday, Oct. 30, 2013. | CREDIT: AP PHOTO/CHARLES DHARAPAK

 Think Progress

With the second Obamacare enrollment period set to begin this weekend, there’s at least one piece of good news for proponents of the health care law.

A new Gallup poll found that more than 70 percent of Americans who bought new health insurance plans through the government exchanges earlier this year rated the quality of their health coverage as “good” or “excellent.” Many of those who purchased new health insurance policies through the exchanges also recounted positive experiences and said they experienced a high quality of health care. According to the poll, more than two-thirds of the newly insured expressed plans to renew their exchange policies.

Pollsters conducted interviews between Oct. 22 and Nov. 12 on Gallup Daily Tracking, asking Americans with health insurance if they obtained their coverage this year, and if so, whether they had done so through federal or state exchanges.

Other recent studies conducted by the Urban Institute and the Commonwealth Fund have found similar levels of satisfaction among new Obamacare customers, who largely say they’re better off with their new coverage.

If the early predictions about health insurance rates in the Obamacare marketplaces hold true, those positive reports could continue. Although premiums in the individual market have previously experienced average annual increases of 10 percent, the rates for next year’s Obamacare plans aren’t expected to rise very much. While experts warn that some people who are already enrolled could experience relatively sharp increases if they simply renew their current plans, they say that newer plans entering the marketplaces will be much cheaper.

As the health law’s second open enrollment period begins, continuing to educate uninsured Americans about their options will be the next challenge for federal officials. In a study conducted by the Kaiser Family Foundation earlier this month, researchers found that two-thirds of respondents knew little about the exchanges they could enter to purchase health plans or the subsidies available to those with low or moderate incomes.

However, during an event at the Center for American Progress (CAP) in Washington, D.C. earlier this week, Health and Human Services Secretary Sylvia Burwell remained optimistic about the health law’s impact among potential enrollees, predicting that 9.1 million people will enroll in a health care exchange this year.

“Will we have challenges? Yes. But the experience is one, overall, that will be a positive one,” Burwell said at the CAP-sponsored event.

The news about consumer satisfaction with Obamacare plans comes amid a period of controversy for the president’s signature health law. A challenge against the law’s subsidies is heading to the Supreme Court. And GOP congressional leaders continue to express outrage over Obamacare architect Jonathan Gruber’s recent comments about the law only being able to pass due to the “stupidity of the American voter.”

Uninsured Rate Drops To Lowest Level Since The ’90s


Obamacare is squeezing down the number of Americans who don’t have health insurance, according to yet another survey. | AP Photo/Charles Dharapak

So, does this means that berating Obamacare is off the GOP agenda this election cycle?  I doubt it…

The Huffington Post

Another day, another survey showing that Obamacare is beginning to cure America’s uninsured problem.

The latest numbers come from the federal Centers for Disease Control and Prevention, which polled more than 27,000 people during the first three months of the year. Forty-one million U.S. residents, or 13.1 percent, were uninsured during the quarter when benefits started to kick in for people who signed up for coverage into private insurance or Medicaid via the Obamacare exchanges or elsewhere.

That’s the lowest number and percentage of uninsured people since the CDC started using this version of its survey in 1997. It’s also down 3.8 million people and 1.3 percentage points from the end of 2013.

The Affordable Care Act’s impact on the uninsured actually is understated by the CDC survey. More than 30 percent of Obamacare’s 8 million private health insurance enrollees signed up in March or later. That means their benefits wouldn’t have kicked in by the end of the third quarter, so a portion of them wouldn’t have had coverage by the time of the CDC poll.

Polling and research by other organizations indicates a greater reduction of the uninsured after March. By the end of June, the uninsured rate fell to 13.3 percent, the lowest since 2008, according to Gallup survey findings released last month. Gallup’s number for the second quarter was down down from 17.1% at the end of 2013. In an article published in the New England Journal of Medicine, the Department of Health and Human Services and the Harvard School of Public Health pegged the number of people who gained coverage since last year at 10 million. The Congressional Budget Office projects 12 million people will gain health insurance by year’s end.

While the CDC survey shows the uninsured rate for children and adults over 65 years old didn’t change much, the share of working-age adults who had no health coverage fell from 20.4 percent at the end of the last year to 18.4 percent during the first three months of 2014. The biggest drop was among adults 19-25 years old; the uninsured rate for this group fell more than 5 points to 20.9 percent.

As other studies have shown, states that adopted Obamacare’s expansion of Medicaid benefits to more poor residents covered a lot more uninsured than those that didn’t. During the first quarter of this year, the uninsured rates in Medicaid-expansion states fell from 18.4 percent to 15.7. In states that refused to accept the Medicaid expansion, the uninsured rate was virtually unchanged, the CDC found. Twenty-three states, mostly in the South, have not opened up Medicaid to more people.

The CDC report also makes plain the connection between income and health insurance. The uninsured rate for poor U.S. residents was 24.1 percent, compared to 26.2 percent for “near-poor” people and 9 percent for everyone else. Obamacare provides financial assistance to people who earn up to four times the federal poverty level, which is about $94,000 for a family of four.

The ethnic group with the highest uninsured rate was Hispanics, at 27.2 percent in the first three months of this year, a decline of more than three points since 2013. The uninsured rate also fell for African-Americans, from 18.9 percent to 15.1 percent. Asians had the third-highest rate at 13.3 percent, followed by whites at 11.5 percent; the share of uninsured Asians and whites didn’t significantly change.

The Census Bureau also released survey findings about health insurance in the United States Tuesday, but its figures are from 2013, before benefits from Obamacare enrollment began to take effect. The Census also changed the way it conducts this survey, making comparisons to previous years impractical.

In 2013, 13.4 percent of the population, or 42 million people, lacked health insurancefor the entire year, the bureau found. By contrast, the CDC survey asks respondents whether they have coverage at the time of the interview, meaning they may have had coverage at another point during the same year.

The next phase of sign-ups on the health insurance exchanges begins Nov. 15 and will run through Feb. 15. According to the Congressional Budget Office, 7 million additional people who currently lack coverage will gain it during the open enrollment period, and more are expected to sign up in the coming years.

But neither the Congressional Budget Office nor anyone else believes Obamacare will ever bring the number of uninsured Americans down to zero. A decade from now, CBO projects 31 million people will not have health insurance, 25 million fewer than if the Affordable Care Act hadn’t been enacted, but still 11 percent of the population.

This story has been updated with figures from the Census Bureau survey.

GOP’s Obamacare Nightmare Is Coming True: It’s Working


AP Photo / Carolyn Kaster


The politics of the health care law have undergone a sea change since its disastrous rollout last fall, when many conservative operatives were salivating at the prospect of a GOP wave in the midterm elections due to an Obamacare “train wreck.”

But the train never wrecked. The law rebounded, surpassing its signups goal and withstanding a flurry of attacks. The issue seems to have mostly lost its power as a weapon against Democrats, and a growing number of Republican governors — even in conservative states — are warming to a core component of Obamacare, the Medicaid expansion.

To get a sense of why this is worrying for Republicans in the long run, look no further than conservative strategist Bill Kristol’s 1993 memo — “Defeating President Clinton’s Health Care Proposal” — warning that reform would paint Democrats as “the generous protector of middle-class interests” and strike a “punishing blow” to the GOP’s anti-government ideology.

“But the long-term political effects of a successful Clinton health care bill will be even worse — much worse. It will relegitimize middle-class dependence for ‘security’ on government spending and regulation. It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government,” Kristol wrote.

In other words, the real fear back then was that health care reform would succeed.

Two decades later, Kristol’s prophecy is haunting Republicans. Obamacare has provided a lifeline by providing coverage to 8 million people on the exchanges, 7 million under Medicaid expansion and 5 million who bought insurance outside the exchanges but benefit from new regulations like the coverage guarantee for individuals with preexisting conditions. Even Republicans in deeply conservative states are suggesting that the popular new benefits cannot be taken away, even if the Obamacare brand still struggles.

The shift has been crystallized in contentious Senate races this fall. Senate Minority Leader Mitch McConnell (R-KY) recently signaled that Kentuckians benefiting from the state’sObamacare exchange and Medicaid expansion should be able to keep their coverage. Senate GOP candidates Joni Ernst of Iowa, Tom Cotton of Arkansas, Scott Brown of New Hampshire and Terri Lynn Land of Michigan have all refused to call for rolling back Medicaid expansion in their states. The number of television ads attacking the law have plummeted in key battleground states since April, and now even vulnerable Democratic Sen. Mark Pryor of Arkansas is touting his vote for protecting Americans with preexisting conditions under Obamacare.

But even if the Obamacare attacks are fading, Republicans remain poised to make gains in the midterms due to a variety of structural advantages. They continue to oppose Obamacare as a whole, and point out that Americans still react negatively when asked about the law.

“Ensuring that people with preexisting conditions have access to coverage has long been a popular policy, and one where there is bipartisan agreement. It’s the the entirety of ObamaCare that remains EXTREMELY unpopular,” Brad Dayspring, a spokesman for the Senate GOP’s campaign arm, told TPM in an email.

Conservative health-policy experts have argued that Obamacare cannot be repealed without a viable alternative to fix broken parts of the system, but Republicans have failed to come up with one that the party can unite behind.

These are signs that Obamacare is weaving into the fabric of American culture and that the dream of repealing or unwinding it is fading. The massive health care industry is adapting to the post-Obamacare world and fears of double-digit hikes in premiums are fading: early datasuggest the prices for benchmark “silver” plans in 2015 are poised to decline slightly.

“We don’t yet have data for all states, but from these 15 states plus DC I think we can start to see a pattern emerging,” Larry Levitt, senior vice president at the Kaiser Family Foundation, said in an email. “In general, changes in premiums for the low-cost plans in the marketplaces are quite modest, and actually decreasing in many places.”

Stability in premiums means “government costs for premium subsidies … are under control, which is good news for taxpayers,” Levitt said.

In the courts, an ongoing conservative lawsuit to cripple Obamacare suffered a major setbacklast week when a federal appeals court vacated a ruling that would have blocked subsidies in 36 states. Legal experts say the full court is likely to uphold the subsidies when a panel with a majority of Democratic-appointed judges re-hears the case.

For Democrats, the dream scenario was that Obamacare would eventually join Social Security and Medicare as an unassailable feature of the American safety net. Like those other major programs, Obamacare won’t be without its share of problems — cost uncertainties for automatically-renewed plans among them. But after more than 50 House votes to repeal or dismantle the law, few could have predicted that Republicans would start warming up to central pieces of the law within a year of its rollout.

(Photos by the Associated Press)