U.S. Politics

Trump’s Broken Promise Will Doom Thousands Of His Voters

Trump’s Broken Promise Will Doom Thousands Of His Voters


Not long ago, Americans learned that the average life expectancy for white people in this country — those most likely to have voted for Donald Trump — actually declined for the first time in many years. The pathologies and frustrations believed to have driven that decline may have motivated the tiny handful of votes that gave Trump his Electoral College victory.

But not long after their euphoria over his inauguration fades, they are going to learn why his administration is so likely to drive those statistics in the wrong direction. Despite his promise to protect Social Security and Medicare — and his vow to replace the Affordable Care Act with “something much better” — Trump’s cabinet appointees and his allies in Congress plan ruinous changes to those programs. And that will mean ruin, and in thousands of cases death, for the mostly white and working class people who depend so heavily on them.

Unless the Republicans come up with a plausible bill to replace Obamacare, which has eluded them since 2009, millions of their constituents will lose the health insurance they have only recently gained — and yes, thousands of those people will die next year.

Back when the president’s health reform plan first passed, Republicans and their media echoes warned loudly about mythical “death panels” embedded in his legislation. Now, the voters who believed that nonsense are about to meet the real death panel — led by House Speaker Paul Ryan, Senate Majority Leader Mitch McConnell, and Rep. Tom Price, the Georgia Republican slated to head the Department of Health and Human Services.

This is not hyperbole: Before the advent of Obamacare, tens of thousands of uninsured Americans died every year because they didn’t receive timely care. Eight years ago, one reputable study estimated that as many as 137,000 Americans had perished prematurely due to lack of health coverage — or more than twice as many as died in the Vietnam War — between 2000 and 2006 alone. The Institute of Medicine has estimated that uninsured adults are 25 percent more likely to die prematurely than those with coverage, with uninsured adults between 55 and 64 years old faring even worse. For them, being uninsured is the third most significant cause of death, behind only heart disease and cancer.

Those estimates don’t include the victims of insurance company profiteering who will die if the repeal of Obamacare undoes its protection of patients suffering from “previously existing conditions.” Exposed to the tender mercies of corporate actuaries, thousands of them will lose their coverage, watch their families driven to destitution, and many of them will die, too.

That isn’t supposed to be what happens under President Trump, who declared in many interviews and debates his determination to provide better and cheaper health insurance “for everybody, let it be for everybody.” But by appointing a far-right ideologue like Price to run health policy, Trump effectively violated that promise before even taking his oath of office. Working with Ryan and the Republican majority in both houses of Congress, Price means to destroy Obamacare, slash Medicare, and decimate Medicaid.

The truth about the current incarnation of the Republican Party, which voters ought to have learned long ago, is that its attitudes toward working Americans of all descriptions range from careless to merciless. If not every Republican shares the “let ‘em die” position on health care screamed by a GOP debate audience in 2012, all too many believe that government has no role in ensuring that every American is insured — even though that would save money as well as lives.

However ridiculous most of Trump’s commitments may seem, his promise to protect Americans who depend on Obamacare, Medicare, and Medicaid is a matter of life or death. Unless he changes course now, we may see a lot of red caps at funerals for people who lost their health insurance, and died much too soon.

U.S. Politics

How Paul Ryan Plans To Teach Scrooge A Lesson

How Paul Ryan Plans To Teach Scrooge A Lesson

REUTERS/Gary Cameron


If Paul Ryan had written A Christmas Carol, Scrooge would have gotten a massive tax break, paid for by taking away Tiny Tim’s health insurance. The obvious lesson of the tale would be that a small businessman had been rewarded for creating a job for Bob Crachit — who could enjoy working overtime on Christmas without the fear of additional compensation, as well as the freedom of knowing that he won’t be able to retire until he’s at least 70, if ever.

Ryan’s glorious vision of Christmas yet to come may sound like a nightmare to you — but if the Speaker of the House gets his way, that nightmare will become America’s reality by the end of 2017.

Let’s go through Scrooge’s wish list, step-by-step, like we’re a concierge Santa service for rich people’s most destructive urges — or as if we were Paul Ryan.

Ebenezer Scrooge may be Charles Dickens’ personification of everything that is wrong with unfettered greed. But to Paul Ryan, Scrooge — with his estimated net worth of $1.6 billion — is a proud example of those job creators known as small businessmen, which by Ryan’s definition includes all Americans who “file their business as individuals, as people.”

This class of taxpayer, New York Magazine‘s Jonathan Chait notes, allegedly includes Donald Trump, a man who seats himself in a gold throne and identifies as a billionaire. Though Trump evidently is not much of a taxpayer.

Ryan doesn’t like to point out that 76.1 percent of his proposed tax cuts go to the richest 1 percent in 2017, and that percentage rises to 99.6 percent by 2025, according to the Center on Budget and Policy Priorities.

But who would? That kind of talk would only make rich people sad, which to Paul Ryan is a crisis almost as severe as America’s recent epidemic of poor people getting health insurance.

Sure, offering tax breaks that mostly benefit the rich blasts a $3.1 trillion hole in the deficit over the next ten years. But, as tattoo artists often lie to their drunkest customers, the Chinese character for “crisis” also means “opportunity.”

So 2017 will be an excellent opportunity to insure poor kids, like — say — Tiny Tim.

Under President Obama, America has hit a remarkable milestone with 95 percent of children covered by health insurance. Ryan has a plan to fix that with a repeal of Obamacare that will increase the number of uninsured kids by 4 million, nearly doubling the uninsured rate from 4 percent to 9 percent, according to a study by the Urban Institute. Ho ho ho!

In exchange for all those uninsured kids, we get a lot of happy Scrooges! We’ll be trading the insurance of about 4 million kids and some 16 million adults for $197,000 a year in sweet tax breaks for the richest .01 percent of people a.k.a. “small businesses” in RyanSpeak.

But, you say, Tiny Tim uses a crutch and an iron frame to support his sickly frame. He has a pre-existing condition! Surely Republicans will make sure he’s still insured.

Well, Scrooge doesn’t have to offer his employees insurance, meaning the Crachits have to get their own coverage. And since the GOP replacement bills all require people to maintain coverage, a few bad months for Bob and his family could leave poor Tim at the mercy of grossly underfunded high risk pools.

Or perhaps Scrooge will offer some of that great new non-Obamacare low-cost insurance that could cover as much as $2,000 a year, which would insure him for a whole day if he ends up in the hospital.

To make up for the hundreds of thousands of dollars that Crachit could end up owing for Tiny Tim’s care — given since Republicans will almost certainly aim to repeal Obamacare’s ban on insurance companies placing yearly or lifetime limits on care — Bob has got to work, all the time. So he does.

But Mr. Scrooge carefully makes sure his star employee earns just over the threshold where no compensation for overtime work is required. President Obama’s Labor Department wanted to raise that threshold from $455 a week to $913, meaning employers like Scrooge would either have to offer a raise or pay overtime. But Paul Ryan’s GOP will make sure that people earning more than $455 but less than $913 can be made to work all the overtime Scrooge wants for no extra compensation — even on Christmas. Just like the wise men!

And the best news of all is Bob Crachit and his son can look forward to working overtime every week of their lives until they’re in their 70s, when they can finally cut back to just working a 40-hour week so they can afford some Fancy Feast to go with the doctors’ bill.

Paul Ryan’s desires to privatize Social Security and Medicare — and pass the losses and costs on to you! — are about as well hidden as his passion for Ayn Rand. It’s what defines his career in public service — but it’s also what makes him repulsive to most Americans. So he tries to hide his passions or cloak them under code words.

Ryan’s plan to privatize most of Medicare and demand future retirees pay more is a part of his “Better Way” plan, which should be named “Better Way for Scrooge” plan. Donald Trump campaigned on preserving both of America’s retirement guarantees, but he has been quickly moving toward Paul and the two now seem to be fully aligned with the president-elect’s choice of Rep. Mick Mulvaney to be his budget director. The GOP congressman from South Carolina is one of the few politicians in America who eagerly declares his desire to cut Social Security.

How else can we afford to make Scrooge’s life easier?

Ryan and Dickens may have had different ideas of happy endings. The author of Great Expectations saw a Scrooge overwhelmed by the plenty with which he had been blessed and the need to which he had become blind. Ryan sees a Scrooge who is overburdened by tax and spend politics and exploited by greedy employees who want Christmas off every single year.

No wonder he prefers the works of Ayn Rand.

Both stories end with Scrooge being able to proudly say, “Merry Christmas!” But in Ryan’s tale, Scrooge is rushing home to inhale a whole turkey by himself. Just like a “small businessman” should.

2016 Hopefuls · Conservatives · Republicans · Sen. Ted Cruz

Good news: Ted Cruz recuses self from having opinions on anything that happened before 1970

U.S. Senator Ted Cruz (R-TX) pauses to look at the crowd as he confirms his candidacy for the 2016 U.S. presidential election race during a speech at Liberty College in Lynchburg, Virginia March 23, 2015. Cruz, a conservative firebrand who frequently clas
U.S. Senator Ted Cruz (R-TX) pauses to look at the crowd as he confirms his candidacy for the 2016 U.S. presidential election race during a speech at Liberty College in Lynchburg, Virginia March 23, 2015 | REUTERS

Daily Kos

This is a political trend I’d like to see more of: I wasn’t alive then, so don’t ask me!

[Q]: A third Texas president, L.B.J., created Medicare in themid-’60s. Your hero Ronald Reagan campaigned vigorously against that, saying it would lead to socialized medicine, would end liberty in the United States. Who was right: L.B.J. or Reagan?[Republican presidential candidate Ted Cruz]: It’s not worth tilting at windmills. I don’t know. I wasn’t alive then.

Who was right? Who’s to say? That was in the before-times. I have no opinions on the before-times. Now maybe Medicare ended liberty in the United States, maybe it didn’t, let’s just leave that one to the History Channel to sort out.

The possibilities here are endless. Sen. Ted Cruz, do you think the American Revolution was a good idea or a bad one? Your party tends to mention Hitler a lot—have any thoughts on the fellow? You have spoken endlessly about your father leaving Cuba, but we cannot help but notice you were not alive then—are you sure you are qualified to discuss this?

The good news, if we can hold him to this, is that Sen. Ted Cruz has now recused himself from having any opinions on anything that happened before December 22, 1970. Not just Medicare but the civil rights struggle are out of scope, but the development of the automobile, the highway system, electrification, indoor plumbing, the Crusades, and sedimentary rocks are all off-limits. As is the Constitution, which is worth more than all the others combined; if we can convince Ted Cruz that he is no longer qualified to give his opinions on what the Constitution says or what the Founding Fathers were thinking during any given lunchtime, we could render the man nearly silent in one stroke.

Other candidates have declared that they are not scientists, recusing them from climate discussions; Ted Cruz considers anything that happened before the Earth was graced with his bare-bottomed presence to be off-limits. Now that’s dedication to not answering the question.

Gov. Rick Scott

FL Gov Rick Scott Pleaded the Fifth a Shocking Number of Times During Medicare Fraud Trial


I’m a couple of days late with this news…

Forward Progressive – By Allen Clifton

It’s been a while since I wrote about one of our nation’s sleaziest governors, Florida Governor Rick Scott. I honestly have no idea how this guy got elected governor. You’d think the fact that he was CEO of a company that was found guilty of defrauding Medicare out of hundreds of millions of dollars would be enough to disqualify him from being elected to such a high office.

But apparently not, because the good people of Florida elected him in 2010. Not only that, but he stands a pretty good at chance at being reelected this November.

Florida, I’m begging you, please don’t reelect this guy.

If his incompetence isn’t potentially banning every computer in the state of Florida, then it’s his blatant (and illegal) attempts to disenfranchise many Florida voters. Or how about denying Floridians paid sick days? No matter how you analyze Rick Scott, he’s easily one of the most incompetent and unethical governors in this country today.

Well, a recent fact-check by Politifact found that Rick Scott pleaded “the Fifth” a shocking 75 times during his Medicare fraud case.

Seventy-five times! 

And he wasn’t even facing prison time. Because why would he, right? He was just the CEO of a company which defrauded the government, of course prison time wouldn’t be on the table.

Now if he had been caught with a moderately sized bag of weed, that would have been an entirely different story.

While I understand that it’s every American’s right to “plead the Fifth” in certain instances when on trial, for a former CEO of a company that’s on trial for massive Medicare fraud to do it 75 times is astounding. That alone tells you that Scott clearly had something to hide.

Oh, and for the record, his former company was found guilty of defrauding Medicare. They were ordered to pay over $600 million in penalties.

Yes, ladies and gentleman, Florida Governor Rick Scott – the man who was CEO of a company which was found guilty of massively defrauding the federal government.

I live in Texas and Rick Perry is definitely a scumbag, but he’s still not on the level of Rick Scott. In my opinion, Scott has proven himself to be one of the most corrupt and unethical politicians in this country.

Tea Party Ignorance · Va. GOP Candidate David Brat

David Brat, the Libertarian Who Beat Eric Cantor, Doesn’t Believe in the “Common” Good

AP/P. Kevin Morely

This Tea Party clown couldn’t even answer serious questions from Chuck Todd this morning…

Mother Jones

Brat has called for slashing Social Security, Medicare, and education spending and says “rich” nations don’t have to fear climate change.

When tea party challenger David Brat sent Rep. Eric Cantor (R-Va.), the House majority leader, to the ash heap on Tuesday night, vanquishing the incumbent by more than 10 points in the primary race, the politerati were stunned. Political journalists scrambled to answer a question: who is this guy? The political pros knew that Brat had mounted a campaign largely based on two issues: bashing Cantor on immigration (that is, excoriating the congressman, who was quite hesitant about immigration reform, for not killing the possibility of any immigration legislation) and denouncing Cantor for supporting a debt ceiling deal that averted possible financial crisis. But not much else was widely known about this local professor who dispatched a Washington power broker.

A quick review of his public statements reveals a fellow who is about as tea party as can be. He appears to endorse slashing Medicare and Social Security payouts to seniors by two-thirds. He wants to dissolve the IRS. And he has called for drastic cuts to education funding, explaining, “My hero Socrates trained in Plato on a rock. How much did that cost? So the greatest minds in history became the greatest minds in history without spending a lot of money.”

An economics professor at Randolph-Macon College in central Virginia, Brat frequently has repeated the conservative canard that Freddie Mac and Fannie Mae brought down the housing market by handling the vast majority of subprime mortgages. That is, he absolves Big Finance and the banks of responsibility for the financial crisis that triggered the recession, which hammered middle-class and low-income families across the country. (In fact, as the housing bubble grew, Freddie and Fannie shed their subprime holdings, while banks grabbed more.)

In his campaign speeches, Brat has pointed out that he isn’t worried about climate change because “rich countries solve their problems”:

If you let Americans do their thing, there is no scarcity, right?  They said we’re going to run out of food 200 years ago, that we’re goin’ to have a ice age. Now we’re heating up…Of course we care for the environment, but we’re not mad people. Over time, rich countries solve their problems. We get it right. It’s not all perfect, but we get it right.

Update: After Mother Jones published this piece, several videos referenced were set to private.

He did not say what might happen to not-so-rich countries due to climate change and the consequent rise in sea levels, droughts, and extreme weather.

Asked about cuts to Medicare, Brat replied that he supported drastic reductions in payouts:

I’ll give you my general answer. And my general answer is you have to do what’s fair. Right. So you put together a graph or a chart and you go out to the American people, you go to the podium, and you say, this is what you put in on average, this is what you get out on average. Currently, seniors are getting about three dollars out of all of the programs for every dollar they put in. So, in general, you’ve got to go to the American people and just be honest with them and say, “Here’s what fairness would look like.” Right. So, maybe the next ten years we have to grandfather some folks in, but basically we’re going to move them in a direct line toward fairness and we have to live within our means.

He frets about the state of morality in schools and about Beyoncé:

For the first 13 years of your kid’s life, we teach them no religion, no philosophy, and no ethics…Who is our great moral teachers these days? Every generation has always had great theologians or philosophers by the century that you can name. Who do we got right now? [Audience: Jay-Z] Right. Right. [Audience: Beyoncé] Right. Beyoncé. When you can’t name a serious philosopher, a national name, or a serious theologian, or a serious religious leader, at the national level, your culture’s got a major problem. We got a major problem.

Brat railed against Cantor for supporting a path to citizenship for some undocumented immigrants. Brat called this a policy of “amnesty” and accused Cantor of “getting big paychecks” from groups like the Chamber of Commerce for his position:

If I misspoke and said “secretly,” he’s been pretty out in the open. He’s been in favor of the KIDS Act, the DREAM Act, the ENLIST Act [which Cantor blocked in May]…On the amnesty card, it’s a matter of motivation. I teach third-world economic development for the past 20 years, I love all people, I went to seminary before I did my economics, and so you look at the motivation. Why is Eric pushing amnesty? It’s not a big issue in our district, everyone’s opposed to it, and so why is he doing it? And the answer is, ’cause he’s got his eye on the speakership. He wants to be speaker, and big business, right? The Business Roundtable and the US Chamber of Commerce wants cheap labor. So he actually is selling out the people in our district. He’s not representing the district, the will of the people, and he’s getting big paychecks by doing so. So he’s very clear on amnesty.

Brat is, not surprisingly, no fan of the United Nations:

“Common-” anything I’m against. United Nations. Common everything. If you say common, by definition you’re saying it’s top-down. I’m going to force this on you. That’s what dictators do.

His view of who deploys a top-down approach, naturally, includes President Barack Obama:

The left does not believe in diversity. They believe in top-down, I’m going to force my way onto you. Obama is forcing un-diversity onto everybody. It’s not diversity. It’s top down, central planning, on everything.

As Mother Jones’s Timothy Murphy noted, Brat identifies as a libertarian but not a full Randian, and he doesn’t buy the idea that there’s anything dangerous about playing chicken with the debt ceiling. Bring it on, he says.

In November, Brat will face Democrat Jack Trammell, a fellow Randolph-Macon professor, in the general election in this Republican district.

Affordable Care Act

You Probably Didn’t Hear About The Most Important Health Care News This Week

Mainstream media is a joke.  This should have been reported just as much as the alleged catastrophic Obamacare website failures…

Think Progress

On Wednesday, the new head of the White House Council of Economic Advisers released a bombshell report finding that U.S. health care spending since 2010 has increased by just 1.3 percent — the smallest cost growth over a three-year period in American history — while prices in the health care sector rose by 50-year lows, thanks in part to structural changes made by the Affordable Care Act. But most media outlets ignored that story, instead choosing to focus on ongoing glitches with the Healthcare.gov website.

According to a ThinkProgress analysis, English-language online and print media published about ten times as many pieces on the troubles with the Obamacare site than they did on the new health care spending report:


Analysts are divided on the extent to which Obamacare has influenced the remarkable slowdown in health spending since the law was passed in 2010. Most agree that it is likely due to a combination of factors, including less health care consumption in the global financial crisis’ wake, savings from the ACA’s hospital payment reforms, increasing reliance on cheaper generic drugs, and ongoing changes in the medical industry as providers form more efficient and collaborative care models encouraged by Obamacare. It will take years before enough data is available to perform a more precise analysis of Obamacare’s effect on health spending.

Regardless, the record slowdown is one of the most important economic developments of the decade, and has huge ramifications for the fiscal viability of major programs like Medicare and Medicaid. In fact, the Congressional Budget Office (CBO) has already cut its projections for Medicare and Medicaid’s price tag in 2020 by $147 billion — a 10 percent reduction from previous estimates.

That’s significant because those health entitlements are the primary driver of U.S. debt. The CBO’s dire predictions about future debt are based on the assumption that health care costs will continue spiking for the foreseeable future. But now that costs are growing more modestly, the country’s long-term budgetary outlook is improving.

Meanwhile, while Healthcare.gov’s rollout has indeed been disastrous, the site is slowly improving.

Affordable Care Act · John Boehner

Boehner proves the wrong point…

House Speaker John Boehner attempts to sign up for healthcare on the DC Health Link in Washington, November 21, 2013.   Boehner said on his blog that he was successfully enrolled after help from the DC Health Link help line.

The Rachel Maddow Blog

Thanks to provisions in the Affordable Care Act that Republicans demanded, members of Congress will have to sign up for health care coverage through exchange marketplaces. That’s not really the point of the exchanges – they’re largely intended for the uninsured and small businesses looking to cover their employees – but GOP lawmakers had a political point to make, and this is the result.
With that in mind, House Speaker John Boehner (R-Ohio) wrote a blog post yesterday, highlighting his own personal experience when he “sat down to try and enroll in the DC exchange.”
Like many Americans, my experience was pretty frustrating. After putting in my personal information, I received an error message. I was able to work past that, but when I went to actually sign up for coverage, I got this “internal server error” screen. […]
Despite multiple attempts, I was unable to get past that point and sign up for a health plan. We’ve got a call into the help desk. Guess I’ll just have to keep trying…
As it turns out, his willingness to “keep trying” was a good idea. Boehner, who is not yet eligible for Medicare, “called the DC Health Link help line,” and a “few hours later,” the process was complete. He’d signed up for health insurance.
Oddly enough, the Republican House Speaker didn’t offer any details about his new health care plan. One would assume that if he’d experienced “sticker shock,” or been stuck choosing a plan that cost far more than his current coverage, Boehner would have mentioned it. Indeed, he would have been eager to mention it, since it would advance his larger political goals.
So why was Boehner silent on this point? Probably because he was able to save some money on an affordable plan – despite being a 64-year-old chain-smoker.
This was supposed to be a little p.r. stunt, intended to reinforce the Republican message. It’s almost certainly why the Speaker invited a photographer to document him going through the process. And while it’s a shame Boehner was one of many who ran into website trouble, I have to say his experience doesn’t sound that bad – he called a help line, signed up for insurance, and likely saved some money, all over the course of an afternoon.
Are Americans supposed to hear this and think, “Quick, repeal this monstrosity before it crushes another person’s dreams”?


Affordable Care Act

The Face Of HealthCare.gov Speaks Out, Says She Was Victim Of ‘Cyberbullying’


Those who would do this to someone who simply posed for a picture is beyond comprehension.   It illustrates the depth of hatred and division this country has been experiencing for the last six years…

TPM LiveWire

The woman who was once the face of the troubled HealthCare.gov website said she’s been the victim of “cyberbullying” since the Affordable Care Act’s rollout began.

Identified only as “Adriana,” she told ABC News about the insults and jokes that have come her way since Oct. 1, when the website went live and her face greeted scores of visitors.

“They have nothing else to do but hide behind the computer. They’re cyberbullying,” she said. “”I mean, I don’t know why people should hate me because it’s just a photo. I didn’t design the website. I didn’t make it fail, so I don’t think they should have any reasons to hate me.”

The picture was ultimately pulled from the front page, which Adriana called a “relief.”

“They took the picture down. I wanted the picture down, and they wanted the picture down. I don’t think anybody wanted to focus on the picture,” she said.

But a Department of Health and Human Services spokesperson told ABC that the photo was not removed because Adriana requested it.

Married for more than six years with a 21-month old, Adriana reached out to the Center for Medicare and Medicaid Services to inquire about having photos of her family taken in exchange for permitting their use on the website. She was notified in the summer that her photo be used on the front page.

Calling herself “pure Colombian,” Adriana said she’s lived in the United States for more than six years and is applying for citizenship. Her husband is an American citizen.


Affordable Care Act · Obamacare

Ten days into ‘Obamacare’

This is very good information…

The Maddow Blog

It’s been 10 days since Americans could start signing up for health care coverage through the Affordable Care Act’s exchange marketplaces, and as you’ve probably heard, there have been some technical troubles. And while I don’t doubt it’s been incredibly frustrating for those who’ve struggled with online glitches, let’s not forget that we’ve seen troubles like this before.

Twelve days after Medicare Part D became the law of the land in 2006, the system was “plagued by problems” and “many of the most vulnerable elderly and disabled patients” were unable to get medicine. Several states were forced to pay for temporary supplies of medicine for Medicare patients because the Bush/Cheney administration was falling short on a systemic level.

The same year, Mitt Romney’s health care reforms in Massachusetts — which later served as the blueprint for the Affordable Care Act — started out with all kinds of problems. Stephanie Mencimer reported this week that in the early months, the state system saw “lost paperwork, computer glitches, confusion over who was eligible for what, and not enough staff to handle the workload.” It led to consumers waiting “several months after submitting an application to finally get coverage.”

In other words, “Obamacare” in good company. In time, the kinks plaguing Medicare and Romneycare got worked out and the public was quite pleased with the results, and chances are pretty good that the Affordable Care Act will follow a similar trajectory. Impatience, whether it’s politically motivated or not, is understandable, but judging a new and complex system after 10 days has never been an especially good idea.

What’s more, let’s also not forget that the negative experiences are not universal.

Robyn J. Skrebes of Minneapolis said she was able to sign up for health insurance in about two hours on Monday using the Web site of the state-run insurance exchange in Minnesota, known as MNsure. Ms. Skrebes, who is 32 and uninsured, said she had selected a policy costing $179 a month, before tax credit subsidies, and also had obtained Medicaid coverage for her 2-year-old daughter, Emma.

“I am thrilled,” Ms. Skrebes said, referring to her policy. “It’s affordable, good coverage. And the Web site of the Minnesota exchange was pretty simple to use, pretty straightforward. The language was really clear.”

Why was her experience so much easier? It wasn’t just luck.

The original plan for the Affordable Care Act to rely on state-based exchanges — rather than have one big federal marketplace, Obamacare intended for states to set up their own exchanges, invite insurers to compete, and trouble-shoot as necessary.

Many states did exactly that, but a variety Republican governors balked — to set up a marketplace for consumers, they said, would be cooperate with a law they don’t like. It meant a sweeping federally run exchange for everyone in those states.

It’s created disparate experiences based on where Americans live.

In Washington State, the state-run exchange had a rocky start on Oct. 1, but managed to turn things around quickly by adjusting certain parameters on its Web site to alleviate bottlenecks. By Monday, more than 9,400 people had signed up for coverage. The Washington Health Benefit Exchange does not require users to create an account before browsing plans.

“The site is up and running smoothly,” said Michael Marchand, a spokesman for the Washington exchange. “We’re seeing a lot of use, a lot of people coming to the Web site. If anything, I think it’s increasing.”

Other states reporting a steady stream of enrollments in recent days include California, Connecticut, Kentucky and Rhode Island.

Some states are having more success than others — as Sarah Kliff explained, ease of use and online registrations matter. But I can’t help but wonder how much easier the last 10 days would have been if more Republican governors weren’t intent on keeping their constituents from signing up for the health care benefits they’re entitled to?

Blog Roundup

Thursday Blog Roundup – 10/10/2013

Meet the 10 most dangerous terrorists

Announcing Fed Nomination, Obama Praises Yellen

T-Mobile getting rid of international data, texting fees 

Oliver Willis: Inevitable: Fox News Hires Dr. Ben Carson

Paul Ryan adds Medicare and Medicaid to the ransom note

Obama chats up prominent figures from conservative media

John Boehner’s Claims On The Medical Device Tax Explored

Ted Cruz Conducts Own Poll To Show Things Aren’t So Bad For GOP

For Boehner, surrender may be only way out of shutdown and debt-ceiling mess

Obama invites all House Republicans to White House meeting, nearly all decline