Krugman: Obamacare Will Be A Debacle — For Republicans

[ProSense]

Obamacare Will Be A Debacle — For Republicans

The Affordable Care Act, aka Obamacare, is a policy Rube Goldberg device — instead of doing the simple, obvious thing, which would just be to insure everyone, it basically relies on a combination of regulations and subsidies to rope, coddle, and nudge us into a rough approximation of a single-payer system. There were reasons for this, of course, mainly political...Still, the question is whether this cobbled-together system will work, and there have been many conservatives rubbing their hands with glee over the prospect of failure.

Whoops.

We won’t really know how Obamacare works until it has been in operation for a while; but we do know that essentially the same system has been running in Massachusetts since 2006, and is doing pretty well. The question, then, is whether other states that don’t have MA’s initial advantages — especially an already low uninsurance rate and an already operating system of community rating — can make this thing work. The big fear has been of sharply rising premiums as insurers are required to cover people with preexisting conditions. And the biggest test case was always going to be California.

Well, the preliminary numbers for CA are in — and they’re looking very good, with costs coming in below expectations. At this point, it looks as if this thing is indeed going to work.

And think about the political dynamics. Because the Supreme Court decided to let states opt out of the Medicaid expansion, some states — notably Texas — will have a pretty dysfunctional version of Obamacare in 2014, although even those systems will provide significant benefits to many people. Still, the whole political calculus was supposed to be that Republicans in red states could point to the horrors of Obamacare and ride them to political victory. Instead, it looks as if we’re going to see blue-state residents reaping the benefits of a functional health care system, while red-state residents are denied many of those benefits, for what looks like no better reason than mean-spirited spite — because what’s going on is, indeed, mean-spirited spite.

- more -

http://krugman.blogs.nytimes.com/2013/05/24/obamacare-will-be-a-debacle-for-republicans/

[graham4anything]

1. President Obama roped the dopes yet again. Krugman is 100% correct on this.

[doc03]

2. Our right wing newspaper has been doing at least one anti-Obamacare front page story since

the first of the year. Sunday they had a doctor that claimed he was retiring because of Obamacare regulations. The guy is 72, he should retire anyway.

[BlueCaliDem]

3. Well, at least in this:

Instead, it looks as if we’re going to see blue-state residents reaping the benefits of a functional health care system, while red-state residents are denied many of those benefits, for what looks like no better reason than mean-spirited spite — because what’s going on is, indeed, mean-spirited spite.

...the people in Red States will live under the policies of their chosen political party - and they'll get a painful lesson.

Hopefully when they feel the pinch they'll vote Democratic Party and boot out the Republicans.

I'm so happy I live in California! Born and bred!

[magellan]

4. Not all of us in Red States live under the policies of our chosen party

We don't deserve the "painful lesson" but are still getting it. Krugman is spot on calling it mean-spirited spite, but I don't think he realizes that it doesn't only come from the right.

[lark]

5. I fear this is over-optimistic.

Conservatives in red states will blame Obamacare because their personal experience will be blamed on the law, not their state and the politicians they elected. They will blame what they see lambasted in their daily papers and news shows and miss out on the real cause. They're Repugs after all, you expect reasonableness?

Dems in red states or even purple states with red state legislatures are the ones who are totally getting screwed. They don't support the Repugs but are stuck with their policies. My son will probably get zero help with healtcare if FL gets it's way since they've said no to Medicaid expansion and he's the working poor.

[magellan]

8. I think you may have meant to reply to BlueCaliDem

I live in FL like your son and know Repubs here won't be running to vote Dem. We'll be lucky to oust Skeletor (I'd be happy with Crist but we won't do better). The state legislature will remain firmly in Repub hands.

I wish we could afford to move to someplace nice like California where BlueCaliDem lives. We have enough pain; we don't need other Dems gloating over the misery of living under Republican rule.

[Grins]

55. They may, but this has handed the Dems a great opportunity!

They can do simple PSA's pointing out the success of California and Massachusetts, pointing out what many do not know - that many of the benefits here here TODAY - pointing out the increased coverage and lower costs; and then added the standard advertising caveat: "Not available in Texas, Kansas, Mississippi, Alabama, Georgian...that chose not to implement the exchange"

They are going to do a nationwide campaign next month to encourage Americans to take advantage of the new insurance options. This is the perfect time.

[BlueCaliDem]

6. Every state is a democracy and in a democracy the majority wins and rules.

I know it's not fair to the Americans who vote Democratic Party in those states, but until and unless the majority in those states feel the pinch in their personal lives, there's no way they're going to change and vote for the political party that best suits their personal needs.

I'm not being spiteful. I'm being realistic and optimistic.

[magellan]

10. I'll grant you're being optimistic

But you aren't being realistic. FL's legislature is heavily Repub and has been for 17 years. They're excellent at blaming the Dems for the state's woes and blocking any legislation that actually might help people. Even without that, the corruption here will make any move in the opposite direction damn near impossible. Never mind the FL Dems insist on running triangulating conservadems who fail in both directions.

Have a heart next time you go on about people who live in Red States. There are plenty of us who are stuck with it and we know the painful realities, thanks very much.

[BlueCaliDem]

26. And realistic.

Here's where the realism comes in: you'll only be able to make the changes necessary if and when the people who vote those clowns in either have an epiphany or stay home.

Since they're preprogrammed to vote no matter what, it appears it'll have to be the former.

How do you change hearts and minds? As we've seen with Republicans, only when they're personally affected. Then they have this surprising epiphany that, lo and behold, have them think and vote Democrat.

As for Florida, I really don't know what's going on over there. They vote Democratic Party for presidential elections but then turn around and elect Republicans for their state legislature and governor. I really don't know what to make of it other than to accept that their voting pattern is weak during mid-terms {where Republicans are always stronger in turn-out} but strong during presidential elections.

The Democrats there - and everywhere - must make it their mission to emphasize that voting in ALL elections is crucial in order to keep and grow our political power. If and when Democratic voters can do that, if they can be that unified and insistent, then the Republicans can be relegated to perpetual minority status in our government and we can neuter the power of the plutocracy.

[secondvariety]

39. What's happening in Florida

is blatant gerrymandering and inept state Democratic leadership. The gerrymandering was supposed to be addressed by a couple of amendments that passed by 80% of the voters but has been virtually ignored by the state legislature and courts. The FDP elected this person;

http://thepoliticalhurricane.com/2012/12/23/tant-flip-flops-on-dbt-involvement-while-giving-money-to-sec-mortham/

I'm not real optimistic about local and state politics in Florida.

[BlueCaliDem]

45. For some strange reason, Floridian Democrats act and support Republicans in their state.

In 2008, Doug Tudor (D), a "twenty-year Navy vet who's selflessly challenging rubber stamp Republican Adam "Howdy Doody Nimrod" Putnam in a district that mostly corresponds with Polk County east of Tampa, Florida. Unlike DWS' district (PVI is D+18), FL-12".

It is well known that Wasserman-Schultz supports Republicans Lincoln Diaz-Balart, Mario Diaz-Balart, and Ileana Ros-Lehtinen over their Democratic opponents, although lately she has been pressured into giving belated and grudging support to Joe Garcia and Raul Martinez who are opposing the Diaz-Balarts. http://downwithtyranny.blogspot.com/2008/09/debbie-wasserman-schultz-to-florida.html

With Democrats like Wasserman-Schultz, we'll be seeing the Democratic Party moving more and more to the right.

But what's clear to me is, if President Obama can win a heavily gerrymandered Florida, that means there has to be more Democrats than Republicans there. We've seen that if they get out the vote in that state, Florida is a Democratic state. Bill Nelson was sent back to the Senate during the 2012 elections, but in contrast, Rubio won his senate seat in 2010 with low Democratic Party turn out.

The solution would be to have the Democratic Party push to get our lazy voters to the polls in force in ALL elections because not doing so is hurting Democratic Party voters across the nation. They need to be more vigilant.

[RedstDem]

41. they will feel the pinch, and it wont change their votes

these people do not vote pocket book, they vote morals.
they think democrats kill babies.

[BlueCaliDem]

48. Those skewed "morals" they vote on

won't help them get medical help when they need it. It won't pay the rent or mortgage. It won't feed or educate their children. It won't create jobs. But as long as these Democratic Party programs continue to help them no matter how they vote, why should they change their political party? They still have the luxury of voting based on "morals". But when these programs are removed and the day-to-day pains hit home because of it, they'll finally wake up from their sleep and be outraged.

Even Sen. Ron Portman of Ohio was forced to have an epiphany and supported same-sex marriage when his son came out. This is what I mean by something needs to happen to affect them personally before Republicans change their minds and begin to think and vote like Democrats.

Republicans in the Senate, seeing that Latino backlash and that their cushy job is in jeopardy if they don't stop with all the anti-Latino bullshit, are suddenly all Democrats in trying to pass immigration reform.

Watching this trend, I have to unfortunately conclude, that it will be the Latinos, Hispanics, and Asians who will, collectively, turn this country blue because unlike some Whites (Republicans exclusively), those groups don't pay attention to corporate media, distrust it, and will keep a clear head in order to vote for the Party that promises to work in their best interest.

[Hippo_Tron]

61. You're assuming they're going to blame the right people for the problem

The reality is that they're going to blame Obama and the Democrats, not their red state legislatures and Governors, because talk radio and Fox News are the only sources of information that they have. Many don't have an internet connection. The New York Times and the Washington Post certainly aren't sold on every corner. The people there aren't stupid. It's just that they have relatively limited access to information and they've had relatively limited access to information their entire lives.

In order for these people to vote Democratic (and some of them still do, btw), they need to see government directly impacting their lives in a positive way. That's why it will be a damn shame if Affordable Care Act doesn't actually help all of these people that it was supposed to help. If someone who believed the Tea Party crap in 2010 suddenly was able to see a doctor for the first time in years, odds are pretty damn good they wouldn't still be believing the Tea Party crap come the 2014 elections.

[demosincebirth]

13. I agree. Kaiser is already implementing many of ACA rules. First, no co pay for colonoscopies,

which the co pay used to be 250 bucks. That will help my daughter out a lot. She is on SSDI.

[Hippo_Tron]

62. That's not really what the ACA is about, though...

If the ACA were just about a bunch of rules to curb insurance company excesses and make health care more affordable to those who already have some access to it, the bill would've sailed through congress.

The ACA is primarily about insuring 40-50 million people who don't have any insurance whatsoever. Whether or not that aspect of it succeeds is what we're going to find out come 2014.

[demosincebirth]

63. The ACA, also, helps seniors on medicare who used to pay for preventive care (co-pays) such as

physicals and any treatment that falls in that category...like some who need colonoscopys

[AllyCat]

44. And we here in Wisconsin get to deal with dysfunction

The GOP rationale (according to Glenn Grothman) is that with federal funding lasting only 3 years, it just isn't sustainable. So they will "study" it and do nothing.

[Iliyah]

7. Ya know they moaned and groaned

about SSI as well as Medicare. It will never work. Socialism. Fascism. Imperialism. Nazism. . . . . .

Un-American, non-patriotic, will kill most Americans, and so forth.

The same seniors and middle age people who vote GOP, now are grateful these programs, go figure.

[merrily]

11. Do you mean OASDI?

[demosincebirth]

14. I worked with a couple of guys for years in the union trucking industry, and they were staunch

republicans getting excellent wages and benefits. We used to discuss politics every now and then, but they had their reasons and very stupid ones...mostly guns, or welfare. Stupid things like that.

[RedstDem]

42. i work with two republicals too

and you said it, in a nutshell. guns and welfare.
damn democrats want to take away my gun. and give freeloaders my money.

amazing way to think isn't it?

[demosincebirth]

53. That was their Mantra...dems will take away their arsenals. Pretty f***ing stupid

[Addison]

9. Link for cost calculator

If you live in (or wish you lived in) California, here's the estimated cost calculator:

http://www.coveredca.com/calculating_the_cost.html

Personally I'm cautiously optimistic, but not holding my breath. Private insurers will always find a way to game the system at the expense of their customers, so it's hard to put much trust in a system that institutionalizes their industry.

[merrily]

12. Like everything else, it will probably be in the eye of the beholder.

I predict that many of the same Democrats who condemned Romneycare in Massachusetts will love Obamacare.

Much like Romney loved Romneycare in Massachusetts, but ran against Obamacare.

Not taking either side right now. Just saying that is how things generally go. People don't seem to make objective or internally consistent decisions.

Partisanship clouds their minds, as does whether they watch Fox News or MSNBC.

It's ridiculous anymore. Both sides.

[geek tragedy]

15. Most of us will side with Krugman vs the Tea Party, but you're

not forced to do so obviously.

[merrily]

16. I took no side on the issue of Obamacare. In fact, I specified that.

[geek tragedy]

17. Exactly. Most of us here take the Krugman side and oppose

the Rick Perry/Ted Cruz side when it comes to Obamacare.

Anything the House Republicans vote 38 times to repeal has to be pretty good.

[merrily]

18. Actually, Rick Perry supported the plan when it was Hillarycare.

Which kind of proves my point, as does your post.

Krugman is speaking to the future. I don't have a prediction about how people will view Obamacare in the future, except the one I stated--that views on both sides will be colored by partisanship.

[merrily]

19. FYI, there positions Rick Perry and Ted Cruz would never take.

Nor would Krugman take them, at least not publicly.

Such as Obamacare being a huge gift to health insurers* And I am not sure you are correct about most posters here taking an "either or" position on Obamacare. I've read plenty of criticism here about it.

And Krugman says, as quoted in the OP, that we are not going to know how Obamacare works until it becomes fully effective. So, he made no prediction carved in stone either.

If you think I lean right, then you are not very perceptive.

Peck away.

*ETA: and pharmaceutical companies.

[Cha]

24. No, not "both sides". there's FACTS and there's fiction. n/m

[Ikonoklast]

52. Uhh, "Romneycare" in Massachussetts was passed by a DEMOCRATIC legislature.

Not too many Democrats were unhappy with that at all.

Can't seem to find any Democrats except those who wanted single payer as the only option condemning Romneycare in Mass.

As an aside, Romney was late to the party on "Romneycare", the impetus to pass a health care reform bill in Mass was a Democratic one, Romney went along for the ride as he knew that his veto of that bill would be over-ridden, just as each one of his other 250 vetos were over-ridden by the Democratic legislature.

[bhikkhu]

54. I take the side where people don't go bankrupt or die

when choosing, respectively, whether to get the medical care they need or not. I don't think it matters what you call it.

I'll be happier when costs come down, and the Krugman article is about the costs actually coming down in california. Of course, the repug argument was that costs would skyrocket, while the best intentions of the administration were to design a system where costs were under control finally, after many years of double-digit increases.

[libodem]

20. Mean spirited spite

Is the entire GOP party platform.

[libdude]

43. I think you could

add hate to that description of the Republican party, most of their politicians and the majority of the Republican base. It is this extteme right wing base that has driven the party to the right and literally controls the agenda. The moderates have been either silenced or adopted the attitude of going along in order to survive. Look at the Romney campaign, many were surprised at his departure from some moderate position that he allegedly held.
I do hope that the ACA does work for the large number of people that it will help, long term, I would like to see a single payer system in which everyone would contribute. To avoid this, it may force private insurers to provide a cost effective insurance product in order to survive.

[Spitfire of ATJ]

21. Future generations are going to study this era as the fall of conservatives.

[ProSense]

22. I don't know, but

"Future generations are going to study this era as the fall of conservatives."

...there are some interesting things to consider.

A Once in a Generation Opportunity for the Democratic Party in Red States in 2014.
http://www.dailykos.com/story/2013/05/24/1210949/-A-Once-in-a-Generation-Opportunity-for-the-Democratic-Party-Red-States-in-2014

[noiretextatique]

23. if they survive their current agenda of mean-spirited idiocy and obstruction

america will be finished. either it needs to die, or many others will.

[Cha]

25. Nerdy Wonka Tweet on Obamacare..

Nerdy Wonka @NerdyWonka

Due to #ObamaCare, Californians will soon see their premiums become lower just like Oregon and Washington. http://money.cnn.com/2013/05/23/news/economy/california-obamacare-premiums/index.html …3:57 AM - 24 May 2013

Obamacare premiums in California lower than predicted
Premiums to be charged in the Obamacare insurance exchanges in California in 2014 are lower than expected.

CNNMoney.com @CNNMoney

http://theobamadiary.com/2013/05/24/president-obama-at-the-united-states-naval-academy/#comment-731336

Thanks for the Krugman article, ProSense

[eridani]

27. MA is a complete disaster for actual sick people

Half of all bankruptcies are STILL medical bankruptcies. Still, Krugman is right--people who have never been expensivly sick are going to be able to delude themselves that they can buy actual protection, and that amounts to 85% of the population.

[ProSense]

28. MA will

"MA is a complete disaster for actual sick people"

...benefit from improvements in the health care law. http://www.healthcare.gov/law/information-for-you/ma.html

[eridani]

29. Too bad overpriced underinsurance is the new normal

That kind of insurance actively prevents people from getting health care. The money they might spend on a doctor visit to check out a worrying symptom goes to the insurance companies instead.

[ProSense]

30. That

"Too bad overpriced underinsurance is the new normal That kind of insurance actively prevents people from getting health care. The money they might spend on a doctor visit to check out a worrying symptom goes to the insurance companies instead.'

...is what the law addressed in two ways: 1) Defining essential health benefits that are an improvement on existing good plans. 2) Adjusting the MLR.

Expanding Medicaid helps low-income Americans, and free preventive care makes the doctor visits less worrisome.

EXPANDING COVERAGE Starting in 2010, all insurers and employers that offer dependent coverage were required to offer coverage to dependent children up to age 26. An estimated 6.6 million people ages 19 through 25 have been able to stay on or join their parents’ plans as result, with more than 3 million previously uninsured young adults getting health insurance. The law requires private health insurers to provide free preventive care, without co-pays or deductibles. Some 71 million Americans have received at least one free preventive service, like a mammogram or a flu shot, and an additional 34 million older Americans got free preventive services in 2012 under Medicare.

http://www.nytimes.com/2013/03/24/opinion/sunday/report-card-on-health-care-reform.html?_r=0

[eridani]

31. MLR adjustment is vastly below world standards

Back in 1993, when everyone was so worried about increasing costs, average MLR was 93%. MLR for Medicare is 97%.

Preventive care isn't very useful if you have a symptom you need to discuss and have already had your yearly physical. Requiring insurance prevents you from doing that. And there is no way that 50% bankruptcy rates are even remotely acceptable. ACA will have little, if any, effect on that. Bronze and silver plans leave you on the hook for 40 and 30% of any expenses you have.

[ProSense]

33. There

"Back in 1993, when everyone was so worried about increasing costs, average MLR was 93%. MLR for Medicare is 97%."

...was absolutely no enforceable MLR back in 1993. That's part of the reason reform reform was needed. Yes, Medicare is a good example of the effects of an enforceable MLR. The health care law moves in that direction.

[eridani]

34. That's wjhat MLRs actuallly WERE, without any laws requiring a minimum

Requiring 80-85% is not very useful. There are no MLR requirements for Medicare--3% just what it costs to administer a system that is universal, albeit only for the age qualified.

[ProSense]

36. You know,

"That's wjhat MLRs actuallly WERE, without any laws requiring a minimum
Requiring 80-85% is not very useful. There are no MLR requirements for Medicare--3% just what it costs to administer a system that is universal, albeit only for the age qualified."

...you're arguing for and against MLRs. They're useful, Medicare has one, and the ACA's will be enforced.

[eridani]

37. Medcare does not have any MLR requirements

3% is just what it happens to cost to administer. I see no reason why, if ACA is going to mandate MLRs, why that mandate can't at least come up to the MLR average that we had in 1993 without any mandate.

[Skip Intro]

32. We'll see soon enough. n/t

[KittyWampus]

35. And ultimately it will make a good number of liberals posting on forums like this look like the

short-sighted, reactionary screamers they actually are.

[eridani]

38. Naturally. Failing to cheer for a 50% medical bankruptcy rate--

--like they have in MA years after Romneycare, makes one a reactionary screamer.

[byeya]

40. I've read the thread 2ce: You won the argument!

Single payer - never serioously considered - is the easiest way to go. The Veterans Affairs method would be tougher to establish but would also work well. 50% of bankruptcies from medical crises - unacceptable.
Get profit completely out of the delivery of health care services.

[woo me with science]

64. +100000

[KittyWampus]

59. No- not realizing that making the perfect the enemy of the good gets us nowheres. Social Security

didn't cover everyone at first.

But the Reactionary Screamers are too busy insisting on their ideologically pure version of reality to grasp incremental change.

[eridani]

60. 50% medical bankrupcties in MA is NOT good, never mind perfect

And all of those bankrupt people, by law, had insurance.

Did Social Security start out as a mandate that everyone would be forced to invest in Wall Street for their retirement or pay a fine? That is what ACA does, essentially.

[BrotherIvan]

47. Why do neoliberals such as yourself use the same phraseology as wingers?

But then again, people voicing their concerns that they wish to improve health CARE and not insurance are just not cheerleading hard enough, right? The fact that the sick and needy will STILL die because they can't pay their high deductibles and so forego care, well that's just plain silly when there's a politician or a party to root for. That people will still go bankrupt (as pointed out above) or in the case of my family, spend the entire estate on healthcare costs, screw them! They're just reactionary screamers! Or, as a Californian, I have seen my insurance costs DOUBLE in the last three years so that it now exceeds over half of my mortgage per month. I tell you, it's utopia and I'm just plain ungrateful. Priorities people!


And why is one allowed to use the word "liberal" as a slur on this board?

[KittyWampus]

58. I'm a Democratic Socialist. And the Reactionary Screamers would have likewise been against Social

Social Security when it was first instituted because it didn't cover everyone.

[southernyankeebelle]

46. That's a republican for you. Always underestimating the right thing to do. Shame on them.

[ProSense]

49. A Once in a Generation Opportunity for the Democratic Party in Red States in 2014.

A Once in a Generation Opportunity for the Democratic Party in Red States in 2014.
http://www.dailykos.com/story/2013/05/24/1210949/-A-Once-in-a-Generation-Opportunity-for-the-Democratic-Party-Red-States-in-2014

GOP Governor Shuts Down Lawmaking Until Her Party Agrees To Expand Medicaid
http://thinkprogress.org/health/2013/05/24/2059031/gop-governor-veto-legislation-medicaid/

[prairierose]

50. I live in a red state...no hope there...and now..I'm losing income...

my employer, a for profit online university, has decided to cut all faculty assignments by 1 class. I am sure, but no one has admitted it, that this is to cut our hours back so that they do not have to provide healthcare.

I live in one of the red states that turned down the fed money for medicaid expansion.

I really wish there was such a think as a not for profit health insurance plan in this country so that I could get into that. But, the way things are going, when I finally turn 65, I'll be able to get medicare but until then, the way things are going, I will not be able to afford anything.

[Beartracks]

51. Red-staters will still blame their "dysfunctional Obamacare" on Obama.

It's the Republican way: support the hobbling of government programs, and then point to the hobbled program as an example of how government doesn't work.

=============

[John2]

56. I disagree in the case

of North Carolina. Republicans are trying to prove themselves in North Carolina but I predict they will fail miserably. You got too many people moving to this state from more Liberal states. And the minority population is growing. The Republicans have to change or flee out West to some rural area. They might consider moving to Mexico and start their own country. North Carolina is like Texas when it comes to changing Demographics. This state is a lot more diverse and Liberal than it was years ago and it keeps changing every year. Especially the Hispanic population. The grocery stores where I stay, are now runned by Hispanics.

[Beartracks]

57. Sorry - I meant "Republicans" generally, not all red-state residents. n/t

I just think Republican voters will, generall speaking, be told by their elected