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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region Forums"How to End the Obamacare Debate"
How to End the Obamacare Debateby Ronald Brownstein at the National Journal
http://www.nationaljournal.com/political-connections/how-to-end-the-obamacare-debate-20130919
"SNIP..............................
Without drawing moral equivalence, its fair to say the health care law is facing more widespread defiance than any federal initiative since the Supreme Court ordered public schools to desegregate in its 1954 Brown v. Board of Education decision. Obama is unlikely to fold against congressional Republican demands for delay. But, even so, some two dozen statesall but two with Republican governorsare refusing to expand Medicaid (which was initially expected to provide about half the laws coverage increase) and to establish the online exchanges for those uninsured people with slightly higher incomes. Meanwhile, almost all Democratic-leaning states are embracing the law.
This contrast creates two powerful dynamics that will shape the unfolding debate. First, it means that with half the states inhibiting it, the program wont enroll as many people nationally as Obama hoped. Because many of the resisting states have big uninsured populations and skimpy safety nets, 8 million of the 13 million people potentially eligible under the laws Medicaid expansion live in states that are not increasing coverage, the Urban Institute calculates. Without state outreach, sign-up on those states exchanges also could slip, again depressing the national results.
That prospect frames a second, potentially decisive, question: Can the laws supporters produce success in the states that are welcoming it? If California, Colorado, Minnesota, and other states that are implementing the law most enthusiastically can enroll large numbers of the uninsured, avoid big logistical snafus, and attract enough healthy young people to restrain premium rates, that would strengthen Obamas hand nationallyand increase popular demands to participate in the resisting states. If it becomes clear that in many of the states that are wholeheartedly implementing it, it is working well, the interesting question is, what kind of pressure will that put on the refusenik states? says Harvard University sociologist Theda Skocpol, who studies the safety net. In particular, success in participating states could inspire growing agitation from health care providers in the refusenik states, which are renouncing nearly $500 billion in federal money through 2022 (at small state cost) by rejecting the Medicaid expansion, the Urban Institute projects.
In this process, California could figure largest because its huge, diverse, and heavily uninsured population presents a tougher test than more-homogenous cooperating states such as Minnesota and Massachusetts. If California succeeds, notes Anthony Wright of the advocacy group Health Access California, we can show it can work in a state where the problem is on the scale of Texas and Florida, the two largest resisting states. California has already negotiated aggressively to limit premium rates for insurers selling through its exchanges and has enrolled (through an early-start waiver) about half of those eligible for the laws Medicaid expansion. But, Wright acknowledges, the state confronts supersized versions of the same daunting logistical challenges looming elsewhere as enrollment begins. Obamas best chance of defending health care reform against its enemies is to ensure that it works for its friends.
.............................SNIP"
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"How to End the Obamacare Debate" (Original Post)
applegrove
Sep 2013
OP
JEFF9K
(1,935 posts)1. I like to ask conservatives what they like ...
... most about Republican market-based health care - the double cost or the non-coverage?
Skittles
(153,122 posts)3. they "like" whatever their dittomasters tell them to like
gopiscrap
(23,726 posts)4. yup