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The Next Campaign To Paint Obamacare As A Failure
The Next Campaign To Paint Obamacare As A Failure
By Igor Volsky
Next week, as uninsured Americans begin signing up for coverage in the Affordable Care Act’s health care marketplaces, Republicans will seize on the trickle of early beneficiaries and technical glitches to paint the measure as a failure. But administration officials tasked with implementing President Obama’s signature domestic policy accomplishment are anticipating these attacks and are confident they will win the public debate and meet their enrollment targets over the long term.
On Tuesday, the nation’s 48 million uninsured will be able to log on to Healthcare.gov, dial a federal hotline, or visit a community “navigator” and begin enrolling in health care coverage through the law’s state-based exchanges to receive coverage next year. The Congressional Budget Office estimates that 7 million enrollees will participate in the marketplaces in 2014; 9 million will sign up for Medicaid. By 2023, the exchanges will hold 24 million people and the law’s Medicaid expansion will accompany another 13 million.
But health care experts caution that enrollment may prove to be more of a marathon than a sprint and will work best in states that are actively helping uninsured people sign up for coverage.
“It just takes time,” Stan Dorn, a Senior Fellow at the Urban Institute’s Health Policy Center, says, pointing to the nation’s experience in encouraging people to sing up for the Children’s Health Insurance Program, a bipartisan Clinton-era initiative that primarily provides health insurance to children in families with incomes too high to qualify for Medicaid. Enacted into law in August of 1997, the plan began enrolling children in 1998, but initially fell short of enrollment goals. Four years later, the Congressional Research Service issued a disappointing report noting that just 60 percent of eligible kids were enrolled in the program. Today, 87 percent of eligible children have coverage in CHIP or Medicaid.
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http://thinkprogress.org/health/2013/09/25/2680481/how-the-bush-administration-is-helping-improve-the-implementation-of-obamacare/
By Igor Volsky
Next week, as uninsured Americans begin signing up for coverage in the Affordable Care Act’s health care marketplaces, Republicans will seize on the trickle of early beneficiaries and technical glitches to paint the measure as a failure. But administration officials tasked with implementing President Obama’s signature domestic policy accomplishment are anticipating these attacks and are confident they will win the public debate and meet their enrollment targets over the long term.
On Tuesday, the nation’s 48 million uninsured will be able to log on to Healthcare.gov, dial a federal hotline, or visit a community “navigator” and begin enrolling in health care coverage through the law’s state-based exchanges to receive coverage next year. The Congressional Budget Office estimates that 7 million enrollees will participate in the marketplaces in 2014; 9 million will sign up for Medicaid. By 2023, the exchanges will hold 24 million people and the law’s Medicaid expansion will accompany another 13 million.
But health care experts caution that enrollment may prove to be more of a marathon than a sprint and will work best in states that are actively helping uninsured people sign up for coverage.
“It just takes time,” Stan Dorn, a Senior Fellow at the Urban Institute’s Health Policy Center, says, pointing to the nation’s experience in encouraging people to sing up for the Children’s Health Insurance Program, a bipartisan Clinton-era initiative that primarily provides health insurance to children in families with incomes too high to qualify for Medicaid. Enacted into law in August of 1997, the plan began enrolling children in 1998, but initially fell short of enrollment goals. Four years later, the Congressional Research Service issued a disappointing report noting that just 60 percent of eligible kids were enrolled in the program. Today, 87 percent of eligible children have coverage in CHIP or Medicaid.
- more -
http://thinkprogress.org/health/2013/09/25/2680481/how-the-bush-administration-is-helping-improve-the-implementation-of-obamacare/
The expectation that everyone will be enrolled within a few weeks or months of the implementation date is unrealistic. Also, there are states that will still be fighting the law. How long will they hold out?
Mooching Off Medicaid
By PAUL KRUGMAN
Conservatives like to say that their position is all about economic freedom, and hence making government’s role in general, and government spending in particular, as small as possible...When it comes to conservatives with actual power, however, there’s an alternative, more cynical view of their motivations — namely, that it’s all about comforting the comfortable and afflicting the afflicted, about giving more to those who already have a lot. And if you want a strong piece of evidence in favor of that cynical view, look at the current state of play over Medicaid.
Some background: Medicaid, which provides health insurance to lower-income Americans, is a highly successful program that’s about to get bigger, because an expansion of Medicaid is one key piece of the Affordable Care Act, a k a Obamacare.
There is, however, a catch. Last year’s Supreme Court decision upholding Obamacare also opened a loophole that lets states turn down the Medicaid expansion if they choose. And there has been a lot of tough talk from Republican governors about standing firm against the terrible, tyrannical notion of helping the uninsured.
Now, in the end most states will probably go along with the expansion because of the huge financial incentives: the federal government will pay the full cost of the expansion for the first three years, and the additional spending will benefit hospitals and doctors as well as patients. Still, some of the states grudgingly allowing the federal government to help their neediest citizens are placing a condition on this aid, insisting that it must be run through private insurance companies. And that tells you a lot about what conservative politicians really want.
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http://www.nytimes.com/2013/03/04/opinion/krugman-mooching-off-medicare.html
By PAUL KRUGMAN
Conservatives like to say that their position is all about economic freedom, and hence making government’s role in general, and government spending in particular, as small as possible...When it comes to conservatives with actual power, however, there’s an alternative, more cynical view of their motivations — namely, that it’s all about comforting the comfortable and afflicting the afflicted, about giving more to those who already have a lot. And if you want a strong piece of evidence in favor of that cynical view, look at the current state of play over Medicaid.
Some background: Medicaid, which provides health insurance to lower-income Americans, is a highly successful program that’s about to get bigger, because an expansion of Medicaid is one key piece of the Affordable Care Act, a k a Obamacare.
There is, however, a catch. Last year’s Supreme Court decision upholding Obamacare also opened a loophole that lets states turn down the Medicaid expansion if they choose. And there has been a lot of tough talk from Republican governors about standing firm against the terrible, tyrannical notion of helping the uninsured.
Now, in the end most states will probably go along with the expansion because of the huge financial incentives: the federal government will pay the full cost of the expansion for the first three years, and the additional spending will benefit hospitals and doctors as well as patients. Still, some of the states grudgingly allowing the federal government to help their neediest citizens are placing a condition on this aid, insisting that it must be run through private insurance companies. And that tells you a lot about what conservative politicians really want.
- more -
http://www.nytimes.com/2013/03/04/opinion/krugman-mooching-off-medicare.html
After Medicaid was intiated, one state held out for 15 years.
<...>
Over time, however, the lure of federal dollars proved strong enough to win over resistant states. Eleven joined the program in 1967. Another wave of eight, largely Southern states came on board in 1970. Arizona proved the last holdout, not joining Medicaid until 1982.
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http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/07/09/six-governors-say-they-will-opt-out-of-medicaid-how-long-will-they-hold-out/
Over time, however, the lure of federal dollars proved strong enough to win over resistant states. Eleven joined the program in 1967. Another wave of eight, largely Southern states came on board in 1970. Arizona proved the last holdout, not joining Medicaid until 1982.
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http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/07/09/six-governors-say-they-will-opt-out-of-medicaid-how-long-will-they-hold-out/
Similarly, SCHIP was implemented in 1997. Yet only 87 percent of eligible children are covered.
As Krugman points out, the incentive to comply is there. These are different times, and the exchanges (in most of the OP states the federal government is running the exchanges), multi-state plans and other factors will make a lengthy holdout unlikely.
It's Obamacare.
http://www.democraticunderground.com/10023715400
2 replies
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K & R 