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What would happen if we unveiled a program that looked like Obamacare, in a place that looked like America, but with competent project management that produced a working website?

Well, your wish is granted. Ladies and gentlemen, I give you California.

The words above are the key to Paul Krugman's column today, California, Here We Come?

Krugman acknowledges the mess of the roll-out, but points at California as an example of how an approach like Obamacare can work, if properly managed.  

He aknowledges the success in Kentucky, how NY is doing okay, and reminds us about Romneycare in MA, but that was a state with relatively few uninsured.  But his focus is California.  Why?

California is, however, an especially useful test case. First of all, it’s huge: if a system can work for 38 million people, it can work for America as a whole. Also, it’s hard to argue that California has had any special advantages other than that of having a government that actually wants to help the uninsured. When Massachusetts put Romneycare into effect, it already had a relatively low number of uninsured residents. California, however, came into health reform with 22 percent of its nonelderly population uninsured, compared with a national average of 18 percent.
Please keep reading.

California authorities have been transparent with their data, which now shows over 10,000 people a day enrolling, and on target to meet goals for 2014.  Contrast this with the Federal program, and as Krugman notes, imagine how the press coverage would be different were that data showing 100,000/day signing up.

Krugman covers what happened with John Boehner, including his office putting the healthcare exchange on hold for 35 minutes.

But there is more to California.  Krugman notes a key statistic:  

To work as planned, health reform has to produce a balanced risk pool — that is, it must sign up young, healthy Americans as well as their older, less healthy compatriots. And so far, so good: in October, 22.5 percent of California enrollees were between the ages of 18 and 34, slightly above that group’s share of the population.

What we have in California, then, is a proof of concept. Yes, Obamacare is workable — in fact, done right, it works just fine.

I would still like to see how much of the problem on was a result of DDOS attacks, since there is now some clear evidence that happened, fomented by right-wing web sites.  

And we know ALEC is still seeking ways to undermine OBamacare, including pushing state legislation that might strip licenses of insurance companies that participated in the program   - although I suspect that any such attempt would create a devastating backlash, including from the insurance companies, for as Krugman notes

one shouldn’t forget that the insurance industry has a big financial stake in the success of Obamacare, and will soon be pitching in with big efforts to sign people up.
California - and red state Kentucky - show that properly administered Obamacare can work, that people want better access to health insurance.  

No, we do not all live in states that have chosen to make the process work.

But the kinks in are being worked out.

More and more people are able to sign up.

And the subsidies are making MEANINGFUL health insurance more affordable than ever.

The question is whether the mainstream media will dig below the surface and the rhetoric to tell the real story.

In the meantime, we have models that show the approach does work.

As Krugman concludes,

Again, Obamacare’s rollout was a disaster. But in California we can see what health reform will look like, beyond the glitches. And it’s going to work.

Originally posted to teacherken on Mon Nov 25, 2013 at 05:00 AM PST.

Also republished by California politics and Los Angeles Kossacks.

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    "We didn't set out to save the world; we set out to wonder how other people are doing and to reflect on how our actions affect other people's hearts." - Pema Chodron

    by teacherken on Mon Nov 25, 2013 at 05:00:35 AM PST

  •  Suprised this want's in pundit roundup (68+ / 0-)

    so I decided to throw a diary together to point people at what I think is a useful and important column

    do with this post what you will

    "We didn't set out to save the world; we set out to wonder how other people are doing and to reflect on how our actions affect other people's hearts." - Pema Chodron

    by teacherken on Mon Nov 25, 2013 at 05:01:27 AM PST

  •  Don't forget Connecticut (91+ / 0-)

    We've been flying under everyone's radar but our rollout of Obamacare has so far gone very well.  One of the key factors was that our state expanded Medicaid a while back so many of the people signing up are signing up for the exchanges.  One of the concerns nationally is that more of the people signing up will be with Medicaid and not the exchanges.  In CT the reverse is happening.  California and Kentucky get all the press because California is huge and Kentucky is the shining example of a successful rollout in a poor and red state but Obamacare is successfully being implemented in several states.

    This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

    by DisNoir36 on Mon Nov 25, 2013 at 05:13:55 AM PST

  •  Always nice to receive some good news. N.T (12+ / 0-)

    What we need is a Democrat in the White House. Warren 2016

    by dkmich on Mon Nov 25, 2013 at 05:33:41 AM PST

  •  Maybe *this* is hiow you turn red states blue. nt (23+ / 0-)

    "Well, yeah, the Constitution is worth it if you succeed." - Nancy Pelosi, 6/30/07 // "Succeed?" At what?

    by nailbender on Mon Nov 25, 2013 at 05:38:54 AM PST

  •  Rhetorical here, but I have to ask... (31+ / 0-)

    Why is the ACA roll out considered such a "disaster" when the Medicare Part D roll out was as difficult, or perhaps more so?

    Especially given the fact that the opposition actually put a good faith effort in to make Part D work, whereas the opposition to the ACA have shown nothing but contempt?

    Besides the political games, the case before the SCOTUS that was not resolved until June 2012 must have had an effect on getting this implementation plan developed, as well as the fact that somewhere around 70% of the states decided to have the Feds do the web portal.  So much for the "States Rights" crowd...

    •  a couple of responses (32+ / 0-)

      Medicare Part D did not have the kind of organized pushback from Dems that Obamacare did from Repubs, so that it was not constantly put into the news.  Thus the problems that may have existed were not a part of the regular news cycle and political discourse

      Red states that did not want to see Obamacare succeed saw no reason to build their own portals, because they were trying not to participate

      as far as SCOTUS, all that did was remove the requirement for Medicaid expansion, which if anything simplified the building of the federal portal, so that should have had NO effect on how well the portal was designed.

      It is true that blocking of navigators may make some things more difficult

      I still think a decent percentage of the problems with may be traceable to DDOS attacks, and would really like to see a forensic analysis of what was going on.

      "We didn't set out to save the world; we set out to wonder how other people are doing and to reflect on how our actions affect other people's hearts." - Pema Chodron

      by teacherken on Mon Nov 25, 2013 at 05:47:38 AM PST

      [ Parent ]

      •  If this is the reason for any significant part of (8+ / 0-)

        the problems with, that would even lessen my view of the competence of those charged with the building of that web site.  

        I still think a decent percentage of the problems with may be traceable to DDOS attacks, and would really like to see a forensic analysis of what was going on.
        Here's my point.  When you announce to the world that you are building a huge website that is going to contain confidential information of millions of Americans, you are supposed to expect those kinds of attacks and design your system as best you can to guard against those.  It is true that if a DDOS attack is large enough, there's no real protection.  But any website like, like Amazon, like bank website, etc.  gets attacks every single day.  It's part of the territory.  And they are able to withstand the vast, vast, vast majority of those attacks.  Sure, once in a long while an attack is massive enough that the website might go down for a day -- and when it does, that is news.  But the website is built with the knowledge that those attacks will come, and the website is built to withstand the vast, vast, vast majority of the attacks.  

        I think the country had a right to expect the same thing from  If they showed us one or two massive attacks of the kind that could take down Visa, sure, that would be news.   And that would explain a short period (a day or so) of non-functioning, just as happens once in a while with similar websites. But the fact that is probably under attack every single day is not news, and is not justification for the problems.  It was something that was to be expected and planned for.  

    •  The reason this is different (3+ / 0-)
      Recommended by:
      fcvaguy, scamperdo, VClib
      Especially given the fact that the opposition actually put a good faith effort in to make Part D work, whereas the opposition to the ACA have shown nothing but contempt?
      Medicare Part D at least got some Democratic votes.  And even some Republicans didn't like it.  See here.  The Democrats who supported it had some buy-in, some "skin in the game" -- i.e., if it failed, those Democrats would share in the blame.  Because there were at least SOME Democratic votes for it, Democrats could not just try to take it down, because some Democrats would have suffered.

      Here, the ACA had only Democratic Support, and absolutely no Republican votes (with the exception, I think, of Rep. Cao from here in New Orleans, who was only Congress as a fluke since the Democrats nominated "Dollar Bill Jefferson," who was already under indictment for the $90,000 found in his freezer.)  So, the Republicans have absolutely no skin in the game -- if it fails, they will only say "I told you so," and lay all the blame on the Democrats who passed it.  

      That's a risk that any Administration takes when it passes something purely on a partisan basis.  That's why, prior to the ACA, I don't think that any huge program like this that affects virtually everyone in the country (Medicare, Social Security) has been passed purely on a partisan basis.  That's because when you pass something with only your own party support and the other party giving you no support whatsoever, you own it completely, and the other side has no interest in helping it succeed.  And a failure actually benefits the other side, who can then say -- "I told you so -- that's why we were against it."

      The Administration, when it signed The ACA into law, had absolutely no reason to think the Republicans would do anything other than oppose implementation each step of the way and continue to take shots at it.  They had to factor that into their rollout plans.  

      •  The problem was... (25+ / 0-)

        ...that it became screamingly, blindingly clear that there was absolutely no version of serious health care reform that could have gained Republican votes in 2009.


        Which meant that it was a choice of going with a "partisan" reform proposal or going with the status quo.

        Political Compass: -6.75, -3.08

        by TexasTom on Mon Nov 25, 2013 at 06:16:56 AM PST

        [ Parent ]

        •  That may well be true, but it doesn't change (3+ / 0-)
          Recommended by:
          Cardinal Fang, VClib, divineorder

          the fact that this was passed purely on a partisan basis, so the Democrats own it and Republicans have no interest in seeing it work.  Since it was passed the Republicans have consistently wanted it repealed.

           So, since it was clear that no Republicans would support the ACA, the Administration had the following choices:  (1) pass the ACA on a purely partisan basis, with the full knowledge that the Democrats would "own" it and that the Republicans would spend the next several years taking shots at it; (2) do a Clinton "triangulation" move: re-vamp the entire nature of health care reform into something that some Republicans would support and that some Democrats would hate and vote against, so that whatever passed would be "bipartisan"; or (3) forgo health care reform for the time, focus on the economy and jobs, build up more political capital and try to bring it up later.  They chose option (1).  That may well have been the correct decision, but they had to expect to live with the fallout -- i.e., continued Republican opposition even after the bill was signed into law.

          My point is not that the Administration could have gotten Republican votes for this.  My point is that the reality is that when you pass a huge program that affects virtually everyone in the country on a purely partisan basis, you have to expect the other side to oppose the implementation of that bill, every step of the way.  You have no basis whatsoever to think that they will be cooperative in implementing a bill that none of them support.  

          That's why I think that the cries of "But Republicans aren't helping!  They are doing everything they can to oppose it!  That's why the roll-out was bad!"  are just ridiculous.  That's exactly what the Administration knew would happen -- and that had to be factored into their roll-out plans.  

          •  Your point and reality live in separate worlds (39+ / 0-)
            My point is not that the Administration could have gotten Republican votes for this.  My point is that the reality is that when you pass a huge program that affects virtually everyone in the country on a purely partisan basis, you have to expect the other side to oppose the implementation of that bill, every step of the way.  You have no basis whatsoever to think that they will be cooperative in implementing a bill that none of them support.  
            The republicans from day ONE have made it their explicit goal to oppose Obama on EVERYTHING and ANYTHING.  So in what fucking world do you live in where a bipartisan proposal was even remotely possible.  

            Also you do realize that the bill was written by the Heritage Foundation, implemented by Mitt Romney in Massachusetts and had tremendous amount of input from GOP politicians in the crafting of it.  To claim it wasn't a bipartisan effort is simply a fucking lie.  Obamacare IS THE REPUBLICAN PLAN. So stop pretending that the Democrats rammed through their bill.  

            This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

            by DisNoir36 on Mon Nov 25, 2013 at 06:40:55 AM PST

            [ Parent ]

            •  It's actually a conservative plan (3+ / 0-)
              Recommended by:
              fcvaguy, VClib, niemann

              adopted by Democrats.  

              "Conservative" is a philosophy, and this plan, based largely on what was put out the by the Heritage Foundation, is a conservative plan.  It's certainly not a progressive plan.

              "Republican" and "Democratic" are political -- not philosophical -- labels.  Regardless of the philosophy it is based on, a bill is only a "Republican" bill if Republicans in Congress support it by voting for it.  Regardless of the philosophy, a bill is a Democratic bill if Democrats support it and vote for it.  

              So this was both a conservative plan, and a purely Democratic bill.  

              Frankly, this makes my point:  

              The republicans from day ONE have made it their explicit goal to oppose Obama on EVERYTHING and ANYTHING.
              This is the point in the comment I am responding to:  
              Especially given the fact that the opposition actually put a good faith effort in to make Part D work, whereas the opposition to the ACA have shown nothing but contempt?
              I am pointing out the reason for the difference in the "good faith effort to make Part D work" and "the opposition to the ACA show[ing] nothing but contempt.  It's because "the opposition" had some buy-in to Medicare Part D -- some Democrats voted for it.  

              There was never any buy-in to the ACA by Republicans.  Democrats think there SHOULD HAVE BEEN buy-in by Republicans, but the fact that Democrats think it SHOULD HAVE BEEN bipartisan does not make it a bipartisan bill if it got no Republican votes.  

              My point is that the Administration had to expect that, after the ACA was passed, Republicans would, for the next several years, show it nothing but contempt, because they had no skin in the game when it was passed.  

              I'm not saying that the Administration could have gotten a bipartisan bill through, unless it did a complete reversal on its strategy, and did a "Clinton triangulation," i.e., similar to something Clinton did on things like welfare reform.  That is, rather than craft a bill that most Democrats supported with the hope of peeling off a few Republicans, but being willing to pass it with no Republican support whatsoever, the Administration could have decided to do a "Clinton triangulation" and make Democrats really angry but pass a bill written by Republicans (there were some Republicans with an alternative plan at the time) with little Democratic support.  Since the Administration did not believe that what the Republicans were proposing would do anything to help the health care system whatsoever, the triangulation thing was probably not an option, so yes, their only option was to do a Democratic bill in the hope of peeling a Republican or two off, but failing that, pass it on a purely partisan basis.  

              That may well have been the only viable option if they wanted to pass some kind of health care reform.  But given that, they had to expect Republicans to show it nothing but contempt for the next several years, because there were no Republican votes for its in Congress.  

              •  triangulate? (9+ / 0-)

                Triangulate to WHAT?  The only other choice was to do nothing since R's were going to oppose anything proposed and/or associated w/President Obama.

                The 1% are becoming sociopaths. PERIOD. That wealth is making them sick. Entitled and unanswerable to anyone.Personal responsibility is for the suckers, er, the middle class and poor.. -- cagernaut, 30 October 2013

                by billlaurelMD on Mon Nov 25, 2013 at 08:36:56 AM PST

                [ Parent ]

                •  Probably not practical in this instance (1+ / 0-)
                  Recommended by:

                  and certainly, since the Administration did not believe in anything the Republicans wanted to do, not really a viable option.  

                  What a"triangulation" strategy would be is to take a Republican bill as a start (one actually introduced by a number of Republican members of Congress, not one that you think Republicans should support),  and announce your support for THAT bill, and try to do some modifications to bring some conservative Democrats along.  Presidents who value politics over substance might have tried that, if they just wanted SOME reform and didn't care what it was. The Administration did not want to adopt the Republican plan so it was not really an option here.  I only mention it because prior Presidents, notably Clinton, used similar tactics.  

                •  I don't recall a single Republican proposal that (6+ / 0-)

                  would have received a single Republican vote.  I frankly don't remember any Republican proposal that wasn't in some fashion "let's keep as many sick people off healthcare as possible".  

                  As leftykook says, the Democrats kept trying but the Republicans kept agreeing to Republican input and then still voting no so they could run against the bill later.

                  Given the three choices you posit - only Democratic votes, triangulation or doing nothing, I'm sure glad the Democrats didn't make the same mistake Clinton did - trying to get triangulation and winding up with nothing.

                  •  That's surely what the Administration was (1+ / 0-)
                    Recommended by:

                    thinking.  And I'm not advocating that they should have done anything else.

                    My only point is that when you pass a major and controversial piece of legislation on a completely partisan basis, you have to expect that the opposition will continue trying to dismantle it whenever they have the opportunity.  

                    •  I think he was still thinking he could get some (3+ / 0-)
                      Recommended by:
                      Tonedevil, niemann, FindingMyVoice

                      cooperation since he had come so far in their direction.  His first couple years were a learning curve for him and for the Democrats as they learned the Republicans really were as bad as the progressives like those at this site were telling the administration.  Hell, the administration still supported Lieberman after all he did to torpedo Democratic ideas.

                    •  Why is the funding for the ACA front loaded? (0+ / 0-)

                      The funding is intact. Smart move, it's what makes it impossible for the R's repeal it, unless they get the Presidency. They can't do much to attack the funding as smartly it was front loaded, in other words the money was passed in prior years to be spent now. That was smartly in anticipation of GOP resistance. Not everything's been bungled, that was a smart move.

                •  Could likely have gotten some Republicans to (0+ / 0-)

                  support if ACA had features such as:

                  1 - Tort reform - with caps on non-economic damages (as California has), damages not including what health insurance would otherwise cover, and stricter procedures where doctors who are clearly negligent lose their license to practice.  Safe harbor when certain protocols are used.  Possibly have claims processed in a similar way as Tricare currently uses.

                  2 - Reduce minimum allowable coverage (to gets premium costs down when ACA starts).  Such as,1) replace max lifetime benefit from unlimited to $5 million, 2) allow for restrictions such as no private or semi-private hospital rooms (unless other not available).  3) Not require coverage for maternity (without complications), osteopaths, child dental, etc..  4) allow lower premiums for those having reasonable weight, those taking annual checkups, taking vaccines, taking their prescriptions, not engaged in substance abuse (based on annual blood test - currently only applies to tobacco), 5) Allow lower rates for those agreeing to reasonable medical directives (living wills).

                  3.  Allow interstate sale of insurance.  Much less here than meets the eye on the downside, as ACA establishes the minimum coverage. But this could increase competition and allow for successful innovations to more quickly spread across states.

                  4. Equal tax benefits for those buying their own insurance as those who get employer provided insurance.

                  The most important way to protect the environment is not to have more than one child.

                  by nextstep on Mon Nov 25, 2013 at 11:52:58 AM PST

                  [ Parent ]

                  •  This is revisionist fantasy (3+ / 0-)

                    They already put in a number of Republican requests, to no avail. They delayed for months, trying to make deals with Republicans, but no deals were forthcoming. Nothing they could have done would have made Republicans vote for the ACA.

                    •  What significant Republican features do you have (0+ / 0-)

                      in mind that a majority of Dems and Pres Obama did not also want in the final ACA?

                      Only ones I can think of are minor such as  the Grassley Congress gets the same deal.

                      The most important way to protect the environment is not to have more than one child.

                      by nextstep on Mon Nov 25, 2013 at 02:08:07 PM PST

                      [ Parent ]

                  •  They offered most of that but the Rethugs didn't (2+ / 0-)
                    Recommended by:
                    bluezen, Yosef 52

                    compromise. I don't want to see Democrats and progressives believing con talk radio lies. They were offered several deals that met most of their terms, and nuked every single one of them. It became very clear that Susan Collins and her twin Senator would NEVER support the ACA-- they played games like the games with the unapproved cabinet and judges. That's over.

              •  OBAMACARE IS TRIANGULATION (2+ / 0-)
                Recommended by:
                Tonedevil, bluezen

                it is the GOP's own plan, enacted by the 2012 GOP presidential candidate and highly lauded by the GOP as an alternative to democratic attempts at socialized health care.

                obama adopted the GOP plan, lock, stock and barrel. the moment obama did this, the GOP decided it was socialism and demanded more concessions.

                it is beyond disingenuous to claim, in 2013, that obama needed to compromise with the GOP, clinton-style. the whole process was one not of compromise, but of outright capitulation to the GOP plan. that the GOP rebuked their own plan is neither here nor there.

                •  Not exactly true. Two points. (0+ / 0-)

                  1.  I agree it was a conservative plan, derived by the Heritage Foundation.  It's not a progressive plan.  That's a philosophy -- it indicates whether the plan comports with certain philosophical views of government, the "free market, etc."    

                  "Democratic" and "Republican" are political terms, signifying political agreement, and political agreement is demonstrated by either by (1) a member of Congress actually proposing legislation in Congress; or (2) votes for a bill.  So, when you look at what happened politically, this cannot possibly be a "Republican" plan, when no Republicans proposed it in Congress (they had a introduced different legislation) and the bill got no Republican votes.  

                  The bottom line truth is that this is a conservative plan adopted as their own -- as the Democratic bill and the Democratic legislation.  The ACA -- which refers to the bill that went through Congress and was signed into law -- cannot possibly be labeled "Republican" when no Republican voted for it.  Certainly, a lot of people think they SHOULD have voted for it, because the legislation was based on a conservative plan, but they did not, so its a Democratic bill, based on a conservative plan.  

                  It doesn't matter how many times people point out that it's based on a Heritage Foundation Plan.  It's not a "Republican" bill if no Republicans voted for it.  

                  2.  I am not suggesting that the President "needed to compromise with the GOP."  I am saying that he decided not to, and the result of that is that he could not expect anything other than the Republicans to do everything they could to dismantle it.  That's fine -- that's a decision he made.  He had only three options: (1) pass it on a purely partisan basis and expect Republicans to try to dismantle it if/when they got any power; (2) anger his own party by supporting a Republican bill so as to pass something that could be labeled "bipartisan" (never a viable option because the President could not support this Republican bill); or (3) not pass health care reform.  

                  He chose option 1.  That's fine, and -- as I'm sure he's been aware -- that means that Republicans spend their time trying to dismantle it.

                  Passing the ACA on a purely partisan basis, and having the Republicans support it, or at least not attack it, after it was signed into law, was never an option.   It was  completely unrealistic.  It could not happen.

                  •  you are pretending the past didn't exist (3+ / 0-)
                    Recommended by:
                    Tonedevil, FindingMyVoice, bluezen

                    many, many republicans championed this plan until obama agreed to it. it came out of the GOP and the heritage foundation, which is a GOP think tank.


                    •  Really? Can you show me an instance of (0+ / 0-)

                      any Republicans in Congress who "championed" the Heritage Foundation's plan?  

                      I know Then-Gov. Romney adopted it in Conjunction with a Democratically-controlled legislatioin.  

                      But which specific Republicans in Congress "championed this plan until" the President agreed to it?  

                      The Heritage Foundation is a conservative think tank.  It's a conservative plan.  It's not a Republican bill unless Republicans in Congress vote for it.  

                      I'll give you another example.  The ACLU is generally considered a progressive organization.  The ACLU wrote an amicus brief in Citizens United supporting the view eventually adopted by the majority on First Amendment grounds.  Under you logic, that makes CU a "Democratic" decision, even though none of the Democratic appointees on the Court voted for it.  

                      The fact that it's a plan put out by the Heritage Foundation makes it a conservative plan.  The legislation --the bill passed by Congress  -- is not a Republican bill when no Republicans voted for it.

                      •  The mandate plan's been with the R party since (1+ / 0-)
                        Recommended by:

                        Nixon proposed it, so did Dole when Clinton was President.

                        The current R's in Congress may never have signed on, but you don't have to look far to find R leaders back in the day, it was their alternative proposal to Clinton's health care plan.

              •  It was the plan that Lieberman, Nelson and Blanche (1+ / 0-)
                Recommended by:

                Lincoln would agree to. They were the swing votes, even Susan Collins and that other northeast female republican voted against it. Had it been watered down further by Collins, most of us would have opposed it. So we had to get Lieberman, Nelson, and Lincoln on board and they did.

            •  And it's dishonest to suggest no Rethug input (18+ / 0-)

              throughout the development of the bill, time after time, the legislation was modified to suit demands of Rethug pols on committees, then, after getting their modification written in, THE BASTARDS VOTED NO.

              "Ronald Reagan is DEAD! His policies live on but we're doing something about THAT!"

              by leftykook on Mon Nov 25, 2013 at 07:22:57 AM PST

              [ Parent ]

              •  Sure, I understand that. (2+ / 0-)
                Recommended by:
                Rick Aucoin, VClib

                I know that some provisions are in the bill because Republicans in committee want them there.  That, of course, never guarantees that the same person will vote for the final bill, after all changes are done.  But again, in the end, it was a purely Democratic bill, because not a single Republican voted for it.  It was not a progressive bill, but a conservative bill.  But it was a conservative bill passed entirely on a partisan Democratic basis.  

                Again, you are making the argument that, because some Republican suggestions were adopted in committee, the Republicans SHOULD HAVE supported it. But one side saying the other side SHOULD HAVE supported it does not make a bill bipartisan.  

                I'm sure that was largely a political calculation as much as anything else by the Republicans.  If they thought it would be unpopular, they likely would have wanted to be able to blame that unpopularity entirely on the Democrats, so in the end they made sure that there was no Republican support and Democrats had to rely on people like Baucus and Landrieu to get it through.  

                •  You are equating "not supporting" the law (12+ / 0-)

                  with taking active steps to sabotage it.
                  They are utterly dishonest, and your comments seem to ignore that.

                  "Ronald Reagan is DEAD! His policies live on but we're doing something about THAT!"

                  by leftykook on Mon Nov 25, 2013 at 07:55:26 AM PST

                  [ Parent ]

                  •  Actually, I'm including both. (3+ / 0-)
                    Recommended by:
                    Rick Aucoin, VClib, divineorder

                    I'm talking about "supporting" while the bill was pending in Congress.

                    Since it was passed, I completely agree that the Republicans have actively opposed it -- most obviously, by voting to repeal it in full and in part.  

                    My point is that if the Administration expected anything else, they were delusional.  There was no reason to expect the Republicans, where the law gave them any option whatsoever (like to set up exchanges), EVER to take the option that would help implementation.  There was no reason to expect that, in any legislative body where they had a majority, that they would do anything OTHER than pass whatever they could to dismantle it in whole or in part.  When you pass huge, and controversial, legislation on a completely partisan basis, you have to expect that, as it is implemented, the opposition will use whatever means is given to them in the law to try to dismantle it.  

                    If the Administration expected anything else, they were living in a fantasy.  The Republicans had no motivation to do anything other than oppose it in any way that they had the power to do.  

                    •  It was also Congress that expected bipartisanship. (4+ / 0-)

                      They kept ignoring everyone who was telling them through the whole process, using live examples, that the Republicans would do all they could to prevent the ACA implementation.

                      It was also corporate America, listening to the corporate news media, who gave the Republicans a chance to overturn the legislation and prevent the ACA from going into effect, thereby encouraging the Republican state governors and legislatures from implementing their own exchanges because why go through the effort if it's going to be repealed anyway?  They could have had their own exchanges suited to their own states, but instead they wound up with the federal site, which was the last thing they wanted to see happen.  As the federal exchange gets better and more people sign up through there, more people are dependent upon the federal government and not the state for their health care choices and that further hurts Republicans.

                      I sure hope the Republicans never recover from this.

                      •  Whether the Republicans "recover" depends (2+ / 0-)
                        Recommended by:
                        VClib, ColoTim

                        largely, I think, on how things go over the next 10 months.  And I'm not just talking about the website.  

                        What I think matters is the opinion of people who had insurance before the ACA.  Polls at the time showed that something like 85% of people who had health insurance liked it.  That's what prompted the "if you like it you can keep it" line.  Essentially, they were promised that we would add the uninsured to the insurance rolls, but that there would be no down side for them.  

                        If, next September, those people think they are better off as a result of the ACA, Democrats will do very well in the midterms.

                        If, next September, those people think they are worse off as a result of the ACA, the Republicans will do very well in the midterms.

                        Something like health insurance affects nearly all Americans directly, and the ACA made a shift in how it's done.  I think that, by far, will be the largest issue in the 2014 midterms.

                        •  No, the electoral equation is this: do more voters (1+ / 0-)
                          Recommended by:

                          like what they got from the ACA or are neutral about than are unhappy.

                          Those won't only be those with cancelled plans that are unhappy. It will include those who didn't have insurance due to preexisting conditions.

                          The numbers of the voters who will benefit are much larger than the cancelled plan numbers. Now it's a question of getting those who benefited to vote.

                          Your equation is off-- it's not just going to rest on cancelled plan people. They are a very small minority that the media has focused on.

            •  DisNoir - while the concept was introduced by (0+ / 0-)

              the Heritage Foundation the ACA is a purely a Democratic law because no Republicans voted for it. It's really that simple.

              "let's talk about that"

              by VClib on Mon Nov 25, 2013 at 10:10:57 AM PST

              [ Parent ]

              •  Kinda-- it used to be the R plan, Nixon's, Dole's, (0+ / 0-)

                Romney's, until the current Congressionals refused it. So it depends on the definition of "is" etc--

                which means everybody in this debate here is correct and wrong. The FACTS are that Nixon proposed it, so did Dole. Gingrich, not sure, McConnell & Boehner, no, they didn't embrace it in recent years. I'm sure sometime in their career they probably did embrace it. Since Obama's been President, the GOP alternative has not been Romneycare, it's been health insurance vouchers, tort reform, health care accounts etc. A plan that is a fig leaf.

              •  Utter bullshit (0+ / 0-)

                The republicans helped write it.  They then voted against the same bill they helped fucking write.

                So this doesn't even pass the smell test.  

                This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

                by DisNoir36 on Tue Nov 26, 2013 at 05:10:39 AM PST

                [ Parent ]

                •  The Democrats own the ACA for better or worse (0+ / 0-)

                  No Republican in the House or Senate voted for the ACA legislation and the Senate needed to use reconciliation to pass the last piece of the puzzle. There is no way to make this a bipartisan problem or benefit.

                  The question is will the Democrats run on or away from the ACA in 2014? There are few political experts who don't think the Dems will receive all the benefits or blame for the ACA in 2014.

                  Interesting that the "generic" CNN House poll has moved 10 points in favor of the GOP in one month. That's all ACA related.

                  "let's talk about that"

                  by VClib on Tue Nov 26, 2013 at 09:33:09 AM PST

                  [ Parent ]

            •  If ACA was a Republican Proposal, because (1+ / 0-)
              Recommended by:

              Heritage proposed a variation of it in the early 1990s, where were the Republicans pushing for this during the Bush years when they had the President, House and Senate?  I cannot even think of one elected Federal Republican who campaigned on something like ACA.

              Just because an organization associated with a political party says something, it does not mean that even a significant minority of the party supports that idea.

              The most important way to protect the environment is not to have more than one child.

              by nextstep on Mon Nov 25, 2013 at 11:14:57 AM PST

              [ Parent ]

              •  They were too busy (1+ / 0-)
                Recommended by:

                Pushing through their giveaway to the PHARMA industry known as Medicare D.

                Trying to push through the privatization of Social Security.

                Starting two wars.

                Pushing tax cuts for the rich.

                Deal with the fallout from their disastrous bungling of Katrina.

                Frankly the fact that it wasn't their priority doesn't change the fact that it wasn't their idea.  It was Bush's plan as well only he didn't use any capital pushing for it.  Instead he pushed for more shit insurance and HSA accounts.  

                And you also conveniently forget that Mitt Rmoney passed and enacted this same fucking plan in Massachusetts in 2006 and that no less than Jim DeMint called it a model for the country.

                So please spare us the revisionist bullshit. It was a GOP plan from the 90's as an alternative to Hillarycare and remained so all the way to 2009 when Obama embraced it.

                This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

                by DisNoir36 on Tue Nov 26, 2013 at 05:20:10 AM PST

                [ Parent ]

          •  What is your evidence for the possiblity of (2)? (14+ / 0-)

            You write that one possibility is the following:

            (2) do a Clinton "triangulation" move: re-vamp the entire nature of health care reform into something that some Republicans would support and that some Democrats would hate and vote against, so that whatever passed would be "bipartisan"
            If there was nothing, absolutely NOTHING, that Republicans would have voted for that was backed by this President, as I think was the case, how does he possibly "triangulate?"  I would submit that the ACA, with its omission of a public option and it's enshrining of the place of insurance companies in the health care system, was an effort to "triangulate," but the Republicans still wouldn't go along with it.

            Republicans made it clear from Day One that their primary goal was to prevent this President from having any significant legislative accomplishments, and thereby make him a one-term President.  Some may disagree with me on the reasons, but I think a major part of it was the fact that the base of the Republican Party is now in the South, and that this President is the first President in our history who isn't white.

            Bin Laden is dead. GM and Chrysler are alive.

            by leevank on Mon Nov 25, 2013 at 07:07:19 AM PST

            [ Parent ]

            •  I think it probably was not a viable option. (2+ / 0-)
              Recommended by:
              VClib, ColoTim

              They didn't really explore it, but I don't know that it was a viable option.  And certainly they weren't going to explore it if the Administration had no belief in the merits of any Republican plan, which clearly they did not.

              My point is NOT that there was a way to get Republican votes for the ACA.  There probably was not.  But that doesn't mean that the Administration was justified in ignoring reality.  When you do a massive bill purely on a partisan basis, the opposition is going to continue to oppose it as it's implemented. That's reality.  The fact that there was no way to get Republican buy-in does not mean that the Administration should then have expected Republican cooperation after the bill was passed -- in fact, that meant just the opposite.  

              I'm not in any way trying to justify as "right" the Republican opposition.  What I am doing is pointing out reality from the Administration's point of view.  And, reality from the Administration's point of view is that they had to EXPECT that the Republicans were going to continue to oppose the ACA as it was implemented.  

              Here's the ultimate point I am making.  If the Administration's plan for a successful implementation depending in any way on Republican cooperation, or depended in any way on Republicans quieting their opposition, that was the Administration's fault because those plans would have been based on fantasy.  The Administration had to plan the implementation, and had the responsibility to ensure a successful implementation, knowing that the Republican opposition would continue.  That's the responsibility they assumed when they passed the bill on a purely partisan basis.  

              •  I don't think Obama was expecting GOP cooperation (5+ / 0-)

                Why should he? The GOP hasn't cooperated for the last 5 years, period. What he was/is hoping is that enough people will sign up for the ACA to make it political suicide to attempt to repeal it. The GOP fears it not because they fear government overeach but because it's an example of government succeeding where the private sector has failed, something that doesn't fit into the GOP plans.

                No being has inherent power, only the illusion of power granted by others who similarly have none.

                by Mark701 on Mon Nov 25, 2013 at 08:09:16 AM PST

                [ Parent ]

                •  Exactly. Which is why it makes no sense when (4+ / 0-)

                  some say, well the implementation would not have gone as badly if the Republicans would have supported the ACA after it passed, like Democrats supported Medicare Part D after it passed (as some people here like to say).  

                  The lack of support, and the outright opposition, by Republicans, cannot have played any role whatsoever in the problems with the implementation, because the Administration never had basis to believe that it would be any other way.

                  •  what about funding for the implementation? (5+ / 0-)

                    Republicans had plenty of control (I thought) over that.

                    The 1% are becoming sociopaths. PERIOD. That wealth is making them sick. Entitled and unanswerable to anyone.Personal responsibility is for the suckers, er, the middle class and poor.. -- cagernaut, 30 October 2013

                    by billlaurelMD on Mon Nov 25, 2013 at 08:39:25 AM PST

                    [ Parent ]

                    •  Sure, once they took the House, they did. (1+ / 0-)
                      Recommended by:

                      And no one should have expected that they would willingly fund the ACA.  The Republicans ran in 2010 on dismantling the ACA, so it should have come as no surprise that, when they were elected, they tried to dismantle the ACA.  

                      Of course, I've never heard anyone argue that they didn't spend enough money on the website and that's the problem.

                      If the Administration's roll-out plans for the ACA depended on Democrats keeping control of the House and Senate in 2010, and the implementation was not going to go well UNLESS Democrats kept control of the House and Senate in 2010, well, that was their miscalculation. (Anyone looking at poll numbers when the ACA was passed could see that about half the country did not like it and so could see some risk in the midterm elections.) But  I think the Administration understood, all along, that once they passed the bill, the Administration was going to have to do this all on its own, through the executive branch, despite whatever incoming fire the Republicans could shoot at it.  

                      My point is that no sane person expected that, as soon as the bill was signed into law, Republicans would stop trying to dismantle it.  That was always to be expected, and any plans had to take that into account.

          •  This part is true enough ... (2+ / 0-)
            Recommended by:
            Tonedevil, doinaheckuvanutjob
            That may well be true, but it doesn't change the fact that this was passed purely on a partisan basis, so the Democrats own it and Republicans have no interest in seeing it work.
            ... but what it really speaks to is Republican hypocrisy ... part of their ongoing pattern of voting against their own ideas once those ideas are adopted (usually wrongly) by Democrats.

            It is just part of their knee-jerk obstruction to everything Democrats do.

            DEMOCRATS:  Let's go out to eat.  Let's have Italian food!

            REPUBLICANS:  NO!  We want hamburgers!

            DEMOCRATS:  Okay, okay.  We'll have hamburgers.  

            REPUBLICANS:  NO!

            DEMOCRATS:  Well, what DO you want then!

            REPUBLICANS:  Hot dogs!

            DEMOCRATS:  Okay, we'll have hot dogs.  Anything to come to some kind of agreement.

            REPUBLICANS:  NO!

      •  It wasn't as different as people say. (4+ / 0-)

        It did make headlines.
        It was considered a disaster.
        But -- it got fixed.  Troops were rallied and people were taken care of.

        LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

        by dinotrac on Mon Nov 25, 2013 at 06:19:44 AM PST

        [ Parent ]

        •  What was different was that (1+ / 0-)
          Recommended by:
          Rick Aucoin

          Medicare Part D got some Democratic votes, so those Democrats had an interest in it succeeding.  

          Since the ACA got NO Republican support, since every one of them opposed it, and still opposes it, they have no interest whatsoever in seeing it become a permanent part of the law of this country.

          •  Medicare Part D was the kind of thing (1+ / 0-)
            Recommended by:

            Oh yeah -- I'm sure people stood up and told their pharmacists -- "But the law got some Democratic votes"

            LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

            by dinotrac on Mon Nov 25, 2013 at 06:26:39 AM PST

            [ Parent ]

            •  That wasn't my point. (3+ / 0-)
              Recommended by:
              dinotrac, Rick Aucoin, divineorder

              My point was that when you pass something on a purely partisan basis, you have no reason to expect the other side to cooperate in its implementation, and you can't blame your own bad implementation on the other side's failure to cooperate.  

              So yes, the Administration had to expect that Republicans were going to spend the next three years talking about how terrible the law was and doing everything they could to see that it wasn't implemented.  The Administration can't blame the bad implementation so far on the Republicans not cooperating (as some are trying to do) because no one had any reason to expect the Republicans would cooperate.  

      •  By your logic (3+ / 0-)
        Recommended by:
        Theodore J Pickle, Tonedevil, bluezen

        180 ideologically unified wingnut congressmen deserve more of a say in policy than 200 congressmen with varied opinions.  How is that democracy?

        It's almost like you're saying their intransigence should be rewarded, or at least regarded as something other than pure malice.

        Fuck all conservatives, always.

        Politics means controlling the balance of economic and institutional power. Everything else is naming post offices.

        by happymisanthropy on Mon Nov 25, 2013 at 08:59:28 AM PST

        [ Parent ]

      •  The Republicans REFUSED to participate in ACA (0+ / 0-)

        as you may recall. They were mandated to participate by the people who voted them into office. They shirked their duty. Then they had the gall to claim that they were shut out (of a plan proposed by the right-wing Heritage Institute no less).

        These are the actions of lazy freeriders and bottomfeeders, not true American patriots and states(people)men who do the best they can for the most people as is their sworn duty.

    •  did people who had coverage (0+ / 0-)

      have to switch under Part-D, or was it a pure expansion of the medicare pool?

      Come January 1, it looks quite possible that there will be fewer insured Americans then back in October.

      •  can you please point to your source of information (5+ / 0-)

        for this:

        Come January 1, it looks quite possible that there will be fewer insured Americans then back in October.

        "The death penalty is never about the criminal. They've already done their worst. The question is always "will we join them"?" - jlynne

        by Hopeful Skeptic on Mon Nov 25, 2013 at 06:34:40 AM PST

        [ Parent ]

        •  the first report was of (0+ / 0-)

          500K enrollees, 100K ACA and 400K Medicare. We've heard that several millions of people were in plans that could not be sold in 2014. Thus the presidents recent proposal that those plans be extended a year.

          So unless millions can get signed up for coverage before Xmas or be permitted to get back into their old plan, they will not have coverage in January.

          Or am I missing something?

          •  aren't there a lot more (0+ / 0-)

            (hundred of thousands to millions) that will be insured through all of the state exchanges?

            "The death penalty is never about the criminal. They've already done their worst. The question is always "will we join them"?" - jlynne

            by Hopeful Skeptic on Mon Nov 25, 2013 at 08:20:38 AM PST

            [ Parent ]

          •  You're missing something (8+ / 0-)

            Several millions of people were in plans that were cancelled. Those people are required by law to buy insurance, and they probably want to buy insurance, as demonstrated by the fact that they had insurance.

            But they don't have to buy on the exchange. They can just call up an insurance company, or an insurance agent, and say, I would like to buy an insurance policy. And the insurance company will be happy to sell them one.

            Or, they can do what some of them undoubtedly did: they can accept the rollover. Most of those cancellations said, We are sorry that your policy has been cancelled. If you do nothing, we will move you to this other policy. Some people will have just shrugged and gone to the new insurance policy.

            Unless you know how many people are signing up outside the exchanges, you don't know how many are uninsured.

    •  Medcare part D was considered a disaster (5+ / 0-)

      And it was in the news.
      And people did make noise.
      And the troops were rallied and the problem was solved.

      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

      by dinotrac on Mon Nov 25, 2013 at 06:18:41 AM PST

      [ Parent ]

    •  It´s been crap (1+ / 0-)
      Recommended by:
      Pablo Bocanegra

      Under ANY measure. The site STILL does not work. I know many people that have tried to enroll and STILL are unable. Every single step has required hours on the phone. It´s a load of crap. It´s just plain awful. Republicans are not managing the damn site. Enough with the excuses

    •  Everyone is now on the internet (3+ / 0-)
      Recommended by:
      billlaurelMD, FiredUpInCA, Tonedevil

      and able to screech their views at high volume on a million social networks. This was not the case in 2006 -- the social networks had not yet reached critical mass and much of the Right Wing's latter-day troll army didn't even own computers yet.  The internet in America still largely belonged to anti-Bush lefties in 2006.

      This is the single reason why the ACA rollout seems worse than Medicare Part D -- the simple fact that everyone's now online and therefore naysayers have a soapbox to screech from which they didn't have in 2006.

      It really is as simple as that.

    •  tampaedski - Medicare Part D was a new benefit (1+ / 0-)
      Recommended by:
      denise b

      Prior to Part D seniors had no Medicare related drug benefits and private plans were very expensive for people over 65. In addition, Part D was and is completely voluntary. No one is required to sign up for Part D, and many seniors haven't. Part D doesn't change anyone's underlying health insurance because all the participants are already on Medicare. In addition, Part D effected a small percentage of the population. Plus Part D was passed on a bipartisan basis with support from both the Republicans and Democrats.

      It's no wonder that the cumbersome roll out of Part D had less bad press than the ACA, there are huge differences in how each program impacts the public.

      "let's talk about that"

      by VClib on Mon Nov 25, 2013 at 10:04:41 AM PST

      [ Parent ]

  •  CA also has a surplus and other success with (21+ / 0-)

    a Dem gov, and isnt CA a better story of management than NJ or WI?  

    Sure lets elect a Governor next, a DEM gov since they actually believe in Gov

    "The poor can never be made to suffer enough." Jimmy Breslin

    by merrywidow on Mon Nov 25, 2013 at 05:57:53 AM PST

  •  HHS/DHS have both stated... (8+ / 0-)

    ...that attacks against the site were minimal in nature and were not successful.

    Even the one DOS tool (not DDOS - there's a big difference) that has come to light is not capable of inflicting significant operational stress on the site.

    (Source: Naked Security, 11/18)

    The word "parent" is supposed to be a VERB, people...

    by wesmorgan1 on Mon Nov 25, 2013 at 06:00:52 AM PST

  •  Well, ok, but, if you know that you need mass (5+ / 0-)

    media coverage and the mass media only cover disasters, why not give them a disaster? You know, like "hush puppies."

    Fact is there were 21,000,000 patients at community health centers, set up under the ACA, receiving primary care on a sliding scale. However, they were shut out of specialized care by a lack of insurance, unless they presented as emergencies.

    The community health centers, funded by the ACA, were/are on a short leash because Congressional funding runs out. So, the patients had to be shifted into another pool, which is going to be funded automatically under the supervision of the IRS via tax collections and subsidies. It's a work-around. The entity being worked around is Congress, which does not want yet another mandatory program whose funding it can't manipulate to secure their own re-election.
    We all know about the PACs. What we don't know is the extent to which grants and contracts are structured so as to benefit supporters and cut out goods and service providers who are dis-favored. The Tea Party people thought the allocations to favorite supports went through the earmarks and targeted them for elimination. But, the earmarks are just the tip of the corruption. The real "work" gets done in appropriations which contain so many caveats and exclusions that sole-source suppliers are the only option. I call it ruling by exception. Nobody gets, except my friend, who's left after all the regulations are met.

    Our industrial sector has reason to be suspicious of regulations because they are often crafted to advantage one party and disadvantage competitors. That's what legislative bodies have always done. And that's why our industrial sector is flacid and commerce is constantly looking to be advantaged. Meanwhile our natural resources are dissipated as waste.

    Obamacare at your fingertips: 1-800-318-2596; TTY: 1-855-889-4325

    by hannah on Mon Nov 25, 2013 at 06:01:09 AM PST

  •  How can fed. govt improve red states where a Dem. (1+ / 0-)
    Recommended by:

    Senator will take heat for a flagging system?  Navigators? More phone support?

  •  is 22% enough? (2+ / 0-)
    Recommended by:
    Betty Pinson, TJ
    And so far, so good: in October, 22.5 percent of California enrollees were between the ages of 18 and 34, slightly above that group’s share of the population.
    according to NPR

    "There's a group of Americans who've been dubbed the Young Invincibles. They're not, of course. But they are young, healthy and people the administration needs to buy health coverage under the Affordable Care Act. The new health insurance exchanges opened October 1st and officials want at least 2.7 million of the seven million estimated new enrollees to fall inside that 18 to 35 age range to keep insurance rates low."

    and as we all know, 2.7 / 7 = 38.5 percent.  So unless California has a much lower share of young people than the nation overall, they are not yet signing up nearly enough to keep the rates down.

    •  Where did you get the 2.7 million number? (6+ / 0-)

      Do you have a link to the administrations estimate? That seems really high, considering that in California only ~21% of the population (as a whole) is 18-34. 38.5% is nearly twice that. Seems like fairly implausible prediction even given that this age group is less likely to be insured (because many will instead qualify for Medicaid).

    •  Even if all of what you are (2+ / 0-)
      Recommended by:
      divineorder, Tonedevil

      claiming and quoting ends up happening--and there are months to go before we have a final tally for this opening--this is only an opening round. Every year there will be more enrolled or simply more $ added to the pot due to the taxes paid by the uninsured, and that tax/fee/whatever you want to call it, is going to rise each year to boot.
      So, if this year the system runs a deficit, so what? It's not as if California is going to go Republican over the ACA (or that would have happened already, given that this has been in the works for years), so the state government has plenty of opportunities to fine tune it to reach solvency. Not only that, but the state government would then have the wind at its back to regulate the insurance companies even more stringently. The only reason rates are even an issue are because we've agreed that insurance companies a) have to exist (sadly); and b) have to earn profits. Regulate b and you no longer have the issue.
      Yes, this is all speculation (and pipe dreaming), but then again, so is much of what you are pointing to.

      "Lone catch of the moon, the roots of the sigh of an idea there will be the outcome may be why?"--from a spam diary entitled "The Vast World."

      by bryduck on Mon Nov 25, 2013 at 09:49:43 AM PST

      [ Parent ]

      •  Apparently CA has relatively weak (0+ / 0-)

        regulation of health insurance companies. Therefore the state insurance commissioner has relatively less ability to regulate the insurance companies with respect to rates and policies. Some other states have more stringent regulations and greater powers for the regulators.

        I think CA could be in a fairly good position in a few years if they passed some legislation to give the insurance commissioner some additional powers in this respect.

        The success of the PPACA in any state is partially dependent on state regulators who have fine grained jurisdiction over the local insurers.

        This is another reason why some states will have minimal success under PPACA. Everyone points to the fact that some states refused to create exchanges and are operating under the struggling federal exchange. However there are more issues under the covers that will slow down progress in states with republican control of the regulation of insurance companies.

        Imagine what will happen in states in which the local regulators did NOT go out of their way to encourage competition among the insurance vendors. Basically there will be MANY instances of sticker shock hitting the subset of customers who are above the levels where subsidies are available.

        I wouldn't be surprised if this wasn't a semi-hidden factor leading to some of the sturm and drang we've had to put up with in the past two months.

        Of course not everything is a 'conspiracy'. There are legitimate reasons why prices are bad in some locations. Apparently people in rural areas are getting socked because of lack of competition and higher cost structure in their regions.

        If there was a working Congress one would imagine that some tweaking and fine tuning could occur to help improve competition in such areas and therefore reduce sticker shock. But unfortunately there is no effective working Congress at this time.

  •  Agreed. (7+ / 0-)

    new rulz:
    always hire someone who actually supports the job description

    "Show up. Pay attention. Tell the truth. And don't be attached to the results." -- Angeles Arrien

    by Sybil Liberty on Mon Nov 25, 2013 at 06:07:20 AM PST

  •  Don't bank too heavily on DDOS attacks. (6+ / 0-)

    First, that's a routine problem web sites face and can defend against.
    Might take you down for a little bit, but not for very long.

    More telling, the site has actually been responsive of late, and the kinds of unsophisticated DDOS attacks some people believe to have happened would show themselves by bringing it to a standstill.

    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

    by dinotrac on Mon Nov 25, 2013 at 06:17:35 AM PST

  •  If the denial of services thing is (2+ / 0-)
    Recommended by:
    divineorder, Notreadytobenice

    True, this needs to be blown wide open. The American people need to know what lengths people will go to in order to stop ACA.

    I want to live in a world where George Zimmerman offered Trayvon Martin a ride home to get him out of the rain that night. -Bishop G. Brewer

    by the dogs sockpuppet on Mon Nov 25, 2013 at 06:20:22 AM PST

  •  If Democrats Can Hammer Home The Fact (12+ / 0-)

    That rightwing governor whackjobs who refuse to help insure their citizens are the real culprits here, it would be MOST helpful.

  •  Re: California, New York are the Texas textbooks (7+ / 0-)

    of insurance. No major carrier can afford to alienate regulators in either state and both states have a track record of calling carriers to the carpet over actions taking place in other jurisdictions.

    Ironically, one of the things that Dodd-Frank (that much hated by Republicans Dodd-Frank) offers insurers is protection from this 'extraterritoriality' practice.

    I imagine they just want insurers protected from ACA working anywhere, because let the sick be uninsured, go bankrupt and die, or something noble like that.

  •  trivia: (0+ / 0-)

    My Rep, John Garamendi (D CA-3) formerly elected twice to CA State Insurance Commissioner (1990 - 2002) among many other state elected offices.

    Wishful thinking: DiFi retires sooner rather than later....

    "Show up. Pay attention. Tell the truth. And don't be attached to the results." -- Angeles Arrien

    by Sybil Liberty on Mon Nov 25, 2013 at 07:07:04 AM PST

  •  CA and KY (0+ / 0-)

    but quit calling my purple state RED, dammit!

    "I was not born for myself alone, but for my neighbor as well as myself."--Richard Overton, leader of the Levellers, a17th C. movement for democracy and equality during the English Civil War. for healthcare coverage in Kentucky

    by SouthernLeveller on Mon Nov 25, 2013 at 07:07:42 AM PST

    •  when a state votes GOP for president (2+ / 0-)
      Recommended by:
      teacherken, Sychotic1

      and senator time after time, that is generally considered red. even when it elects democratic governors, in a mirror image of how many blue states elect republican governors but are straight-ticket voters nationally.

      kentucky hasn't swung in a federal race in some time. best hopes for this being the year, though!

  •  ladies and gents, i give you an OR insurance succe (6+ / 0-)


    at the end of krugman's piece is "There will also probably be growing use of workarounds — for example, encouraging people to go directly to insurers."

    in oregon, our insurer came to us, with an ACA plan better than ours and asked us to just go direct through them and not website, and they'll square away all the tax credits and subsidies.  we like them anyhow. so that's what we're doing. of course i checked the website for comparison shopping.

    we won't be a statistic maybe for a web application, but it must show up as an ACA stat somewhere.  if dems want to steal the private insurance works banner, just to piss off R's they can do it.  just for kicks even. we're saving a ton

    what lincoln said

    by rasfrome on Mon Nov 25, 2013 at 07:22:59 AM PST

  •  A life-long resident of the Golden State, (7+ / 0-)

    I can't resist pointing out that we're "the cradle of the best and of the worst," to borrow Leonard Cohen's immortal phrase. Where California goes, for good or ill, the rest of the country seems to follow.

    Heh, for one example, it was here Proposition 13 was passed. The famous legislation sharply limited personal (and corporate) property taxes, radically cutting funding for public schools and other public infrastructure. This was in 1978. I was a student at Carmel Middle School. Prop 13's passage ushered in the anti-tax mania that has defined public discourse ever since, throughout the republic, and I'm well into my 40s now.

    I would love to see Obamacare succeed here, setting a "dangerous" precedent for the austerians.

    It's here they got the range/ and the machinery for change/ and it's here they got the spiritual thirst. --Leonard Cohen

    by karmsy on Mon Nov 25, 2013 at 07:35:52 AM PST

  •  It's always been abundantly clear (7+ / 0-)

    that the Republicans greatest fear is that the ACA will work. If it truly was the abomination that they claim it is, they would sit back and let the train go off the rails. This would all but hand them the Senate in 2014 and the White House in 2016.

    Instead, they have done everything they can (and then some) to hamstring implementation of the law, and it still isn't enough. It's going forward, people are signing up, and come January millions of people are going to be able to visit a doctor who couldn't do so before.

    In a way, the situation is similar the the Soviet Union in their waning days. For decades, they controlled all media and used propaganda to tell their citizens that they had the highest standard of living in the world. Then, outside news began filtering in and they realized that they had been lied to all those years. Same thing here - people in red states are going to look to their neighboring states and ask: why can't we do the same thing here? And the reason won't make them very happy.

    The United States does not negotiate with terrorists - that includes Republicans.

    by frsbdg on Mon Nov 25, 2013 at 07:36:39 AM PST

    •  Republicans are 100% commited to propaganda (3+ / 0-)
      Recommended by:
      paulex, ColoTim, divineorder

      If they had a motto it would be "Who are you going to believe: me or your own lying eyes?"

      We're currently in the stage where they use a compliant press to try to sell the American people on the idea that regulating the health insurance market is a catastrophe.

      Soon they'll switch to telling everyone that it was their idea in the first place.

      And in a few years we'll see them saying that Democrats are going to ruin your Obamacare.

      •  Well, it was a Heritage Plan first implemented (0+ / 0-)

        under a Republican governor (over his protests, of course).  Of course it was their plan.  A true progressive plan would be single payer or at least a public option.

  •  It's the ugly ones who make us look good (1+ / 0-)
    Recommended by:

    I've been to Covered California's website. Twice when attempting to go through certain portions (recently this weekend) parts of the site say it's closed until business hours. That might be understandable if I were trying to access live help ... instead of trying to find information like an address or try an online application. Which is all I was doing.

    But still, nice going, Calif.

    Anyway, last time I checked, health care & insurance costs keep rising, ACA notwithstanding. The entire reason for the ACA was to make health care affordable. Bless its little heart, but ACA can't make the insurance companies , Big Pharma etc stop gouging people. Slowing down the rate of gouging doesn't mean you've stopped it. We're still at Texas Chainsaw Massacre level.

    Still, nice going, ACA.

    •  My ACA Supported Rates Finally Stabilized (7+ / 0-)

      I'm under 40 and in generally good health. My insurance should have been reasonable, but it had been going up around 10% and sometimes considerably more than 10% a year for the 8 years I've had my individual plan.

      My rate for this year is $775/month. That's down from the $830/month last year. Next year it's $465/month. It seems to have stopped the bleeding on my end (for now at least).

      BTW, keep in mind these numbers are for one person without any subsidies. Ouch. This is why it seriously sucks to be left to fend for yourself on the individual market and in Silicon Valley there are a lot of people like me who strike out on their own and you find out that you'd better pray your health keeps up while you're pushing yourself to every minute possible and sleep as little as possible to press your ideas into action.

  •  The Math doesn't work (3+ / 0-)
    Recommended by:
    Brainwrap, TJ, divineorder

    In order to remain solvent, ACA needs to sign up 7 million paying customers (as opposed to Medicaid) and get a 50/50 split of Medicaid/paying customers.

    According to, through 11/21 California had signed up approximately 80,000 "customers" and 135,000 new Medicaid enrollees.  And while, it is likely the pace of paying signups will increase as we head for April's deadline, it is equally true that many listed as paying enrollees will not complete their purchases.  In addition, there have been over 1 million policies in California cancelled, if/when these people sign up for new policies it will not count towards the 7 million required (though to the extent they are now paying for services they may not require this does subsidize the rest of the system).

    For California to meet its "mathematical" obligations, it must sell 847,000 new insurance policies (Cali = apx 12% of the US population of apx 314 million).

    Meaning, that even if every single enrollee pays for their policies they have still achieved less than 9 1/2 percent of their "quota".

    Under any other circumstances these numbers would be viewed as a failure.  That things are so bad elsewhere is the only reason a positive spin is being put on Cali.

    •  Recced for referencing my site, but... (1+ / 0-)
      Recommended by:
      wu ming

      ...I'm not sure that your logic necessarily follows.

      It's possible that the "7 million" target figure does take into account those who've had their junk accounts scrapped.

      Plus, some states are actually doing better than that--look at Connecticut, which has already hit over 24% of their target (8,000 enrolled out of a target of 33,000 by 3/31/14):

      •  Problem with your figures (1+ / 0-)
        Recommended by:

        Connecticut has a population of apx 3.6 million people, or 1.15% of the US population. Meaning in order to meet its "quota" it must have a bit over 80,000 policies issued (not including medicaid), not 33,000.

        •  the "quotas" aren't the same percentage (1+ / 0-)
          Recommended by:

          ...for every state. Again, check the official targets:

          For Connecticut, they're targeting 33,000 out of 3.6 million, or about 0.9% of the state popluation.

          For California, they're targeting 1.3 million people, or about 3.4% of the population.

          For Texas and Oklahoma (deep red states, one large, one small), they're targeting 2.4 and 2.2% respectively, so it ranges.

          The interesting one is Vermont--Vermont has about 9% of the total population of 626,000 uninsured (about 57,000 people)...and the target is 57,000.

          In other words, the HHS Dept. has been hoping that Vermont (deep blue, moving towards single payer anyway) will have EVERYONE without coverage signed up by 3/31/14.

          Conversely, they far more realistically only expected Texas (6.3 million uninsured, 630,000 target) to have 10% of their uninsured covered by then.

          •  That actually makes things worse (0+ / 0-)

            I see that now, not sure what the basis is of having Conn expecting only half of the required average, but if Cali requires 1.3 million new policies - instead of the 847,000 figure I used doesn't that underscore my point?

            That the math just doesn't add up.

            And, while you can point at Connecticut, if their required "quota" is less than 1/30th of California's and California's numbers are anemic how can this be viewed as anything other than a prelude to the "death spiral"?  

    •  It's all one risk pool (0+ / 0-)

      Anthem doesn't care if you sign up on or off the exchanges. They just want their money.

  •  Wrapping it would have been nice, Paul. (0+ / 0-)

    Oh, and you left the price tag on.

    "The purpose of education is not to validate ignorance, but to overcome it" - Dr. Lawrence Krauss

    by AlyoshaKaramazov on Mon Nov 25, 2013 at 08:03:35 AM PST

  •  Any Kossack in California that enrolled... (3+ / 0-)
    Recommended by:
    imagiste, smirking, SixSixSix

    ...please contact me.

    I enrolled weeks ago through but have not received anything from the insurance company I selected.  I did call them but they are swamped it seems.

    Love teach and Krugman but they should have dug a little deeper.

    Daily Kos an oasis of truth. Truth that leads to action.

    by Shockwave on Mon Nov 25, 2013 at 08:04:23 AM PST

    •  signed up via CA exchange first weekend (2+ / 0-)
      Recommended by:
      Shockwave, divineorder

      Received packet three weeks later.

    •  I enrolled... still waiting too... (4+ / 0-)
      Recommended by:
      Shockwave, divineorder, ybruti, wu ming

      I enrolled on the first week, but my enrollment was affected by errors. It took CoveredCA over a month to mail me an update and that update was just to tell me that my SSID couldn't be verified and that I'd need to submit a birth certificate to prove my citizenship.

      It turns out that I accidentally checked that I was a naturalized citizen and once you check something like that, they don't let you uncheck it so my application was messed up. I abandoned that and started a new one. I got the update in about two weeks this time.

      The website again told me I would need a passport or a birth certificate because they couldn't verify my SSID, but when I got my confirmation letter a few days ago, the only thing I needed to do was pick my plan. Either the SSID error message was faulty or they manually connected the dots after my application was submitted.

      So now I'm waiting for Anthem to send me my bill for my January premium.

      Incidentally, I did check Anthem's site when I initially signed up the first week to see if they would offer the exchange plan on their own site. While going through their private market process, I experienced a lot of problems as well. It's not just the exchange sites that are screwy. A mega company like Blue Cross couldn't get it all right either in California.

    •  Call your insurance company (1+ / 0-)
      Recommended by:

      Call them up directly. They know whether they've processed your application. They might say, "We're still processing applications. Wait a week." Or they might say, "If you haven't heard from us, your application didn't go through. Try again." Either way, you'll get better information.

      •  Ooops, sorry. (2+ / 0-)
        Recommended by:
        Shockwave, divineorder

        Apologies, overlooked the part where you said you called them. My bad.

        What does it say on CoveredCA? Does it say Enrolled?

        •  It says that I completed my application (1+ / 0-)
          Recommended by:

          CoveredCA photo CoveredCA_zps2aa4a6d1.jpg

          Daily Kos an oasis of truth. Truth that leads to action.

          by Shockwave on Mon Nov 25, 2013 at 09:04:27 AM PST

          [ Parent ]

          •  Last week, Peter Lee, the director of Covered (2+ / 0-)
            Recommended by:
            denise b, Shockwave

            California, was in Fresno. Here's part of the newspaper report:  

            With only two decisionmakers for Covered California, issues get resolved quickly, Lee said.... Some of the decisions that Covered California made have frustrated consumers and insurers, Lee admitted.

            For example, California health plans did not receive any completed applications from the exchange until mid-November, he said. The delay was intentional: "That was absolutely a very conscious choice of sequencing our work load."

            ...The enrollment arm of the system has been taken down almost nightly for repairs to increase bandwidth and page-loading speeds, said Anne F. Gonzales, a Covered California spokeswoman. Link

            The spirit of liberty is the spirit which is not too sure that it is right. -- Judge Learned Hand, May 21, 1944

            by ybruti on Mon Nov 25, 2013 at 11:14:54 AM PST

            [ Parent ]

      •  PPACA (2+ / 0-)
        Recommended by:
        Shockwave, divineorder
         INDIVIDUAL AND GROUP MARKET.—Subject to subsections (b) through (e), each health insurance issuer that offers health insurance coverage in the individual or group market in a State must accept every employer and individual in the State that applies for such coverage.
         ‘‘(b) ENROLLMENT.—
         ‘‘(1) RESTRICTION.—A health insurance issuer
         described in subsection (a) may restrict enrollment in coverage described in such subsection to open or special enrollment periods....
        There is no (c)-(e) in my downloaded version.
         ‘‘(a) IN GENERAL.—Except as provided in this section,
         if a health insurance issuer offers health insurance coverage in the individual or group market, the issuer must renew or continue in force such coverage at the option of the plan sponsor or the individual, as applicable.
        •  They have to give the insurance to Shockwave (1+ / 0-)
          Recommended by:

          but others on this site have experienced problems and glitches where they thought they had enrolled, but somehow their application did not end up getting transmitted to the insurer, for whatever reason.  

          CoveredCA is working well, and it's likely that Shockwave will soon hear from the insurer. But Shockwave, prudently, wants to make sure that the application has reached the insurer.

    •  Same problem.... Waiting for follow-up (2+ / 0-)
      Recommended by:
      Shockwave, divineorder

      I applied for Medi-Cal through Covered CA, and it indicated I was likely to be accepted, and they'd follow up with requests for proof of residency/income. That was the first Friday in October. Have tried following up via live chat at Covered CA, but they keep saying Medi-Cal is going to follow up with me via e-mail.

      I'm trying to be patient. I understand they are probably dealing with a ton of new applicants. Still, though, I haven't been able to see a Doctor since I lost my job over a year ago. I have prescriptions I need to take, and conditions to be managed.

  •  The massive outreach for the ACA in California (4+ / 0-)
    Recommended by:
    divineorder, wu ming, fumie, Tonedevil

    is impressive. I saw the professionals at work on Saturday at a health fair which, according to the newspaper, ten or fifteen thousand people attended at the county fairgrounds. People of all ages were lined up for blocks to enter the fair, which had many attractions including health screenings. After people had their health needs evaluated they were asked if they had healthcare coverage. If they did not, they were led to an area where 25 social workers, each at a round table with a computer and paper applications, were ready to sign them up. Fax machines and printers were also available. The social workers expected to enroll many Medi-Cal clients, but were ready to help with private plans in the Covered California exchange too. It was all very efficient and wonderful to see.

    Also, on Jan. 1, 2014, they'll be adding 600,000 clients to Medi-Cal from the temporary Low Income Health Program which was set up in 2010 to help adults who couldn't qualify for Medi-Cal then, but as of 2014 will qualify for Medi-Cal Expansion. Link

    The spirit of liberty is the spirit which is not too sure that it is right. -- Judge Learned Hand, May 21, 1944

    by ybruti on Mon Nov 25, 2013 at 08:29:21 AM PST

    •  Here in one Florida library (2+ / 0-)
      Recommended by:
      ybruti, divineorder

      A rep sat for a few hours with no customer contacts made.

      The library manager made an announcement but no one came to see her.

      About a week later I overheard a conversation of a young woman seeking coverage who made a cell phone call from the library.

      They asked the young woman for quite a bit of information.

      •  I haven't seen anyone at the (0+ / 0-)

        Covered California events at our local library every Friday. They have had a large meeting room with nobody in it. That's why I was so impressed with the professional outreach at the fair.

        The spirit of liberty is the spirit which is not too sure that it is right. -- Judge Learned Hand, May 21, 1944

        by ybruti on Mon Nov 25, 2013 at 10:24:02 AM PST

        [ Parent ]

  •  Uninsured Motorist Statistics (0+ / 0-)
    States with the Highest Percent of Uninsured Motorists  
    Mississippi 26 %
    Alabama 25 %
    California 25 %
    New Mexico 24 %
    Arizona 22 %
    Tennessee 21 %

    States with the Lowest Percent of Uninsured Motorists  
    Maine 4%
    Vermont 6 %
    Massachusetts 6 %
    New York 7 %
    Nebraska 8 %
    North Carolina 8 %

    Reasons Cited for Not Having Insurance  
    Vehicle not in operating condition 24 %
    Can’t afford to buy insurance 21 %
    Premiums are too high 20 %
    Vehicle runs but is not being used 17 %
    Uninsured Motorist Statistics Data
    Percent of car accidents caused by uninsured motorists 14 %
    Percent of drivers who are uninsured 16.1 %
    Total revenue collected from uninsured motorist tickets $860.5 Million
    Percent of vehicles 15 years or older that are uninsured 40 %
    Source: Insurance Research Council, California Department of Insurance
    Date Verified: 4.28.2013
  •  Am fortunate to live in California (5+ / 0-)

    and have shared my experience with CoveredCA in posts before.  After the first few days, when the site was slammed, I was able to create an account, and then go through the process of signing up for health coverage.  

    Last week, I got a letter from Kaiser, telling me that I was almost completely done with my registration.  The last step?  Make my first premium payment by December 27th.  

    And that's how simple the process was for me.  As of January 1st, I will have Kaiser coverage, with low co-pays, no deductible, and best of all, no hassling with the insurance company over payments for services rendered.  (I'm going through a teeny hassle over getting my colonoscopy covered because of confusion over PCIP California (closed since 06/30/13), and the Federal PCIP program.)

    I am so thankful Jerry Brown is our governor, and actually governs, unlike his idiot predecessor.  And I'm so thankful that the Democrats have control of our state legislature.  

  •  Golden State nugget #2 (0+ / 0-)
    Approximately one out of every three drivers on California Roads today is uninsured or inadequately insured.

    These "uninsured motorists" typically drive the most unreliable and unsafe cars, and are the least careful drivers.

    Nearly one out of every two-car accidents is caused by an uninsured or inadequately insured driver.


    Uninsured (including underinsured) motorist coverage is a part of almost every automobile policy sold in California.
  •  CA single payer (5+ / 0-)

    The reason Krugman featured CA is because of the relatively high numbers of uninsured who are being covered.  There has been an active single payer faction in CA for over 25 years with legislation that has been passed, but vetoed by Schwarzenegger.  I believe the ACA allows states flexibility to create their own plans.  With time we may become a single payer state and a model for the ACA.

  •  We'll take California (2+ / 0-)
    Recommended by:
    chantedor, Code Monkey

    "There are two kinds of truth, small truth and great truth. You can recognize a small truth because its opposite is a falsehood. The opposite of a great truth is another truth." -- Niels Bohr

    by paxpi on Mon Nov 25, 2013 at 10:29:13 AM PST

  •  And as somebody who lives in California (4+ / 0-)
    Recommended by:
    ybruti, LillithMc, Tonedevil, Byblis

    I've even seen our local news, which tends to have a conservative slant because I'm in the heart of farmland-and-small-town Northern California, have some extremely positive reports on how Covered California is functioning--both the program and the website. They interviewed a bunch of people, all of whom were positive. Not to say that I haven't met some people grumbling about Obamacare in my daily life, but invariably those are people who haven't yet visited the website or checked out their options and think their rates are much higher because of those letters the insurance companies sent out bumping them into another, higher-cost plan. I've been doing my best to enlighten them.

  •  I believe he should have include WA State (1+ / 0-)
    Recommended by:

    We are plugging along doing fine. I feel so ever blessed that my insurance through the exchange will start Jan. 1.
    Have also paid my first month premium. Thank you President Obama..

  •  My county was bragging about a 30 second (1+ / 0-)
    Recommended by:

    wait to phone in and get registered.

    ...Son, those Elephants always look out for themselves. If you happen to get a crumb or two from their policies, it's a complete coincidence. -Malharden's Dad

    by slowbutsure on Mon Nov 25, 2013 at 12:13:52 PM PST

  •  ACA works well except where Thugs sabotague it. (2+ / 0-)
    Recommended by:
    Tonedevil, waterstreet2013

    The only reason the website suxs is it was never intended to cover 1/2 the country and 30 plus states... at least not with Congress refusing to fund any of it (which is exactly what Thugs did thanks to 2010).

  •  way to go Cali! Here in Wash. State I hear (2+ / 0-)
    Recommended by:
    Tonedevil, Byblis

    we are ranking #3 nationally in new signups.

  •  Not a disaster. A mess. Other more colorful (0+ / 0-)

    Terms akin to munged or fubar'd.

    But not as disaster.

    Thump! Bang. Whack-boing. It's dub!

    by dadadata on Mon Nov 25, 2013 at 04:55:20 PM PST

  •  What are the odds? (0+ / 0-)

    "The question is whether the mainstream media will dig below the surface and the rhetoric to tell the real story."

    I'd say there is no chance, unless it somehow involves a singer or actress who doesn't wear panties under her skirt.

    Warren/Grayson 2016! Yes We Can!

    by BenFranklin99 on Tue Nov 26, 2013 at 01:07:13 PM PST


    As soon as Obamacare gets a foot hold and if and when the White Republican Christians take control of both the Houses of Congress, they'll repeal a sentence of OBAMACARE and change the name to WHITEMAN HEALTHCARE, REPUBLICAN HEALTHCARE, CHRISTIAN HEALTHCARE OR RYANCARE (Paul Ryan).


  •  This may be a bit nitpicky, but . . . (0+ / 0-)

    Let's stop calling it Obamacare. It's used by the right as a pejorative. It's kinda like calling a woman a broad or a chick; there's no reason and it's really disrespectful. I would rather refer to it as the Affordable Care Act, or ACA. Just a thought.

    If the theories of Karl Marx have been so completely disproved, why are people still arguing with them?

    by crankycurmudgeon on Tue Nov 26, 2013 at 07:15:09 PM PST

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