A four-year slowdown in health spending growth could be coming to an end.Jonathan Bernstein:
Americans used more medical care in 2013 as the economy recovered, new reports show. Federal data suggests that health care spending is now growing just as quickly as it was prior to the recession.
"We're at the highest level of growth since the slowdown began," Paul Hughes-Cromwick, a senior health economist at the Altarum Institute, which tracks health spending. "You have to go back seven years to see growth like this."
More health spending can sometimes be a good thing: it might reflect more Americans gaining health insurance and seeking out needed medical care as the economy recovers.
But it also present challenges for the government. More than a quarter of the federal budget already goes towards health programs. That number could rise if health care costs started growing faster than the rest of the economy again.
Today, the biggest news about the Affordable Care Act probably is a Politico story that says insurance companies are becoming exchange optimists. It’s too early to predict, but it looks as though both large and smaller insurers are going to be more likely to jump into state exchanges than to leave them. That’s huge. The whole idea of the exchanges is to deliver the advantages of market mechanisms that were largely unavailable pre-reform. If this pans out, it would help bring down prices and encourage better insurance products.More politics and policy below the fold.
Meanwhile, a lot of buzz is being generated by a Census Bureau plan to change the way it conducts its survey on health insurance, a change that will make it harder to make pre- and post-Obamacare comparisons. Sarah Kliff has more. And Jonathan Cohn explains the Census's move in the context of all the ways the government assesses who has health care and who doesn't (the change affects only one of those methods, so we should be careful not to overstate its importance). My favorite take on this is Kevin Drum’s conclusion that the Census probably gave change is likely to give plenty of grist for Fox News conspiracy theorists:
The U.S. Census Bureau's decision to change its annual survey -- reported Tuesday by the New York Times -- drew the ire of Republicans and some nonpartisan health policy scholars, who complained that it would make it harder to measure Obamacare's effects on the uninsured rate.What's sparking the change is worry about producing bad data. The change will likely spark outrage and gnashing of teeth from Republicans, because they see conspiracies behind every tree and bush, but there's not much you can do to change that. That's because grievance is a favorite tool for their fundraising.
The fear was that the metric would change between 2013 and 2014, making it very difficult to discern the health care law's impact on insurance coverage. That would've been problematic. But the Census revisions, set for this fall, will measure data from 2013 onward. That means researchers will have a direct comparison from 2013 to 2014, the most critical period during which Obamacare's main coverage expansion took effect.
"We will still have an apples to apples comparison of 2013 vs. 2014 in the current [census]," Larry Levitt, vice president of the nonpartisan Kaiser Family Foundation, said in an email. He said the new Census questions are a more accurate indicator of insurance coverage.
According to the Times, internal tests involving the new survey suggested that the old survey was inflating the number of uninsured people in America.
Alex Seitz-Wald on Andrew Cuomo's growing problem with the Democratic base:
In the past month, liberal protesters outside Cuomo's office have dubbed him "Governor 1 Percent"; a prominent progressive activist has suggested that he run for reelection as a Republican; the head of a major labor union has called for someone to challenge the governor in the Democratic primary; and a series of behind-the-scenes feuds between Cuomo and other top Democratic officials have spilled out into public view.USA Today:
The proximal cause for the infighting during an election year, when parties typically put aside their internal differences, is the state's recently concluded, highly contentious budget process, which ended many Democrats' hopes for sweeping ethics reforms this year. On fiscal policy, Cuomo aides insist the budget is "very progressive," but the labor-backed Working Families Party, which endorsed the governor in 2010, is reconsidering its support this year, saying that Cuomo "chose inequality over progress."
Behind the scenes, however, tensions have been building for years.
"This is not a minor shift, but it comes after a slow burn that started in 2010 ... and finally just exploded in the past week and a half," says Bill Samuels, a New York City Democratic fundraiser and activist. "There was probably no one who liked Andrew better than me.… He lost most of us permanently. And I mean permanently. I don't have one friend who is a Cuomo supporter."
The political action committee created by former congresswoman Gabrielle Giffords and her husband to try to reduce gun violence raised more than $2.5 million in the first three months of this year.NY Times:
Americans for Responsible Solutions Political Action Committee had nearly $7.7 million in cash at the end of March heading into the election season, said Pia Carusone, executive director of the group.
The organization was created two years after the Jan. 8, 2011, mass shooting in Tucson that killed six people and wounded Giffords and 12 others at a Congress on Your Corner event.
Michael R. Bloomberg, making his first major political investment since leaving office, plans to spend $50 million this year building a nationwide grass-roots network to motivate voters who feel strongly about curbing gun violence, an organization he hopes can eventually outmuscle the National Rifle Association.Jonathan Capehart:
Mr. Bloomberg, the former mayor of New York, said gun control advocates need to learn from the N.R.A. and punish those politicians who fail to support their agenda — even Democrats whose positions otherwise align with his own.
“They say, ‘We don’t care. We’re going to go after you,’ ” he said of the N.R.A. “ ‘If you don’t vote with us we’re going to go after your kids and your grandkids and your great-grandkids. And we’re never going to stop.’ ”
He added: “We’ve got to make them afraid of us.”
Folks, today is one of those days I despair of our political discourse. Sahil Kapur of Talking Points Memo had no choice but to introduce to the lexicon “shoe truthers.” These misguided folks actually believe that Hillary Rodham Clinton staged last Thursday’s infamous Las Vegas shoe-throwing incident.Jay Rosen:
The Washington Post and the Guardian won the big prize: the Pulitzer for public service. There’s no prize for the network of journalists and newsrooms that brought the surveillance story forward.