Pick any Obamacare metric. There are people who dramatically overstate its importance, and other people who dramatically understate it (1/7)
— @sam_baker
That sounds like false equivalence, but it’s true. Every metric you’ve heard of matters in some way, but no single metric is decisive (2/7)
— @sam_baker
Total enrollment matters because that’s the whole point. Risk mix matters more for premiums -- which affect enrollment (3/7)
— @sam_baker
Health status matters more than age. Age still matters because no one knows health status. (4/7)
— @sam_baker
7.1M matters but isn’t the whole story. Unpaid premiums matter but law will remain stable. Uninsured rate matters but it’s only year 1 (5/7)
— @sam_baker
In Oct, partisan Ds hyped web traffic to excuse (temporary) failure. Now, partisan Rs hype data gaps to deny (incomplete) success (6/7)
— @sam_baker
If you’re obsessed with any one number, or if you’re dismissing any number out of hand, you’re doing it wrong. (7/7)
— @sam_baker
Preach it, brother Baker. Amen.
WaPo:
Louisiana Gov. Bobby Jindal on Wednesday announced a plan to repeal and replace President Obama’s health-care law, an effort by the Republican to insert himself into the increasingly competitive early maneuvering for his party’s presidential nomination.
In his 26-page plan, Jindal lays out a lengthy critique of the health law — which he refers to throughout as “Obamacare” — and reiterates his belief that it needs to be entirely done away with. In its place, he sets forth a bevy of ideas that have run through conservative thought for years, in some cases renaming them and in other cases suggesting new variations on old themes.
“There is a void out there,” Jindal said in an interview. “Consider this plan open-source code for Republicans, who are welcome to cut and paste from it.”
He meant copy and paste (which is what he did with other people's ideas), but Republicans can never resist cutting. But don't worry. On the central point, Jindal's all about repeal. This, from
Philip Klein:
“I absolutely do not think we can give up the fight to repeal Obamacare,” he said when I pressed him on that point. “That’s the attack from the Left obviously, that once you’ve given stuff to folks, once you've expanded a program, you can’t cut it back. If as conservatives we concede that, we’re done. We’re done as a country and we’re done as a conservative movement.”
Not really, but then again, Jindal is almost always wrong.
More politics and policy below the fold.
Jeffrey Young:
5 Things The Obamacare Enrollment Numbers Won't Tell You
How many people really signed up for health insurance?
The 7.1 million figure the White House cited may be too low. The raw number doesn't include all of the most recent updates from 14 states and the District of Columbia, which have their own websites and saw a flurry of activity leading up to the open enrollment deadline. Nor does it include the applications still pending at the exchanges. Also missing: those who will sign up throughout the year when they become eligible because of a major life change, like marriage or moving to another state.
People who bought Obamacare-compliant insurance directly from a carrier aren't counted either.
Confusingly, the 7 million number may also be too high: We don't know how many of those people took the crucial final step and actually paid their first month's insurance premium to lock in coverage. Based on anecdotal reports from individual insurance companies, Health and Human Services Secretary Kathleen Sebelius said 80 percent to 90 percent of consumers thus far had paid up. There also will surely be people who let their policies lapse during the rest of the year.
Lisa Aliferis has a great piece on Kaiser Health News blog about those who don't pay.
A new analysis finds that many people who signed up for a Covered California health insurance exchange plan are likely to drop the coverage for a good reason: They found insurance elsewhere.
Researchers at the U.C. Berkeley Labor Center released estimates Wednesday showing that about 20 percent of Covered California enrollees are expected to leave the program because they found a job that offers health insurance. Another 20 percent will see their incomes fall and become eligible for Medi-Cal, the state’s insurance program for people who are low income.
In addition to the 40 percent of enrollees who move to Medi-Cal or job-based insurance, between 2 and 8 percent of those who sign up for Covered California are estimated to become uninsured, the analysis noted.
This process — “churn” to those who study health insurance — is well-known in the Medi-Cal and individual insurance market.
According to the report between 53 and 58 percent of Covered California enrollees are expected to stay in a Covered California plan for 12 months. This analysis is consistent with a Kaiser Family Foundation study published earlier this year. It found that of people who enrolled in an individual insurance plan in 2010, years before the health law fully kicked in, only about 48 percent were still in the individual market two years later. (Kaiser Health News is an editorially independent program of the foundation.)
Drew Altman:
The Affordable Care Act's first open enrollment period has come to an end. The ACA is not out of the woods, but it is gaining some momentum, and the technological meltdown of October and November is behind it.
Yet there is a part of the law that is not at all working as originally envisioned, because the Supreme Court dramatically altered the structure of the ACA when it ruled that the expansion of Medicaid should be voluntary for states.
Since then, political and fiscal considerations have led almost half of governors and state legislatures to choose not to expand Medicaid. The result is an insurance system that makes very little sense: An estimated 4.8 million poor Americans in states not expanding Medicaid will fall in a coverage gap this year and get no help paying for insurance, while 10.1 million people in those states who earn more than they do can get tax credits to help pay for coverage.
Want to fix ACA? Start with expanding Medicaid everywhere.
It won't be easy. Staunchly opposed states like Texas will hold out the longest. The details will matter. Achieving an end run around the political polarization surrounding Obamacare, getting 4.8 million people covered, closing the equity gap and building a bipartisan foundation for the ACA will require proactive and pragmatic policy making that we haven't seen for quite some time, at least in Washington, but there are signs that the logjam may be beginning to break.
Peter Beinert:
How McCutcheon Could Come Back to Haunt the Republican Party
Just as liberal judges trapped 1970s Democrats in a "soft on crime" paradigm, conservatives on the Court will make it harder for the GOP to shake a reputation as the party of plutocrats.
Jonathan Bernstein:
Q: OK. What does that mean for the 2014 and 2016 elections?
A: Probably not much. For now, the contribution limits to individual candidates and formal party organizations are intact. It may mean that some money that would have gone to independent expenditures now moves to candidates and party organizations. It’s unlikely to mean more money in the system in general, or more influence for big money as opposed to smaller donors (or non-donors, for that matter).
