Obamacare

How the End of Obamacare's Open Enrollment Resets the Health Care Debate

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Whitehouse.gov

Sign-ups for private insurance through Obamacare were "on track" to hit seven million yesterday, the last official day of open enrollment under the law, multiple White House officials tell the Associated Press.

[Update: White House Press Secretary Jay Carney confirmed this afternoon that there were at least 7.04 million sign ups by the end of yesterday, and that the final number will be even higher once additional last-day enrollments from state-based exchanges are tallied.] 

The political narrative from here is easy to predict: a come-from-behind victory that many thought was doomed. But in many respects, it puts us right back where we started—with critics pointing out its problems, supporters touting its successes, with Democrats attached to the law and all its flaws, and with Republicans adrift, lacking unified plans of their own.

It's not clear exactly what the final sign-up totals are. Some reports suggest that the seven million mark has already been crossed, and that the final figure might be even higher once state-based exchanges are factored in. But even if the seven million sign-ups figure includes a few expected sign-ups through the special enrollment period that begins today for people who attempted to enroll but for whatever reason could not, it's clear that the last-minute surge in sign-up activity is huge. More people appear to have signed up for insurance through the health law in the last five days of March than in the entire month of February.

Actual enrollment will be significantly lower due to non-payment: Between 15 and 20 percent of the people who've selected a plan in an exchange, and thus been counted as a sign up, probably won't end up paying the first month's premium. Non-payment in later months will result in further attrition.

Even still, the end result will be far more robust enrollment than was widely predicted even just a few weeks ago. (Avalere, a health care consulting firm that's been tracking activity in the exchanges, predicted in mid-March that sign-ups would be just 5.4 million at the end of the month.) As a result, the potential problems associated with low national enrollment are unlikely to materialize.

The White House will no doubt tout this as a victory. But if anything, it reveals the goal-shifting rhetorical games the administration has played with the law over the last six months. In September, just before the exchanges launched, Health and Human Services Secretary Kathleen Sebelius said that success was signing up at least 7 million people for coverage by the end of March. By January, with a buggy website and enrollment lagging, White House Press Secretary Jay Carney was backing off of that claim, suggesting that 7 million had never really been the goal. But the celebrations today—the administration's top technology staffer literally broke out the champagne at 12:01 last night—make it pretty clear that 7 million really was the goal all along.

The administration also got the month-by-month totals wrong, which is one reason why few people expected a late-breaking sign-up surge of this size. Early projections by the administration expected that about 1.8 million people, or 20 percent of the total, would sign up in March. Instead, almost 3 million people ended up signing up in March.

Whitehouse.gov

Hitting the seven million mark is more of a vindication for the Congressional Budget Office (CBO), which initially predicted that about seven million would be covered through private plans in the exchanges this year. What we still don't know, however, is how well the CBO fared on two other important questions: What percentage of the people covered through the exchange are young and therefore relatively healthy, and what percentage of the people covered were previously insured? Early indications are that the exchange population may be older (and presumably sicker) and significantly lighter on previously uninsured beneficiaries than CBO expected.

To a great extent, then, this is all just an expectations game. Seven million sign-ups is a seen as a big, unexpected victory in the sense that, after wildly lowering expectations by botching the exchanges, the administration managed, at the last minute, to achieve its original headline sign-up goal. The law ended up doing at least some of what most people expected it would do.

So in some sense what the end of open enrollment does is reset the Obamacare debate. Critics who had problems with the law before the exchanges failed, and before sign-ups started to lag, will still oppose the law for most all the reasons they did for the three years when almost everyone assumed that of course Obamacare would expand health insurance coverage. Obamacare supporters, meanwhile, will keep supporting the law for all the reasons they did before.

It's the same old back and forth—but with one major difference. Now millions of people have health coverage through the law.

Yes, the coverage may be frustrating, and yes, some of those people, perhaps a very large percentage, were previously insured in the individual market. And some may drop their coverage by not paying premiums, or by opting out if rates go up next year. But what matters is that Obamacare is now the vehicle by which millions of people have health coverage. Very few of them are likely to want that taken away.

That will make the Republican message of repeal without a viable, coherent replacement much more difficult to sustain. This was always going to be a problem for the party, which has lacked a unified, coherent strategy on health policy throughout the Obama era. But the failure of the exchanges, and the slow start to the sign-up process, seemed to convince many in the GOP that it was a problem they would never have to face. 

I wrote about this a few months ago in a piece called "After Obamacare" for Reason's print edition. When I pitched the piece in September, before the exchanges crashed, I assumed that it was a problem Republicans would start to face before the end of  2013. But as I continued reporting through the end of October, when most exchanges were essentially non-functional, it became clear that the GOP had decided that there was no problem. Obamacare was failing, and that was all they needed to say. It provided them an out. As one House GOP staffer told me at the time, "There's just no appetite to lay out an entirely new agenda of ideas." The entire focus would be on "expanding existing criticism" and "continuing to bludgeon the administration" over problems with the current law. "If Republicans were interested in fixing health care, they would have been talking about it much earlier," the staffer said. "They weren't."

Obamacare's obvious failures gave Republicans an excuse to avoid the hard and divisive work of figuring out what sort of health policy they actually favor. But that excuse won't hold up much longer.

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  1. Since they fudge the numbers on everything and have been caught doing it with this program already, what’s the point of discussing this?

    Until we return to holding our overlords accountable for their lies, fraud, and other crimes and misdemeanors, we’re as well off counting angels on a pin.

    1. If they can’t fudge the numbers, they’ll just change the metric.

      1. I just don’t see the point in pretending that we don’t know that these numbers are highly questionable at best. Why not focus entirely on the fact that they’re lying and fudging the numbers? Surely that is the real news.

        1. Don’t worry. These will quietly be “unexpectedly” adjusted down next month. Just like my expectations of Suder-man’s alt-text.

        2. “Health insurance created or saved”.

        3. But most of the national media will not print the news if it undermines the Democratic narrative.

        4. That is all over the news. At least the conservative talk radio channels i listen to. I don’t watch Fox News by they play soundbites of guys like Charles Krauthamer saying these numbers are lies or that nobody knows the number that has actually paid, therefore has insurance. Or the fact that they have no idea who the people who have signed up are. They could ALL be those with pre-existing conditions or high risk pool for all we know. They don’t even bother to collect that information. Wonder why? Could be because they know that the answer could be really bad. But what do you expect from a program designed to attract the high risk at the expense of the low risk?

      2. Arguably the best response should be to compare whatever numbers they spit out against the 45 million uninsured that were the excuse for this heinous monstrosity.

        “Oh, really? One sixth? That’s what all this havoc and expense was about? Insuring a sixth of the uninsured?”

        1. All while totally fucking up everyone else’s coverage and healthcare. My deductibles doubled and my premiums went way up. And I’m not supposed to be the focus of this abomination in the first place.

          I am so sick of being a victim of this fucked-up government.

        2. They didn’t even do that. My wife and I know quite a few people that were forced onto the exchange because their company dropped their insurance.

          I’m gonna bet that the number of uninsured that signed up and actually end up paying is around 1.5Million.

          1. 1.5 million? Aren’t you the optimist.

          2. I have seen estimates, i forget where, that say about 70-85% of the 7 million have paid. Of course, these are kinda like exit polls where they asked the insurance companies in the exchanges what the real number should be. Grain of salt taken.

        3. Yep Mike, I notice very little discussion of that in the MSM. Very little meaning zero.

      3. They’re fudging all of us, why stop at numbers?

    2. How nice it must be to attribute every fact you don’t like to a conspiracy theory.

      1. Right. Never attribute to malice that which is easlily explained by stupidity…

  2. …the administration’s top technology staffer literally broke out the champagne at 12:01 last night…

    Staffer?!

    1. Well, no actual cabinet member knew what a computer even was.

  3. You can get dizzy watching those goal posts move.

    1. If you stand back, it’s a bit of a poetic ballet of goal posts.

  4. So is that Matthew Modine pirate movie really that terrible?

  5. Obamacare’s obvious failures gave Republicans an excuse to avoid the hard and divisive work of figuring out what sort of health policy they actually favor. But that excuse won’t hold up much longer.

    Let me get this straight, Peter. Do you think Obamacare will soon have no obvious failures?

    Also, anyone else noticing posting squirrels?

    1. Also, anyone else noticing posting squirrels?

      Are you using Firefox? Maybe the squirrels are making a political statement.

    2. Yes, the squirrels are after me again.

    3. I think he’s saying that, now that people are dependent upon Obamacare, it’ll be impossible to repeal without a popular replacement program. Like Social Security or Medicare. He’s saying that we’re stuck with Obamacare now because the Republicans suckered themselves into thinking that the law was so unpopular that people will beg for repeal. Problem is, the people the law was designed to favor now depend on it, even if it is a bad deal or bad for everyone else. That’s the whole leftist idea. The needy need it. Everyone else can go f themselves.

  6. Hitting the seven million mark is more of a vindication for the Congressional Budget Office (CBO), which initially predicted that about seven million would be covered through private plans in the exchanges this year.

    Assuming a 15% nonpayment rate, the CBO was only off by about a million! Vindication, indeed.

    1. I’d like to know exactly how much money the administration has paid to get whatever mystery number it has actually gotten to enroll.

    2. What I want to know is if the 7 million estimate was before they knew that 6+ million were going to lose their plans, if not, then 7 million is still a fail.

  7. The degree to which millions of people have insurance through the exchanges translates into actual support for the law depends on a few things:

    (1) How many of those millions were insured last year? Those folks aren’t going to be super-impressed by the fact that they also have insurance this year.

    (2) How many are going to actually be reasonably happy with their plan? Premiums, co-pays, deductibles, networks – there’s a lot in there that can piss people off and blowback against support.

    1. I am going to be one of the people in (1) in a couple of months. My COBRA runs out in June, and they won’t continue it as a private plan because it’s non-compliant with Obamacare.

      I’m one of their “success” stories.

      1. No, no, no, you can keep your plan, if you like it.

        1. Apparently, I didn’t like my awesome plan.

          1. You couldn’t have, since you aren’t keeping it.

      2. As I’ve posted before, I’m also one of their “success” stories. Funny how the only three people on the entire planet who were adversely affected happen to be posting on the same thread.

      3. Wow. You’re paying for COBRA? I can’t imagine having to pay those outrageous rates. That’s why I had an individual policy that was much much cheaper. Had.

        1. Same here. Funny how that happens.

          Wait wait, they did let me keep it. Yes, I can keep it until next summer you know, right after the elections. I get doubly screwed because everyone else at least got until 2016.

          And of course I’ll keep it, every other plan is 2x more expensive and the premiums and out of pocket are so high, I’d be paying twice the money for the privilege of paying for everything out of pocket.

      4. Playa

        Try this if you’re interested.

        http://www.libertyhealth.org/

        It’s better than Obamacare

  8. I actually tried to sign up three separate times over the past several weeks and the site was down each time. Oh well, I’ll pay the $95 annually or whatever.

    1. It’s 1% of your income, not $95. Next year it will be 2.5%.

      1. Isn’t it whatever is more? Which is usually the 1%

        1. Juice is assuming he makes more than $9,500 per year.

        2. So, people who refuse to get 0care are the 1%?

  9. I fail to see how backing over someone you’ve run over is fixing the problem. Maybe if government got out of the way health care wouldn’t be a shit sandwich in the first place? I say “maybe” but in fact the entire reason health care was fucked up was tax policy causing insurance to be tied to employment. So I’m being disingenuous by pretending there can be any skepticism about government’s being the cause of the entire problem.

    1. The high costs all originate from state laws that limit competition in healthcare delivery. State laws limiting competition in the insurance industry exacerbate the problem, but they are not the source.

      1. The costs “originate” from state laws but the state laws are not the “source”.

        Makes perfect sense.

        1. I think he is saying that the (state’s) limitation in healthcare delivery is the big problem.

          Limiting competition in the insurance industry is a lesser issue, but it exacerbates the bigger problem.

    2. I fail to see how backing over someone you’ve run over is fixing the problem.

      Corpses are generally no longer a problem.

      1. DEATH PANELS CONFORMED

      2. Depends on the body count…

    3. I fail to see how backing over someone you’ve run over is fixing the problem.

      This is why they’re mandating rear-view camera’s

      1. I thought those were so they’d have just that many more cameras watching everyone, always gathering evidence for who knows what bullshit.

    4. “I fail to see how backing over someone you’ve run over is fixing the problem.”

      This reminded me of my USAF days where an airman cut through a trunk of copper cabling about the size of your waist, thinking it was not in use – but it was. After he re-spliced the cables, he was given a medal!

    5. Yes, but insurance being tied to your employment IS a result of the gubmint. After WW2 it tried to limit wages and employers used benefits, like medical insurance, to lure workers. That’s how the employer paying for medical insurance got so prevalent.

  10. Am I wrong in noticing that throughout this piece, Suderman notes the problems that critics claim will lead to the death spiral scenario, but doesn’t mention the death spiral?

    Why shoud the R’s do anything when there seems to be a real possibility that this thing will kill itself?

    1. Because it won’t kill itself. It will turn into a massive tax suck to keep all those shitty new plans and heavily-subsidized recipients afloat until it is so obvious that it is a complete failure, the Democrats can push single payer.

      1. The fucking GOP better fucking kill this fucking law completely when they control fucking Congress next year.

        1. By the time the NeoCon – SoCon – libertarianish civil war is over, the survivors will envy the derped.

          1. Half a league, half a league half a league onward!
            Into the valley of derp rode the six hundred!

        2. They won’t. It might hurt somebody’s fealings and jeapardize someone’s reelection chances.

        3. I’m investing in popcorn.

          When 0care, and the rest of the welfare state collapses, worthless people will start killing each other in the street.

          1. Promise ?

        4. Ding ding ding. I think you just discovered why, as Suderman says, the GOP didn’t bother to do the work of coming up with an alternative. When you have something very unpopular to peg your opponents to, why kill it? Use it against them to win election. They proved it works down in Florida last week. Why kill the golden goose that is the Democrats’ marriage to Obamacare.

          They won’t be able to kill it even if they do take the Senate because Obama will still be president. They’ll probably just try to milk it for another 2 years to try to take the White House. By then, even more people will be dependent on Obamacare and it’ll be that much harder to repeal. They’ll probably just do what Republicans have always done with liberal welfare state programs. Find ways to make them last longer.

      2. I just want to say:

        Thanks suckers for working harder so I can get my premium reduced to what it was last year when my wife had insurance through her employer and we could actually afford it.

        And I hope the GOP kills this fucking thing with fire if they control Congress next year. (I’m not very optimistic)

        1. “(I’m not very optimistic)”

          I feel most of us on here arn’t.

        2. It’s funny. Had a contractor come to my shop and he was saying he can’t wait for a Republican president so they can kill Obamacare because it’ll save jobs and the economy will boom and all that. Not sure what would make him think Rs would follow through. Sure they say they are for repeal/replace (or just get rid of parts they don’t like), but 100 years of welfare state program experience shows us that Republicans are more likely to find ways to preserve Obamacare for future generations to ‘enjoy.’

  11. Thanks, Peter, for a well-reasoned and fair article. I think you are exactly right. There are still milestones to be reached yet, as you say, not the least of which is the number of “young” people who signed up. We will see.

    But your take on how the debate has changed is spot on. Previously, all you ever heard was “repeal.” Clearly, that won’t fly anymore. At best you would have “repeal and replace,” but I don’t think that will do either. Most people want the effort in keeping the law but improving it, and that includes not just a majority of Democrats, but also Independents and even over 30% of Republicans (according to Pew).

    Let’s face it…the ACA- in one form or another- is here to stay.

    1. I, for one, long for repeal. But I hold no illusions that it will happen.

    2. No it isn’t. The “ACA” is an abject failure, and one way or another it is going to go the way of the dodo.

      That which cannot be sustained, won’t.

      But why do so many equate obozokare with some immutable law of nature? It’s a ridiculously terrible law, just repeal the motherfucker and then repeal the rest of the laws restricting competition and “access” in healthcare and health insurance.

      1. Ridiculously terrible laws have a life of their own. Remember that terrible Patriot Act?

        1. Besides, undoing the damage will be like trying to solve a Rubik’s cube while wearing boxing gloves.

          1. I would pay my penaltax *and* sign up on a terrible website to see the ACA solved wearing boxing gloves.

            I pray they try to fix the ACA with boxing gloves. I think it’s a general problem with our legislature that we don’t fix enough of the grandstanding with a good right cross.

            1. They could call it either “the romp in the swamp” or the “brawl in the mall”.

              I’d buy that for a dollar.

      2. It will be repealed bit by bit until it’s nothing but a Medicare expansion.

    3. Let’s face it…the ACA- in one form or another- is here to stay.

      Absolutely not. The ACA’s supporters have been trying to change the terms of the discussion by begging the question from day one. That was the purpose of the whole “law of the land” trope. But look at what the law’s chief sponsor and architect has been doing since it passed. For something that’s supposed to be an immutable fixture of the American landscape an awful lot of it has been postponed or tabled.

      If the Repubs take the Senate–and I think that’s a fair possibility–I think it’s totally reasonable to expect a repeal of the law to move through Congress. Obama will veto, but then he has to explain why a law he refuses to enforce should nevertheless stay on the books. At a minimum, I expect that the ACA will be revised into oblivion if not completely eliminated.

      1. I do note that a few commenters here agree with you. We will see. I think that Peter, who has been a strong critic and advocate for repeal, has seen that things have changed.

        First it was that it never will pass, then it was that it was unconstitutional, then it was most people don’t like it, then it was the website can’t be fixed, then it was no one will sign up. And now? People won’t pay, and the young won’t sign up.

        The best that can be said is…we will see. But the critics have been wrong every step of the way. What Peter realizes is that a government program marketing affordable (guess we’ll see on that too) health care is a winner, as is a remedy to pre-existing condition coverage denial.

        Which is why this isn’t going anywhere, and whoever else is in office in 2016 will have to have at a minimum an alternative.

        1. First it was that it never will pass

          It barely passed.

          then it was that it was unconstitutional

          All hail Justice Roberts, king of selective interpretation.

          then it was most people don’t like it,

          They don’t, as most polls indicate.

          then it was the website can’t be fixed,

          It still doesn’t operate the way it was supposed to.

          then it was no one will sign up.

          Getting a large number of people’s insurance policies cancelled went a long way to encouraging them to sign up.

          But the critics have been wrong every step of the way.

          Apparently, so were the supporters, since there’s few aspects of the law that haven’t been changed since it was passed.

          1. You proved my point on everyone of those points other than whether or not people like it.

            Just today:
            http://www.washingtonpost.com/…..re-surges/

            49% like the law, and 48% don’t. And the trend keeps going that way.

            1. However, the parts which nail the majority of voters have yet to take effect. Wait until the employer mandate takes hold and millions who enjoy their company based insurance feel the pain.

              The show hasn’t even begun yet.

            2. My point is that one small step above utter failure is not resounding success.

              But sure, people love a law that is half-implemented and whose true cost has barely begun to be seen.

        2. Procedural tricks and back room deals aren’t exactly “passing” laws.

          It is still unconstitutional, just like the the law that was upheld by Wickard v. Filburn is still unconstitutional.

          For the time being, most people still don’t like it (if the polls are to be believed).

          The website is still barely functional and for some people still completely unfunctional.

          The intended number of previoiusly uninsured that have signed up is a complete mystery.

          And the last time I checked, a decent chunk of people haven’t payed their premiums and the early word is that the majority of signups were people already eligible for Medicare and mostly older people.

          The government hasn’t even been able to make health insurance more affordable so anyone that believes they’re going to make care more affordable is a fucking retard.

        3. I hope a Dem wins in 2016, then this atrocity can be shoved up their ass.

          Then we just inform them it’s established law and they’ll have to take care of it.

      2. His answer will be that over 7 million low income American families depend on Obamacare for their health insurance. To repeal Obamacare would mean that little Timmy and Suzy will be without coverage and won’t be able to see a doctor when they get strep throat or when little Jimmy breaks his leg playing football. Don’t you evil Republicans want little Jimmy and Suzy to rest assured that if they get sick, we’ll take care of them?

        I know. It’s stupid. But it works.

    4. “Let’s face it…the ACA- in one form or another- is here to stay.”

      This is horseshit.

      In Chile, they used to have a social security system like ours. They gave people the opportunity to opt out of it, and many of them did.

      Now they have a big problem with all the people who are stuck in the old social security system–and can’t get out.

      They’re suing to get out!

      There needs to be a private option. Someone needs to be given the right to refuse service to Medicare and Medicaid patients–not even through the ER.

      Hell, I’d favor moving to a system where the federal government funds stand alone ERs for the poor if that’s necessary. But why destroy the rest of the healthcare system for everyone else–just because you don’t want to fix Medicare and Medicaid because that’s politically dangerous?

      We don’t need to fix Medicare and Medicaid. We just need to allow for a private option.

      Then watch people clamor for what they want. This is like watching the mayor of New York close down charter schools–because they’re an embarrassment to public schools and the bureaucrats who run them.

      1. Well, here’s the deal, though. Nothing will happen until at best 2016…nearly 2 years. And it will just keep chugging along- more than likely with even more looking to sign up. I know most here still have confidence it will implode, but so far it doesn’t look like that.

        But anyway, 2 years more at a minimum, while it continues to work behind the scenes. Is Peter going to continue to write his twice weekly articles about how bad the ACA is? I doubt it. It will continue to recede in what America is talking about. And behind the scenes it will keep moving on.

        Anyway, I hope Peter won’t continue his blitz…it already was getting stale.

        1. The quality of our healthcare will deteriorate.

          The cost of our healthcare will continue to balloon.

          The choices we’re allowed to make for ourselves will continue to dwindle, and the choices bureaucrats make on our behalf will continue to grow.

          There will be rationing.

          And you don’t think we’ll still be talking about those problems two years from now?

          There’s a political cycle that at times is completely divorced from the economic cycle and the way things are happening the real world, but the real world and the way the economics of these things really work will reassert themselves. There will be major problems.

          And we’ll still be talking about them two years from now, absolutely.

          1. These things are happening in places with Nationalized healthcare systems and they love it. It seems people are thankful for what they have and don’t mind thinking about what they could have had. Normally a virtue.

            1. When a group of people are emotionally invested in an outcome based on idiology they will fight tooth and nail to get those outcomes even if they’re worse off afterwards.

  12. I am so sick of being a victim of this fucked-up government.

    “Doctor Obama can’t see you today. He’s playing golf with some very important campaign donors.”

  13. Absent some truly astonishing developments, here’s my predictions:

    (1) We never learn the truth about how many newly eligible (not “woodwork effect) people signed up for Medicaid under the expansion.

    (2) We never get a solid number on how many people lost their insurance last year due to ObamaCare.

    (3) We never get a solid number for how many people who signed up on the exchanges were uninsured last year.

    (4) Stories attempting to analyze the financial impact of the exchange plans on people get buried by the DemOp media peddling feel-good anecdotes.

    Against this background of ignorance, disinformation, and misdirection, ObamaCare is relentlessly promoted as a huge success. Gutless Repubs fail to pass repeal bills out of Congress. Reform bills turn into a massive clusterfuck of rent-seeking and bureaucratic expansion.

    (5) The exchange pools turn out to be fairly toxic, with 2015 setting up as the first year of a death spiral. This is prevented by massive applications of taxpayer money in the form of “risk corridor” subsidies and bigger premium subsidies.

    End result: ObamaCare, incredible as it may seem today, actually gets worse: more expensive to the taxpayer, with new layers of bureaucracy, more regulations, etc.

    1. Damnit RC, you just made my outlook of this cluster fuck even worse. Thanks a lot!

    2. “The exchange pools turn out to be fairly toxic, with 2015 setting up as the first year of a death spiral. This is prevented by massive applications of taxpayer money in the form of “risk corridor” subsidies and bigger premium subsidies.”

      There won’t be any hiding that.

      The public expenditures will be what they are and public.

      The insurers earnings will be what they are and public.

      I think United Health and Wellpoint report earnings for Q1 in a couple of weeks.

      In the meantime, Wellpoint, the biggest exchange participant, is asking for a “double-digit plus” rate increase in 2015.

      “Two months before health insurers must submit rate proposals for 2015 to government regulators, WellPoint Inc. (WLP) fired a surprising shot across their bow by predicting it may ask for “double-digit plus” increases.”

      http://www.bloomberg.com/news/…..cmpid=yhoo

      1. “…your premiums will go down.”

        That was ‘If you liked your plan’, though.

    3. And don’t forget that the Federal Government subsidy to expand Medicaid will phase out, sticking state governments with a huge bill that will require raising state taxes. That’s what a large chunk of the 7 million is.

  14. “But in many respects, it puts us right back where we started?with critics pointing out its problems, supporters touting its successes, with Democrats attached to the law and all its flaws, and with Republicans adrift, lacking unified plans of their own.”

    “Lacking unified plans of their own” is exactly the way things should be. In fact, I don’t want any politician from any party to have a unified plan for any part of the economy.

    So, yeah, fuck the Democrats and their unified plan, and the fuck any single Republican or any other politician that has a unified plan that involves me. I don’t want to be part of any politician’s unified plan.

    Oh, and while we’re at it, I’d like to opt out of Medicare.

    1. I was under the impression that the unified plan was to repeal the thing. That’s good enough for me.

      1. If the ACA is repealed, it would have to be replaced with something else. The GOP has no plan to do this. You can’t go back.

        1. “You can’t go back.”

          Who says?!

          And why go back when we can go forward?

          And why does it need to be a national plan?

          Why can’t we introduce a private option?

        2. Why not?

          1. Even if Republicans win every Senate race in 2014, they won’t have enough votes to override a presidential veto. To “repeal Obamacare” before 2016 would require Democrats to scuttle the thing they’ve dreamed of for 100 years.

            The only way Obamacare is going away is if Blue Cross files bankruptcy and Congress passes an “emergency” law to end private health insurance and replace it with government run health coverage, perhaps expanding Medicare.

            Once health care providers are being paid only by the government, there will be nobody left to “cost shift” the low reimbursements of Medicare and Medicaid onto. I wonder how US doctors will react to being paid $67 a month like their peers in Cuba.

            1. Even if Republicans win every Senate race in 2014, they won’t have enough votes to override a presidential veto.

              Hm. Do you suppose they’d have enough votes to impeach and remove from office a dishonest and dishonorable son of a bitch? Not that Biden couldn’t veto a repeal as well, but a successful impeachment might give him pause.

        3. Lol what? Why the Hell can’t we go back?

          “this should be good”

          1. “The children” – MSM

  15. There is not one scintilla of evidence that what they say is true, nor a single reason to believe that they would be telling the truth. In fact, given their history of transparent and atrocious lies, given that the website is essentially non-functional, that it is a little too convenient that march would end and they claim the number they were shooting for when nothing else has gone as planned, there is every reason to believe they are lying yet again.

    1. It doesn’t matter.

      The fundamentals are still what they are.

      How long did it take the Soviet Union to fail–more than 70 years?

      The important reasons to oppose ObamaCare was always the lack of choice, being able to make qualitative choices for yourself rather than have qualitative choices made for you by bureaucrats, the increased expense, and the lack of government intrusion in your life, the lack of access, the inevitable rationing, the impact it will ultimately have on the poor, etc., etc.

      The exchanges were one big bump in the road that made a lot of headlines; they weren’t even really a battle, much less the war. It’s not like the Republicans and libertarians were in favor of screwed up exchanges, and Obama and the Democrats overcame our opposition to having exchanges that function properly.

      This is the story of Obama’s struggle to survive and overcome the incompetence of his own administration.

    2. Weren’t they saying throughout October that they have no way of knowing how many people were signing up? And now they’re getting accurate, day-by-day numbers on the federal exchanges? Quite convenient!

      1. The NSA was probably willing to help them with a more accurate count… not so much interest in fixing the site.

  16. The bottom line is, the only way to keep the obozokare charade going is to raise taxes on a working population who are already being taxed out the ass, or to print even more money.

    Guess which is more likely to happen?

    Like I said, what cannot be sustained, won’t. Obozokare cannot be sustained, so they’ll print more fiat dollarz in the attempt to evade reality for a little while longer.

    It all ends with the abandonment and collapse of the US dollar. Justice does exist in the world, whether men choose to practice it or not; the avenger is reality. And when the dollar goes, so does statism, collectivism and leftoidism; they will go the way of all light timbers who cannot stand on their own weight.

    1. And when the dollar goes, so does statism, collectivism and leftoidism;

      Unfortunately, I think not – at any rate, I can’t think of any other example of a currency collapse that got rid of statism and authoritarian government. Generally it gets worse, although the particular players in power might change.

  17. “Critics who had problems with the law before the exchanges failed, and before sign-ups started to lag, will still oppose the law for most all the reasons they did for the three years when almost everyone assumed that of course Obamacare would expand health insurance coverage.”

    This was largely a media creation.

    My problems with ObamaCare were never about the problems with the exchanges; in fact, some of us have been arguing here for a long time that the problems with the website were a distraction.

    Malfunctioning websites got so many bad headlines, it’s hard to imagine why the Obama Administration would want that headache, but the fact is that now we get to see the system fail–when working as it’s supposed to.

    That’s what all those vile progressives fear most.

  18. the GOP had decided that there was no problem

    Relying on hope is easier than coming up with a strategy.

  19. It’s hilarious that they’re trumpeting this as some kind of massive victory. The administration has just proven that, with several years, numerous contractors, experts and government employees, and a ton of money it can successfully create a web-based form. I mean, seriously, they basically moved heaven and earth to recreate Hotels.com.

    If anything illustrates the blundering inefficiency of the government in accomplishing any given task, this does.

    1. “The administration has just proven that, with several years, numerous contractors, experts and government employees, and a ton of money it can successfully create a web-based form.”

      I agree with your general assessment, but, just for the record, a lot of those exchanges were fixed by the insurers themselves.

      Exhibit A:

      http://www.bloomberg.com/news/…..sites.html

      1. But I am not convinced that Healthcare.gov is “fixed” yet. AFAIK the back end is still not fully functional, so insurers are not getting accurate information, and enrollees cannot fix errors in their accounts except by faxing in a form that someone enters manually. And I don’t think the security issues are fixed.

        1. Most of the functionality they’re trying to get is already available to the insurers (and providers). There wasn’t anything new to invent.

          Your local hospital can enroll you in Medicaid. Your insurer can process your application online. The systems I QC’d had been running for decades.

          Sibelius and company tried to reinvent decades worth of evolved wheel in-house as much as possible because either a) she’s an ignoramus or b) she works for an ignoramus.

          1. Ah, but much of the back end involves connecting with scores of different databases at IRS, HHS, Homeland Security, Treasury, plus all the insurers, plus all the state Medicaid systems. That’s not trivial and I don’t think it’s done.

            1. We’ve already been doing that for years!

              I worked for a software company putting the payers and groupers together for hospitals in just about every state in the country.

              Okay, the IRS thing may be relatively new–to healthcare. (But checking someone’s eligibility for Medicaid isn’t–they’ve been doing that from the hospitals for people without insurance for decades).

              Also, you have to interface with the IRS database online to confirm your income during your FASFA application for student aid, too.

              There is nothing new here that hasn’t been done for decades.

              Nothing. All they had to do was some minimal integration and open it up to the public on a website. Only the government would think they needed to reinvent the wheel and do any of it in-house.

    2. What’s really fucking retarded is there were already at least a couple of websites where you could compare plans.

      1. What’s changed is “must issue” for individual health insurance plans without actuarial risk other than age and smoking status. Add to that the 3x limit on premium between young and old, which significantly cuts premiums for those over 55. None if that is part of the insurance exchanges or healthcare.gov

        I signed up directly with Blue Cross and they had no ability to deny coverage unless they stop writing individual coverage for everyone. I’m 58 and my Blue Cross went from what would have been about $1000 a month in the high risk pool I was in with a $5k deductible – to $511 a month with a $5500 deductible. The “subsidy” is not overt, it is implicit in the 3x rule and the “risk corridors”.

        I am on no medications and haven’t seen a doctor since 2010. My motivation is solely to avoid the hospital looting my entire net worth if I wind up in the ER with a splinter.

  20. But the critics have been wrong every step of the way.

    [citation needed]

    I suppose, “Not even those jackasses on the Supreme Court can find a way to let this stand” counts as being wrong, but still….

    We have yet to see evidence in the world outside Obama’s head of actual covered care which is better or cheaper(!) than what was previously available.

    1. See kbolino’s response to me above. In trying to refute it, he only proved it.

      1. Umm, no.

        The only way you can pretend those were refutations is if you choose to define those arguments as wrong even if they are 99% true, while forcing ACA apologists into no such straight jacket.

        For example, the website works..for some. That means the website doesn’t work, unless you are dishonest.

        Another example is the constitutionality argument. The law, as it stood, was by definition, unconstitutional. Why do you think the USSC changed it to a tax? To give it the patina of constitutionality! This is well documented and quite indisputable, even for a cretin like yourself.

        Your other points can be similarly destroyed, but I think this is enough for now.

        1. The ruling stated that people can not be compelled to purchase things by government. The Obama admin didn’t even argue it was a tax.

        2. When the website did not work, few were signing up. Now that 7M have signed up, it works. And whatever problems it has will get fixed. Websites never work 100% of the time for anyone.

          You THINK the law is unconstitutional. The Supreme Court ruled the law IS constitutional.

          The gap between the two is big enough to drive a truck through.

          1. They ruled it’s constitutional as a tax. Not as a penalty. Words have meanings, Jack an Ass.

            1. Are any and all taxes constitutional now just because they are a tax?

      2. The only thing I proved was that supporters of the law can’t shift goalposts fast enough to make themselves look good.

  21. The “sensible” proggie at work admitted that 7 million was a deliberately set low bar so, while victory dances in the street may be enough for the unwashed to feel good, the truth is: it proves the penalty tax is way too low and the subsidies for those who can’t afford health insurance is way too low. Solution: more taxes on the rich to subsidize the poor who can’t afford even $1 per month, and sock those who can afford it but won’t sign up with huge penalties that account for the missing premiums. “Hey you don’t see people failing to sign up for social security do you?” End game of course is
    Universal Medicare.

    1. More likely it will be more taxes on the middle class rather than the rich; that’s who usually pays for this kind of crap.

  22. But what matters is that Obamacare is now the vehicle by which millions of people have health coverage. Very few of them are likely to want that taken away.

    Shit into one hand. Want into the other. See which fills up first.

    1. Just grandfather in the “successes”: “If you like your Obamacare, you can keep your Obamacare.”

      1. Lol. Good one!

  23. This was always going to be a problem for the party, which has lacked a unified, coherent strategy on health policy throughout the Obama era.

    I, Senator Paul., propose major reforms to our current conceal carry laws in the United States. The system is broken, and it’s a hodge-podge of rules varying from state to state, jurisdiction to jurisdiction. Keeping and bearing arms is a right. It’s a right every American should have. The goal of my reforms is to insure that every American among the fifty states shall be able to receive a conceal carry permit on request, as long as they are eligible to own a firearm. The permits will be administered through state exchanges, and will enjoy 50 state reciprocity. The time has come for this long awaited reform to be realized.

    Democrats: Wait… what? This is bullshit, this reform is… not necessary and… what now? How is this going to fix… how are the exchanges going to be built, how are we… wait… fuck… no!

    Media: Sen. Paul. (l- Washington) has proposed major reforms for conceal carry permits at the federal level. The Democrats have yet to propose any meaningful, coherent plan of their own to allow 50 state conceal carry.

    1. I came.

  24. I just saw a clip of Obama bragging about the 7 million sign ups. He actually had the audacity to state that this great success came without any kind of hard sell on his part, unlike the billions that critics spent criticizing obamacare.

    1. Obama is an arrogant son of a bitch, if he is anything.

  25. Honestly, I don’t think Obama was very audacious at all. He should have claimed 70 million people signed up. Who’d challenge it? The liberal media would question it but then drop the subject. Nobody ignorant enough to understand it was bullshit listens to conservative media, and people would just move on to the next story.
    Tell your friends: “70 million people signed up!”

  26. Would repeal require that we cancel their insurance?

    1. Of course it would. Or, you could tell them that the insurance companies can once again drop them, set a cap, not take them for pre-existing, etc.

      Also, the rest of the USA (310 millions) would lose the benefits they have such as your kids being allowed to be on policies longer, etc. etc.

      In other words, we’d go back to the 10% plus per year increases, the vast number of people underinsured or not insured at all – and the horror stories of people being dropped because they had the audacity of having been born with a tendency toward a disease.

      Anything goes. That’s the “free market”.

      You are going to have a lot of angry people – and not just those 7-10 million, if this law goes away. You will also vastly increase the deficit and debt, as health care is what drove us into this hole.

      Not good.

      1. “we’d go back to the 10% plus per year increase”

        Care to revisit this once the insurance companies raise their rates to cover this debacle?

      2. Of course it would.

        The insurance doesn’t have to be cancelled, but it’s unlikely that most people want to pay for things they don’t need.

        Or, you could tell them that the insurance companies can once again drop them, set a cap, not take them for pre-existing, etc.

        Yeah, it’s crazy how $100/mo of insurance doesn’t buy you $1000/mo of care.

        Also, the rest of the USA (310 millions) would lose the benefits they have such as your kids being allowed to be on policies longer, etc. etc.

        Yes, every single one of the 310 million people in the USA are under 26. And I’m sure no insurance company would ever sell an affordable policy for a healthy young individual.

        we’d go back to the 10% plus per year increases

        You ain’t seen nothing yet. Ten percent per year is going to look like a handout compared to the penury we’re headed for. And I wonder why insurance companies were raising their rates? Oh I’m sure it’s those evil greedy profits again and has nothing to do with externally imposed costs.

        the horror stories of people being dropped because they had the audacity of having been born with a tendency toward a disease.

        Yes, the horror stories of people wanting levels of care far in excess of their ability to pay for it.

        Anything goes. That’s the “free market”.

        Yeah, and this cowboy shitshow rodeo is nothing but order and efficiency.

        1. “The insurance doesn’t have to be cancelled, but it’s unlikely that most people want to pay for things they don’t need.”

          Do you know how silly this sounds?

          Here’s an example.

          You buy life insurance – but, you decide you “don’t need” covered for the possibilities of:
          1. A plane falling out of the sky and hitting your house.
          2. A truck crashing into you while you are walking.
          3. Certain forms (you choose) of cancer.
          4. Fire – since you know you have smoke detectors up to date, etc.

          Your point is not worthwhile of a “reasoned” counterpoint. Insurance is the pooling of risk. While it’s unlikely a 60 year old man is gonna get preggy, he has to pay for others – just like they pay for his prostate cancer even though they are unlikely to get it.

      3. You are going to have a lot of angry people

        Yep, it’s totally fine to give people welfare forever and ever because they might get angry if you stop. Taxpayers are totally not being held hostage here, not at all.

        You will also vastly increase the deficit and debt, as health care is what drove us into this hole.

        Yes, by spending less we will increase the deficit. Medicare and Social Security are just the boogeymen of right-wing nutjobs.

        It’s government health care that drove the government deficit. To say that we have a high public debt because of private health care is not just ludicrous, it’s mendacious.

  27. So here we are and Obamacare turned out exactly like us right wing nutcases predicted it would. Let’s summarize the lies and disaster of the rollout.

    People massively lost their insurance. Huge amounts of people in every state were told that they could keep their plan when in fact they couldn’t. And let’s see what the Progressive’s answer to this lie is: “Not uh.” Brilliant Pelosi.

    Premiums have gone up for anyone with a decent job. Huge increases. And forecasted next year to go up even more to pay for the less successful or those who don’t work at all. Pelosi’s answer? “Not uh.”

    How’s that website enrollment? Smooth as the U.S. Post office, Barry? Actually the Post Office is going bankrupt and your enrollment protocols have been a disaster. Your answer? “Not uh.”

    ACA. Completely unable to sustain itself. Youth doesn’t think you’re nearly as cool, Barry, once they realize they have to pay more so someone else pays less. Again let me hear your response?
    “Not uh.”

    ACA may very well end our economy as my fiction predicts if someone doesn’t admit out loud that the emperor has no clothes. Then again, maybe that was Barry’s intent in the beginning.

    Charles Hurst. Author of THE SECOND FALL. An offbeat story of Armageddon. And creator of THE RUNNINGWOLF EZINE

    1. Of course it came out exactly as you said. There is absolutely no way, not matter what reality is or was, that it could be any different.

      BTW, I’m happy for the post office. Priority mail is much cheaper and quicker than UPS or Fed Express. Sometimes 1/3 the price.

      BTW, just for your continuing education, ALL insurance means that you pay for others. That’s the whole idea. Very few people hang around to take advantage of their life insurance. And very few people are happy when they get their monies worth because they have a bad case of cancer.

      Look up insurance. Study it. We have actuaries in our family – it’s all about paying for others. That’s the whole idea.

      I’ll bet you have insurance of some type. If so, I’m either paying for you or you are paying for me.

      1. “I’ll bet you have insurance of some type. If so, I’m either paying for you or you are paying for me.”

        And how much of that did the state MAKE you buy? And don’t trot out any tired bullshit about the insurance you must have to drive.

        1. Silly arguments – all.

          The “state” makes me buy clothes with their silly rules that I not walk about naked. They make me pay for the police, national guard, military and thousands of others things which I may or may not use.

          Please. Let’s talk more once you can make a reasoned point.

      2. If so, I’m either paying for you or you are paying for me.

        So because people were voluntarily doing this, therefore it’s totally okay to compel them to do it?

        I do not begin to understand how people voluntarily resolving problems is justification for coercive state action.

        1. I don’t remember volunteering for property taxes of any sort, for car insurance, etc…..

          I didn’t even volunteer for sales taxes, gas taxes, etc. – I am being forced into them. You could argue that I don’t have to drive or live anywhere, but that’s a hollow point.

          The “being forced” issue simply does not hold water.

  28. Why would those who made up their minds already be so concerned about the metrics?

    For those with “reason” – here’s 317 million reasons you may want to support health care reform in this country….
    http://www.cnn.com/2014/03/31/…..?hpt=hp_t4

    I live in MA-which effectively has had the ACA for many years, signed by the GOP Prez candidate of 2012.

    98% of our citizens are covered. We have the best health care in the nation.

    I have been paying 100% of my own insurance and deductibles for decades – it’s not any different now. The ONLY differences are:

    1. My son was on the policy a few extra years
    2. now covers vast amounts of preventative care
    3. Electronic records-much easier.
    4. No caps
    5. No problems with pre-exiting
    6. A more “results and science based” approach
    7. More community based health initiatives for those of limited income

    No one of reason could be against those things. When I speak to most of my “conservative” friends, they usually agree that most of them are great!

    So, why the venom? Simple. People aren’t reasonable. They are ideologues and easy to convince using propaganda.

    They want the ACA to fail so they can rework BUT take credit.

    Trying to convince a reasonable person that universal health care and “skin in the game” health insurance is crazy just won’t cut it. You’ll have to come up with more “reason-able” stuff like the faked moon landing.

    1. We have the best health care in the nation.

      Citation needed

      1. Read a bit about Mass General Hospital, Harvard, our Biotech industry, etc.

        Example – MGH 2nd best hospital in the USA.
        http://www.cnn.com/2013/07/16/…..index.html

        I’ve lived in TN, in WV, in PA, NJ and other places. Believe me, I’ve never seen anything like Mass. General – same goes for other famous Hospitals in Boston.

        Our biotech industry is the 2nd biggest in the country, after “liberal” california.

        Sure, there are a lot of factors involved. But I from my 60+ years of experience, it’s the best around.

        Could it improve? Yes.
        Are there other good hospitals? Yes, many….John Hopkins, Mayo, others too.

        But in our case, these facilities are available to anyone. That’s a big deal. I know a very poor person who had a terrible accident and was taken care of at the best hospitals and rehab facilities in Boston.

        That simply doesn’t happen everywhere.

        Just the fact of 98% covered – combined with the low rates of STD’s and other conditions prevalent in many states – make MA the 4th healthiest state in “official” measurements.

        “Free” states like TX. are 36th, etc.

        Again, if we are looking at a mag called “Reason”, we should use some. No one can say the ACA is not effective in MA because it simply is. That’s a fact.

        1. So Massachusetts General was some backwater shithole hospital before RomneyCare came in and made it great?

          Oh and you have some anecdote about a poor person getting great care. It’s a real shame that all the charity hospitals mysteriously disappeared, but now thanks to RomneyCare, everybody can be glad that there’s a small chance they’ll be chosen as a political showpiece and get better care.

    2. With all due respect CraiginMass, you’re deluded. Longest wait-times for an appointment in urban areas? BOSTON of course! At almost TRIPLE the wait-times of other large cities. It is far higher than prior to the Mass. Romneycare was passed.

      http://www.washingtonpost.com/…..18-5-days/

      You liberals have a very loose understanding of human nature and economics. If Romneycare and Obamacare are so obviously good for everyone, why do you have to put a gun to the rest of our heads in order to implement it? Because it isn’t is the simple answer. Sure, everyone may be ‘covered’ under Romneycare, but the level, quality, and certainly timeliness of care have all gotten worse. You cannot simply pass a law that McDonald’s will serve a better burger, cheaper and faster and make it happen! Has forcing people to buy car insurance in any state led to much cheaper rates? no. Would forcing everyone to buy a McDonalds hamburger magically raise the quality and lower the cost of a burger? NO…

      talk about your ‘faith-based initiatives’… there is nothing more faith-based than a socialist cause which violates the basic laws of economics and human nature and claims to overcomes these mere barriers with the stroke of a pen and by putting a gun to fellow citizens head 🙂

      1. I lost my other reply – but not just that – it’s bankrupting the state. A google search for MA health care budget costs returns article after article discussing the need to reign in costs.

        So yeah, apparently “successful” in craig’s mind meant unworkable, unsustainable program.

        & I’m unsure what about any unsustainable program should be counted as success since it’s all a temporary illusion – if it cannot sustain itself, it will die; whether MA, craig, Obama, Romney, or anyone cares, reality will prove that the light they are seeing isn’t the end of the tunnel, but the headlamp of the oncoming train.

        1. Ha, you can use google to find anything you want! That’s a joke – but there is simple proof of what the truth is.

          First, you cannot doubt we have the highest percentage of people covered in the US.

          The doctors in the state like it. The other health care orgs in the state like it.

          The PEOPLE in the state like it – and crow all you want about “liberals”, somehow we actually elected Romney as well as a number of other Republicans including Scott Brown – both darlings of the right.

          The most highly education populace in the country – which also has among the highest incomes per capita – LIKE ObamaCare (romney care, same thing).

          You embody what I mean by “mind made up”. Instead, you google for “facts” and think that they have it right in the states with the most disease, poverty and ignorance. That’s backwards bizzarro world.

          The USA was the only advanced country in the entire world without a plan. Now we have one. It’s not perfect – but what action of mankind is? Name one.

          As the man says in this and other articles – state your case. The GOP and the haters can’t name what their policy is other than “let ’em die” and “make sure the corporate-medical-insurance” complex can rake people over the coals when they are most susceptible. Raw capitalism simply does not work with health care because, in theory, you could make a billionaire sign over every cent he has if you can save his life. It’s basic reason. You have to have controls, which is what the ACA does.

          1. Electing Romney and Brown doesn’t prove MA isn’t “liberal”, it proves it is. And it doesn’t matter who “likes” it or how many are “covered”, it doesn’t pay for it self.

            1. Wouldn’t matter if it did pay for itself – it’s still tyrannically immoral.

              1. It’s immoral to care about public health but moral to “let en die” on the side of the road?

                Fantastic.

            2. Wouldn’t matter if it did pay for itself – it’s still tyrannically immoral.

          2. That’s a joke – but there is simple proof of what the truth is.

            In other words, you’re going to ignore every point you made and throw up irrelevant shit, hoping that it distracts stupid people long enough to forget the original purpose.

            The most highly education populace in the country – which also has among the highest incomes per capita – LIKE ObamaCare (romney care, same thing).

            Yes, Massachusetts magically became filled with rich, smart people thanks to socialism.

            The USA was the only advanced country in the entire world without a plan.

            What is the HMO Act of 1973, Alex?

            As the man says in this and other articles – state your case.

            Whereupon you will ignore it or otherwise deride it as not meeting some arbitrary criterion that you get to pull out of your ass to frame the debate.

            1. … you’re going to ignore every point that was made …

      2. Picking out “facts” to prove your made-up mind is not really reasoning. You failed to quote the article where it said “Even Boston, which has eye-popping wait times, has gotten better. The city’s average wait time dropped”

        Secondly, you are cherry picking. You can find whatever numbers you want, but folks here live longer and have better health than most other states (we are #4 in health). Infant mortality is low, so are many other diseases which are the result of poor medical care.

        ALL insurance could be construed as “socialism”, while all predatory behavior could be called “capitalism”. Neither is true.

        We know how the “Republican” plan works- that can be found in the last two decades. No one of right mind thinks that the costs, the increases, the uninsured, the horror stories, etc. can go on.

        Somehow folks like you think it’s OK to prey on the population as a whole…that is, charge them ridiculous prices and/or even deny them life saving care – because they are not wealthy.

        It doesn’t make any sense.

        The day y’all stop throwing around ridiculous “socialist” crap is the day you may start to get listened to by “reasonable” people. But, as of now – when the Republican Prez Candidate signed the first Obamacare law – the right has very little leg to stand on.

        Someday, mark these words, the right will try to take credit for universal health care in this country…if they don’t, they are history.

    3. Please tie #6 to the Masshole version of the ACA.

      Cite your work.

      1. Uhhh……like my doc telling me that doing the PSA or digital rectal exam now proves little, so unless I insist, he won’t give it?
        Or like the same with the old tube up the ass (scope), which I’ve had done twice or three times, and the docs who did it want to schedule me again, but my primary says no way it’s needed?

        In other words, proven science and medicine are being used to educate patients about their health – so they don’t simply use and abuse the system costing us all money – for results which are unproven.

        They paid 100% for my shingles vaccine because it’s proven that it helps prevent pain in the future.

        Some of these are due directly to RomneyCare, but many are improvements which we made in the last couple of years based on being as good or better than ACA (things such as free physicals, etc. having to be included as well as other preventative care)….

        That’s science. It’s a fact that a penny in time saves nine. Hopefully you don’t need “proof” that preventative and/or early care is preferable to treatment of conditions which have become acute.

  29. Something that hasn’t been mentioned in all this debate over the numbers is what the pattern of enrollment tells me. Why has there been a sudden surge of enrollments at the 11th hour?

    If I started a one week promotion to give away free gold coins, am I more likely to run out of gold coins on day one or the last day of the give away? The difference is clearly in perceived value. If Obamacare was truly providing the exceptional value that the libs claimed wouldn’t people have signed up more heavily at launch then waiting until the deadline passed? The fact that many people waited until the last day to comply with the law tells you that people are doing it out of forced coercion and not because they perceive any value in signing up.

    If someone stands to get a refund from their tax return they file early, if they are likely to owe, they wait until April 15th; basic human nature, incentives matter.

    Instead of attacking the numbers of who has signed up, the fact that they have to threaten people with fines and penalties to get people to sign-up for something that they sold as good for them is the real story no one is talking about. Most people have avoided signing up initially cause they know it is a useless scam with very little value for the average person.

    1. I was in sales and marketing much of my life and I often ran promotions which went on for two months or so.

      We usually sold as many units the last day of the sale as we sold the 2 months before.

      Just saying……no plot here. Just an attempt to promote people having “skin in the game”. It’s strange seeing the same people who made up that “skin in the game” thing now saying they are against it. They’d rather people NOT have skin in the game and have me and other taxpayers pay for the losers. Not me. I want everyone in the pool to the extent they can be.

      1. If you are a taxpayer, you are still going to be paying for the “losers” as you call them. Where do you think subsidies come from? Who do you think pays for the Medicaid that the “losers” will have to sign up for?

      2. Anecdotes!=data.

      3. It’s strange seeing the same people who made up that “skin in the game” thing now saying they are against it.

        It’s strange seeing people accuse us of not supporting things we don’t support, as though that’s surprising somehow.

        Maybe, just maybe, and I know this is crazy, you’re not as smart as you think you are and actually have to involve your opponents in the discussion, instead of pretending you know what they think.

        They’d rather people NOT have skin in the game and have me and other taxpayers pay for the losers.

        It’s amazing how you can break my leg then blame me for it. The government created this problem by mandating this and that without bothering to account for how to pay for it. Get rid of the mandates, and then you won’t have to pay for other people.

  30. “When there’s no clear option, it’s better to do nothing.” ? Erwin Rommel

  31. Obviously, the people of this country were finally enlightened by the basking glow of their/our betters, the all-knowing cherished wonderful leaders that care only for our well being.

    Nevermind the odd timing of the number surge – spiritual epiphanies are the work of the holy ones.

    1. Oh, I thought the Spirit World was only relevant on the “reason” able side of the aisle.

      Why not ask Nancy Reagan? She and ronnie were big time into numerology and astrology. Maybe the moon or the tides caused a surge?

      1. Why not ask Nancy Reagan?

        I’ll be sure to bring it up with her at the next meeting of the right-wing circlejerk that happens in your head.

  32. The number is 7 million. The number has always been 7 million…

    We are at war with eastasia, we’ve always been at ware with eastasia.

  33. I’ll believe it when the news comes from somewhere other than the White House. Why is that, I wonder??

    1. ‘Cuz if you like your healthcare plan and your doctor, you can keep your healthcare plan and your doctor. Period.

  34. I don’t see many people paying attention to what was said here: a whole lot of people have accepted the fact that they will buy insurance through the exchanges & changing that will be nearly impossible in political terms. The GOP has to face up to the fact that they can’t repeal, but they can alter the ACA.

    Pretending that the cost of health insurance wasn’t going up long before Obama ever announced he was running for President, is ignoring reality. Pretending that letting the cost of healthcare eat up our GDP is ok, as long as it’s not the government paying the bill, is ignoring reality.

    1. Pretending that a serious loss of liberty will prevent the cost of health insurance or healthcare from increasing or eating up the GDP is also “ignoring reality.”

    2. It was going up much faster and people were being dropped from the rolls for almost nothing. Lots of years during the Bush admin there were 10% plus raises per year.

      The “liberty” talking point is really a bunch of crap. I have a house. I must pay taxes to fix the potholes in my town even if I don’t drive.

      The same righties who yelled about “people should have skin in the game” (isn’t that libertarianism?) now think “people should mooch off others when they get sick”.

      You couldn’t have made up a story with such a big about face. I want to think “conservatives” believe in something, but when they never like the practice of what they preach, it’s hard.

      When cornered – as in this debate – they throw out some of their big words.
      Liberty
      Constitution
      Socialism

      as if they have an idea what they really mean. After all, we know that 50 million Americans now (the far right) must be qualified to sit on the SCOTUS and decide what is and what isn’t.

      For some reason you never heard those words out of their mouths when Bush was invading Iraq, giving tax breaks from deficit and letting the economy self-destruct. No….(apologies to perhaps the 5% of conservatives who opposed the wars).

      1. For some reason you never heard those words out of their mouths when Bush was invading Iraq, giving tax breaks from deficit and letting the economy self-destruct.

        READ THE ARCHIVES OF THIS WEBSITE.

        Seriously, read them.

        You fucking mendacious shithead.

    3. Pretending that Obama has reduced the cost of health insurance, even the rate of increase, is ignoring reality. Obamacare amounts to a series of price controls, taxes, and other manipulations that make the health insurance market less efficient. Not all cost is measured in dollars and sense. Some is unemployment or underemployment. Some is debt. Dead weight loss. Obamacare could only make things worse.

  35. “Obamacare’s obvious failures gave Republicans an excuse to avoid the hard and divisive work of figuring out what sort of health policy they actually favor. But that excuse won’t hold up much longer.”

    Perfect last statement. Couldn’t agree more.

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  36. The 7 million sign up totals (meaningless without knowing how many were previously uninsured, and whether the young are buying into the scheme) can’t quite make up for the fact that the public increasingly witnessed warnings by the center right opposition come true – the terrible website, rising premiums and deductibles, limited choices, etc.

    The next stage of the ACA will involve people actually finding hospitals that takes new medicaid patients or offer benefits and services. The prospect of crowded hospitals and long waiting time are a popular argument against socialized medicine.

    I frequent free clinics and such all the time, and I can’t imagine the Latinos and the low income folks tolerating slowdowns in their hospitals. And if I’m paying 300 bucks a month for insurance, I’m driving up to UCLA medical center or somewhere where people know what they’re doing. Others will follow suit.

    1. And what is your point?

      Read the article again. It’s not about being a monday morning QB, but about whether the right had or has a true plan which works better.

      These things must be compared with the status quo. Health care costs have stopped going up as much – cut by about 1/2 or more in terms of price increases. Families are able to keep their kids on their policies longer. Pre-existing conditions are not turned away. No caps. Preventative care is included….

      Most of these things are already in effect – so the exchange signups are really just one part of the whole. Hundreds of millions of Americans are already enjoying the other benefits (insurance companies must pay out at least 85% of what they take in, as well as the stuff mentioned above).

      It’s always easy to be a critic. But what’s the plan? There has been none except one I saw where the righties were allowing fraudulent insurance to be sold that covered virtually nothing. An industry expert said you can’t even call that insurance.

      1. There has been none except one I saw where the righties were allowing fraudulent insurance to be sold that covered virtually nothing.

        The people’s revolutionary truth has decreed what is and is not valid insurance! Why can’t you ignorant lumpenproles understand!

        An industry expert said you can’t even call that insurance.

        Look, I found this one guy, and he said something, and you people like people like him, so therefore you should accept what he says.

  37. Start working at home with Google! It’s by-far the best job I’ve had. Last Wednesday I got a brand new BMW since getting a check for $6474 this – 4 weeks past. I began this 8-months ago and immediately was bringing home at least $77 per hour. I work through this link, go to tech tab for work detail
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  38. Just dawned on me. The point to Obamacare was to lump more low risk people into the pool to cover the high risk people. Sounds an awful lot like what they did with subprime mortgages in the housing crash. Lump subprime mortgages with AAA rated ones so that they could sell them at higher credit ratings.

    1. Actually, it’s what they do with flood insurance, property taxes (you may not use the roads and schools, but you pay) and just about everything else in modern life. In fact, you are paying for parks whether or not you set foot in them.
      You are paying for space stations too…..

      Try to open your mind instead of comparing oranges to candy bars. No relationship at all between the things you mention.

      I’ll simplify some of it for you. ACA is:
      1. Better bargaining power in bulk – an individual could get good rates in the past. Now they can.
      2. Responsibility and audits – Insurance companies are now limited – they MUST pay back 85 cents of each dollar. Before, they could make 90 cents on a dollar and only give you (health care pros) 10.
      3. Spread the risk – this is true of all insurance. Each of us will be young and healthy and then, probably, old and sick. It’s impossible for the old and sick to pay the “real” costs (that would be $40K a year minimum for a 75 year old couple), so instead we (they too) pay when we are younger.
      4. Lower or stabilize the cost curve – we spend MUCH more – about double – what other highly advanced countries spend on medical care. Yet the results don’t show it. Basically we are being ripped off and it’s killing our economy and our people.

      This is about public health, the general welfare and the happiness of the people. Period.

  39. The primary promise of ACA was that it would get all uninsured covered and thereby reduce health care costs. Is it doing that? No.

    1. You are wrong.

      Only in the minds of folks here is $$$ the most important thing. No. Health and Happiness of the people is very important. So, if your answer was “to get uninsured covered, improve care and bend the cost curve” (3 things), it would be more accurate.

      You cannot state with a straight face that it is not doing all three. More people are covered, the coverages is much better and the cost curve has flattened. Specifically, medical costs going forward are projected to rise 5.8% per year for the next ten years.

      This includes both inflation as well as an increase in population and GDP, so it turns out to be well less than 5.8% in reality. In addition, we will have almost everyone covered and better coverage (no pre-existing, no caps, etc.)

      The FORMER increases, such in the Bush years of 2000-2006, were over 10% per year – and, in addition to the increases, more and more were uninsured and went bankrupt and were driven from the insurance marketplace.

      So, are you actually claiming the present and future are not economically and socially better than the past?

  40. Now I’m concerned about moral hazard. I’m also worried about the huge influx of new patients who will be using our healthcare system, because the cart is before the horse.

    By bringing millions of more Americans into Medicaid, Obama is doing worse than ignoring his own 2009 warning that Medicaid is a “broken system” when it comes to financial costs. He may also be writing a prescription for disaster when it comes to our nation’s overall health. Here’s why:

    “People respond to incentives, although not necessarily in ways that are predictable or manifest. Therefore, one of the most powerful laws in the universe is the law of unintended consequences.” -From the book “SuperFreakonomics”

    Hint:

    “Chelsea Byers of Flagstaff is insured for the first time in her life through Healthcare.gov and couldn’t be more pleased. She might even go skiing for the first time, now that any injuries from an accident would be covered.” -Arizona Daily Sun, January 21, 2014 – http://azdailysun.com/news/loc…..f887a.html

    That in mind, see:

    “Obamacare: Making a bad situation worse” http://relevantmatters.wordpre…..ion-worse/

    1. Anecdotes are not facts….

      “Moral Hazard”? So, you think the increases in costs because people have freedom to live (change jobs, play sports, etc.) and know they have medical coverage total up to be more than the benefits of:
      1. Making sure insurance companies pay out 85 cents of each dollar.
      2. Making certain as many people as possible pay into the system.
      3. Preventative care – being included free or at very low costs – resulting in better outcomes.

      I think we can both agree that vast numbers of people are not going to he wishing for cancer and heart disease (two leading killers) because they have insurance.

      You folks are really reaching for straws! Why not just open your minds instead of starting with a conclusion and then finding the “facts” to buttress it. That’s what “reason” is all about. The name of the site is not “I hate Obama dot com”. It’s Reason.

  41. Well, wadda ya know?

    “U.S. budget deficits over the next decade will be $286 billion less than previously estimated, the Congressional Budget Office said on Monday, attributing much of the decline to lower estimates of subsidy costs under President Barack Obama’s health …”
    “Twelve million more non-elderly people will have health insurance in 2014 than if Obamacare had not become law”

    This is from the CBO…..not Faux News or MSNBC……

    Facts are stubborn things. No matter how some folks negate them, they still stand.

  42. More “reason” about this particular story:

    “New results from a Reuters/Ipsos tracking poll show that Dems lead the GOP by at least seven percentage points on health care. Of the 1,2000 adults interviewed between April 1 and April 16, 29% said they believe Dems have “the better plan for health care.” Only 22% favored GOP proposals.”

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