Kochs and Other Conservatives Split Over Strategy on Health Law
WASHINGTON — Under attack for the government shutdown, some of the most vocal elements of the conservative wing of the Republican Party are publicly splintering, a sign of growing concerns among even hard-core conservatives that the defeat-health-care-at-any-cost strategy may have backfired.
The dispute centers on the best way to oppose President Obama’s health care plan: to immediately try to bring it down by blocking any federal budget deal that includes funding for it, or to gradually build public opposition until Congress and the White House are controlled by elected officials willing to repeal the law.
On Thursday, the divisions were on display as conservative groups like the Heritage Action for America said they would not fight a short-term increase in the debt ceiling while Americans for Prosperity insisted just a few days ago that any increase be tied to cuts in social programs.
Their actions followed an unusual public statement on Wednesday by the Koch Companies, the conglomerate controlled by the billionaire conservative brothers Charles and David Koch, who sent a letter to the Senate stating that they did not support the effort led by Heritage Action to force the partial closing of federal government as a way to eliminate funding for the health care program.
“We want to set the record straight and correct this misinformation,” the letter said.
The conflicting opinions, which had been kept mostly private for months as the budget conflict in Washington escalated, reflect a growing fear that the Republicans will be blamed for fallout from the government shutdown without anything to show for it.
“We were fighting a battle where we already lost, on the same battlefield where we already lost it,” said Hogan Gidley, a former executive director of the South Carolina Republican Party and an adviser to Rick Santorum’s presidential campaign last year.
Dan Holler, a spokesman for Heritage Action, which has led the effort to defund the health care program even if it meant a government shutdown, said the divisions among conservative activists were not a surprise.
Health Act Embraced in California
LOS ANGELES — There are radio and television commercials galore, along with Twitter and Facebook posts and scores of highway billboards. There are armies of outreach workers who speak Spanish, Tagalog, Cambodian, Mandarin and Cantonese, all flocking to county fairs, farmers markets, street festivals and back-to-school nights across the state. There are even dinner parties in Latino neighborhoods designed to reach one family at a time.
With enthusiastic backing from state officials and an estimated seven million uninsured, California is a crucial testing ground for the success of President Obama’s health care law.
It is building the country’s largest state-run health insurance exchange and has already expanded Medicaid coverage for the poor. Officials hope that the efforts here will eventually attract more than two million people who are currently uninsured.
And as the exchange, known as Covered California, has begun the painstaking effort to enroll potential customers in the subsidized insurance plans or expanded Medicaid, the public outreach effort here can seem akin to a huge political campaign.
The state is spending $94 million to help local health clinics, community groups and labor unions reach residents — many who have lived without health insurance for years — and have them complete the often bewildering process of signing up for coverage. “It’s going to take a little bit of everyone doing a lot of different things to get this all together,” said Lisa Hubbard, a director at St. John’s Well Child and Family Clinic in South Los Angeles, which has one of the highest rates of uninsured in the country. “We’re really going to have to try anything and everything.”
In Florida, Opposition by the State and Snags in Signing Up on the Web
MIAMI — Be it gold, silver or bronze level, there are two ironclad requirements for buying health insurance in Florida on the federal online exchange: patience and persistence.
“Please wait,” read the message on the exchange Web site. “Your account cannot be created at this time,” read another. Or, worse yet, an applicant’s information simply vanished into the ether, and neither the 800 number nor the online chat session could reverse its disappearance.
“I had to take the day off work to come here,” Liliana Cardenas said in frustration after sitting nearly two hours with a counselor at a health clinic in Hialeah, a mostly Cuban suburb of Miami, only to see her information disappear. “I don’t know when I can come back.”
And so it went in Florida, where access to health insurance under the Affordable Care Act may seem as elusive as compromise in Washington.
First the State Legislature roundly rejected the law, refusing to create a state insurance exchange and punting it to the federal government to run the new insurance market. It also rejected $51 billion in federal funds that was available over 10 years to expand Medicaid coverage for the state’s poor. As the day neared for consumers to enroll in insurance plans, state officials announced that so-called navigators — a group assigned to help people sign up — would be barred from state health offices just like all other outside groups.
But blame this week shifted to the federal government. Its Web site remains so error-prone that the overwhelming majority of Floridians who have tried to buy affordable health insurance have had little luck. Anecdotal evidence across Florida, which has 3.5 million uninsured residents, the second highest in the country, indicated that few Floridians managed to enroll. Those who pushed past the pleas for patience often did so in the evening or early in the morning — when Web site traffic is down.
Trusting the Doctor
We drove along the dirt and gravel roads of western Massachusetts, on our way to the Umpachene Falls.Every summer my family and I stay for a few days at my best friend’s lake house in the Berkshires and engage in our silly rituals. Jumping off the dock into Lake Garfield while shouting “Kowabunga!” Paddling the kayak across the lake to visit the photographer whose dog once jumped onto the kayak’s deck to see if he’ll do it again. And going to the Falls.
We passed the occasional penned horses and llamas, ignored the sign warning us that, somewhere up ahead, a bridge was out, and turned into a grassy parking lot. We could hear their roar, muted by a wall of trees. I turned to my 9-year-old daughter, who was sitting in the back seat of our rental car, and asked, “Do you think you’ll do it this year?”
She nodded tentatively. Her 12-year-old brother, a three-year veteran of the falls, tried to reassure her. “It’ll be easy!” She smiled, her confidence slightly bolstered.
Blue Cross Plans Jump to an Early Lead
Color the new online insurance marketplaces Blue.
On the first day that people could buy coverage under the federal health care law last week, the chief executive of Independence Blue Cross in Philadelphia had just learned that his company’s plans were the area’s least expensive available through the new state exchanges. “We were thrilled,” said Daniel J. Hilferty, the nonprofit insurer’s chief executive.
A 36-year-old can buy a so-called silver policy — a midrange plan — for $246 a month, not including the federal subsidies that could lower the cost even further. Out-of-pocket costs would vary, depending on the choice of hospital and doctor.
While other brand-name insurers like UnitedHealth Group, Aetna and Cigna are selling coverage only sporadically on the exchanges, consumers will find local nonprofit Blue Cross and Blue Shield plans in nearly every state and market in much the same way they did before the federal health law was enacted.
WellPoint, which became one of the nation’s largest insurers by combining more than a dozen Blue Cross plans into a profit-making company, is also actively participating in the exchanges in all 14 states where it operates. “We expect to be a strong competitor in most regions because our brand and local market experience are meaningful differentiating factors,” the company’s chief executive, Joseph R. Swedish, recently told investors.
Medicare for all would be good for business
By the Editorial BoardInside Tucson Business, Oct. 11, 2013
The nasty fight over Obamacare that has shutdown our country and threatens to destroy the world if the U.S. defaults on its loans is seen as a liberals vs. conservatives battle.
Liberals see it as compromise legislation that finally found a way to bring millions of uninsured Americans under a health insurance umbrella through expanded indigent health care rolls and mandated insurance purchases by businesses and individuals.
Conservatives, who used to be pro-business Republicans, see Obamacare as a hideous government takeover of the national health system.
It’s neither. It’s a sloppy wet kiss to the U.S. health insurance industry. Which could be seen as pro-business, assuming you’re in the health insurance business or own stock in one.
It also has the potential to be pro-business in that it could unintendedly relieve American businesses of the burden of subsidizing their workers’ health insurance.
The Affordable Care Act is so complicated it was bound to be beleaguered by the law of unintended consequences. One of the most prominent has been the 30-hour rule, in which companies with more than 50 workers must offer any employee working more than 30 hours a week subsidized health insurance.
That has prompted some employers, mostly small franchisers who hire mostly part-time workers, to cut maximum employee hours to 29 to avoid the mandate.
But while that has been cause for a lot “I told you so” shouting on conservative media, it hasn’t proved to be very prevalent. While there are anecdotal incidents of a few hundred companies saying they’ll cut worker hours, it’s a drop in the bucket in the massive American workplace.
http://www.pnhp.org/print/news/2013/october/medicare-for-all-would-be-good-for-business
Republicans’ biggest misunderstanding about Obamacare
The right hates the new healthcare law because they think its reach will be universal. The problem is the opposite.
By Adam Gaffney, M.D.Salon, Oct. 10, 2013
The battle for universal healthcare is not over. This is not because of the reason you might suspect – that Republicans will obstinately endeavor to obstruct Obamacare in every way they can (though that seems to be the case). Instead, even after the smoke clears from the government shutdown (presumably with the law intact), the battle over universal healthcare will still not be over, but for a more fundamental reason: Obamacare, whatever its advantages (and despite the right’s worst fears), does not create a system of universal healthcare.
Now first, to be clear, this is not to say that Obama’s Affordable Care Act won’t help many people. The uninsured who become eligible for coverage through the expansion of Medicaid, for example, will of course be better off – assuming they don’t live in one of the 20 or more states that have callously elected to deny them this potentially lifesaving opportunity. Additionally, many uninsured who were previously unable to afford private health insurance may now be able to do so, for instance through the new income-based premium subsidies. And most of us will benefit from many of the law’s insurance reforms, like the one that prevents insurers’ from denying us coverage because we are sick.
And at the same time, have no doubt: The various Republican alternatives for American healthcare would be disastrous. Consider the most recent GOP healthcare proposal H.R. 3121, which would gut state insurance regulations, eliminate popular ACA reforms like the ban on “preexisting conditions,” end the Medicaid expansion, and provide tax benefits that would preferentially benefit the wealthy, among other unhelpful proposals that would do nothing to help the uninsured. Conservative “consumer-driven” healthcare dreams, more generally, would in truth be nightmares, radically furthering the transformation of healthcare into yet another commodity, bought by “consumers” in proportion to their means, not provided to patients on the basis of their needs.
http://www.pnhp.org/print/news/2013/october/republicans’-biggest-misunderstanding-about-obamacare
Single-Payer Prescription for What Ails Obamacare
By Amy GoodmanTruthdig, October 9, 2013
“We apologize for the inconvenience. The Marketplace is currently undergoing regularly scheduled maintenance and will be back up Monday 10/7/3013.” You read it right, 3013. That was the message on the homepage of the New York state health insurance exchange website this past weekend.
Yes, the Affordable Care Act (ACA), popularly known as Obamacare, is going through difficult birth pains, as the marketplace websites went live only to crash. The government is not giving out numbers, but informed observers speculate that very few people have succeeded in signing up for any of the plans so far.
The ACA rollout occurred as Republicans shut down the government in their attempt to defund Obamacare. But their strategy backfired. Had there been no shutdown, all of the attention would have been on the disastrous rollout. The fundamental issue, at the core of the health-care dispute, is typically ignored and goes unreported: The for-profit health-insurance industry in the United States is profoundly inefficient and costly, and a sane and sustainable alternative exists—single-payer, otherwise known as expanded and improved Medicare for all. Just change the age of eligibility from 65 to zero.
“When Medicare was rolled out in 1966, it was rolled out in six months using index cards,” Dr. Steffie Woolhandler told me Monday. “So if you have a simple system, you do not have to have all this expense and all this complexity and work.” Woolhandler is professor of public health at CUNY-Hunter College and a primary-care physician. She is a visiting professor at Harvard Medical School and the co-founder of Physicians for a National Health Program, or PNHP. PNHP is an organization with 17,000 physicians as members, advocating for a single-payer health-care system in the U.S.
http://www.pnhp.org/print/news/2013/october/single-payer-prescription-for-what-ails-obamacare
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