Job Killer? How Media Spin Got Obamacare Wrong - and Why Single-Payer Could Cure Its Actual Flaws
Friday, 07 February 2014 11:16By Amy Goodman and Juan Gonzalez, Democracy Now! | Video Interview
Obamacare is a job killer — that was the message across the media this week after the release of a new Congressional Budget Office report about the Affordable Care Act. But what does the CBO report really say? We speak to Pulitzer Prize-winning Los Angeles Times columnist Michael Hiltzik, who says detractors have misinterpreted a report that actually brought good news. That is not to say Obamacare does not have its drawbacks, which Hiltzik argues could be cured by a single-payer healthcare system.
TRANSCRIPT:
This is a rush transcript. Copy may not be in its final form.
JUAN GONZÁLEZ: We turn now to the latest controversy over "Obamacare." On Tuesday, the Congressional Budget Office released a 175-page report on the nation’s budget and economy over the next decade. The CBO report quickly became the top story of the day.
ALISYN CAMEROTA: We do begin with a Fox News alert: There is a bombshell new CBO report that finds Obamacare will be much worse for the economy than previously predicted. Welcome to HQ. I’m Alisyn Camerota.
BILL HEMMER: I’m Bill Hemmer. Nice to see you, Ali.
ALISYN CAMEROTA: You too, Bill.
BILL HEMMER: The effects over the next decade will be substantially larger than estimated, nearly three times larger. That adds a trillion dollars to the debt. It sheds 2.3 million jobs. And Lou Dobbs, host of Lou Dobbs Tonight on Fox Business Network, is here on this. Lou, good day to you. Wow.
LOU DOBBS: Bill.
BILL HEMMER: So this thing was dropped about 90 minutes ago.
LOU DOBBS: Right.
BILL HEMMER: I mean, what are we to think now? CBO, non-congressional, Congression Budget Office.
LOU DOBBS: Nonpartisan.
BILL HEMMER: Nonpartisan, I should say.
LOU DOBBS: Nonpartisan as it gets, Bill, as you’re saying. And what we’re looking at are just another round of devastating numbers for—for all Americans, because the result of this is there will be fewer jobs.
JUAN GONZÁLEZ: That was a Fox News report on Tuesday. Many other media organizations and right-wing pundits quickly claimed theCBO report proved the Affordable Care Act is a job killer. Many outlets claim the report found Obamacare would result in the loss of about 2.5 million full-time jobs. On the Washington Post website, Jennifer Rubin wrote the CBO report, quote, "confirms what critics have been saying all along: Obamacare is killing jobs and squelching growth."
AMY GOODMAN: But it turns out these initial media coverage misinterpreted the report’s actual findings. On Wednesday, the director of the Congressional Budget Office, Director Douglas Elmendorf, said the agency has found Obamacare, quote, "spurs employment and would reduce unemployment over the next few years."
Our first guest today, Michael Hiltzik, is a Pulitzer Prize-winning columnist at the Los Angeles Times. Earlier this week, he wrote a piece titled "Why the New CBO Report on Obamacare is Good News." He’s also argued many of the health law’s ailments could be cured by a single-payer system.
We’ll get to that in a moment, but, Michael Hiltzik, well, welcome to Democracy Now! Start off by just explaining what exactly this Congressional Budget Office report says.
Obamacare is a job killer — that was the message across the media this week after the release of a new Congressional Budget Office report about the Affordable Care Act. But what does the CBO report really say? We speak to Pulitzer Prize-winning Los Angeles Times columnist Michael Hiltzik, who says detractors have misinterpreted a report that actually brought good news. That is not to say Obamacare does not have its drawbacks, which Hiltzik argues could be cured by a single-payer healthcare system.
TRANSCRIPT:
This is a rush transcript. Copy may not be in its final form.
ALISYN CAMEROTA: We do begin with a Fox News alert: There is a bombshell new CBO report that finds Obamacare will be much worse for the economy than previously predicted. Welcome to HQ. I’m Alisyn Camerota.
BILL HEMMER: I’m Bill Hemmer. Nice to see you, Ali.
ALISYN CAMEROTA: You too, Bill.
BILL HEMMER: The effects over the next decade will be substantially larger than estimated, nearly three times larger. That adds a trillion dollars to the debt. It sheds 2.3 million jobs. And Lou Dobbs, host of Lou Dobbs Tonight on Fox Business Network, is here on this. Lou, good day to you. Wow.
LOU DOBBS: Bill.
BILL HEMMER: So this thing was dropped about 90 minutes ago.
LOU DOBBS: Right.
BILL HEMMER: I mean, what are we to think now? CBO, non-congressional, Congression Budget Office.
LOU DOBBS: Nonpartisan.
BILL HEMMER: Nonpartisan, I should say.
LOU DOBBS: Nonpartisan as it gets, Bill, as you’re saying. And what we’re looking at are just another round of devastating numbers for—for all Americans, because the result of this is there will be fewer jobs.
'Job-lock' and the Republican dilemma over Obamacare
A day or so of careful reading and cogitation by the media has begun to turn the tide on what had been the Congressional Budget Office's most widely misunderstood finding about the Affordable Care Act.
It is now recognized that, no, the CBO didn't say that Obamacare would lead to job losses, but instead that it would allow many workers to voluntarily leave their jobs or retire without giving up health coverage.
Even House Budget Committee Chairman Paul Ryan (R-Wis.) felt the need to get things straight at his hearing Wednesday on the CBO report. "Just to understand," he queried CBO Director Doug Elmendorf, "it's not that employers are laying people off?"
"That's right," Elmendorf replied.
But it's now becoming plain that the CBO finding creates a problem for Republican critics of the healthcare law. That's because relieving millions of Americans of "job-lock," which is what the CBO is talking about, is something the GOP has favored for years. In fact, it was a selling point of healthcare proposals they put on the table prior to 2010, when they decided to abandon the field of healthcare reform.
For example, listen to Ryan speaking in May 2009: "[The] key question that ought to be addressed in any healthcare reform legislation is, are we going to continue job-lock or are we going to allow individuals more choice and portability to fit the 21st century workforce?"
Here are a couple of Heritage Foundation analysts in 2008, praising a healthcare plan proposed by then-GOP presidential nominee John McCain: "Individuals who wish to take a better job, change careers or leave the workforce to raise a family or to retire early take substantial risks. ... This health insurance obstacle to labor mobility is sometimes called 'job-lock.'" (Igor Volsky has more examples of conservative hand-wringing about job-lock here.)
That's exactly what the CBO projects to be a result of the Affordable Care Act. Relieved of the U.S. healthcare system's merciless link between employment and health insurance, more Americans will leave their jobs. They'll "choose to supply less labor" by working fewer hours or taking early retirement. To put it in the Heritage Foundation's vocabulary, many will "leave the workforce to raise a family or retire early." Until now, that meant losing health insurance. No longer.
The CBO said the reduction in hours worked will be the equivalent of 2.5 million full-time workers over the next decade or so, but that overall employment will still grow and, in fact, the unemployment rate will drop.
The only real option the GOP has for turning what is plainly a virtue for millions of Americans into a curse is to create their own picture of these departing workers. They're no longer people forced to hang on to soul-sapping, lousy-paying jobs merely for the health insurance, instead of raising kids or retiring after an arduous career.
Now they're slackers, taking a government handout as an easy way out. That's the subtext of another statement Ryan made during Wednesday's hearing. After Elmendorf explained that the healthcare law's premium subsidies made people "better off," Ryan declared:
http://www.latimes.com/business/hiltzik/la-fi-mh-job-lock-20140205,0,2101794.story#ixzz2svpiwj5Q
Why the new CBO report on Obamacare is good news
The Congressional Budget Office is out with its latest report on the Affordable Care Act, and here are a few bottom lines:
— The ACA is cheaper than it expected.
— It will "markedly increase" the number of Americans with health insurance.
— The risk-adjustment provisions, which Congressional Republicans want to overturn as a "bailout" of the insurance industry, will actually turn a profit to the U.S. Treasury.
Given all this, why are the first news headlines on the CBO report depicting it as calling Obamacare a job killer?
You can chalk up some of that to the crudity of headline-writing, and some to basic innumeracy in the press. But it's important to examine what the CBO actually says about the ACA's impact on the labor market. (You can find it at pages 117-127, excerpted here.)
The CBO projects that the act will reduce the supply of labor, not the availability of jobs. There's a big difference. In fact, it suggests that aggregate demand for labor (that is, the number of jobs) will increase, not decrease; but that many workers or would-be workers will be prompted by the ACA to leave the labor force, many of them voluntarily.
As economist Dean Baker points out, this is, in fact, a beneficial effect of the law, and a sign that it will achieve an important goal. It helps "older workers with serious health conditions who are working now because this is the only way to get health insurance. And (one for the family-values crowd) many young mothers who return to work earlier than they would like because they need health insurance. This is a huge plus."
The ACA will reduce the total hours worked by about 1.5% to 2% in 2017 to 2024, the CBO forecasts, "almost entirely because workers will choose to supply less labor — given the new taxes and other incentives they will face and the financial benefits some will receive." That translates into about 2.5 million full-time equivalents by 2024 — not the number of workers, because some will reduce their number of hours worked rather than leaving the workforce entirely.
The overall impact on the community will be muted, moreover, because most of that effect will be seen at the lowest levels of the wage-earning scale. The effect will be "small or negligible for most categories of workers," the CBO says, because there will be almost no impact on workers who get their insurance from their employers or who earn more than 400% of the federal poverty line (for a family of three, that's $78,120), the point at which eligibility for federal premium disappears.
http://www.latimes.com/business/hiltzik/la-fi-mh-cbo-20140204,0,3106578.story#ixzz2svqiOfMR
Posted Feb. 07, 2014, at 12:04 p.m.
Don’t be fooled by a supposed alternative to Medicaid expansion some Republicans, including Gov. Paul LePage, are floating.
In a WGAN radio interview last month, the Republican governor said he would support legislation — if it existed — that provides Medicaid coverage to approximately 30,000 Maine adults without children whose incomes fall below the federal poverty level ($11,490 for a single person).
Anyone with a higher income, he reasoned, can and should enroll in subsidized, private insurance through the Affordable Care Act’s online insurance exchange, HealthCare.gov.
The problem — which LePage acknowledged — is that the Obama administration has made it clear to states that they can’t partially expand Medicaid and still qualify for the full expansion funding authorized in the federal health care law.
In other words, governors like LePage can’t stop the expansion at 100 percent of poverty; they have to expand it to everyone earning up to 138 percent of the poverty level (about $15,860 for a single person).
That reality, of course, isn’t stopping resistance to the common-sense Medicaid expansion. Rather, it gives cover to LePage and other Republican expansion opponents, who can claim they’re in favor of extending coverage if only the federal government would work with them.
Even without any expansion, Republicans often point out that about half of those in Maine who would be eligible for Medicaid if it were expanded can instead purchase steeply subsidized private insurance.
That’s true, but there’s a reason the Affordable Care Act extended Medicaid — and not private — coverage to all those earning up to 138 percent of the poverty level: Medicaid is more affordable than private insurance, both for the beneficiaries and the federal government.
Yes, under the Affordable Care Act, some low-income individuals can get heavily subsidized private insurance. But without expansion, no help is available at all for those with incomes below the poverty level. It’s a cruel loophole that wouldn’t even matter if all states expanded Medicaid.
By all accounts, a $9-a-month plan with a $200 deductible that limits all potential out-of-pocket expenses to $500 annually is a good deal. But consider who would be paying the bill: Hypothetically, a single person who earns about $13,000 a year. That’s about 113 percent of the poverty level, or about 29 hours a week at $8.50 an hour.
Once you figure in the cost of rent, heat and utilities (even when subsidized); food (what isn’t covered by food stamps); the expense of transportation in rural Maine; and state income tax liability, there’s little income to spare for a health plan that costs $108 a year with the potential for $500 more out of pocket. Imagine if this person wanted to enroll in a training program to improve his or her job prospects. Should she choose health insurance or education?
Health policy research consistently shows that out-of-pocket costs for a low-income person on private insurance are significantly higher than they would be for that person if he or she qualified for Medicaid. That doesn’t mean Medicaid provides a free ride: An Urban Institute study of Medicaid expenditures from 2003 to 2009 found Medicaid beneficiaries paid $257 out of pocket on average per year.
When health care costs are steep — or even perceived as costly — someone who can’t afford needed care to address a small problem is likely to put off treatment until the problem festers into something that’s more severe and more expensive to address.
Obamacare recruiters woo ‘young invincibles’
Enrolling 18- to 34-year-olds in a health insurance plan is crucial to the success of the reform law.
By Julie Pace
The Associated Press
The Associated Press
WASHINGTON — Facing a rapidly approaching deadline, the White House and its allies are racing to enroll young people in new insurance plans offered under President Obama’s signature health care law, a sweeping effort that underscores how crucial the so-called young invincibles are to the measure’s success.
An army of workers and volunteers is targeting people between the ages of 18 and 34 on college campuses, in bars and even in Laundromats. The recruiting effort is based in part on lessons learned from Obama’s presidential races, which revolutionized the way campaigns tracked voters.
“On the campaign, you want to be able to find an Obama voter, and you want to get them to vote,” said Matt Saniie, who worked on the 2012 campaign’s data team and is now analytics director at the organization Enroll America. “In the enrollment world, you want to find someone who is uninsured, and you want to get them to enroll.”
More than any other group, participation from the young invincibles will be crucial to the law’s success. Young people tend to be healthier, and the Kaiser Family Foundation estimates that they need to make up about 40 percent of enrollment in the new health program to balance out the higher costs of insuring older, sicker people.
Lost in Clinical Translation
By THERESA BROWN
A classic “Far Side” cartoon shows a man talking forcefully to his dog. The man says: “Okay, Ginger! I’ve had it! You stay out of the garbage!” But the dog hears only: “Blah blah Ginger blah blah blah blah blah blah blah blah Ginger …”
As a nurse, I often worry that patients’ comprehension of doctors and nurses is equally limited — except what the patient hears from us is: “Blah blah blah Heart Attack blah blah blah Cancer.”
I first witnessed one of these lost-in-translation moments as a nursing student. My patient, a single woman, a flight attendant in her early 30s, had developed chest pain and severe shortness of breath during the final leg of a flight. She thought she was having a heart attack, but it turned out to be a pulmonary embolism: a blood clot in the lungs. Treatment required several days in the hospital. Already far from home and alone, she was very worried that a clotting problem would mean she could no longer fly.
When the medical team came to her room, they discussed her situation in detail: the problem itself, the necessary course of anti-coagulation treatment and the required blood tests that went with it. To me, just at the start of my nursing education, the explanations were clear and easy to follow, and I felt hopeful they would give my patient some comfort.
After the rounding team left, though, she turned a stricken face to me and deadpanned, “Well, that was clear as mud, wasn’t it?”
I sat down and clarified as best I could. But until then, I hadn’t realized what a huge comprehension gap often exists between what we in health care say to patients and what those patients actually understand.
Is Obamacare Unraveling?
Rumors have been circulating in the marketplace all week that the administration was thinking of extending the individual health insurance policies that Obamacare was supposed to have cancelled for as much as three more years.
Those rumors have now come out into the open with Tom Murphy's AP story that began running today.
That the administration might extend these polices shouldn't come as a shock. My sense has always been that at least 80% of the pre-Obamacare policies would ultimately have to be canceled because of the administration's stringent grandfathering rules that forced almost all of the old individual market into the new Obamacare risk pool.
But with the literal drop dead date for these old policies hitting by December 31, 2014, that would have meant those final cancellation letters would have had to go out about election day 2014. That would have meant that the administration was going to have to live through the cancelled policy nightmare all over again––but this time on election day.http://healthpolicyandmarket.blogspot.com
Those rumors have now come out into the open with Tom Murphy's AP story that began running today.
That the administration might extend these polices shouldn't come as a shock. My sense has always been that at least 80% of the pre-Obamacare policies would ultimately have to be canceled because of the administration's stringent grandfathering rules that forced almost all of the old individual market into the new Obamacare risk pool.
But with the literal drop dead date for these old policies hitting by December 31, 2014, that would have meant those final cancellation letters would have had to go out about election day 2014. That would have meant that the administration was going to have to live through the cancelled policy nightmare all over again––but this time on election day.http://healthpolicyandmarket.blogspot.com
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