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The Wake Up Call on Obamacare

According to Kaiser, health care spending continues to be lower than it has been in years. The question is why? Maybe it’s because in a tight economy, Americans hold fast to their dollars, including their healthcare dollars. But maybe it is the sense that Americans may be shouldering more of the cost of their own healthcare. And maybe all the discussion around Obamacare has actually led to some awareness and belt tightening before the program even kicks in. That is interesting to me. Maybe there was a lot of waste in the system that is being whittled down in anticipation of lower compensation. Maybe it was time for Americans to take on more responsibility for their health and wellness. Either way, the reformers have to feel buoyed by the knowledge that spending is heading in the right direction. For the moment, that is. Here is a link to a series of articles from the New York Times to Politico.com that offer different thoughts on the subject. http://www.kaiserhealthnews.org/daily-reports/2013/may/07/health-cost-studies.aspx

There is a lot of other information worth noting that may be getting lost in the headlines and general noise around who is to blame. One report I just read says that, according to McKinsey and Company, private employers could dump up to 30% of insured employees as the cost of providing coverage rises. So, the idea that getting a job is the quick fix for getting health insurance benefits is no longer necessarily true. 

And what about those State Exchanges? The most closely watched states New Jersey and Florida hemmed and hawed but ultimately, like Missouri, they decided to join the 27 states that think it is best to let the Feds run the show or at least, provide the dollars it will cost to. So much for my hope that states could join together to create bigger purchasing pools that lower costs while providing access. According to Kaiser, “17 Declared State-based Exchange; 7 Planning for PartnershipExchange; 27 Default to Federal Exchange.”

I also think it’s interesting that the employer mandate has been delayed by a year. That eases the pressure for businesses with 50 or more employees who will now have until 2015 to provide coverage or face penalties. The Republicans are saying Obamacare should have been repealed outright and that its delay is an indication of how misguided it was for the Feds to get into the healthcare business. The Democrats are blaming the Republicans and saying that if they had just freed up more money to educate the states on implementation, there wouldn’t be any delays to begin with.  

Personally, I’m back to where I began years ago, when I wasn’t reporting or working in politics, which is why couldn’t we just figure out a way to insure the uninsured and leave what was working well enough alone? Consider this article from Sarah Skiff of the Washington Post, who writes, that even with Obamacare, 30 million Americans will be left uninsured. 

Obamacare leaves millions uninsured. Here’s who they are.

By Sarah Kliff, Published: June 7, 2013 at 1:42 pmE-mail the writer

Welcome to Health Reform Watch, Sarah Kliff’s regular look at how the Affordable Care Act is changing the American health-care system — and being changed by it. You can reach Sarah with questions, comments and suggestions here. Check back every Monday, Wednesday and Friday afternoon for the latest edition, and read previous columns here.

When we talk about the Affordable Care Act, we mostly focus on the millions of Americans who will gain health insurance coverage. We talk less about the millions who will remain uninsured.

And there are a lot of them: 30 million Americans will not have coverage under Obamacare, according to a new analysis in the journal Health Affairs. 

“Even if the law were fully implemented, there would have been 26 million uninsured people,” co-author Steffie Woolhandler said in an interview Thursday. “This isn’t just about the Medicaid expansion. This is the system as originally designed.”

Thirty million is a lot smaller than the 48.6 million Americans who lack insurance coverage right now. It’s also, as Woolhandler points out, not exactly breaking news: The Congressional Budget Office estimated over a year ago that between 26 million and 27 million Americans would not have insurance under the expansion.

 

 

A Summer Education

This year’s Summer vacation has been spent working my way around my old stomping grounds visiting family and friends in Florida, New Jersey, Philadelphia, Connecticut and New York.  And it hasn’t just been a vacation, it has been an education.

Last week, I was on the New Jersey Shore watching dolphins play in the surf at dusk, a scene at stark odds with the images of destruction post-Hurricane Sandy.  Yesterday, I was told that the lazy Summer rain I watched from inside a quiet New England house had actually spawned tornadoes that led to power outages and flooding. Tornadoes? I am fairly certain my only exposure to a tornado as a kid was the one in the Wizard of Oz.  For our generation, it seems, tornadoes have become a regular occurrence. So too, drought. Right now, it’s 130 degrees in Death Valley. I guess Mother Nature is like all mothers, a repository of gifts and nurturing but when she has a lesson to teach, capable of being swift and harsh. 

As we sat on the beach, we had to acknowledge that something is happening with the climate. Yes, it could be part of a natural warming cycle but whether you attribute the wild swings in weather to a naturally occurring phenomenom or neglect, the evidence of climate change is hard to ignore. 

A highlight of my travels was a conversation I had with a volunteer for a climate change organization in which she essentially said, “What part of you is a Republican?”  The answer is my core belief that once people are doing well, the chances of them having the time and interest in doing good are that much greater. We just have to do a better job encouraging people, who are dialing out because they’re so turned off by the fight, to dial back in. To take a piece of it and effect change. 

The challenge for our generation is to effect change from the outside in. To remind Washington that these goals do not have to be mutually exclusive or more relevantly, party exclusive. With the exception of President Obama’s press conference on reducing carbon emissions last week, the conversations around environmental change are winding down to a slow din.  Why do Republicans cede progress on the environment to the other side? It just makes us look like we have our heads buried in the sand. And by the way, those sandy beaches may be eroding. 

Doesn’t it seem like one of the solutions to bridging the gap between the parties is to include big business, not alienate them, when addressing concerns like healthcare reform and now climate change? Our future as Americans lies in solutions where we all have a seat at the table. Demonizing the successful, saddling them with unfunded federal mandates and stifling job creation will only stifle our progress as a nation. The answer lies in our shared concerns. 

According to the New York Times, 

“Nearly two-thirds think the EPA should cap emissions in existing power plants, including 86 percent of Democrats and 54 percent of Republicans.”

These concerns are not party driven. They are observations from a generation that embraces fitness and the outdoor life. Our earth isn’t the domain of one party or the other. Lots of successful businessman escape the office by throwing a line and fishing in pristine waters. So do many of our legislators who may need to escape the choke hold that special interests have on them.  

ModerateMoms needs to create a safe haven to do what’s right. And to create a safe place in the center where reasonable conversations can be held on difficult topics that concern us all. 

A battle for 7 states

By JONATHAN MARTIN | 10/23/12 4:37 AM EDT

BOCA RATON, Fla. — The two presidential campaigns are sounding sharply different notes about how they can get to 270 electoral votes, but beneath the post-debate bravado from both sides there is a rough consensus about the shape of the race in its final two weeks.

Top strategists for both Barack Obama and Mitt Romney flooded the media center following the third and final presidential debate here Monday night, and made clear they will be primarily fighting over seven states and will spend most of their time and money in them between now and Nov. 6.

Continue Reading

Spin room reactions

Campaigns describe final push

Obama, Romney best lines

 

(Also on POLITICO: 7 takeaways from final debate)

The main battlegrounds: Ohio, Iowa, Colorado, Virginia, New Hampshire, Florida and Wisconsin. The late inclusion of Wisconsin on this list reflects a bet by Romney — buoyed by some polls showing an opportunity for him there — that he can turn a state that has not voted for a Republican presidential nominee since 1984.

Romney officials, eyeing steady gains in the polls, have not ruled out attempting to broaden the map in other states — claims met with disparagement by Obama aides, who say they remain confident their electoral college firewall is intact even amid a tightening national race and signs that three swing states in the South are looking more favorable for the GOP nominee.

Republicans are genuinely intrigued by the prospect of a strike in Pennsylvania and, POLITICO has learned, are considering going up on TV there outside the expensive Philadelphia market. But what Romney officials worry about, both in Pennsylvania and Michigan, is that if they put some cash down or use precious hours to send their candidate there Obama will respond by crushing their offensive with a big ad buy of his own.

(Also on POLITICO: 6 questions that will settle the election)

So while Boston is open to the idea of going into such traditional Democratic strongholds, it is still mostly playing within the same map the two candidates have been locked in for months. And, increasingly, it is narrowing its focus as prospects improve in North Carolina, Florida and Virginia.

“That states that we’re playing in are the states we need to win,” noted Romney strategist Russ Schriefer. “We’ll see what happens in the next two weeks. We’re going to concentrate on Ohio and Colorado and Iowa and New Hampshire.”

“We’ll be in Ohio a lot,” added Romney strategist Stuart Stevens.

The Romney campaign is already airing TV ads in Wisconsin. The former Massachusetts governor has not been to the state since he tapped Paul Ryan as his running mate in August but is headed back soon.

(Also on POLITICO: Mitt Romney: I come in peace)

“We’ll be back in Wisconsin,” said Eric Fehrnstrom. “Wisconsin is definitely in play.”

Obama officials, meanwhile, are convinced that they have a lead in Ohio, Wisconsin, Iowa, New Hampshire and Nevada — and aren’t yet willing to write off Colorado, Florida and Virginia.

But senior Democrats increasingly recognize that their path to 270 electoral votes is not in the latter three but in the Midwest.

“Iowa, Wisconsin and Ohio are crucial — if we win those three states, the president is reelected,” said Senate Democratic Whip Dick Durbin (D-Ill.), a close Obama ally.

(Also on POLITICO: Media: Obama in fighting mood)

Obama adviser Robert Gibbs put it another way, saying Romney’s fate would depend on whether he can sweep the trio of Big 10 states.

“We intend to go out and win each of the three of those states,” said Gibbs.

And Pennsylvania and Michigan? They’re not worried and aren’t likely to send Obama there.

“Probably not, no,” said Obama deputy campaign manager Stephanie Cutter when asked if the president would rally supporters in the two traditionally Democratic electoral troves. “We have significant resources there. We are invested in those states at a much higher level than Gov. Romney is.”