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Posts Tagged ‘Obamacare’

Candidate Clinton?

What an interesting week it has been in politics. First, last week’s stunning defeat of Virginia’s Eric Cantor, who lost to an unknown Tea Party candidate. Then the admission on the heels of the Romney summit in Utah that there is a division within the Republican Party and no clear Presidential candidate in sight for 2016. Today, I read rumblings that some are hoping Gov. Mitt Romney will give it another whirl. That would be interesting, especially if he decides not to be muffled by the extremists and to run on a platform similar to the one he employed in Massachusetts. It’s time for moderate Republicans to organize and he really is a moderate at heart, as evidenced by his leadership as Governor. Speak past the extremists if you do, Mitt!

Now, Hillary Clinton’s “Is She or Isn’t She?” interview on CNN. The interview was ostensibly about her book, “Hard Choices.”  I dialed in late so I don’t know if Christiane Amanpour disclosed at the outset that her husband, James Rubin, had worked on Clinton’s 2007 campaign. Amanpour was clearly a “friendly” as we say in the media but I will not slam CNN or Hillary for that given that this is one woman in politics who has had her share of harsh treatment. Interestingly, harsh was missing from the exchange. She was measured and circumspect.

I will say it was interesting that the speech bubble Amanpour held up with viewers’  impressions of Hillary had only positive messaging on it. The most visible word on there was “President.”

Highlights of the interview include her statements that she is going to move forward on immigration reform, that she would send young children back to the Latin American countries they have fled to enter the U.S. illegally (once a responsible party is identified), that the blame for not arming rebels in Syria lies with Obama, that she is going to let states decide on recreational marijuana but hasn’t smoked herself. She was her most forceful on the issue of background checks, saying polls show Americans are overwhelmingly in favor of them.

Even if she doesn’t run, her interview raised some interesting points about American attitudes towards female candidates. Of course, we should be as comfortable electing a woman as a man. And we should pay her the same as we would pay him. But when someone like Hillary Clinton is asked why she wants to run when she has a grandchild on the way, you seriously have to wonder whether people realize how inherently sexist our assumptions still are. Her answer that a lot of Grandfathers have run for public office was spot on.

I just got back from a week in Texas. I saw three Presidential libraries in a week. First, President Bill Clinton’s in Arkansas, then Lyndon Baines Johnson’s in Johnson City and finally George H.W. Bush’s at Texas A & M in College Station. I told friends my favorite thing about the trip was how each of these Presidents’ libraries allowed them to depict their legacies as they see fit. The truth is there is more room for that than ever. With partisan rancor at its worst, Americans are so unsure of what is news and what is spin, that they are turning away from politics altogether.  That is where the danger lies. Not only when it comes to an informed electorate but also for future generations.

I’m actually beginning to question whether our conventional methods of weaning out the differences between candidates, like press conferences, debates and :30 campaign spots have become obsolete. Maybe each candidate should be given weekly one-on-one, half-hour or hour long, interviews in which they are asked to focus on just one issue like education, the economy, foreign affairs or energy. Americans will at least get to choose without the constant interruptions or one liners that make for exciting television but do little to help Americans decide who is telling the truth, who has the temperament and experience to lead and who inspires them.

I would love to see Mitt Romney in a similar interview to tonight’s interview with Hillary. After all, many people believe, he was treated unfairly by the press at times, in part because he was wealthy and successful.

In the last week, I have had a bright young person tell me she no longer believes in party politics. I listened to an accountant who has voted for Democrats say he’ll vote for whoever can right the ship financially by reforming entitlements, military spending, underfunded pensions and reigning in the interest on our debts. I’ve had a green Republican admit alternative energy has to be part of the energy mix going forward because of EPA mandates to upgrade infrastructure as well as concerns about global warming and sustainability.  I read an article about how handwriting could be phased out after second grade under Common Core because “kids won’t need it.”  I signed a petition urging our Governor to veto a law that creates a 72 hour waiting period for abortion because I am outraged that the one legal provider in our state is under attack … again. (As I’ve said before, “agreeing to disagree” on social issues is fine but dialing back rights isn’t) I wondered who is going to pay for Medicaid expansion in this state, which I was originally opposed to, but am reconsidering, as hospitals lay off employees because of the unfair burden Obamacare has placed on them.

I write this a day after the Supreme Court of the United States agreed to consider whether vicious lies in the midst of political campaigns about a candidate’s criminal convictions and mental state fall under free speech or whether that should be criminal, as it currently is according to Ohio. A law like that, broadly applied, would be a game changing tipping point in politics as we know it.

 

 

 

We need a Choice, not an Echo

The title for this post is the title of a book conservative author and media personality, Phyllis Schlafly, self published in her battle over the Equal Rights Amendment. Back then, she was worried that government regulation would rob women of their choice to stay home as housewives and mothers. It is an equally forceful title today. But one that has taken on new meaning. 

I just got back from Lincoln Days, the Republican Party’s convention here in Missouri. And one of the more memorable moments for me this weekend was when a woman raised her hand and said, “Republicans need to be proud to be Republicans again.” “Like Phyllis Schlafly said, we need a choice, not an echo.” The guest speaker at this luncheon was Sharon Day, who is co-chair of the Republican National Party. She talked at length about what the party is doing to recruit candidates and to open up the Party to women and minorities. Seated just down the dais from her was the Hon. Catherine Hanaway, a former U.S. Attorney and the first woman to serve as Speaker of the House. If elected, she will be Missouri’s first female Governor.

It’s shaping up to be an interesting battle. Her likely opponent is a Democrat who used to be a Republican. He left over the party’s litmus tests and hard lines. Hanaway has opened up her coalition to include suburban Republicans as well as conservatives outstate.  A moderate in temperament and approach, Hanaway has consistently been a team player for the Republicans. And as a prosecutor, she has put child pornographers away and shed a spotlight on Missouri’s newest black eye, human trafficking. 

I drove down to Springfield on I-44, on a stretch of highway named after Gov. Mel Carnahan, a Democrat who died in a tragic plane crash in the midst of a heated Senate race against Republican John Ashcroft. I took note of that sign as I drove on while the audio version of the book, Faith and Politics, by retired Republican Sen. John C. Danforth, played on the cd player in my car. I was listening for inspiration because I wasn’t sure what I would find in Springfield. I tried to commit certain phrases to memory like, “faith is not politics,” and “reconciliation”.

After blogging as a relatively radical moderate Republican woman for the last two and half years, I needed to psych myself up because I wasn’t sure what kind of reception I might get or what reconciliation might look like. I needed to know it would be okay to say I am pro-choice, pro-gay and pro-stem cell in a state that saw some of its top scientists leave over laws that restricted medical research or that is currently debating whether to recognize the marriages of gay couples who were legally wed in other states. 

The wheel is just beginning to turn, even if Missouri Republicans are only in the most initial stages of change, at least in terms of their messaging. Sure, there is still the occasional recalcitrant who gets up and declares the Republican Party, “The Pro-Life Party.” My goodness. But overall, if there was an echo, it is that the national GOP is in the midst of some earnest, and some might say overdue, self-improvement. Yes, there are many women who are pro-life in that party, including Hanaway. But, there seems to be a growing acknowledgement that it may be time to acknowledge there are lots of other kinds of Republicans out there. Continuing to draw battle lines over women’s issues is just slowing the party down from its’ other work.

Voters will have a choice that they haven’t had in the past. Do they take the long view and get on board with the party that shut down the federal government over its’ opposition to Obamacare? Do they help usher in more female candidates and hope that these women can be more willing and flexible negotiators in reconciling the thorniest issues of our day? Will Republicans on the fringes put their differences aside over single issues, especially social issues, so they can focus on job creation?  If there was a message echoing from Springfield this weeked, it is that the Missouri Republicans have realized choosing to be more inclusive is the right choice. 

House Passes 1.1 Trillion Dollar Spending Bill / New York Times

In Defeat for Tea Party, House Passes $1.1 Trillion Spending Bill

By 

 

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Speaker John A. Boehner on Wednesday after the vote on a spending bill that left some conservative groups fuming. J. Scott Applewhite/Associated Press

WASHINGTON — The House voted overwhelmingly on Wednesday, 359 to 67, to approve a $1.1 trillion spending bill for the current fiscal year, shrugging off the angry threats of Tea Party activists and conservative groups whose power has ebbed as Congress has moved toward fiscal cooperation.

The legislation, 1,582 pages in length and unveiled only two nights ago, embodies precisely what many House Republicans have railed against since the Tea Party movement began, a huge bill dropped in the cover of darkness and voted on before lawmakers could possibly have read it.

The conservative political action committee Club for Growth denounced it and said a vote for it would hurt any lawmaker’s conservative scorecard. Heritage Action, the political arm of the Heritage Foundation, castigated it as a profligate budget buster that is returning Washington to its free-spending ways.

“Has Congress learned nothing from the Obamacare disaster?” said Jenny Beth Martin, national coordinator of the Tea Party Patriots. “We need members in the House and the Senate who are willing to keep their campaign promises, stand up for the people and protect Americans from Washington’s tax, borrow, spend and spend and spend mentality.”

The response in the Republican-led House was a collective shrug, with 166 Republicans voting for it and 64 opposing it. The Senate, controlled by Democrats, is expected to pass it easily this week.

“If I started voting how they want me to, versus what I think is right, then they’ve already won,” said Representative Mike Simpson, Republican of Idaho, who is dealing with one of the best-financed Tea Party challenges of this campaign year. “Eh, it is what it is.”

The budget process that is culminating in the passage of the spending bill has ushered in a remarkable marginalization of the Republican far right. After a politically disastrous 16-day government shutdown last fall, the House voted 285 to 144 to reopen the government on Oct. 16. Only 87 Republicans voted yes; 144 voted no.

The legislation that reopened the government set the parameters for a broad budget deal that was again denounced by conservatives. But in December, that deal passed the House 332 to 94, with 169 Republicans backing it. That budget blueprint yielded more than 1,500 pages of fine print.

For the most ardent conservatives, the spending bill passed by the House on Wednesday represented a tangible backslide from fiscal discipline, a $45 billion increase in spending compared with where the budget would have been had House Republicans let another round of automatic spending cuts take effect.

Yet it passed the House with an even greater margin — and even more Republican votes.

“Our people learned a lot of tough lessons in the last year, and I think you’re seeing the tough lessons applied,” said Representative Tom Cole, Republican of Oklahoma.

In the process, Speaker John A. Boehner has reasserted control over his fractious Republican conference, leaving his far-right flank angry and isolated. The speaker’s public and private denunciations of the outside conservative groups have created conditions in which members must choose sides, and they have.

“The Tea Party groups and conservative movement in America gave the speaker his speakership, and I think it’s time for us to be grateful for what these outside groups have done,” said Representative Raúl R. Labrador, Republican of Idaho, who has remained in the Tea Party camp.

But most have aligned with the speaker in what Republican leaders say is a growing realization that incremental moves toward governance are better than the purist, ideological stands demanded by the right.

“We can push large ideas out of the House and say, ‘This is what we feel is the right thing to do,’ but if we’re going to actually move things, they’re going to have to be smaller things,” said Representative James Lankford of Oklahoma, a member of the Republican leadership.

The Heritage Foundation drafted a lengthy to-do list for the huge spending bill, which included prohibiting funds to build a prison in the United States to house detainees from Guantánamo Bay, Cuba; eliminating all money for Vice President Joseph R. Biden Jr.’s cherished high-speed rail projects; cutting the operating budget of the Fish and Wildlife Service; providing money for private school vouchers for the District of Columbia; and significantly reducing the Internal Revenue Service’s budget, with language requiring more oversight of the potential targeting of political groups.

All of those requests — about half the to-do list, in all — were carried out, and yet Heritage Action demanded a “no” vote.

That ideological purity has lost its power.

“They’re going to have their various metrics,” said Representative Greg Walden of Oregon, chairman of the National Republican Congressional Committee. “What we need to be able to do is go home and explain what’s inside the bills and why they matter.”

Chris Chocola, president of the Club for Growth, said Wednesday that his group’s influence had not waned, but that the budget process had highlighted that “we’ve got work to do.”

“We’d love to put ourselves out of business,” he said, “but until you get a majority of economic conservatives, you’ve got to keep fighting.”

That will not sit well with Republicans now more willing to speak out against such groups.

“I hope they spend some time trying to win the United States Senate and working with us when we have a nominee to win the presidency,” Mr. Cole said. “But I don’t think condemning Republicans who are making amazing progress in a challenging environment is the appropriate thing to do.”

A version of this article appears in print on January 16, 2014, on page A18 of the New York edition with the headline: In Defeat for Tea Party, House Passes $1.1 Trillion Spending Bill. Order Reprints|Today’s Paper|Subscribe

Explaining Obamcare to Kids

From Healthcare.gov

• Most people who currently have health insurance can keep it.

• Young adults can stay on their parents plan until 26.

• If you don’t have coverage, you can use the new Health Insurance Marketplace to buy a private insurance plan.

• Open enrollment in the Health Insurance Marketplace goes from October 1st, 2013 to March 31st, 2014.

• If you don’t obtain coverage or an exemption by January 1st, 2014 you must pay a per-month fee on your federal income tax return for every month you are without health insurance.

• In 2014 the fee is $95 per adult ($47.50 per child) or 1% of income, whichever is higher. The family max is $285.

• The cost of your marketplace health insurance works on a sliding scale. Those who make less, pay less.

• American making less than $45,960 as individual or $94,200 as a family of 4 may be eligible for premium tax credits through the marketplace. Tax credits subsidize insurance premium costs.

• If you are able to get qualified health insurance through your employer you won’t be able to receive marketplace tax credits unless the employer doesn’t cover at least 60% of your premium cost, doesn’t provide quality insurance or provides insurance that exceeds 9.5% of your families income.

• Up to 82% of nearly 16 million uninsured young U.S. adults will qualify for federal subsidies or Medicaid through the marketplace.

• You don’t have to use the marketplace to buy insurance, but you should fill out an application to see if you qualify for assistance before shopping for insurance outside of the marketplace.

• The ACA does away with pre-existing conditions and gender discrimination so these factors will no longer affect the cost of your insurance on or off the marketplace.

• You can’t be denied health coverage based on health status.

• You can’t be dropped from coverage when you are sick.

• Health Insurers can’t place lifetime limits on your coverage. As of 2014 annual limits are eliminated as well.

• All new plans sold on or off the marketplace must include a wide range of new benefits including wellness visits and preventative tests and treatments at no additional out-of-pocket cost.

• All full-time workers who work for companies with over 50 employees must be offered job based health coverage by 2015. Employers who do not offer coverage will pay a per-employee fee.

• Small businesses with under 50 full-time employees can use a part of the marketplace called the SHOP (small business health options program) to purchase group health plans for their employees.

• Small businesses with under 25 full-time employees can use the marketplace to purchase subsidized insurance for their employees.

• Medicare isn’t part of the marketplace. If you have Medicare keep it!

• Medicaid and CHIP are expanded to provide insurance to up to 16 million of our nations poorest.

• When you apply for the marketplace you’ll find out if you qualify for free or low-cost coverage from Medicaid or the Children’s Health Insurance Program (CHIP). You’ll also be made aware if you qualify for Medicare.

 

Why the Health Care Law is so Complicated / Gerald F. Seib

Why New Health Law Is So Complicated

http://on.wsj.com/1byWoH

The rollout of the Affordable Care Act is in trouble, functionally and politically, and the simplest critique of the new health law is that it’s simply proving too complicated. Indeed, its complexity—the need for multiple pieces to work in harmony from the outset—is the single best explanation of why its introduction has been so problematic.

What’s less recognized is why the new law is so complex in the first place: It represents what may be the biggest attempt ever to weave together big-government impulses with free-market forces.
 
That is what sets Obamacare apart from other big efforts at social engineering. The effort to improve health care would be much simpler—though no less controversial—if it instead took the form of the dream system that either liberals or conservatives would love to create.
 
For liberals, that ideal would be a single-payer system in which the government simply bypasses the health-insurance system and provides coverage for everyone. For conservatives, the dream system would place health care firmly in the hands of the private sector, with insurers and doctors handling decisions and the government providing aid directly to those without the resources to buy their own coverage.
 
In that sense, it is an even grander experiment than commonly recognized. Whether it ultimately works or is seen as a hopeless Rube Goldberg machine may well determine whether such an effort, on such a scale, will be attempted again.
 
To see the challenge, consider how the Affordable Care Act incorporates elements of both worlds. It is built on the back of the current, private employer-based insurance system.
 
Two of its fundamental components—health-insurance exchanges and the individual mandate—actually began as Republican ideas, conceived as ways to better put market forces and the conservative notion of personal responsibility to work in the health sphere.
 
Exchanges are simply health-insurance marketplaces that, while organized by law, are meant to foster competition within the private sector by bringing together multiple insurance companies and their policies to jockey for consumers’ business.
 
Early exchanges were created by two Republican governors, Jon Huntsman in Utah and Mitt Romney in Massachusetts.
 
And the idea of an individual mandate—that every individual be required to acquire health insurance to improve the efficiency and fairness of the broader system—was advanced in a 1989 publication by the Heritage Foundation, a conservative think tank. It argued that requiring every household to have coverage would ease the burden on businesses, and prevent any household from placing an undue obligation on society to provide it with health care.
 
If exchanges and the individual mandate represent two pillars of Obamacare, the others come out of the playbooks of Democrats and liberals.
 
The dream of insuring millions more Americans is possible only with significant expansion of a classic government benefits program, Medicaid. It provides government health coverage directly to the poor and many of the elderly—and is the very route by which the largest number of Americans are taking advantage of the new law. Other coverage expansion comes through direct government subsidies to the working poor.
 
In addition, the dream that health care be made not merely available but robust for all is to be achieved through a basic liberal impulse, which is to simply impose new standards that all health policies have to meet.
 
This regulatory impulse, of course, is what pulled President Barack Obama into a nasty trap over the past two weeks, and it presents a classic illustration of why it is so hard to reconcile market forces and regulatory impulses at the same time.
 
The idea, oft articulated by Mr. Obama, that “if you like your insurance you can keep it” under the Affordable Care Act neatly captures the free-market impulse behind the plan: No, the government isn’t supplanting your private insurance. And in theory it isn’t. But the law’s imposition of standards for acceptable policies—and the unavoidable reality that some people will lose policies that don’t meet them—sends government mandates running smack into free-market impulses.
 
Is it possible to weave together big-government ideas and free-market forces? In smaller ways, it has been done. States already intervene in both the health and auto-insurance markets, though in more limited ways.
 
The explosion of 401(k) retirement programs is, in a sense, also an example of government power and market forces working in tandem: Government sets the rules and provides the incentives, but private investment firms handle the money, the risks and the rewards.
 
Can merging the two impulses be done successfully on this scale? That’s the big question hanging over Obamacare, and the answer will determine its fate.
 
Write to Gerald F. Seib at jerry.seib@wsj.com

Halloween and Obamacare: Trick or Treat?

 

By M.W. Guzy, special to the Beacon

6:34 am on Thu, 10.31.13

When I was a kid, Halloween was the day we gave thanks for attending Catholic school. Because the day after is All Saint’s Day in church liturgy, we were off for a holy day of obligation while our public-school counterparts attended classes as usual after a night of trick or treating. (Suckers.)

Of course, back then Halloween was the province of children. By the time you were old enough for junior high, you were expected to hang up your costume and act your age. You might escort younger siblings around the neighborhood or help your parents hand out candy, but your days of door to door marauding were over.

Today, all that has changed. Reflecting the fashionable “All Mardi Gras – No Lent” approach to life, church attendance has dwindled while Halloween has morphed into a major commercial holiday celebrated by people of all ages. Fewer people worship on All Saints’ but far more party on its eve.

From a societal perspective, the problem with our collective Peter Pan pledge to never grow up is that we’re fast running out of adults to provide the treats. This, I suspect, is the emergent problem with Obamacare.

The disastrous first effort to fully implement the Affordable Care Act — often referred to as the plan’s “roll-out” — was mitigated by a strange miscegenation of Republican stupidity and Democratic incompetence.

The Republicans, you’ll recall, recently decided to shut down the government. The last time they tried that trick, they were treated to the re-election of Bill Clinton. Reluctant to learn from experience, they decided to stick their hand back in the fire to see if it was still hot. Not surprisingly, they again got burnt.

Ironically, the casus belli for the GOP stunt was the effort to de-fund Obamacare. Not only did they fail in that endeavor but the outrage they engendered managed to divert public attention from the shocking ineptitude displayed by the administration during the program’s initiation.

Having spent three years and hundreds of millions of dollars in preparation, Health and Human Services Secretary Kathleen Sebelius unveiled an enrollment website on Oct. 1 that people found difficult to use because it didn’t work. Luckily for the Dems, most people were too busy cursing Republicans to take much notice.

Eventually, of course, the government resumed full operations and public attention shifted to deficiencies in the Obamacare roll-out. The computer problems actually may have provided a hidden benefit for Democrats by delaying access to the plan. It seems the hardy souls who negotiated the hurdles of the website and got to the substance of the program often didn’t like what they found there.

I heard two different case histories reported as examples of the challenges of implementing the new venture. Both are admittedly anecdotal and thus not necessarily representative of the experience of others. Consider them parables illustrating the tricks and treats of health-care reform.

CNN interviewed a woman who’d spent three weeks trying to enroll on-line. She attempted to log in at midnight when she hoped most of her fellow citizens would be asleep; she tried during morning and evening rush hours when she thought most people would be commuting.

It was never explained why she didn’t enroll by phone but she did ultimately succeed in buying health insurance through the website for herself and her daughter. This victory was more than symbolic because both women suffered from pre-existing medical conditions that had previously precluded private insurance and their medical bills had driven their household into bankruptcy. For her, Obamacare — its shortcomings notwithstanding — represented salvation. She advises that, with her worries about medical bills allayed, she can now sleep at night.

CBS reported the story of a 56-year-old Florida woman who had a less happy ending. She currently has health insurance that she feels is adequate to her needs. Her contribution for the coverage is $54 a month.

She thought the president had guaranteed that persons who were happy with their insurance could keep it. Now, she learns that her satisfaction is not enough — the president has to like her policy as well.

Her insurer recently notified her that the current policy doesn’t satisfy the criteria of Obamacare. Among its deficiencies is its failure to provide birth control and maternity benefits. Effective Jan. 1, her monthly premiums will increase to $591 for better coverage.

That’s an annual increase of $6,444 — but the post-menopausal woman will have access to free contraceptives and full pregnancy care. She understands that she may be eligible for some kind of tax credit but states she can’t afford the extra $537 a month to continue coverage in the meantime.

With the control of the Congress at stake, you’ll hear a lot stories like these during the coming off-year election season. It is estimated that about 15 percent of Americans lack adequate health-care coverage without Obamacare. But that leaves 85 percent of the population who are presently fairly comfortable without it.

Most of the insured receive coverage through their employers. Paradoxically, the new law charges employers a head tax for each employee and employee dependant they cover. The government will thus penalize the businesses that provide most of the nation’s health care for doing so. Proceeds from the tax will be used to offset the increased cost of insuring applicants with pre-existing medical conditions.

The employer will then be responsible for insuring himself, his family, his employees, their families and for paying a bonus to insurance companies for selling their product to people they don’t want to cover in the first place.  Sounds fair to me…

Democrats have about a year to convince insured Americans that Obamacare provides better treatment than they receive at present. All things considered, that sales job could be a tricky proposition.

 
 

A Show with No End?

Americans care less and less about politics. They’re tired of all of it. Unless, you were heading to a National Monument, you might not have even noticed the Shutdown.

Today, the headlines are all about the end of the Debt Drama. About the fact that the debt ceiling just inched a little higher. 

If the Debt Drama were a play, unfortunately, we would barely be at intermission. 

Just as Tea Partyer Ted Cruz (or Ted bin Laden as the press is calling him) was crucified, a chorus of women came on stage and prevailed upon the mostly male warriors to put aside their differences for the sake of moving forward.  

Meanwhile, President Barack Obama is enjoying a resurrection that his political enemies handed him. His baby, Obamacare, whose sacrifice they were demanding, is intact. In fact, emboldened. 

The shadow of Republican attempts to attach Obamacare to government funding has been moving across the stage throughout this play and captivated the audience’s attention as it appears to have eclipsed some Republicans’ prospects in 2014.

Emerging from rear stage is the long suffering Treasury Secretary, who has been performing tricks in the shadows to pay the country’s bills, which are now twice what we bring in.

If this were actual theater, as opposed to the political theatre it has become, the writers would be furiously working overtime on their rewrites.  Fiscal liberals demanding that words like “spending”  be replaced with terms like the one I saw in today’s Washington Post, “domestic investments.”

The soothsayer is carrying a placard across the boards and lobbying for a bigger role. And despite her gloomy presence is actually being considered for a larger part. She’s carrying what  looks like a ledger that says the following … 1) Federal Debt Limit – 16 trillion dollars 2) Interest on Debt due Nov. 15 – 29 billion dollars 3) Obamacare – 6 trillion dollars.  

It seems an appropriate time to ask whether this fool has been brought in to shame the wise? Because once again, what looks like a solution, “another day that got saved in the nation’s capitol” is merely a chimera, a glittery illusion made up of disjointed parts that in reality is actually a fire breathing dragon.  

If Congress wants to hang onto its’ audience, they should probably work on the scene called, “The Budget,” which is coming up next, in January. This budget saga just leads to too many plot twists and side stories, like sequester hearings and debt ceiling crises. Why not write a scene in its’ place that brings closure, like our elected leaders failed to balance their budget and got sent home. Close curtain. 

 

 

Click here for headlines

Can it be stopped? 8 answers on Obamacare and the shutdown

By Z. Byron Wolf, CNN
Washington (CNN) — Over the next few days, the drama of a potential government shutdown will collide with the promise of a new health insurance system known as Obamacare.

Here are answers to eight of the most pressing questions about both:

1. What happens on October 1 with Obamacare and the government shutdown?

First, the health insurance exchanges established by the Affordable Care Act — or Obamacare — will be open for business. Millions of uninsured Americans will be able to enroll in health plans before the law kicks in on January 1, 2014. Second, the U.S. government might “shut down” if lawmakers can’t agree to pass a funding bill that has attached to it a provision to defund Obamacare. These two events are linked. The reason both houses of Congress may not be able to agree on a funding bill — also known as a continuing resolution — is that some senators and representatives see this as their last chance to stop Obamacare. But that’s really where the link ends.

 2. Does a government shutdown shut down Obamacare?

Not really. Most of the funding for Obamacare comes from new taxes and fees, from cost cuts to other programs like Medicare and other types of funding that carry on even in the event of a government shutdown. Congress’ research arm, the Congressional Research service, prepared a memo for Republican Sen. Tom Coburn, R-Oklahoma, that suggested an effort to use the government shutdown as leverage to force Democrats to delay implementing the law would not really work because the law will continue regardless of a shutdown. Plus, the law would still be in effect, so its many new requirements — everything from forcing insurance companies to cover anyone who wants insurance to forcing everyday Americans to carry health insurance or pay a fine — would still be in effect, too.

Government shutdown: Again? Seriously?

3. Do I have to sign up for a new health insurance plan on October 1 when open enrollment for Obamacare begins?

Maybe — Take this quick survey and we’ll find out:

A. Do you get health insurance from your employer? 
If the answer is yes — and this is by far the No. 1 way Americans get health insurance — go on about your business. Obamacare doesn’t really affect you. At least not yet. A lot of people think that because of Obamacare, fewer companies will offer health insurance, particularly to low-paid workers and retirees. There is some evidence of this. These employers would have to pay a per-worker fine to the government, but it might be cheaper for them in the long run to pay this fine to the government rather than offer insurance. Other companies might cut hours for some workers, making them part-timers working fewer than 30 hours a week in order to avoid helping pay their health insurance. But it will take some years to see if it really comes to pass. However, if you get health insurance at work, you could probably drop that coverage and buy health insurance on the Obamacare exchanges. But you might not want to. You won’t qualify for any government help to buy your insurance and your employer wouldn’t be contributing any of the money it is now.

B. Do you get health insurance from the government? 
If the answer is yes, go on about your business. Obamacare doesn’t really affect you. At least not yet. While Obamacare relies on making Medicare more efficient as a way to pay for some new services for younger people, it is not supposed to change the services offered by Medicare. One big test of this promise is Medicare Advantage. These are privately administered insurance plans that provide Medicare services to seniors. They cost the government more per person to provide Medicare. So, Obamacare seeks to bring their spending back in line with the rest of Medicare. This could lead to changes in Medicare Advantage options, like gym memberships and other items that are offered as enticements. But the same core Medicare services are supposed to remain in effect. The same goes for Medicaid. If you get your insurance from one of the 50 state-run Medicaid programs, Obamacare should not affect you. But you’ll have a lot more company in these programs, which will grow to insure a larger portion of Americans.

 

Zelizer: GOP strategy on shutdown courts doom

4. Do you have an individual health insurance plan?

If yes, Obamacare is going to affect you. It is possible that your insurance plan won’t change, but it’s just as likely that your plan doesn’t meet all the minimum requirements the law imposes. These include new rules for how much profit companies can take for plans, new rules for coverage of women’s services, new rules for how much more insurance companies can charge for women than men, and a lot more. So, you might have to buy a more expensive plan. In this case, your insurance company has probably already let you know. It’s also possible you might want a new plan. Check out your new state health insurance exchange or the one the federal government set up in your state if your state government refused to do so. People who like and dislike Obamacare have something to like about costs of individual plans. Prelminary estimates have come in lower than some government prognosticators expected. So it is fair to say Obamacare might be cheaper than expected for some individuals. But it is also accurate to say that premiums are likely to rise for healthy people on the individual market. Why? They’re going to get more robust insurance plans that cover more things. At the same time, a lot of sick people who get private insurance now pay a ton for it; their costs could decrease.

 

Congress: will it be a government shutdown or budget compromise?

5. Do you have no health insurance?

If so, Obamacare is for you, like it or not. You’re either going to have to enroll in Medicaid or buy health insurance from a private company on an “exchange” organized by either your state government or the federal government. If you’re single and you make less than $15,281.70 ($31,321.50 for a family of four), you’re likely to get Medicaid, although some states have refused to expand their programs. Those income levels for Medicaid — 133% of the federal poverty level — will increase from year to year.

10 ways a government shutdown would affect your daily life

6. How much is Obamacare going to cost me?

It depends. What if you make more than $15,281.70, but not that much more? You don’t get Medcaid. You don’t have employer-sponsored health insurance and you do want coverage. How are you supposed to afford a new health insurance plan?

The government is going to help a lot of people pay for it. If you’re single and you make less than $45,960 ($94,200 for a family of four), you’ll qualify for a government-sponsored subsidy to help you buy insurance. The Kaiser Family Foundation has estimated the average government subsidy for a family will be about $2,700 and the average premium costs will be about $8,250. Those costs will vary depending on the age and number of family members and the level of plan they choose to buy. Try your own scenario here.

Q&A: The lowdown on the shutdown, or why you should care about the CR

7. Is Obamacare health insurance government insurance?

No. Many state Medicaid programs will grow to insure much larger portions of their state populations. But the core of the law is the creation of new health insurance exchanges. These are places — online, mostly — where people who don’t get insurance can buy it from a private company. On the one hand, the government is making people either carry insurance or pay a fine, on the other hand the government is making insurance companies provide insurance to anyone who wants it and they’re controlling how much the insurance companies can charge.

 

8. What happens if I don’t buy health insurance?

You’re young and healthy. You don’t really want health insurance. No sweat. You don’t have to buy it. You can “opt out.” But then you’ll have to pay a fine of between $95 for every adult in your house or 1% of your income after $10,000, whichever is larger. So if you’re single and you make $50,000, you’d have to pay a $400 fine for not having health insurance. The Supreme Court called this fine a tax. You can look at it that way. Or you can view it as an upfront payment for having hospital and ambulance services able to come get you if you need them. Or you can look at it as horrible government overreach. Some people do.

5 strange things about deb

The First Mom’s Push on Obamacare

This is an interesting article from the Washington Post on how Michelle Obama is getting ready to roll out a media campaign urging young people to sign up for health insurance under Obamacare. I love that her previous focus has been on organic, fresh food and that she has overseen a “Let’s Move” campaign for youth. Because food and exercise are going to be a key factor in keeping health care spending down as the health insurance landscape changes over the coming decades.

What the article doesn’t say is that Obamacare hinges on people buying in, especially the young, because the cost of insuring each individual covered depends on the number of people in the system. Will 2.5 million healthy young men buy in or will they default and pay the 95 dollar fine instead? I already know lots of business owners are planning to pay the fine because they won’t be able to afford the mandate to provide health insurance to their employees. 

I also think it’s impressive that Sen. Roy Blunt is trying to encourage Republicans to consider ways to provide universal access by allowing small businesses and individuals to join together to get better rates by shopping across state lines.  I would like to see states join together to set up similar purchasing pools that would give them more leverage in negotiating better rates and coverage. 

If there is good news here, it is that we seem to have reached the tipping point on access. And both sides are inching towards each other on how to provide it. Michelle Obama’s campaign for healthy eating and exercise shows the Democrats recognize personal responsibility will be a key factor in keeping costs down. And Roy Blunt calling for universal access shows Republicans do care about the little guy .

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Obamacare backers launch campaign, want moms to convince their youths to get coverage

By , Published: July 6

The Obama administration and its allies need lots of healthy young adults to sign up for insurance this fall to make the president’s health-care law successful.

So they are going after their moms.

They put up Web ads on Facebook and Allrecipes.com alongside slogans such as “Moms know best: ‘Get yourself health insurance.’ ” They have enlisted the help of parent-activist groups such as Moms Rising, which has already begun mobilizing its vast network of more than 1 million members and 3 million e-mail subscribers on behalf of the health-care law.

They are collaborating with Elle and Cosmopolitan magazines, organizing mom-oriented wine-and-cheese parties and preparing commercials that will run during shows popular with mothers, such as “Good Morning America.” And soon, they plan to deploy first lady Michelle Obama, the nation’s mother in chief, who has already put her stamp on health-care with her anti-obesity “Let’s Move!” campaign.

The targeted messaging is part of an enormous grass-roots campaign mobilizing this summer and fall to persuade uninsured people to sign up for coverage beginning Oct. 1, when systems are expected to be in place for them to find benefits as well as financial assistance from the government, if they qualify.

But it may not be an easy sell, and the effort comes at a time of increasing doubts about the viability of the health-care law. Last week, the administration disclosed it was delaying a key provision that would have required large employers to offer health coverage to all full-time workers.

That came on the heels of an announcement by the National Football League that it probably would not lend its name to the law’s promotion efforts — a particular blow in the campaign for young men.

The share of 19- through 25-year-olds who lack coverage has dwindled since the passage of the law, which requires insurers to cover children up to age 26. But 41 percent were still uninsured in 2012, according to the Commonwealth Fund.

Costly campaigns

The White House is aiming initially to sign up 2.7 million healthy young adults for coverage. Young men especially are cheap to insure and are therefore critical to keeping the law on a good financial footing.

As it stands, however, advocates worry that young men will forgo insurance and instead pay the fine, which begins at $95 for the first year.

As a result, insurers, advocates, hospitals and others eager to see the law succeed are mounting costly campaigns to persuade people, particularly young and healthy ones, to buy insurance. And many see mothers as a potent part of that effort.

“In the end, it will be the moms of America who are going to decide if their families get coverage,” said Celinda Lake, a Democratic pollster who has conducted focus groups for health exchanges in three states. “They will decide and then insist their children and husbands sign up.”

Women, Lake said, are responsible for 80 percent of the health-care spending decisions for families, and they will probably be the ones to delve deeply into the new health insurance options and obligations under the law.

Their influence is particularly strong among men under age 26, who are a key target of advocates because they rarely use medical services and are therefore cheap to insure.

According to her research, when asked whom they would turn to for trusted information about the health-care law, the top answer in that demographic was their mothers.

Mothers, however, have been turned off by the divisive nature of the debate over the law, Lake said.

Even for mothers engaged in politics, the law’s close association with President Obama is not always a plus. While unmarried moms overwhelmingly supported him in last year’s election, married mothers leaned slightly toward Obama’s Republican opponent, Mitt Romney, who had promised to try to repeal the health-care law, exit polls show.

A poll commissioned by Enroll America, a large umbrella group mounting a multimillion-dollar enrollment effort this year, shows that while many poor, uninsured women would like coverage, they are skeptical that they will be able to afford it even with government assistance.

Hadley Heath, health policy analyst for the conservative Independent Women’s Forum, said she believes mothers will ultimately advise their children based on what is best for them, not politics. But as a 25-year-old, she said she finds the mom focus a little condescending.

“I’d rather they talk to me rather than my mom, because I make my own decisions and pay my own bills,” she said.

The administration has already begun its outreach to mothers, with a series of events in conjunction with Mother’s Day in May. In addition to Cosmo, they have reached out to Elle and Ms. Magazine and forged a partnership with Text4baby, a text-
messaging information service for pregnant women and new moms that has more than 500,000 subscribers.

Putting a face on the issue

An official said all the primary White House figures, including Obama, Vice President Biden and Michelle Obama, will eventually be out publicly urging the uninsured to sign up for coverage.

“What Michelle says will be important, because moms really love her,” Lake said.

Enroll America is planning targeted outreach to mothers, including a series of mom-oriented house parties this summer, President Anne Filipic said, adding that they view moms as a top messenger along with doctors. Health officials in Oregon are taking things one step further by targeting grandmothers.

A group poised to become more visible because of its activism around the health-care law is Moms Rising, a nonprofit group that formed in 2006. The group has a “wellness wonder team” of mothers who have pledged to learn about the law and spread the word about its benefits. It also plans to highlight the stories of women and mothers who have already benefited from the law.

“A lot of times, [moms’] stories relate to their children, and their children are their hearts,” said Lisa Doyle, 55, a Moms Rising member in Minnesota, explaining why she thinks mothers’ opinions are so powerful on this issue. “You go out there and you talk with your heart. All of a sudden, all this health-care talk has a face.”

 

Scott Clement and Sarah Kliff contributed to this report.

 

 

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.