The obvious thing is that the Republicans totally stepped on their own chances of pointing out what a clusterfuck the Obamacare rollout is. They’ve never had a coherent narrative of just what was wrong with Obamacare, and when actual problems materialized they looked away for some reason.
I’d have to consult a psychiatrist or a circus owner to get an expert opinion, but I have a couple of unschooled guesses why the Obamacare rollout isn’t occupying banner headlines on Fox and shooting to the top of Memeorandum.
First, the right is dealing with an audience that’s been told that Obamacare will lead to an end of the American way of life as we know it, create panels that determine whether you live or die, and make you stand in line for hours to get even a band-aid from some doctor (not your own) toiling under the thumb of faceless bureaucrats. Compared to all that, a website that crashes or takes a long time to complete an enrollment is almost a good news story.
Second, if you start talking about exchanges having trouble signing people up, you must acknowledge the fact that people are signing up. If you acknowledge that, you acknowledge that a four year effort to kill off Obamacare has amounted to precisely nothing.
It’s similar to the messaging on gay marriage. The right spent years telling us that same sex marriage would lead to people marrying dogs or turtles. None of their dire predictions panned out, and they’re losing that fight pretty decisively. So, instead of reporting every food poisoning incident at a gay wedding reception, they’re looking for the next threat to the white, straight American way of life. Goldline isn’t going to pay for ads on a network reporting about petty inconveniences — it’s only the threat of impending apocalypse that moves product.
LittlePig
Err, umm……Title?
ETA: now it’s there. It was blank space – I must have caught it just as WordPress was cobbling the page together.
Baud
Also, if you’re them, why advertise the website? Wingnuts need health insurance too.
RepubAnon
I thought that the definition of “death panel” was a group of Republicans discussing how to repeal Obamacare in order to deny care to folks unable to get employer-based health insurance.
geg6
Well, that and the state exchanges are going gangbusters. And, as even Ezra Klein admitted last night, the federal website is improving. And this weekend’s shutdown and fixes will presumably improve it even more. Chris Hayes seemed disappointed that it was improving. Fucking panicky liberals are making more of a fuss over this even as they admit that the glitches aren’t unheard of or insurmountable and are likely to improve fairly quickly.
RaflW
Good insight. It has been fairly true that in places like MN, the right is mostly silent on gay marriage now, except the occasional bullshit about protecting florists (I know, what?!) or inns that want to discriminate.
Otherwise, gay marriage? Crickets. Because they lost and have to move on, since sulfurous stones didn’t hurl from the heavens on Aug. 1.
Ben Franklin
The concierge medicine loophole needs to be closed if we want to avoid a genuine trap for ACA. NHS is a downer because of the two-tiered system for the 1%.
Ed in NJ
I have a colleague who works for a Fortune 100 company in Arkansas. He claims that his annual renewal keeps his premiums level, but switches from a co-pay/deductible model to a straight deductible of $3200, including his drug plan. Of course he insists that this is due to Obamacare. Anyone have thoughts on this? I know Arkansas is using federal money to by private insurance instead of doing a true Medicaid expansion. Is this another example of red states screwing themselves? I assume the risk pool for private insurers must be affected by all those pre-existing conditions now being covered. Also, I know the governor is a Dem, but he couldn’t get the Medicaid expansion past the legislature.
debbie
The message-makers’ problem is that they rely on exaggeration over reality. If Republicans had stood up and said that the spectre of death panels was silly and overwrought, but here are our real objections to ACA, they’d be in a better position today. They may have even got more of the kind of plan they wanted.
amk
Five sensible suggestions for gop rebranding.
Not.Gonna.Happen.
catclub
Also, they might have their readers and viewers remember that the GOP has been trying to sabotage the thing for years, and somehow, reporting that the sabotage is partially working just has problems as a story line.
I wonder if there will be some computer guy claiming he was the one who sabotaged Obamacare!
Of course not, he would get fired.
AdamK
I wanted to marry a turtle. I’m disappointed.
catclub
@Ed in NJ: “a colleague who works for a Fortune 100 company”
Does the ACA have ANYTHING to say about these policies? I think not. Or it tells them they have to do what 99% of them have already been doing.
The only regulations on company supplied healthcare that I know of is that gold plated policies will not ALL be deductible for the employer. I think it is the level of policy that costs over $25k/yr – but that is just my guess.
This aspect of the ACA has been unpopular with some unions.
Baud
@AdamK:
There’s always McConnell.
Corner Stone
@AdamK:
Aw, don’t be so down about it. I’m sure somewhere out there is the turtle for you. Probably just taking a while to get there, that’s all.
Corner Stone
“Panicky liberals” like Robert Gibbs?
Ed in NJ
@catclub:
Thanks for the response. I wonder if they are reducing coverage to avoid the cadillac tax. This is definitely a high earner, but he describes his plan as a typical plan. Typical for who?
For all I know, the company could have an employer-funded HSA to cover the deductible, so he’s not paying a dime either way, but the company restructured the plans to avoid having to tax the policies.
TaMara (BHF)
Ummm..this was the lead story on ABC News last night, how fucked Obamacare roll out is.
NBC Nightly News had a similar story to open the news cast.
And just like DP said above, besides the apocalyptic tone, the buried lead is 11 MILLION people trying to sign into website. I guess it is a total failure, isn’t it?
Just Some Fuckhead, Thought Leader
Ted Cruz made me smack my head on a low overhang this morning and now I’ve got an owwie.
Ruckus
When you are a bullshitter you can’t all of a sudden start telling the truth.
No one would believe you if you even tried.
Besides their whole stick is based on building fear. The truth just gets in the way of that. Because as much as life sometimes shits on us, for the most part it is not terrifying on a day to day basis. Take away that fear by telling the truth and conservatives have nothing, zero, bupkus. Which is why when they create something to really fear, in this case the default, they have to downplay it.
The real issue with conservatives is truth. If you know the truth, conservatives also have nothing for you. And most of them know it.
aimai
@AdamK: And now you can! Thanks Obama!
Just Some Fuckhead, Thought Leader
@Ed in NJ: I’d say one of the following is operative, in this order:
1. Your friend is a congenital liar.
2. Your friend is a fucking moron.
3. Your friend is secretly retarded/Republican.
4. Your friend is confused.
5. Your friend is ill-informed.
6. Your friend is a composite spanning several individual experiences.
7. You don’t actually have any friends.
–
99. Something is wrong with the system.
RaflW
@Ed in NJ:
Well, that is a question! Some of these folks have a very, very distorted idea of what is typical. Their peers make oodles. Their relatives who are ‘struggling middle class people’ might have a household income of $100K and up.
What they see around them they normalize. Romney in a classic example thought that $200-250K was ‘middle class’.
Its top 5% or higher, dude.
So what would a Platinum plan person know about average policies?
aimai
@catclub: So: Ted Cruz’s family policy, in other words. 40,000 in coverage per year for thee, and not for me.
aimai
@debbie: But they didn’t want any plan. That’s why none of their negotiating strategies made any sense. When you talk to true believing Republicans, like people in the street, and you start from first principles you can get somewhere but not with the top line Republicans.
For example you can say to people
We have a health care crisis
Lots of uninsured and uninsurable people
What do you want to do about that?
and they will independently come up with some or all of the Obamacare solutions and/or go all the way left and describe an idealized single payer type system.
But the Republican donors and leaders don’t acknowledge that there is a problem and don’t see any need to seek solutions. So they were never willing to tinker around the edge of what was, of course, their own plan.
ruemara
I couldn’t sign on to WoW for 2 days due to glitches. It must be a failure. And Apple’s OS had glitches with fingerprint recognition, so total failure. Can I have a daily wonk column now?
Sly
We know how they’re responding to the Exchange rollout. They’re lying.
Not exactly a new approach.
SarahT
Heh :
http://clotureclub.com/tea-party-insult-generator/
Gex
The next threat, btw, is atheists. I follow the anti-gay groups pretty closely and they have been starting to replace the word “gays” with “atheists” when they talk about who is destroying America and persecuting God-fearing “real” Americans.
So it looks like I’m in for another couple of decades of the religious right waging war against me. It’s so much fun to be on their shit list.
BretH
“Goldline isn’t going to pay for ads on a network reporting about petty inconveniences — it’s only the threat of impending apocalypse that moves product.”
Nail, meet hammer.
Ruckus
@Gex:
I think that list makes us special.
Corner Stone
@Gex: Wait a second. First you made me divorce my wife. And now you’re making me divorce God!?
You, Gex, are pure evil.
*shutters*
dmbeaster
@Gex:
lol.
I guess then is gonna be about how wrong it is that atheists are allowed to marry.
gene108
@Ed in NJ:
Yes, it’s because of Obamacare.
The “Cadillac tax” has caused companies to move from co-pay/deductible plans to high deductible plans.
My brother works for a large company in NYC and he showed me his new plan choices. They basically line up with the Silver Plan option under the Obamacare exchange.
But he’s able to save a lot on the employee contribution and the employer is chipping in a bit to cover the deductible.
Sucks for him that his employer isn’t passing on any savings on the health insurance onto him, but high deductible plans are the future of insurance in this country for the foreseeable future.
Mike in NC
The problem with demonizing the ACA is that the typical Fox Noise consumer is 72 years old and is getting Medicare, and possibly has no grasp of what a “web site” is.
But change the subject to dirty illegal aliens and they’d jump right out of their lawn chairs.
Jewish Steel
driftglass:
Anya
@geg6: I am puzzled by Ezra Klein’s giddiness at the glitches. I am not an Ezra hater, in fact I like him a lot. But I am really disappointed at his constant harping on the glitches. Ezra was a champion of the health care law and he devoted a lot of time to make people understand it, so his performance is a bit odd.
debbie
@aimai:
Very true, I keep asking my Republican family members, “If you believe in (choose something relatively reasonable), why do you stay silent when the clowns rush the microphones?” They never have an answer.
Bill E Pilgrim
Well or put another way: if their entire existence lately has been devoted to the idea that this affordable health care program will destroy the life of anyone who signs up for it, it’s a little tricky to turn the fact of people not being able to sign up for it into something equally tragic.
I did see some butch haircutted Republican on CNN last night arguing that “someone should be fired” and so on, but the CNN host, to my complete astonishment, was more or less rolling her eyes and saying oh there you Republicans go, just looking for a scalp for political reasons. I’m telling you if the Erin Burnetts of the world are going to be even a little suspicious of GOPer motives, openly, on TV, this is a miracle on the order of the loaves and the fishes.
Villago Delenda Est
Which, naturally, is something that they simply cannot do. Because, you know, it’s reality. And we all know what kind of bias reality has…
gene108
@gene108:
Just want to add that there’s a provision in the ACA that employer coverage cannot cost the employee more than 9.5% of his/her gross income. To make sure lower wage workers are within this requirement employers are moving to high deductible plans to have lower premiums that would comply with this provision.
Obamacare has made high deductible plans the norm, for better or worse.
Soonergrunt
@debbie: That’s a point that needs to be made over and over again. By allowing the clowns to speak unchallenged, they choose for the clowns to speak for them.
Corner Stone
@Anya:
Ezra was on Martin Bashir’s MSNBC show yesterday. Martin quoted Ted Cruz using Ezra’s statements in part of his (Cruz) stump speech somewhere.
Ezra then said that was odd since he had never said what was quoted. Bashir gave him the perfect opening to state what he thought of that kind of effort by Cruz. Ezra just elided past it and didn’t comment at all on the lies made by Ted Cruz.
I thought it was pretty eye opening that for him, the effort to remain journalistically neutral entails not calling a lie a lie.
I know people here call EK the new Broder but I still found it disappointing.
pseudonymous in nc
@Anya:
I think his attitude here is “YOU HAD ONE JOB”.
The best thing that can come out of the Healthcare.gov launch is a revolution in government tech.
I was listening to the head of the UK’s digital efforts talk about his team’s work at the CFA Summit last week, and he said that he could have predicted Healthcare.gov’s problems just from the budget. Too big, too many partners, and driven by a contracting system where procurement is seen as the end goal, not delivery. Of course, he doesn’t have to contend with wingnut state governments foisting responsibility for exchanges onto the feds, but it’s a valid criticism.
This isn’t a partisan thing: it’s a structural thing.
gene108
@Bill E Pilgrim:
I think it just proves MLK, Jr.’s point about the arc of history moving towards justice. The more people scream that inequality must be maintained because the alternative will destroy civilization and when a move towards equality does not, we have a better society and the reactionaries move onto something else that’s going to destroy civilization.
In 1960, Ronald Reagan predicted kids would be telling their grandchildren about “when Americans were free”, because of Medicare. Now those kids are on Medicare and they aren’t about to give it up or tell their grandkids Medicare is destroying freedom.
Same with integration, interracial marriage and a host of other things that do not spark significant civilization ending social outrage.
Chris
@amk:
Best line in the article.
Well, yes and no. It’s true that invoking the god Ronald Reagan serves as a substitute for articulating anything, but it’s not like they’re poring over everything Reagan did and mirroring it as closely as possible. Like all True Believers, they simply do what they want and then say “Reagan would have supported this because shut up that’s why,” and then ignore everything he actually did that suggests otherwise.
Can’t do it. Any attempt to improve their tone will be interpreted by the base as an act of appeasement and leave them vulnerable to a primarying action two years down the line. Figure out how to defang the primarying threat and then you’ll be on to something.
Jamey
And what came of that was the realization by all that the only people talking about sex with turtles or dogs were … religious conservatives.
God has blessed us with incompetent enemies.
Corner Stone
LTG Cooch (R-VAG) gave the GOP Weekly Address it seems. He presents as just an awful public speaker. A high, thin and reedy like voice with overly rouged cheekbones and the inability to look into the camera when speaking.
Who could ever vote for that guy in the first place, even before all the creepy ladyparts legislation he likes?
schrodinger's cat
@amk: Has the person who wrote the article been living under a rock for the last 5 years? And she wants more of Susan Collins? Surely she is not serious.
Chris
@gene108:
This needs to be on a quote wall somewhere.
Fair Economist
@geg6:
They aren’t unheard of or insurmountable but they certainly are inexcusable. And, as usual, it’s a private contractor that caused the problem. If they’d had the government do it via the NSA or the IRS it would have come out MUCH better. Private contractors would have been fine for the glitzy front-end but if something really needs to work you want the government to do it.
Jibeaux
What is disappointing about Ezra is that he keeps talking about the ACA as synonymous with the website. The problems are with the website, but I think they’re well-founded objections. A few days of high traffic crashing the thing one thing. Heading into week 4 with profound underlying problems is another.
Omnes Omnibus
@AdamK: Give it time. Rome wasn’t burned in a day.
Anya
@Corner Stone: That’s disappointing. If he can’t call out a man who’s universally hated then WTF is he good for. I hardly watch t.v. so I miss his “I want to be a VSP” performance but I like his wonkblog. Although, the blog has become “Obamacare a failure” daily blog, which is disappointing.
Elie
Frankly, its taken me several hours to change to a new web and teleconferencing set up inside my employer! I have been employed for over two years and the system doesn’t recognize me so I have to go through a bunch more help desk time to fix. And by the way, many of us are having this problem, so its not a one-off type of problem.
Now talk to me about Obamacare enrollment woes and how unusual this is.
Elie
@pseudonymous in nc:
That and the fact that the US is three times larger than the UK with much more systemic variation. They implemented NHS after WWII when their healthcare institutions were rebuilding and it was relatively easier to push through big change. Our change was made at the peak of percent of GNP for healthcare — lots of piglets on the healthcare hog and getting smooth change while shrinking the piglets and the mama — well — there is no easy way to do it fast.
But have your fantasy that this could all have been done “better”. No doubt — in a fantasy somewhere, I am sure it could have been.
schrodinger's cat
@Elie: The teething problems of Obamacare are not unusual at all. The MSM has been bashing the Republicans for over a week now, bashing these exchanges is a form of balance for them. Both sides do it, see.
Matt McIrvin
New Jersey gets same-sex marriage on Monday. New Mexico has been gaining it piecemeal for months. It’s almost a non-story.
schrodinger's cat
@Corner Stone:
That would be me. Let me give you two examples.
1. He criticized the conclusions drawn by Ferguson’s Inside Job, by a hoocodhavenode defense.
2. He was pro Larry Summers for Fed
If not a new Broder he is definitely sympathetic to the DLC brand of neoliberalism.
mai naem
Billmon had a link to piece on NRO(yes, I know NRO) about the problems with the rollout. I know its NRO, but it really did seem to point out some problems and Ezra Klein’s stuff seems to make the same points. I hope its wrong but it does worry me. Even if you take it as a per day enrollment for every day till end of march March, you need around 45k enrollees a day and, yes, it’s early but it doesn’t sound like they’re making the numbers. Also I didn’t realize it takes 2 mos. for them to verify everything. I heard a piece on NPR where they said it’s going to take months to fix the architecture. Ugh. I am really disappointed in Sebelius or whoever was in charge of this. Even if this had gone off really well, the GOP was going to be looking for stuff. The admin just handed them this on a silver platter.
Kay
There may be a little bit of a disconnect between media reports and people in this.
A lot of less-interested people I spoke with here were attributing the problems to the shut down, which is perfectly reasonable if one doesn’t know what was shut down, who is “non essential” etc – (I don’t understand that myself).
I read Ezra Klein’s posts so I know that the general answer to that is NOT the shutdown, and I suppose that absolutely true regarding the contractor fixing the site, but is it absolutely true regarding HHS managers getting on the contractor to fix the site? Were they working? I read a coupla media reports where they made a point out of “no one answering the phone” at HHS. That was shut-down, was it not?
Anyway, people here think the thing didn’t work because the government was shut down. Rational, right?
Elie
@Elie:
..And let me also add that NHS was implemented during the era of paper records. Everything moved slower and that allowed change to be slower.
Now, enrollment and delivery of care have to happen much faster and any glitches about how that happens are recorded immediately and broadcast to the world …
The left/prog is its own enemy and slows the success of things they say they want by helping the right criticize and find fault with any effort…
Elie
@mai naem:
There will be other issues as well with having enough providers — particularly primary care physicians in some places. No way to fix that fast — have to train more docs (takes time) and physician extenders — advanced practice nurses and physicians assistants.
What to do!!!????
We keep going. Do the best we can. There may be queues in some places for a while till we can get enough care givers…
Anybody see GRAVITY? GREAT movie… ostensibly about dealing with space catastrophes and dealing with what you have to figure out a solution. I encourage all to go see that and keep in mind that in my opinion, we are in a very new place — a new frontier — and we — those who support this change, have an obligation to pull up our britches and stay strong for the times ahead — and there will be many. But we are going to do it. Americans who never had healthcare will begin to receive it. That is all.
mai naem
@gene108: From what I saw, there are copays, not just a straight deductible in the Silver Plans – it seems like its 80/20, 70/30 and copays for office visits but then there’s also the preventive stuff that’s included
. @schrodinger’s cat: I don’t think Klein is a superficial fluffer like Broder and his reporting is solid. He’s more like a version of a younger Kinsley. I don’t think he wants a in the bag leftie rep of a Chris Hayes because then he won’t get invited to all the Kool Kids Kocktail Parties.
aimai
@Gex: Well I definitely don’ tthink atheists should be allowed to get married to other atheists. They should be assigned a religious person.
Corner Stone
I find the arguments that, “Hey! It’s such a success it’s crashing!” to be a little curious.
First, the reason for the push to change to ACA was, IMO, to provide access to health insurance to some 30M+ people who couldn’t get it. So, it should have been fairly intuitive that demand to see what it was all about would be some faction of that total.
Second, people won’t even buy a cheap LCD TV without visiting 4 to 6 websites for pricing and reading reviews. Something their life/economic well being does not depend on may take a couple weeks and several visits before a purchase.
Third, blaming it on a contractor who reportedly used outdated technology is completely lame.
Fourth, if your platform is that government can be a force for good in peoples’ lives (my interpretation of a Democratic Party main plank), then competence has to be one of your key drivers. Telling us that health law varies between jurisdiction and between insurers who may or may not be participating in good faith does not cut it.
Fifth, the website is completely separate from the actual policy outcome but none of this is helping anyone at this point. In a year, IMO, we’re going to look back and say, “Rough start, but good progress so far.”
Because, ultimately, too many people will do exactly what Ted Cruz said they would, “like the sugar” (in so many words). And that’s just human nature. So it’s good politics to provide it. Hopefully we can wedge into the policy of it and keep ACA improving over the next decade or so.
Ruckus
@mai naem:
Look at @Elie’s: post above about signing on to an internal website. The ACA website is, or should be considering what it does, several orders of magnitude more complex. Many of the sites it has to check were probably never made to interact with other systems and yet now they have to. Add in 50 states and their systems never made to be compatable….
The real issue was the mistake of having to set up an account to browse. And this is not just an ACA problem. I occasionally run into this in the commerce world and they don’t get my business because of it. Those needing the insurance can’t say that. But it sounds like they have fixed this. I’m not going to go look because they don’t need the extra traffic and I don’t need the insurance.
Ed Drone
@Fair Economist:
It has occurred to me that the private contractor may be in the pockets of an Obamacare Denier, and the fuck-ups are deliberate.
Someone needs to investigate. It’s really easy for a programmer to insist on really inefficient, memory-hogging code, and tell the client, “That’s as good as it gets.”
I hope to hell someone is investigating, and if any connection with the opponents or their Svengalis or money-men, throw the bastards in jail. And forfeit their fees and payments.
aimai
@mai naem: Oh for christ’s sake–do you know how long it takes insurance companies to verify stuff for you when you apply? Or life insurance? Nothing is instantaneous. 1/4 of the people who need to sign up in Kentucky have signed up in the first two weeks. Why? Because people who are already in the system have information already in the system that can be used to verify them and get them perfectly fitted. In other states where there was no state buy in there is going to be some slippage. People should be complaining to their state legislators about why their state didn’t run the exchanges and devolve information gathering down to a more manageable level.
Corner Stone
Oh, and Go Cocks!
gene108
@Matt McIrvin:
NJ would’ve had same sex marriage a few years ago (civil unions have been legal for years), but Christie vetoed the bill. Most folks in NJ do have not problem with same sex marriage.
Nutella
See this link on whether employer plans might be different/more expensive. It’s a little dated but it makes the point that employer plans are required to change so there will be some where premiums go up.
Now in corporate plans preventive care has to be covered without copay, adult children must be covered, pre-existing conditions must be covered, traditional discrimination in rates that made women pay more are gone, lifetime limits are gone.
These are all good things (well, except for the adult children one which I don’t like but is politically popular) but not necessarily free.
If you were one of the few lucky people who had a good deal on insurance in the past you are probably going to pay more. My small company’s rates are going up.
High-salary people at big companies probably have premiums going up too.
There are millions more winners than losers, though, and more choices and more plan comparison information so overall it’s definitely better than what we had. Not good enough yet but changing an industry that accounts for 17% of a big economy can never be easy.
Kay
And then I’ll play devil’s advocate and worrywart and ponder whether the delay could be construed by a litigious Republican as a reason to delay the fee imposition that goes along with the mandate.
Which is one of the reasons I’m a little curious whether the shut down had any effect on the delay in fixing it, because that might be the response :)
gene108
@mai naem:
Preventive care is 100% covered in all tiers of plans under Obamacare. Even Ed in NJ’s friend will have preventive care 100% covered.
Having employer coverage, I haven’t gone onto the exchanges. My brother’s policy has co-pays for some prescription drugs to mitigate chronic conditions.
But most of his medical charges will go against his deductible.
From shopping my company’s plan at our annual renewal, what I was told was that high deductible plans will be the products insurance companies will be offering now. The option for a $20-co-pay for a doctor’s visit will be going way, from what I was told.
My sample size of what I’ve seen under the ACA is not infinite, so I could’ve missed some thing that are being offered.
WereBear
@amk: Thank you so much for the roll-on-the-floor helpless laughter.
Oh, yeah, they are good suggestions. But being a Wingnut is the true meaning of never having to say you’re sorry.
gene108
@Nutella:
It’s an easy way to push the “young invincibles” into the insurance pool that will lower the overall rates for the rest of us.
Fully insured employer plans ( as opposed to self-insured) have had a lot of things to be covered that may not have been required previously by state law, which is one reason insurance premiums have gone up for some people.
In my opinion, there are going to be winners and losers under Obamacare. My assumption is the gains the “winners” will have will far outweigh the losses the “losers” will endure.
Villago Delenda Est
@Jamey:
Voltaire’s prayer keeps paying dividends, over two centuries later.
gene108
@WereBear:
Other than not invoking Reagan, as if he were a Biblical figure, whose words are the infallible word of God, amk’s article is what Republicans have been saying for years.
They need to change their messaging and tone, as opposed to changing their actual message.
Since Bush, Jr. is now a liberal RINO traitor, there’s no place to go but go all in on granny starving and kicking the poor, so the rich can get richer. Bush, Jr. at least offered some fig-leaf cover to funnel wealth to the rich, such as Medicare Part D, but these guys don’t want to deal with that level of subtlety.
Lurking Canadian
@gene108: can you explain how the deductibles work? If somebody has a $3000 deductible, does that mean you have to get to $3000 worth of medical costs before the insurance pays anything? Is that $3000 in a year, or a lifetime, or in one incident, or…? And how does the deductible interact with the rules about certain things (contraceptives, for example) being covered “free”?
fuckwit
You are correct. This is true of ALL fears! They seem so blown up and terrifying, then when you do them, you realize it’s not that scary.
Think of the first time you did anything that scared you. You did it, you survived, and you said, “wow, it wasn’t that bad!”
If you have kids, you have no doubt helped your kids through dozens, maybe hundreds, of these situations. They think they’re gonna die from jumping into the deep end of the pool, then they do it, and now you can’t get them out of the damn thing.
This is how humans grow and learn.
mai naem
@Ruckus: I went on the website the first day and I am one of the ones who got stuck at the security questions but they had one of those surveys about site experience and I did state they should have a chart form of plans available for shopping and when I went on a couple of days ago they did have that(yeah, it was solely because of my request:>) But, the NRO piece and Ezra Klein say that the consumer and the insurance cos. are sometimes getting the wrong info. @gene108: Practically, what’s the difference between a 70/30,80/20 plan and a copay with routine medical care – with a doctors visit the $$ is probably going to be about the same. Also preventive stuff was not always included so it’s saving you $$. I think for most people it’s going to be a wash short term and positive in the long term. Also, I do think Obamacare’s goal which the Dems will never admit to, is to break the employer/healthcare system which is good thing in the long term.
@aimai: I only mention the two month deal because it means it’s one more stressor on the system. I was expecting problems but the Obama people have handed an issue that the Republicans are going to be using as a cudgel till 2016. I was hoping a smooth rollout of Obamacare would help the Dems take the House in 2014 and make the necessary fixes to the ACA, among other things.
WereBear
This probably explains the early-this-year realignment of my health insurance; I’m with a non-profit who doesn’t pay all that well, but has good bennies.
We have a higher deductible, but the company helps with that. And after the deductible, it’s 100% coverage… which is HUGE.
gene108
@Lurking Canadian:
You pay $3000 in a year before the insurance kicks in. This resets every year. Things that are not paid for by you do not count towards your deductible, like preventive care which is now covered by all insurance providers.
aimai
@gene108: I agree. Its hard to explain it to the former winners because they don’t know they were winners before in a rigged lottery. Many, if not most, of them may not have known what the content of their health insurance policies were before, or how they compared to other people’s choices. I know our policy is presented to us by my hsuband’s company and we have no chance to compare at all. Its take what they give you. So whether it is better or worse, higher copays or lower copays and higher deductible, absolutely was invisible to us.
If you are a middle class person with good coverage that you have accessed or that you haven’t accessed you don’t necessarily grasp that the laws enabling the insurance company to toss people like you off their rolls (recission) enabled them to keep some teaser rates low. Or that your employer is bearing a huge part of the costs of insuring you and simply taking it from the pay they would otherwise have to pay you to cover your own insurance.
So there are bound to be some unhappy people when wealthy, middle class people begin to see and understand that they have been subsidized by a lot of people and that those subsidies are going away or being given directly to poor people whose existence they had denied.
It should be obvious that 44 million people going from no insurance to good insurance has to outweigh a story here or there about some upper class person paying a bit more in premiums for good coverage in case of an accident or illness. Even those higher premiums for our theoretically middle class person come with a benefit–but its hidden from their view: the benefit is that they can’t lose health care coverage because they get sick (no recission), that they can’t lose it because they lose their job (the exchanges), they won’t lose it if they lose their income (divorce! widowhood!), the caps no longer exist–these are all worth paying for and if you asked people point blank whether they were willing to pay a few extra dollars a month to make sure the system would care for them in the event of these catastrophes they would probably willingly accept them.
Instead of calling it a premium or a tax we should offer everyone a chance to check a box on their taxes to pay for a “personal permanent portable insurance fund” aka national health by another name. We’ll get there. It just has to be framed as personal benefit not as something scary like a right extended to poor people.
aimai
@mai naem: A smooth roll out would just have been invisible and so wouldn’t have helped take the house. And as we now know the republicans simply lie about everything and invent stuff when they don’t have a catastrophe to monger. I’ve given up worrying about what we are or are not doing right or wrong. Begin with that and you calm down about little bumps in the road.
gene108
@mai naem:
They went about it in a strange way. The ACA currently doubles down on employers providing insurance.
There’s a chance we can move away from employer based coverage. I hope it happens.
There’s also a chance that by all the states giving up on setting up their own exchanges and having a national health care “marketplace” where people by their coverage, we can move closer to some kind of national minimum universal coverage – even single payer – because so many states have been integrated into a national system already.
WereBear
Garsh, this statement covers a Grand Canyon of butt-hurt.
They regard their upper-middle-class-white-guy status as a given.
Baud
@gene108:
Currently, small employers can purchase insurance for their employees through the Exchanges. In 2016 or 2017, the Exchanges open up to large employers, if the states allow it. Once they’re fully open, it will hopefully be possible to minimize employer involvement and employee dependency on employers for health insurance.
gene108
@aimai:
If only the obvious happened.
Republicans, with their huge media megaphone, are already screeching about anyone – and I mean anyone – who provides an anecdote about their premiums going up and/or deductibles going up.
The MSM ain’t in the business of doing human interest stories anymore about the “common man” facing struggles in our society today, whether it is with unemployment, under employment or lack of access to health care.
Look for the low info voter to get bombarded by anecdotes of every person, who has had a premium or deductible going up, which means Obamacare is an overpriced big government failure and nothing about all the people finally getting medical attention because they now have insurance.
taylormattd
@geg6: The state exchange websites are now working fantastically. It’s more fun, however, for white progressive bloggers to pretend a difficult rollout of an exceedingly popular product is something they could have fixed, via their own amazing webdev skills.
gene108
@Baud:
By 2016 or 2017 the penalty for employers not providing insurance really kicks into gear. Even the above statement just gives another market, where employers can still shop for plans.
Unless the penalties for not providing or offering insurance to employees gets eliminated, employers will still be under pressure to make sure their employees do not go onto the exchanges and get their own insurance.
Baud
@gene108:
I believe the long term goal is that employees will be able to choose from whatever plans are available on the exchange, while the employers role will be limited to making contributions towards the premiums. Still have a ways to go, however.
rikyrah
Billionaire Koch Brothers Spending Millions To Deny Health Coverage To Low-Income Americans
By Igor Volsky on October 19, 2013 at 12:00 pm
Conservative advocates funded by the billionaire industrialist brothers Charles and David Koch have launched a massive campaign pressuring states to deny health care coverage to lower income Americans through the Medicaid expansion contained in the Affordable Care Act.
The effort, orchestrated by the group Americans for Prosperity, is targeting lawmakers in Virginia tasked with deciding whether the state should accept federal dollars to provide insurance to individuals and families below 133 percent of the federal poverty line ($31,321 in income for a family of four). Volunteers with the organization are distributing flyers through door-to-door canvassing, attending committee hearings, and according to one lawmakers who has become a target of the campaign, intimidating constituents.
As many as 400,000 Virginians could qualify for coverage if the state expands the Medicaid program, but AFP is warning Virginians that the system “will cost Virginia taxpayers billions,” require “future tax hikes and budget cuts to vital services like schools, police and fire departments,” undermine the “doctor-patient relationship,” increase wait times and even endanger lives. “Medicaid patients are almost twice as likely to die during surgery than individuals with private insurance,” the group writes on its website.
Under the Affordable Care Act, the federal government will pick up 100 percent of the cost of growing the program from 2014 to 2016 and states would contribute 10 percent thereafter. Analysis from the Commonwealth Institute for Fiscal Analysis in Richmond finds that “net savings from Medicaid expansion would average about $135 million per year in the upcoming budget cycle” since expanding Medicaid “would allow the state to use federal funds instead of state dollars for these programs that already provide care to the uninsured in Virginia.”
http://thinkprogress.org/health/2013/10/19/2806521/billionaire-koch-brothers-spending-millions-deny-health-coverage-income-americans/
rikyrah
@geg6:
of course he was..
what would he and Ezra have to whine about?
said it before and will say it again..
IF YOU HAVE no Insurance..
Or
You are paying through the nose for insurance….
You will have the patience of JOB if there is a possibility that, at the end, you can get the peace of mind that affordable health insurance brings.
WATB about a website crashing..
what Ezra and Hayes need to be doing everyday is reporting on the folks whose lives have changed because of Obamacare..
DavidTC
@AdamK:
I wanted to marry a turtle. I’m disappointed.
Turtles? Pshaw:
https://www.youtube.com/watch?v=EXPcBI4CJc8
DavidTC
@Ruckus:
The real issue was the mistake of having to set up an account to browse. And this is not just an ACA problem. I occasionally run into this in the commerce world and they don’t get my business because of it. Those needing the insurance can’t say that. But it sounds like they have fixed this. I’m not going to go look because they don’t need the extra traffic and I don’t need the insurance.
Yeah, this entire setup is completely absurd.
This is how the website should work:
1) You type your zip (Or verify it after it tries to detect your location) and it sends you either to the state exchange or Federal. (Yes, I know they’re asking for state instead, but they have to ask for zip to get a plan list, so they should just have the user tell them at the _start_.)
2) It then lays out out the basic rules. American citizen, who doesn’t get employer based health care. You click that your employer doesn’t offer them, or doesn’t offer affordable ones.
3) Then it lays out:
a) the plans.
b) (optional) income to calculate subsidies.
4) Then the goddamn complicated application.
That can be confusing and complicated, but you give that to people after they already see something they want, you morons. Checkout can be complicated, _shopping_ cannot. Ask yourself if any e-commerce site requires you to login and confirm your account _before_ browsing products.
Hell, in case the site is broken, they can call the damn insurance company they’ve selected themselves and buy the plan direct from them. Or call up the government and say ‘I want plan GA-931’ or whatever. Or print a damn form.
Jesus Christ, I look at the e-commerce sites on the internet, compared to this turd, and one phrase springs into mind ‘Government contractors’. Huge amounts of time spent to make it look flashy, heaven forbid you just _tell people what they want to know_.
Meanwhile, in the existing system, I skipped past the subsidies thing, despite being eligible for them, so now I have to figure out how to go back and get them. At least I finally have some prices, after a week of being stuck and unable to click ‘Set’ to get a plan listing. (No, I’m not stupid, the site just wasn’t letting me click, probably some sort of fucked Javascript.)
Mnemosyne (iPhone)
@gene108:
I’m not sure about your police work there, Lou. :-) The Giant Evil Corporation I work for (which is self-insured) is offering three plans to us that seem to match the Bronze, Silver, and Gold levels of the exchanges:
Our “bronze” plan has the lowest payroll deduction, but the highest total deductible (there are separate deductibles for doctor visits and prescriptions). The company puts money in an HSA for you that covers about half of the deductible, and the employee is responsible for the rest.
Our “silver” plan has a medium payroll deduction, with a smaller total deductible. It also allows you to see out-of-network doctors at a lower percentage covered.
Our “gold” plan has the highest payroll deduction ($24 for one person), but it does have co-pays for doctor visits and for prescriptions.
(They also offer a fourth plan, which is Kaiser, but that’s kind of outside the discussion.)
So if a company is only offering “bronze” coverage then, yes, you could say they’re going to higher deductibles. But if they’re offering coverage that’s better than bronze, those are the plans that have co-pays.
catclub
@rikyrah: “You will have the patience of JOB if there is a possibility that,”
This is the only part that Ezra says that is important. If it is hard to sign up, the people who sign up will
be those who would normally be denied health insurance – they know they have serious health care expenses.
While the people who say ” ah, forget it” are those who are healthy ( at least now).
This is negative selection and leads to a dismal spiral of higher rates and further self-selection by only those who are expensive. THAT is why the website needs to be fixed. Make it dead simple for the people who don’t think they need it much.
Kay
@rikyrah:
I’m suspicious of this. I know they’re doing something to stop the Medicaid expansion, ads, buying lawmakers, etc., but there’s no way to verify claims of doors knocked, or individuals contacted,
Where did they get all these people to do this work? It’s hard to get people for an issue rather than a candidate, and this is not the kind of issue that inspires the sort of people who traditionally knock doors and do other grunt work.
I’m having a little trouble imagining the plutocrat’s grunt work army. I know they can get conservative religious people to do actual work, but the Koch Bros fans? Really?
It just seems very “placed” after their embarrassing loss. The thing about libertarians is they don’t volunteer and they don’t work well in groups, right? There’s a reason labor unions are better at this sort of thing, and it’s more than matching t shirts. Their whole thing is collective.
Pogonip
@Corner Stone: I knew it was time to get in shape when the turtle left ME at the altar.
Bill Arnold
@gene108:
This is the bottom line, isn’t it. There are employers who are blaming Obamacare to their employees, while pocketing all or most of the lower costs.
Employees figure this stuff out pretty quickly.
Ruckus
Back when the ACA passed I got asked by some friends why it didn’t take effect till 2014.
My answer was that it is a complex process and even after the USSC stupidity, and I didn’t think there would be so many states that refused to go along with getting lots more money for their citizens, I figured the whole process would barely get done in time. This is a big undertaking. Making all these systems work together? Getting things done in a timely fashion? When has a project anywhere near this massive been done on time and I believe, in budget? Never? Maybe once or twice before? Yes I’m amazed it works anywhere near as well as it does at this point in time. As many of us said when it finally passed, I hope this shit law gets better over time. It’s still pretty spectacular now, better is yet to come but we shouldn’t let the specter of progress be marred by the failure of perfection.
Steve J.
Goldline isn’t going to pay for ads on a network reporting about petty inconveniences — it’s only the threat of impending apocalypse that moves product.
Great point
Wally
Goldline isn’t going to pay for ads on a network reporting about petty inconveniences — it’s only the threat of impending apocalypse that moves product.
Beautiful. And recall that Goldline is not the only cash generating business that profits from impending apocolypse related to health and disease. American entrepreneurs have a long history of this from snake oil to flouride. http://www.mmm-online.com/in-wild-west-of-facebook-sites-snakeoil-salesmen-abound/article/190109/
The guys and gals with their own individual political snake oil wagons these days do very well spreading fear and conspiracy about standard health care. E.g. Sarah Palin, Glen Beck, Rush Limbaugh and now a US Senator himself. While there is precedent for this level of fear mongering in the US Congress about communism (see, McCarthy, Joseph), Cruz and guys like Rep. Yoho return to the indigenous American snake oil roots.
CaptDMO
” Goldline isn’t going to pay for ads on a network reporting about petty inconveniences —”
to a “demo” that covets a magic gub’mint “care” for all their immediate wants and needs, forever.
Dave E.
Meh, just wait until the rolling catastrophe gets around to really rationing care. The whole system will become one giant death panel at that point, with every American kid born this century cheering the deaths of the old jerks who so badly screwed them over financially.