Good news everybody

National healthcare spending is significantly (~10%) below 2010 projections:

And people are less stressed about being able to pay for a medical bill:

Why I was told that was Unpossible

Open thread

Long (Hate) Read: “The Selling of Obama”

This showed up online well in advance of last night’s WHCD, as part of Politico‘s “Media Issue,” as a story about how the President failed to uphold the Media Village Idiots’ prescriptions:

President Barack Obama insists he does not obsess about “the narrative,” the everyday media play-by-play of political Washington. He urges his team to tune out “the noise,” “the echo chamber,” the Beltway obsession with who’s up and who’s down. But in the fall of 2014, he got sick of the narrative of gloom hovering over his White House. Unemployment was dropping and troops were coming home, yet only one in four Americans thought the nation was on the right track—and Democrats worried about the midterm elections were sprinting away from him. He wanted to break through the noise… [I]in a speech at Northwestern University, he tried to reshape his narrative. If the presidential bully pulpit couldn’t drown out the echo chamber, he figured nothing could.

The facts were that America had put more people back to work than the rest of the world’s advanced economies combined. High school graduation rates were at an all-time high, while oil imports, the deficit, and the uninsured rate had plunged. The professor-turned-president was even more insistent than usual that he was merely relying on “logic and reason and facts and data,” challenging his critics to do the same. “Those are the facts. It’s not conjecture. It’s not opinion. It’s not partisan rhetoric. I laid out facts.”

The Northwestern speech did reshape the narrative, but not in the way Obama intended. The only line that made news came near the end of his 54-minute address, an observation that while he wouldn’t be on the ballot in the fall midterms, “these policies are on the ballot—every single one of them.” When Obama boarded Air Force One after his speech, his speechwriter, Cody Keenan, told him the Internet had already flagged that line as an idiotic political gaffe… Obama’s words couldn’t change the narrative of his unpopularity; they just gave Republicans a new opening to exploit it. They quickly became a staple of campaign ads and stump speeches tying Democrats ball-and-chain to their leader. “Republicans couldn’t have written a better script,” declared The Fix, the Washington Post’s column for political junkies. Even Axelrod called it “a mistake” on Meet the Press. The substance of the speech was ignored, and Keenan still blames himself for letting one off-message phrase eclipse a story of revival, a prelude to the second Republican midterm landslide of the Obama era. “I’m still pissed off about that,” Keenan told me. “Everything he said was true and important, and that one line got turned against him.”

Obama was hailed as a new Great Communicator during his yes-we-can 2008 campaign, but he’s often had a real failure to communicate in office. The narrative began spinning out of his control in the turbulent opening days of his presidency, and he’s never totally recaptured it. His tenure has often felt like an endless series of media frenzies over messaging snafus—from the fizzled “Recovery Summer” to “you didn’t build that” to the Benghazi furor, which is mostly a furor about talking points…
Read more

I Pity The Fools (GOP ODS edition)

Well, not really.  But over and over again, President Obama does something that rises above — way higher than — ordinary political discourse. Just as Bill Clinton in the 90s was without doubt the best retail politician I’ve seen in my lifetime, Obama does an epic job of being president.

He’s the Ted Williams of the job:  he’s got that quality of gracefulness, a stillness within himself, joined to an analogue to Williams’ sweet swing — the capacity to unwind suddenly, and produce so precisely, so effectively, that the audience doesn’t have time to register how hard it was to do what they just saw.  He’s a virtuoso.


What I’m trying to say is that there are people — easy to identify in sports, I think — whom even opposing fans can simply admire, suspending for a moment their tribal obligation to deride and deny anyone wearing the wrong laundry.  Opposing fans could boo Williams.  But they watched, knowing that they might witness something special.  Nowadays, for a sport closer to Obama’s heart, think Steph Curry; even when he destroys your team, you can’t take your eyes off him.

But pity the poor GOP.  President Obama owns his role by this point.  With increasing confidence and skill over his time in office, he defines objectives and outplays opponents* to get what he wants.   As the occupant of the bully pulpit, he nails the lay-ups** and he blows away the impossible shots.  It’s been really special to watch — someone sustaining a formidably complicated performance with ever increasing elegance.

All of which to say is that were you to find politics and public life fascinating as well as vital, you should be enjoying this presidency as performance even if you deplored its content.  But the GOP, it seems, can’t allow themselves even that pleasure.

All of that is prologue to say that I don’t think Obama’s speech in Cuba yesterday has gotten enough attention — at least part, understandably enough, because of the Brussels attacks.  But it’s still worth a listen, for what it means within the process of US-Cuba reconciliation, certainly, but at least as much for its formal excellence.  The speech is simply a masterpiece, in my view, a remarkable demonstration of saying difficult things to multiple audiences while moving the rock, at least a little, on that long journey up the hill.  Here’s the transcript, and here’s the speech itself:


It really is an amazing piece of work.  I love the small touches — he clearly worked on his Spanish accent, to pretty good effect, and it was such a hoot to hear him throw a little shade on Raul Castro and his … let’s say, garrulousness.  But the speech as a whole was much more than the sum of its parts and gestures.  It’s completely worth your time, so I’m only going to quote one passage:

…before I discuss those issues, we also need to recognize how much we share. Because in many ways, the United States and Cuba are like two brothers that have been estranged for many years, even as we share the same blood. We both live in a new world, colonized by Europeans.

Cuba, like the United States, was built in part by slaves brought here from Africa. Like the United States, the Cuban people can trace their heritage to both slaves and slave owners. We’ve welcomed both immigrants who came a great distance to start new lives in the Americas.

Over the years, our cultures have blended together. Dr. Carlos Finlay worked in Cuba, paved the way for generations of doctors, including Walter Reed, who drew on Dr. Finlay’s work to help combat yellow fever. Just as Marti wrote some of his famous words in New York, Earnest Hemingway made a home in Cuba and found inspiration in the waters of these shores.

We share a national past time, la pelotero, and later today our players will compete on the same Havana field that Jackie Robinson played on before he made his major league debut.

And it is said that our greatest boxer, Muhammad Ali, once paid tribute to a Cuban that he could never fight, saying that he would only be able to reach a draw with the great Cuban, Teofilo Stevenson.

As I read that, it’s addressed to the Cuban people of course, just like the title of the speech says.  But it’s impossible not to notice who else Obama engages here: an America whose self-portrait is changing faster than its [dwindling white majority] perception of it has shifted.  As the president noted,

You had two Cuban Americans in the Republican party running against the legacy of a Black man who was president while arguing that they’re the best person to beat the Democratic nominee, who will either be a woman or a democracy socialist.

Again — spoken to Cubans; addressed to those back home.

Relish what you’re seeing in this president.  Perfect he ain’t, of course; that’s no one’s inheritance short of the grave.  But he’s so damn good at this now.  We won’t see his like again soon.

*I’m not saying Garland’s appointment will go through — though the odds are better than I thought they’d be.  My point is that Obama’s handling of this on both its substance and politics has been elegant.

**ETA: And bang! Obama slams another one home. To Ted Cruz’s proposal to “patrol and secure” Muslim neighborhoods in the US, POTUS replied, “I just left a country that engages in that kind of neighborhood surveillance…Which, by the way, the father of Sen. Cruz escaped for America.”

That one leaves a mark.

Image:  Edgar Degas, Ballet – l’étoile (Rosita Mauri), c. 1878.

When Grown Ups Are In Charge

Here’s President Obama, writing in SCOTUSblog* on what he’ll look for in a Supreme Court nominee (h/t Washington Monthly):

First and foremost, the person I appoint will be eminently qualified.  He or she will have an independent mind, rigorous intellect, impeccable credentials, and a record of excellence and integrity.  I’m looking for a mastery of the law, with an ability to hone in on the key issues before the Court, and provide clear answers to complex legal questions.

Second, the person I appoint will be someone who recognizes the limits of the judiciary’s role; who understands that a judge’s job is to interpret the law, not make the law.  I seek judges who approach decisions without any particular ideology or agenda, but rather a commitment to impartial justice, a respect for precedent, and a determination to faithfully apply the law to the facts at hand.

But I’m also mindful that there will be cases that reach the Supreme Court in which the law is not clear.  There will be cases in which a judge’s analysis necessarily will be shaped by his or her own perspective, ethics, and judgment.  That’s why the third quality I seek in a judge is a keen understanding that justice is not about abstract legal theory, nor some footnote in a dusty casebook.  It’s the kind of life experience earned outside the classroom and the courtroom; experience that suggests he or she views the law not only as an intellectual exercise, but also grasps the way it affects the daily reality of people’s lives in a big, complicated democracy, and in rapidly changing times.  That, I believe, is an essential element for arriving at just decisions and fair outcomes.


Also — just in case you were worrying (I wasn’t and am not) that President Obama might take seriously for a moment any suggestion that he should punt on this choice, here’s all you need to know:

The Constitution vests in the President the power to appoint judges to the Supreme Court.  It’s a duty that I take seriously, and one that I will fulfill in the weeks ahead.

I will so miss this man.

*POTUS blogging FTW!

Image:  David Gilmour Blythe, Justicec. 1860

The Supreme Court thoughts

Here are a few thoughts on the Supreme Court vacancy as my kids are slowly quieting down for the night.

First, a 4-4 court from a liberal perspective is no worse than the current situation.  Crappy decisions like the DACA decision out of the 5th Circuit will continue to be affirmed.  However the affirmation will be on because the court can not come to a majority decision therefore the appeals court ruling holds only for that circuit and not for the nation.  Questions coming out of liberal rulings in the appeals courts where the four liberal votes are voting to uphold and where there is a conservative swing vote (Kennedy or Roberts most likely) do not change in their outcome as the alignment would be a 5-3  or 6-2 ruling with a clear majority.  The cases where Scalia would have been a member of a five person majority are the cases that are now being tossed back to the appeals courts as unresolved.

As of this year, most of the Appeals circuits including the DC circuit have a Democratic appointed judge majority.  Cases which were granted cert from these circuits and would have been 5-4 reactionary judgments will be kicked back to the circuits.  Those circuits will either have ruled with fairly liberal judges on the initial ruling or if the case was important enough and the randomly selected appeals panel was significantly out of line with the circuit consensus, en banc hearings would have final say.

If there is a long stretch of an 8 member court that can’t decide anything controversial, I predict that there will be a significantly higher number of en banc hearings conducting mini-reversals.  The probability of a Supreme Court bench-slapping goes down dramatically.

Now onto healthcare.  There are only two major healthcare cases on the docket right now.  The first case is a technical discussion as to whether or not ERISA pre-emption regulations prohibit states from requiring self-insured companies from providing data to all payer claims databases.  I don’t know if this was lining up to be a 5-4 decision nor what the configuration would have been.  My preference is that the Supreme Court rules that all payer claims databases can require self-insured companies to submit data without running afoul of ERISA.

The other major healthcare case is the Little Sisters of the Poor et al.   This is a birth control cases for religiously affiliated non-profits that think the mere act of signing a piece paper that states birth control is icky and the damn sluts should have the risk of pregnancy every time they spread their legs is an infringement on their rights under the Religious Freedom Restoration Act.  This is a continuation of the line of logic that powered Hobby Lobby but it attacks the work-around that a third party administrator pays for birth control instead of the employer sponsor of the plan.  This would have been a priori a 5-4 loss for PPACA and the notion that female reproductive autonomy is between a woman and her doctor.  Now it is most likely a 4-4 case where the appeals courts have been slapping down the argument that the Little Sisters and others are making: signing a piece of paper is too much effort on their part.

As far as nominations, the only scenario where a nominee to the right of Atilla the Hun goes through is if by mid-May early polling and indicators show that the Democrats will most likely hold onto the White House and pick up at least four if not five or six Senate seats in November.  At that point, the calculation could be that from a policy perspective, a Republican majority in the Senate could not get any better than having some say in a nominee instead of seeing a Democratic president nominate a choice constrained by Manchin instead of Grassley and a 51 or 53 vote Democratic Senate effectively say that if the Republicans want to run the Senate like Parliament, then by god they’ll get that.

Res Ipsa Loquitur: Obama Derangement/Immigration Edition

I really do think the Democrats would have a lock on election success if only Obama would say publicly that drinking Drano(hemlock?) is a bad idea.

Jacques-Louis_David_-_The_Death_of_Socrates_-_Google_Art_Project (1)

For the latest on that score, check this out:

Most Americans say they back a plan that would allow certain illegal immigrants to stay in the country, but support for the idea slips when President Barack Obama’s name is attached to the question, according to a recent Reuters/Ipsos poll.

That is:

Sixty-one percent of Americans supported Obama’s plan — which shields some undocumented immigrants from deportation — when they were not told Obama had taken the action, according to the poll released Wednesday. While half of Republicans rejected the plan when described this way, 42 percent of Republicans supported it.

Told that the idea was Obama’s, though…and this happened:

Support fell to 54 percent overall, with only 31 percent of Republicans supporting it and 62 percent opposing the measures.

I guess that the fact that almost a third of Republicans still managed to hang on to their view exceeds my expectations.  But a 20 percent swing attributable only to the horror at lining up with the Kenyan Moooslim Socialist Usurper is a measure of the triumph of the worst elements in our polity.  They’ve managed to make agreement with even the most mild of sensible ideas an existential horror for too many.  (See criminal justice reform for another reminder.)

As long as that prevails (and it looks like it will for quite a while) we’ve got problems. And the urgent need to elect a Democrat to the Presidency this November.

Good news everybody

From the Center for Medicare and Medicaid Services regarding enrollment for policies that go live on 1/1/16:

Through the deadline for January 1, 2016 coverage, almost 6 million people signed up for health coverage through, compared to last year when about 3.4 million had signed up by the first enrollment deadline. Of the nearly 6 million total consumers already enrolled for 2016 coverage, 2.4 million are new consumers, compared to 1.8 million new consumers in the same period for OE2

Enrollment growth is happening fast, 33% more new buyers than old buyers.  And 60% more total policies.

More importantly, on first glance the risk pool is getting better:

. By the end of the first deadline this year (December 17), there were about 2.1 million consumers under 35 years old, compared to about 1.1 million before the first deadline last year. Those under 35 composed 35% of consumers by the end of the first deadline this year, compared to 33% before the deadline last year for January 1 coverage….

those under 35 composed 41% of new consumers by the end of the first deadline this year (December 17), compared to 38% before the deadline last year (December 15).

The risk pool is getting younger which means, on average, it is getting cheaper to cover.  More importantly, it is getting younger through growth of younger new buyers instead of attrition from older, previous previous period policy holders.

My one big question is which band are these younger buyers go into?  If they are going into Bronze because they can get very low post-subsidy plans to avoid the mandate penalty, they don’t help the aggregate program health all that much.  If they are going into Silver at near proportional rates, they’ll make the biggest risk pool a whole lot healthier.  We’ll find that out when we see the ASPE report.