Wednesday Open Thread [4.2.14]
Last fall, I argued that Obama’s presidency, already historic in significant ways, would become as influential as Reagan’s if two things happened: if the ACA stuck and American entered an era of near-universal healthcare; and if the negotiations with Iran led to an end of sanctions and a controlled Iranian nuclear capability. Both would be generational game-changers – one in domestic policy, the other in foreign affairs. […] So where are we? Too soon to tell on Iran. But after a clear, self-inflicted disaster – the website’s debut – we’ve seen a classic Obama pattern. The fail is replaced by a dogged, persistent, relentless attempt at repair. I’d argue that the competence behind the repair of the site and the revival of the ACA’s fortunes has been as striking as the original incompetence. And we do not and should not judge a president by his mistakes; the critical judgment is in how he responds to those mistakes. As Dick Cheney might put it, the results speak for themselves[.]
Now look at the economic forecast: the IMF is predicting growth of 2.8 percent this year and 3 percent in 2015, easily the best performance among Western economies. We may see further declines in unemployment. This does not seem to me to be compatible with declining support for Obama and his record. In fact, I’d be surprised – barring, of course, any number of game-changing events – if Obama’s approval ratings were not ticking up by the summer.
We’ve been here so many times before with this president – when he seems temporarily becalmed, inert, unable or unwilling to seize every moment. But over the long run, you see the virtues of persistence, relentlessness and pragmatic advance. The hopes he once inspired may be dimmed or dashed right now; but in the cold light of day, they shouldn’t be. Like the slow, excruciating accumulation of delegates in the epic 2008 primary campaign, Obama never puts it away until he puts it away. But it’s coming. And more and more people are beginning to see it.
In December 1986, it seemed reasonably possible that Reagan, then beset by the Iran Contra scandal with polls in the low 40s, might be impeached. And yet, he is generally remembered among the general population fondly and having a successful Presidency. Sullivan has always made the comparison of Obama to Reagan as far as how their respective Presidencies played out. And I think he is right. In the end, Obama will be remembered as fondly as Reagan is or was.
Markos on what the big milestone yesterday means for 2014:
Maybe it won’t matter because turnout rates will favor Republicans this year, but today has the potential to change everything. How big was hitting 7 million? Pretty f’n big.
1) It denied Republicans their biggest talking point, that no one wanted Obamacare.
2) It generated positive headlines for an administration and law that desperately needed them. Had the numbers come in even a few thousand under 7 million, the headlines would’ve been all about “coming up short” and “fails expectations”.
3) It jazzed our side up. Admit it, you feel jazzed. Sure, some of that is schadenfreude for all the shit Republicans threw at the law over the past several years, but still, it’s motivating. And heading into November, that’s our biggest enemy—apathy. The more engaged and motivated we are, the better Team Blue will do.
4) It will move numbers in a positive direction. This is conjecture, of course, but I’m willing to bet right now that we will see positive movement across the board, from ACA approval ratings, to Obama approval ratings, to the generic congressional ballot. The crush of positive coverage and vibes, and that little spring in the step of Democrats (with a touch of cockiness) can’t help but move numbers the right direction.
And that’s where we are. We’ve come a long way. And we still have 2014 to contend with. The costs were high and could get higher. But today, it’s clear we’ve taken a huge step forward, and Republicans have been knocked back hard on defense.
Michael Hiltzik of the L.A. Times offers a handy guide debunking the nonsense about Obamacare enrollment figures that is likely to come from the radical right now that 7 million people have enrolled through the exchanges.
“How many have paid?” (Also known as “The statistics are full of deadbeats”): We examined this argument a few days ago. We observed that the concern is probably exaggerated and certainly premature, since many people who enrolled late in the cycle, including those in the March surge, may not have payments due for as much as six weeks after enrollment. Many haven’t even received their first monthly premium bill yet.
Figures from states that track this metric, including California and Vermont, show that 85% to 90% of enrollees have paid on time, which secures them the coverage they applied for.“Most of them were already insured”: The argument here is that if we’ve just moved people from one insurance plan to another, we’ve just been wasting Americans’ time and subjecting them to an onerous bureaucratic procedure as well. The claim is based primarily on a survey in January from McKinsey and Co., which concluded that only 11% of exchange enrollees had been previously uninsured. A McKinsey survey a month later raised that figure to 27% — still low, compared to expectations. The major problem with the McKinsey survey is that doesn’t say what its hawkers claim. The survey combines on-exchange enrollments and off-exchange enrollments; the latter are likely to heavily skew figures toward the previously insured because those are people merely signing up again with their existing carriers. The goal of the exchange marketplaces, however, is to reach uninsured Americans, and the McKinsey surveys fail to do that. The few states that do break out their own numbers, moreover, contradict McKinsey. Kentucky says that some 75% of its exchange enrollees were previously uninsured. New York says that about 60% of its exchange enrollees were previously uninsured. That number has been rising over time, raising the prospect that the March surge will include an even higher ratio of uninsured customers; Gaba, who has calculated a time series of New York enrollments based on the state’s monthly news releases, calculates that of enrollees in mid-February, at least 92% had been uninsured.
“‘Young invincibles’ aren’t signing up”: This is related to the oft-mentioned threat of a “death spiral” in the insurance market — if the enrollees are predominantly older and sicker consumers, they’ll drive up premiums, which will discourage younger and healthier people from enrolling, which drives up premiums, which discourages, the young, etc., etc. Federal officials have set an informal target of 40% of enrollments in the 18-34 age range. The latest figures from various states put the enrollment rate at the mid-20% level. But it was always expected that younger people would be among the last to enroll, and reports from the states suggest that’s happening. Even if the statistics remain fixed in the mid-20s, however, the death spiral won’t be happening. The Kaiser Family Foundation estimated that even if the young enrolled at only 50% of expected levels, premiums for 2015 would have to be raised a couple of percentage points. That’s nowhere near enough to set off a death spiral.
Moreover, as we explained way back in October, the ACA has a corrective to the death spiral written in. It’s called risk adjustment, and it works by paying a subsidy to insurance companies that end up with older or sicker customer bases than they anticipated. The money comes from payments made by carriers that end up with favorable customer profiles. Republicans know this arrangement will keep Obamacare stable. How do we know? Because in a majestically cynical move spearheaded by Sen. Marco Rubio, R-Fla., they tried late last year to kill it, calling it an insurance “bailout.”
“More people got cancellations than signed up”: The numbers never supported this claim, and the latest estimates make it even more of a fantasy. It’s based on the wave of reports late last year of insurance companies canceling old policies that didn’t meet ACA standards, which led to hysterical claims that as many as 17 million Americans were being left uninsured. Rand’s figures support earlier estimates that fewer than 1 million people who had health plans in 2013 are now uninsured because of cancellations. Insurance companies that issued the cancellation notices say they’ve retained “the vast majority” of their old customers, mostly by moving them into new, compliant, plans.
“The White House is ‘cooking the books'”: […] What makes this claim particularly fatuous is that the most encouraging figures don’t come from the federal government at all, but from states with their own enrollment programs. The eight states with the best records of signing up their eligible citizens in exchange plans (actually seven states and D.C.), all have their own exchanges and websites. Vermont leads the parade at 83% enrolled. California, which leads all states in number of exchange enrollees at more than 1 million, ranks fourth with a 41% outreach rate. If the feds are cooking the books, they’ve cooked them to look worse, not better — the 36 states that dumped their enrollment responsibilities on the federal government are clustered at the bottom of the list, most of them with enrollment rates of 20% or less of eligible citizens. Many of these are states that actively discouraged or interfered with enrollments of their citizens in health insurance plans — behavior that should be grounds for impeachment or recall of their governors and legislators.
