ObamaCare Passes 7 Million Served

After many ballyhooed glitches, 7 million Americans have signed up for ObamaCare. Now what?

health-costs-money-stethoscope

After many ballyhooed glitches, which continued as the sort-of-deadline for signups created a last-minute surge yesterday, 7 million Americans have signed up for ObamaCare. Now what?

The Hill reports the White House’s giddy announcement:

The White House chief technology officer on Monday night said the administration has enrolled more than 7 million people on the ObamaCare exchanges.

According to the American Urban Radio Network, White House Chief Technology Officer Todd Park announced that the administration had pushed past the goal at a champagne toast shortly after midnight, with staffers who had worked to repair the website.

“I am proud to tell y’all that y’all carried the ball over the impossible line,” Park said, according to the report. “Y’all exceeded the goal.”

I reckon he’s pleased. He’s not alone.

Hitting 7 million enrollments would be a major symbolic achievement for the White House, after the opening months of the ObamaCare exchanges were plagued by technical glitches that prevented many consumers from completing an application.
The Congressional Budget Office had projected that number would enroll in the program before the botched rollout and subsequently revised down its estimate based on the rocky start.

Allies of the administration on Monday night were celebrating the high enrollment.

“If you build it, they will come … I have wanted to say that for the last 5 months and now I can as ACA enrollment hits 7 million!” tweeted Neera Tanden, the president of the Center for American Progress.

“ACA working is truly the nightmare for GOP repealers,” said Democratic Congressional Campaign Committee staffer Jesse Ferguson, adding a “#7million” hashtag to his post.

Democratic National Committee Communications Director Mo Elleithee tweeted, “Seven ‘BFD’ Million,’ in a callback to Vice President Biden’s famous open-mic curse the day the healthcare bill was signed.

I’m not sure this number means anything to the general public. Alexis Simendinger and Caitlin Huey-Burns for RealClearPolitics

The public has maintained a generally unfavorable opinion of the Affordable Care Act since its enactment, according to polls since 2010. More than 52 percent of Americans say they oppose the law, while just under 39 percent say they favor it, according to the RealClearPolitics average

Nevertheless, specific provisions are popular, surveys indicate, including parents’ ability to insure their children on their plans through age 26; prescription drugs made more affordable under Medicare; and mandated coverage of pre-existing conditions.

Recent polls find greater support for repairs rather than repeal of the law. A recent Kaiser Family Foundation Health Tracking Poll found 49 percent of Americans support the ACA but would like to see some changes, while 11 percent prefer to replace it with a GOP-sponsored alternative. Ten percent would like to keep the law as is. And 18 percent think Congress should repeal it without any replacement. Independent voters say they favor amending the law (44 percent) over repealing it, adding a replacement (9 percent), or scrapping it altogether (23 percent).

While the administration has for months advertised the law’s March 31 enrollment deadline, and eased the process for employers and applicants, 60 percent of those who say they are uninsured also said they were unaware of the deadline, the Kaiser Foundation found.

Still, I believe passing the target that the administration set up as a viability threshold does change the narrative to some extent. In the long run, few will care that the roll-out of the website was a debacle. The focus will shift to the program itself.

Brian Beutler, meanwhile, thinks the news is bad for Republicans: 

Last week, the Kaiser Family Foundation released new data from its healthcare tracking poll. There are a lot of goodies in there, but two of them cut against the idea that Obamacare is a big, enduring political liability for Democrats. First, the law’s favorables are climbing and unfavorables are falling. It’s still underwater, but recovering from the political damage it suffered during the humiliating Healthcare.gov outage.

But more important, a majority of people in the country (53 percent) are just exhausted by the repeal obsession and want the parties to move on to other issues. Forty-two percent think the country needs to continue to debate the law.

Where things get really interesting, though, is in the ideological breakdown of that split. It’s not that the 42 percent solely represents GOP activists, energized and ready to go elect some Republicans. About half of all people who have unfavorable views of the law think the country ought to move on anyhow. And a large minority of the people who want the country to be focused on ACA are people who actually like it.

Saying “we didn’t pass Obamacare” over and over again probably draws base voters out to the polls. But it’s not all upside for the GOP. And if Obamacare fatigue creates the space Democrats need to make the election about multiple policy issues, then Republicans will have a huge problem on their hands.

In terms of the sheer electoral politics, I’d guess ObamaCare benefits the GOP this November and is irrelevant or a net minus come 2016. But it really depends on how the new system actually does at improving healthcare. And the jury on that is still out.

Megan McArdle points out that there’s still a lot we don’t know:

· How many people have bought and paid for policies

· How many people have signed up for Medicaid who weren’t eligible before 2010

· How many people who are buying insurance didn’t have insurance before

· How the new policies compare to the old policies

· How much subsidies are costing

Jonathan Cohn anticipates the next round of battles:

Whatever the final tally, you can count on law’s critics to keep saying the number is less impressive than it seems. They will say that some people aren’t paying premiums, while others had insurance already. They will say sign-up numbers don’t account for the law’s downsides—like how many people lost plans they liked, or are paying more for coverage than they did before, or are having difficulty seeing the doctors they know. All of these arguments have at least some truth. And you should think about them when, inevitably, the Administration celebrates the final enrollment statistics.

Still, he’s cautiously optimistic:

Think for a moment, in very basic terms, about what the Affordable Care Act is supposed to do. It really boils down to two simple goals. One is to improve economic security—to protect people from crippling medical costs, so that they can get the care they need without enduring financial ruin. The other goal, related but separate, is to transform medical care itself, so that it either costs less or provides better value for the price—or, ideally, some combination of the two. Nobody ever imagined that Obamacare alone would accomplish the goals. The best hope of supporters was that it would produce progress towards them. That’s why Senator Tom Harkin, whose committee helped write the bill, famously referred to the law as a “starter home.”

Four years after enactment, and six months into the final stage of implementation, the starter home may not look great. But it’s weathered the political and technological storms, albeit better in some parts of the country than others, and it is still standing. People are using the new marketplaces to get insurance. And the available evidence—a combination of state-specific data from places like Washington, Kentucky, and New York, along with fuzzy polling data and fuzzier anecdotes—suggests strongly the number of people without insurance is declining. 

It’s impossible to tell by how much, so you should ignore anybody, left or right, who claims to know the answer. But the fact that enrollments through the marketplaces are approaching what the Congressional Budget Office and other experts once predicted ought to make you more confident about their other projections. And these authorities predicted the law would mean many more people had real, stable health insurance coverage. One reason, often overlooked in this debate, is that lots of people are getting coverage through other sources—like Medicaid or, if they are young adults, through their parents’ employers—that would not have been available without Obamacare. Another is that conservative stories of several million people losing coverage because insurers cancelled plans last year overlook one key fact: Nearly all of those people got new insurance, usually through the same carriers as before.

Ed Kilgore builds on this argument:

Paul Waldman argued that we are about to enter a lull in which news of or arguments about Obamacare won’t generate screaming headlines. A day later, CBO issued a new report on the impact of the law on employment that will undoubtedly dwarf positive news about the enrollment numbers at many conservative news outlets. Let’s face it: our friends on the Right have managed to keep the embers of Benghazi! glowing for a year-and-a-half. They will find ways to demonize Obamacare every day at least through November.

So in reality, and certainly in the distorted lens of politics, it’s not time to take stock of the successes or shortcomings of the Affordable Care Act in any definitive way and then move on to other issues. But it’s good to know that despite technological glitches and the complexity of the law and the extraordinary efforts of so many Republicans to gum up the works, Obamacare remains that “starter home” for an effective system of universal health coverage it was intended to be.

I’m not so sure about that. While, as an opponent of the law while it was under debate, I was arguing that it was essentially a Trojan horse designed to kill off our system of employer-provided insurance to pave way for the Democrats’ desired-but-unobtainable goal of a single payer system, it certainly wasn’t sold as that. ObamaCare supporters are expecting a much improved health delivery system. And, because our healthcare system was so bad in 2009 and ObamaCare really did very little to fix it—and in some ways actually made it less economically sustainable—it’s quite likely to disappoint.

FILED UNDER: Health, Science & Technology, US Politics, , , , , , , , , , , , , , , ,
James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College. He's a former Army officer and Desert Storm veteran. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. michael reynolds says:

    This was a national problem that the nation was refusing to engage with. We were in denial. Now we are engaged. Now it is a federal issue. So now, whatever comes, the answer will be something as opposed to nothing.

  2. Stan says:

    The Affordable Care Act might disappoint you, but then you have health insurance and you’ve probably had it your entire life. For those who’ve gone without, it’s a blessing.

  3. John425 says:

    Of that 7 million- how many were already insured but had their policies cancelled and had to sign up thru Obamacare? My son’s family plan was replaced and he now has a $150 month increase in premiums AND higher deductibles and co-pays. He also has a Seattle-based business with 9 employees and the likelihood of Seattle enacting a $15/hr. minimum wage will put him out of business because he competes against free-lancers who are solo and will cut prices.

  4. C. Clavin says:

    ObamaCare really did very little to fix it—and in some ways actually made it less economically sustainable…

    Please explain how bending the curve of health care inflation down, and extending the life of medicare…makes the health care system less sustainable?
    I agree with you…we should have single payer. But that is politically impossible. Obamacare is a study in the possible…against all possible odds.
    And you will have to excuse the schadenfreude I am enjoying…watching Republicans flail against their own failure to destroy their own bill.

  5. mantis says:

    And, because our healthcare system was so bad in 2009 and ObamaCare really did very little to fix it—and in some ways actually made it less economically sustainable—it’s quite likely to disappoint.

    I like how you make no effort to support these claims.

    And let’s not forget that the 7 million is just for enrollments through the exchanges. Rand estimates that an additional 9 million have purchased plans directly from insurers, and some small fraction of those were previously uninsured. According to the CDC, 3 million under-26ers have insurance through their parents thanks to the ACA. And Rand estimates that 4.5 million previously uninsured now have Medicaid, and that would be more if it werent for sadistic Republican governors in many states. Plus the 7 million number doesn’t include sign ups on the 14 state-run exchanges from the last couple of days, and those will be significant.

    But James says it won’t work just because, so I guess that settles it. Repeal! Tell those millions upon millions of newly insured folks to fu©k off and die already! USA USA USA!

  6. David M says:

    @John425:

    Some of the signups were from plans cancelled, but it’s a small number that is dwarfed by the number of signups, both on and off exchange.

    And your anecdote about a cost increase is meaningless without more context.

  7. C. Clavin says:

    @John425:
    Blah blah blah…I know someone who…blah blah blah.
    If what you say is true then chances are excellent that your sons plan had substandard coverage. Now he has better coverage.
    And why is he paying his workers shitty wages anyway?
    Sucks to be him.
    Maybe he should move to Crimea.
    Or Louisiana or Texas where 25% of the people have no insurance and they pay people crap.
    Sounds like both of you would be happier there.

  8. mantis says:

    @John425:

    Of that 7 million- how many were already insured but had their policies cancelled and had to sign up thru Obamacare? My son’s family plan was replaced and he now has a $150 month increase in premiums AND higher deductibles and co-pays.

    So your son had his plan replaced by his insurance company, and he’s your example of people who purchased through the exchanges? Did he do that, or did he just accept whatever replacement plan his current carrier offered? If the latter, that would not support your position. Was his plan canceled because it didn’t meet minimum requirement under the ACA, or some other reason? If the former, why did he have such a terrible plan for his family? If the latter, did you know that insurance companies have been canceling plans and raising rates forever, and this is not some new thing Obama invented? Did he shop around to try to fund a better plan? If so, what did he find? If not, why not?

  9. mantis says:

    @John425:

    Oh, and what kind of business that has freelance competition pays minimum wage? Are there freelance burger flippers?

  10. C. Clavin says:

    Via Sullivan…Ted Cruz’s F-Book Page…enjoy the comments…
    https://www.facebook.com/SenatorTedCruz/posts/517779935000978

  11. James Joyner says:

    @michael reynolds: That’s possible. But the flip side, as you yourself may have pointed out, is that this likely constitutes the last bite at the apple for 20 years.

    @C. Clavin: @mantis: I’ve written dozens of posts about these topics over the years; I’m not going to recap every argument in every post. ObamaCare puts more people into the system—good—including more sick people—good—but does nothing to control costs–bad. Even single payer—Medicare for all seems the obvious approach—has that problem. We still have to address the fundamental problem that doctors and hospitals—and, yes, insurance companies—make fantastic amounts of money charging customers who have little elasticity of demand and little interest in what the service costs.

  12. Rick DeMent says:

    What’s next? Single payer of course. Wasn’t that the plan all along?

  13. Jack says:

    @Stan: Health Insurance does not equal health care. I doubt insurance is a blessing to anyone. Now, we can begin to debate about all those that can no longer see their doctors or all the doctors and hospitals that are refusing to service Obamacare customers.

  14. Moosebreath says:

    @James Joyner:

    “but does nothing to control costs–bad”

    Umm, no. Recall the Republican talking point since 2010 that Obamacare included a $700 Billion cut to Medicare?

    And the health care cost curve is actually bending downwards — the question is whether Obamacare deserves the credit:

    “Federal actuaries estimate that real spending on health care increased only 0.8 percent per person in 2012, slightly less than real gross domestic product per capita. Comparatively, since 1960, spending has increased an average of 2.3 percentage points more than GDP growth.”

  15. Jack says:

    @C. Clavin: The curve never went down,. It went up drastically. Let’s talk again after insurance companies triple their prices this year for next year’s policies.

  16. C. Clavin says:

    @James Joyner:

    but does nothing to control costs–bad

    Simply untrue.
    There is greater competition among health plans, taxes on high-priced insurance coverage, measures to cut fraud, and a bunch of other stuff I don’t feel like typing out.

  17. michael reynolds says:

    @James Joyner:

    That’s possible. But the flip side, as you yourself may have pointed out, is that this likely constitutes the last bite at the apple for 20 years.

    That’s more Dave Schuler’s position, I think. I think just like every other government program ever in the history of the universe Obamacare is sub-optimal. But it is at least now in-hand. So we will endeavor to adjust it as necessary. We’ll have no other choice. The only way we ever get anything done in this country is when we have no way left to avoid it.

  18. C. Clavin says:

    @Jack:
    You are wrong.
    If you have to lie to support your ODS…then perhaps you need professional help.

  19. mantis says:

    @James Joyner:

    but does nothing to control costs–bad.

    Are you lying or just ignorant to the facts?

    For many decades, growth in the prices paid for services has exceeded overall inflation. But, beginning in 2011, when the Medicare productivity adjustments began to take hold, prices have grown more slowly, roughly in line with overall inflation. Medical price growth is also being held down by a 2 percent Medicare price cut due to the so-called “sequester.”

    The ACA and the sequester only directly affect Medicare prices, but Medicare’s prices reverberate through the entire healthcare system. Research, including my own work, has demonstrated significant price spillovers, meaning that when Medicare cuts its prices, private health plans end up paying lower prices, too. Medicare prices also put a ceiling on the prices that state Medicaid programs can set.

    In addition to the ACA’s Medicare productivity adjustments, there are other features of the ACA that are helping control costs or will do so as even more people get insured.

    We would be able to do more, of course, if we had a functioning Congress. Too bad one party has zero interest in controlling healthcare costs. It’s the one you keep voting for.

  20. C. Clavin says:

    @mantis:

    It’s the one you keep voting for.

    x 10

  21. mantis says:

    @Jack:

    I doubt insurance is a blessing to anyone.

    Well, you’re an idiot, so that tracks.

    Now, we can begin to debate about all those that can no longer see their doctors or all the doctors and hospitals that are refusing to service Obamacare customers.

    There are no “Obamacare customers.” The exchanges sell plans from private insurers. When hospitals stop accepting health insurance from Blue Cross, Aetna, etc., you let us know.

  22. anjin-san says:

    @John425:

    I am one of the people who received the dreaded cancellation notice. Kaiser offered me another plan with better coverage, at a price that was higher, but not unreasonably so. I made one phone call and switched to the new plan. Pretty simple. Pretty painless.

    I note that Republicans did not make a peep when health care costs more than doubled during the Bush years. Kind of like the deficit – it’s fine when the GOP does it, but a heinous crime if it occurs under Democrats.

  23. anjin-san says:

    @ Jack

    The curve never went down,. It went up drastically.

    Kindly prove this claim.

  24. anjin-san says:
  25. anjin-san says:

    @ James Joyner

    We still have to address the fundamental problem that doctors and hospitals—and, yes, insurance companies—make fantastic amounts of money charging customers who have little elasticity of demand and little interest in what the service costs.

    Well, the position of your party seems to be that businesses exist for one reason – to make a profit. Providing health care services is then merely a means to this end. If health care is too expensive and the system functions poorly, that pales in comparison to the importance of a CEO’s bonus.

  26. Rob in CT says:

    The ACA is an improvement over the status quo ante. If the critique is now entering the “but, but, it’s not perfect!” phase, I can only smile and shake my head. Of course it’s not, silly.

    The ACA is a simulation of single-payer with various concessions to established interests. Though I think a single-payer system is the obvious, logical and proven option, it not only was politically impossible in 2009, but it also was the more radical change. I think it’s entirely possible that the ACA or something very much like it is the appropriate bridge step between our pre-ACA “system” and SP. This is because I’m cautious by nature and think change is something best done at a moderate pace. This, in certain circles, makes me some sort of wild-eyed socialist revolutionary. Bah humbug.

  27. wr says:

    @John425: ” He also has a Seattle-based business with 9 employees and the likelihood of Seattle enacting a $15/hr. minimum wage will put him out of business because he competes against free-lancers who are solo and will cut prices.”

    If his business can’t survive without paying people wages it’s impossible to live on, then he deserves to go out of busines. Let him start a new company with a sustainable business model.

  28. wr says:

    @wr: Also, if free-lancers can do the job as well as his employees, why shouldn’t his people all go freelance and actually keep what they earn, instead of letting him siphon it off?

  29. michael reynolds says:

    @Jack:

    Health Insurance does not equal health care.

    Excellent work regurgitating the new Fox Party Line.

  30. wr says:

    @Jack: “The curve never went down,. It went up drastically. ”

    Let’s see… Moosebreath claims the curve is going down, and links to a National Journal article that contains the statistics and explanation.

    Then you say “no it didn’t!!!” and don’t cite or quote anything.

    Yeah, I’m going to believe you!

  31. Woody says:

    Every non-Murdoch news outlet is leading with “7M Obamacare Goal Reached As Expected”. Save for the captured conservative media, this effectively kills off the first month’s troubles.

    This is remarkable considering one of America’s major political parties has ceaselessly campaigned against the ACA (nationally) and effectively prevented implementation (GOP governors/statehouses).

    It’s too early to tell, but if the ACA does succeed in better healthcare while lowering the deficit, it’ll be difficult for conservative media to maintain a reality to deny it. They will succeed, mind.

  32. gVOR08 says:

    Seems to me Republicans are jumbling the Kubler Ross thing a little.

    Anger. They’ve been pissed, they’re still pissed, when they realize the clueless, ineffective Kenyan Muslim stuck it to them (again) they’re going to get really pissed for a while.

    Bargaining. They’ve passed repeal bills in the House every week or so and threatened to hold up increasing the debt ceiling ‘til their faces turned blue orange. They’ll still run on repeal for a while, although it’s a lost cause.

    Denial. Right now Rs are headed seriously into denial. The 7 million isn’t real, they won’t pay the premiums, it isn’t cutting cost, whatever.

    Depression. One hopes we get to depression soon and thoroughly. It will represent progress and I’ll enjoy the schadenfreude no end. But their depression may not reach full bloom until they lose in ’16.

    Acceptance. This will take years. Then they will simultaneously take credit for it and claim it’ll be bankrupt in ten years. At some point they’ll try to privatize it and get really depressed when they find out it already is. Then for the next century they’ll try to kill it anyway.

  33. Stan says:

    @Jack: When you come up with doctors who refuse to treat Obamacare patients let us know.

  34. C. Clavin says:

    @anjin-san:
    And the only option other than Obamacare is the pre-Obamacare status-quo…which does absolutely nothing to address this.

  35. grumpy realist says:

    @Jack: May you develop a chronic health condition requiring large amounts of expensive treatment and may you lose all your health insurance.

    I think your mind would change drastically. Unfortunately, a lot of people can’t understand reality until it jumps up and bites them in the face.

  36. anjin-san says:

    @ grumpy realist

    Conservatives tend to oppose the social safety net – until they need it.

    They despise government, but that does not stop them from using the roads it builds and maintains, wanting their homes to be connected to sewer lines, expecting the armed forces to defend their freedom, and the police and fire departments to respond when they call, and so on, and so on – pretty much forever.

  37. C. Clavin says:

    @grumpy realist:
    You mean like Paul Ryan’s idol, Ayn Rand…who embraced Medicare the very second she got ill?

  38. beth says:

    @Jack: Exactly how do they know the patients are “Obamacare” patients? All the insurance policies are regular health policies through companies like Blue Cross, Anthem, United Health, or are people using Medicaid which has been around for decades.

    You’ve really got to start shoveling a higher quality of bs.

  39. C. Clavin says:

    @beth:
    Go easy, Beth.
    He’s only repeating what Fox News tells him to say.

  40. stonetools says:

    I must say I’m enjoying significant schadenfruede watching conservative reaction to the good newsThe right wing BS machine just wasn’t ready for the Administration reaching the 7M target. After all, Republicans had done every possible legal thing they could do to sabatage Obamacare, including billions in anti-Obamacare propoganda and 50 votes to defund. They had help from feckless Democratic support and Administration incompetence. Despite all that Obamacare achieved its 7M private enrollment goal. This doesn’teven count the millions signed up through Medicaid. Looks to me that the Republicansbet everything on sinking Obamacare-and failed.
    Politically, nothing succeeds like success. Obamacare(which the Republicans will soon stop calling Obamacare) is soon going to look a lot like Social Security and Medicare-another successful social insurance program. And all the credit is going to go to the Democrats.

    For the 2014 political season , this is going to be a wind in the Democrats sails. The Republican governors and legislators in states that refused Medicaid expansion are already scrambling to explain just why they are turning down healthcare for millions of their citizens. Since they have no answer -other than sociopathic meanness-the Democrats can hit them with this all summer long. I Think Nate Silver will be recalibrating his political projections in a few months

  41. wr says:

    @anjin-san: “Conservatives tend to oppose the social safety net – until they need it.”

    Actually, they tend to still oppose it then. It’s just that they oppose it for other people… you know, the ones who, unlike them, don’t deserve it.

  42. stonetools says:

    @gVOR08:

    Heh, some folks on Fox News are already saying that “no one” opposed some of the ACA provisions.

    In fact, multiple Republicans have come out against prohibiting insurers from denying coverage to people with pre-existing conditions — and most GOP health care replacements would allow insurers to cherry pick the healthiest enrollees and shift sicker people into state-based high risk insurance pools.

    During his 2012 presidential run, Rick Santorum was perhaps the most direct about the GOP’s support for permitting insurers to discriminate against Americans. The former Pennsylvania senator not only defended insurers for denying coverage to people with pre-existing conditions, he also argued that individuals who are sick should pay higher premiums because they cost more money to insure.

    In July of 2012, now-retired Rep. David Dreier (R-CA) said that insurance companies should be allowed to discriminate against people with brain tumors. “I don’t that think someone who is diagnosed with a massive tumor should the next day be able to have millions and millions and millions of dollars in health care provided,” he said.

    The rewrite of history has begun.

  43. John425 says:

    @C. Clavin: You know, Cliff, sometimes you talk out of your ass and your mouth should know better. He started a personal pet services business after he and his wife were laid off during Obama’s stimulus boondoggle. They employ 9 young people that used to be “independent contract employees” but they strove to give everybody as much money as possible by putting them on payroll. Daily dog services is somewhat inelastic in pricing. The fact that my son’s company is bonded, licensed, with all workers taught Pet CPR, and has to bill near $20/per pet per day to make it gets lost in the shuffle when some bored housewife wants to pick up a few bucks at $10 per dog with just her promise to do a good job.

  44. John425 says:

    @wr: Next time you need a basic service like a housewife that practices tax law or a physician that has an outcall service only- hire that freelancer.

    His employees are bonded even for overnight pet and house sitting AND they have keys to enter the client’s house. I f you are comfortable in letting some Joe Blow into your house, go right ahead. Smart thinking, you moron

  45. anjin-san says:

    @John425

    after he and his wife were laid off during Obama’s stimulus boondoggle

    Ah, so losing their jobs had nothing to do with the massive job losses created by the Bush crash. I see…

  46. grumpy realist says:

    @John425: That’s a bonded vs. non-bonded issue and has nothing to do with health insurance. If clients are happy going with a non-bonded pet walker and the non-bonded pet walker is willing to put herself in the position of personal liability etc., then there’s obviously going to be a possible price difference between what a professional company and some “bored housewife” will charge.

    Also, doesn’t your son’t company fall below the size limits of being required to offer health insurance to its employees?

  47. anjin-san says:

    John425

    he competes against free-lancers who are solo and will cut prices.

    His employees are bonded even for overnight pet and house sitting AND they have keys to enter the client’s house. I f you are comfortable in letting some Joe Blow into your house, go right ahead.

    You seem to be contradicting yourself. First you say he competes with freelances that undercut him, then you say that only someone with very poor judgement would hire one of the freelancers.

    You can’t have it both ways. If you would have to be crazy to let one of the freelancers into your home, they are not a competitive threat.

    As is often the case, you seem to be confused.

  48. Stan says:

    I quote from a Krugman blog post:

    “Suppose you want preexisting conditions covered. Then you have to impose community rating — insurers must offer the same policies to people regardless of medical history. But just doing that causes a death spiral, because people wait until they’re sick to buy insurance. So you also have to have a mandate, requiring healthy people to join the risk pool. And to make buying insurance possible for people with lower incomes, you have to have subsidies.”

    That’s it in a nutshell. If JJ or some other opponent of ObamaCare feels that we can eliminate denial of coverage due to pre-existing conditions or coverage caps without an individual mandate and a subsidy for people with low incomes, let them explain how. And if they think the status quo is OK, let them say so.

  49. Jack says:

    The entire reason to try and get ObamaCare passed was supposedly to “insure the uninsured” and we were told there were 35 million uninsured in 2009. Of the 7 million signups touted, 5 million are those who lost their coverage DUE TO ObamaCare creating policy cancellations and re-enrolled through ObamaCare. Of the remaining 2 million *enrollees* they are also counting 1 million Medicaid signups.

    So this 2,700 page, $3 trillion healthcare monstrosity boondoggle has generated, at best, insurance for 1 million out of the original 35 million uninsured.

    This entire 7,000,000 number is a ruse. A fabricated construct of total falsehood. Lies. Propaganda…

  50. wr says:

    @John425: Hey stupid — You’re the one bragging about how your son pays minimum wage.

    When I want a valuable service performed, I don’t look for the cheapest bottom feeder. I look for someone with a good reputation. I pay ludicrous rates to board my dog, because I want a place run by professionals who will take care of him.

    And you see? I pay a premium for premium service. If your son is too stupid — a fault he owes solely to genetics, I’m sure — to understand that the answer is not to pay minimum wage, but to market himself to a clientele who cares enough about what he’s offering to pay for it, then he deserves to go out of business.

    Labor is a key part of any business’ costs, but for some reason Republicans think they deserve to get it for as close to free as possible.

  51. wr says:

    @John425: “They employ 9 young people that used to be “independent contract employees” but they strove to give everybody as much money as possible by putting them on payroll”

    According to you, that massive generosity meant paying them minimum wage. So apologies if I don’t fall all over myself gushing at their wonderfulness.

  52. wr says:

    @Jack: Do you really think if you make up enough bullshit numbers, people will believe you because we assume no one would lie that blatantly?

    Sorry, not working.

  53. mantis says:

    @Jack:

    Stop repeating bullshit numbers talk radio feeds you. You reveal yourself the fool.

  54. C. Clavin says:

    @Jack:
    More falsehoods.
    Obamacare ain’t perfect by a long shot…but if you have to make shit up to complain about….

  55. anjin-san says:

    @Jack

    The squirrels out in my back yard are more credible than you.

  56. C. Clavin says:

    @John425:
    Yes…a bad business plan is Obamas fault.

  57. Stan says:

    @Jack: 5 million people lost their policies? What’s your source?

  58. mattbernius says:

    @John425:

    His employees are bonded even for overnight pet and house sitting AND they have keys to enter the client’s house. I f you are comfortable in letting some Joe Blow into your house, go right ahead. Smart thinking, you moron

    So he’s providing a valuable, trust based service — which if his customers care about, they should be willing to pay a premium.

    And if they don’t care about that, then they can spin the wheel of fortune with unbonded, fly-by-night freelancers. And after enough of those experiences go badly, then the customers should — if you believe in market based corrections — return to a service like your son’s.

    Where’s the issue here?

  59. mattbernius says:

    @grumpy realist:

    Also, doesn’t your son’t company fall below the size limits of being required to offer health insurance to its employees?

    BINGO:

    Under Obamacare, the mandate requires employers with 50 or more employees (or “full-time equivalents”—we’ll get to that next) to offer coverage or pay a $2,000 fine per employee, not counting the first 30 employees, starting in 2014. Micro-businesses like yours, with fewer than 10 employees, are well under the limit.

    The mandate has gotten lots of attention, but nationwide it will apply to very few businesses. That’s because 96 percent of all businesses have fewer than 50 employees, says David Chase, an outreach director at Small Business Majority, a lobbying group that supports health-care reform. “Of the 4 percent who’ll be mandated to offer insurance, 96 percent of those companies already offer it. So it’s 4 percent of the 4 percent that will be affected by the mandate.”

    http://www.businessweek.com/articles/2013-03-28/advice-for-small-employers-confused-by-obamacare

    Now, if your son wished to offer health insurance to his employee’s, he should know that the law offer tax credits to small businesses with fewer than 25 full-time equivalent employees with average annual wages below $50,000 to help pay for employee premiums.

    Hopefully John’s Son’s accountant has directed him to the related information. If not, I was able to come up with this info based on a quick internet search.

  60. Jack says:

    @anjin-san: Awwww, Cupcake, aren’t you cute. If you so heartily disagree you should have just shaken your head, and moved on….instead of compulsively vomiting stupidity all over the internet. No one cares what you think, and I certainly didn’t instruct you to whine like a little b1tch.

  61. anjin-san says:

    @ mattbernius

    So it seems that John, like so many frothing-at-the-mouth Obamacare critics, has either not bothered to do basic research to get the actual facts, or has fallen for GOP disinformation, or perhaps both.

  62. Jack says:

    @Stan: It was reported by every main stream news agency. If you want a source, look it up.

  63. mattbernius says:

    @John425:

    The fact that my son’s company is bonded, licensed, with all workers taught Pet CPR, and has to bill near $20/per pet per day to make it gets lost in the shuffle when some bored housewife wants to pick up a few bucks at $10 per dog with just her promise to do a good job.

    BTW, $20/per pet per day is friggin cheap. Here in Rochester NY, a far smaller city than Seattle, a similar service runs upwards of $30/day, with the option for lower rates if the service is bought in advance. Additional rates are added on for services like grooming, training, and play-groups.

    BTW, I know this because I have spent a bit of time in the shelter and pet services industry myself. I’d suggest he does some competitive benchmarking as I have a hard time believing that what he’s charging is the going market rate for his service. He might also want to invest in some market research and consider upscaling his service or shifting to a different model (i.e. centralized doggie day-care vs house-sitting).

  64. C. Clavin says:

    Obama:

    This law is doing what it’s supposed to do. It’s working. It’s helping people from coast to coast. All of which makes the lengths to which critics have gone to scare people, or undermine the law, or repeal the law… so hard to understand…I don’t get it. Why are folks working so hard for people not to have health insurance? Why are they so mad about the idea of folks having health insurance?”

  65. Jack says:

    @C. Clavin: Again, this law was passed to insure over 30M uninsured. And this is success? It’s doing what it’s supposed to do?

  66. mantis says:

    @John425:

    Your son’s competition is not the neighbor kid or bored housewife, but other pet care services, which have to pay their employees at least minimum wage also. If he can’t compete on price with the neighbor kid/bored housewife now, a minimum wage hike will change nothing.

    Also, Seattle’s minimum wage has fu©kall to do with healthcare.

  67. mantis says:

    @Jack:

    It was reported by every main stream news agency. If you want a source, look it up.

    Translation: I got nothin.

  68. anjin-san says:

    Why are they so mad about the idea of folks having health insurance?”

    An excellent question.

  69. mantis says:

    @Jack:

    Again, this law was passed to insure over 30M uninsured.

    No one claimed it would get them all covered, and certainly no one claimed they would all get covered right off the bat. But the number of newly insured is certainly above 10 million already. Repeating my comment up thread:

    And let’s not forget that the 7 million is just for enrollments through the exchanges. Rand estimates that an additional 9 million have purchased plans directly from insurers, and some small fraction of those were previously uninsured. According to the CDC, 3 million under-26ers have insurance through their parents thanks to the ACA. And Rand estimates that 4.5 million previously uninsured now have Medicaid, and that would be more if it werent for sadistic Republican governors in many states. Plus the 7 million number doesn’t include sign ups on the 14 state-run exchanges from the last couple of days, and those will be significant.

  70. mattbernius says:

    @Jack:
    Um, no Jack — in an argument it doesn’t work that way – YOU raised the claim, YOU back it up. That’s the way it always works.

    For the record, while approximately 5 million plans were cancelled/discontinued, a high percentage were replaced with similar non-Obamacare plans from the existing insurer. That’s because the original plans were not in compliance with the law. In other words, those people didn’t have to sign-up through the existing exchanges.

    BTW, it should also be noted that the 7million does not, last I check, include all the people who gained health insurance through the state expansion of medicaid that was also part of the legislation.

    Here are some actual, you know, facts, that you might want to read before continuing to spew your crappy and false analysis:
    http://www.latimes.com/nation/la-na-obamacare-uninsured-national-20140331,0,5472960.story#axzz2xg7xH6DW
    http://www.politifact.com/truth-o-meter/statements/2014/mar/18/john-boehner/john-boehner-says-more-people-are-uninsured-obamac/
    http://www.washingtonpost.com/blogs/fact-checker/wp/2014/03/17/boehners-claim-that-obamacare-has-resulted-in-a-net-loss-of-people-with-health-insurance/

  71. anjin-san says:

    @ Jack

    If you so heartily disagree

    For me to disagree with you, you would first have to present an argument that has an iota of merit/fact/thought. You have not done that.

    What you are saying is too stupid to disagree with. People are more or less making fun of you, not arguing with you.

  72. dazedandconfused says:

    The GOP position has morphed from fear mongering about a “Government take over of our medical system!” and “Communism!” to “There aren’t enough cost controls!”

    As good as it will ever get.

  73. Scott says:

    Here are some real numbers on the effect of the ACA on the uninsured.

    http://acasignups.net/graph

    There are federal exchange signups, state exchange signups, medicaid expansion signups, under 26 coverages, etc.

    I think these are the best documented numbers around.

  74. David M says:

    @Scott:

    You linked to the wrong graph for the winguts. Here are the unskewed, GOP approved numbers.

  75. C. Clavin says:

    @Jack:
    In order:
    No, it wasn’t. Stop lying.
    Yes.
    And yes.

  76. Scott says:

    @David M: OK, I expected a real attempt at right wing spin. That made me laugh!

  77. C. Clavin says:

    The headline above asks what’s next.
    I want to know the make-up of the pool.
    That’s the next critical test.

  78. stonetools says:

    @mattbernius:

    Another ACA horror story debunked. Must be a day that ends in Y.
    Every ACA horror story trumpeted by the right wing media has fallen apart on analysis, often within hours. Now I’m sure that there must be a few people who have lost out due to the ACA, but the conservatives just haven’t been able to find them.
    What we have has been just the kind of dishonesty presented here. Not a way to build credibility.

  79. Tyrell says:

    Some time ago our doctor talked about the situation of health care in this country. Over medicated, over doctored, over specialized, and over tested. He spoke of the growing dependence on antibiotics as people want instant recovery instead of letting the body take control. He said that doctors are calling people in just for a chat, and people who will come in with just a cold, something our parents would never consider. And the myriad of multiple, overlapping, repetitive tests. The heavy reliance on specialists who concentrate on one area, often missing the total picture.
    We really do need to think of our attitudes, habits, and actions when it comes to health instead of running to the doctor screaming and crying for a quick cure.
    “Trailer for sale or rent, rooms to let fifty cents ….I’m a man of means by no means, King of the Road” (the incomparable Roger Miller)

  80. Matt says:

    @grumpy realist: Not only that but he should also be getting tax breaks if he did offer insurance for his employees.

  81. Hal_10000 says:

    @John425:

    According to Rand, about 60-75% of the seven million people enrolled had previously had insurance. As for the nine million who enrolled on their own, you add that to the 7 million and you get 16 million. That’s … close to the typical number of new individual policies issued every year according to Rand. So in terms of people getting new private insurance policies, we are probably looking at a couple of million.

    When you add in Medicaid and the age 26 thing, we’re looking at something like 5-10 million, depending on who you believe. CBO estimated the number of uninsured would be reduced by 22% as of last month; actually reduction looks more like 12%. The initial estimate from Obama, BTW, was 45%.

    So I would not be flogging this as a huge success. It’s better than nothing. But it is about 1/4-1/2 of what was promised. And counting people who were already insured as though they were newly insured is just rigging the numbers.

  82. Hal_10000 says:

    Here’s the LAT round-up of the numbers. They’re saying 9.5 million fewer insured, but that’s probably an upper bound. The initial CBO estimate was 20-25 million. If the Republican governors had expanded Medicaid, you’d have a few million more, but not 15 million more.

  83. DB says:

    @Jack: what’@Jack:

    There is no such thing as an Obamacare customer. Doctors will only know who your insurance carrier is, not where you bought your coverage.

    C’mon.

  84. Stonetools says:

    @Hal_10000:

    Hey, it’s a lot better than nothing and it would been even better if sociopathic Republican governors hadn’t denied millions coverage by refusing Medicaid expansion. It will look a lot better in a few years.
    It’s amazing that we have gone already from “Obamacare can’t succeed” to “Obamacare isn’t succeeding fast enough”.

  85. wr says:

    @Stonetools: “It’s amazing that we have gone already from “Obamacare can’t succeed” to “Obamacare isn’t succeeding fast enough”.”

    Actually, it’s “Obamacare isn’t succeeding fast enough, so we need to kill it.”

  86. humanoid.panda says:

    @Hal_10000: Those estimates are multi-year though. I think this year’s estimate was 13 million, and we are not terribly behind on that.

  87. bill says:

    @C. Clavin: if you don’t feel like typing then you know you have nothing to type about……seriously.
    just for measure, was it really a great thing to get 2% of the populace insured at such a cost? granted the numbers will be more like 1% when the math is done- after clamoring that 30 million are uninsured and how his plan would save them (and everybody) money/lives?
    it’s still a disaster, and if the senate changes hands in november you can blame it all on this.

  88. humanoid.panda says:

    @bill: FYI, subsidies on the exchanges for this year will cost the feds something like 10 billion dollars. This is definitely worth the price at this initial phase as far as I am concerned.
    As for the ACA only covering 2% of the population for now (actually, its more like 3%, but who’s counting?)- the same estimates that nailed enrollment this year predict that in 3 years from now, the ACA will have covered 25 million through the exchanges and perhaps 10 million more through Medicaid. Would you still consider that a disaster? If yes, why? If not, why is the initial estimate that is right on the mark indicates a “disaster”?

  89. David M says:

    @bill:

    You do know that the enrollment will continue increasing, right?

  90. anjin-san says:

    @ bill

    I will ask you again (you vanished the last time I asked you this) how exactly is Obamacare a “disaster”? Please be specific and provide cites.

  91. MarkedMan says:

    James, I’m not sure where you are getting your information about “Obamacare not doing anything to control costs” but it is absolutely incorrect. For four years, The Advisory Group, a consulting firm that interviews hundreds of hospital CEO’s and CFO’s has spent a very large share of its annual report on how the two major health care bills have been or will be negatively impacting hospital’s bottom line. This past report started to shift focus a bit, but I suspect that’s because Obamacare is a done deal at this point.

    Repeating the conservative trope about Obamacare not affecting costs just makes you look ill-informed.

  92. David M says:

    @anjin-san:

    how exactly is Obamacare a “disaster”? Please be specific and provide cites.

    Obamacare is a Democratic initiative. What further evidence could be required that it is a disaster?

  93. Just 'nutha' ig'rant cracker says:

    @michael reynolds: Shorter version: “You can count on America to do the right thing, after it has exhausted all of the other options.”

    I believe that’s from Sir Winston Churchill.

  94. C. Clavin says:

    @David M:
    No…it’s a Rrpublican initiative implemented by Democrats…who will, in the long run, get full credit for getting desperately needed insurance to tens of millions of people.
    That’s why it’s a disaster.

  95. C. Clavin says:

    @bill:
    There is no cost. In the long run, according to the CBO, it will reduce deficits.
    Now you no doubt know more than the CBO.
    I look forward to your detailed economic analysis.

  96. C. Clavin says:

    This milestone points up the very real problem of the Republican Party.
    The status quo insurance situation was a problem. Obama made an imperfect effort to fix it. Republicans did nothing but tell lies and make predictions about its failure and the apocalypse it foretold.
    They were wrong.
    But look at the list of things they are wrong about .
    Marriage equality.
    Marihuana legalization.
    Immigration.
    Gun control.
    Economics.
    Conservatism has so much to offer this Nation .
    Republicanism ? Nothing.

  97. @Jack:

    What an asshole you are.

    I thankfully have insurance through my employer (which I also contribute to, but it’s a very large group plan), but if not I would be screwed. I’m a type 1 diabetic which requires using two types of insulin. The non health-insurance cost of those prescriptions are approximately $250 a month each. And it’s not like I get to go to CVS and ask them if I can negotiate the price down like insurance companies do.

    As I said previously: asshole.

  98. stonetools says:

    Heh.

    Conservatives Discover That Obamacare Will Help A Lot Of People

    Central to their dilemma is the emerging discovery that many people will end up benefiting from Obamacare. Despite the health care law’s problems, unanswered questions and unknown costs, it can hardly be denied that millions of American are slated to reap the benefits of its insurance subsidies, the Medicaid expansion and beefed-up consumer protections.

    And conservatives note the dangers this poses for the GOP’s promise of repeal. Staying the course means stripping coverage from as many as millions of newly insured, causing the sorts of disruptions and cancellations they’ve raised hell about since last fall. But abandoning the repeal mantra would constitute a monumental backtracking ahead of a promising mid-term election where Obamacare is a vulnerability for many Democrats.

    What happens if Obamacare works as intended and millions of people are enjoying the benefits of health insurance by the summer-especially those white workng class voters who were most suspicious of the program named after the black man in the White House. Now logically, they should concude that the Republicans have been ying their a$$es off for five years, playing on their racial and economic fears. However, Fox News and the Republicans are going to do their best to see they don’t draw that logical conclusion.
    I’m hoping the Democrats , so usually horrible about messaging, will come through just this once with the kind of hard hitting appeal that will blow through the right wing BS. A liberal can dream…
    Hey, what has happened with our libertarian in residence. I notice Doug just about stopped posting about the ACA recently.Come on, Doug, what does UnitedLiberty.org has to say?

  99. Blue Galangal says:

    @Hal_10000: The other thing to note is that this was the open enrollment period. People who lose insurance because of job loss/change, divorce, moving, graduating from college/aging out of parental policies will be eligible to enroll at any time – it’s a life changing event. So I would expect to see the ACA start to target, say, college seniors in the next few months, and hopefully a push to educate consumers on the ability to enroll if they lose coverage for a life-changing event reason. That will also add to the numbers. I can’t recall off the top of my head but I think it’s around 1.5 million every year who drop out of coverage simply due to change/loss of employment.

  100. C. Clavin says:

    @Blue Galangal:
    In addition…the CBO was spot-on with their enrollment figure…or the administration hit the goal the CBO set for it…depending on how you look at it. This in spite of the totally botched roll-out.
    But the CBO also says that enrollment will more than triple by the end of ’16 to 22M and then level out between 24M and 25M in ’17.
    I’m sure there are plenty of haters here who will tell us the CBO is wrong…even though the CBO was right.

  101. gVOR08 says:

    @stonetools: I figure we’re within ten years of, “Keep the government’s hands off my ACA insurance.”

  102. MarkedMan says:

    @gVOR08: You are too painfully right. I’m old enough to remember how the Repubs went from mocking Senator Al Gore for being a nerd droning on and on about how we had to fund the this thing called the “Internet” and what a fool he was for thinking it would be important to the average joe (those my age will remember the abuse he took for calling it “The Information Superhighway”) to getting the whole press to make fun of him for claiming to have anything to do with it. Repub leaders simply do not care about truth one iota, and Repub voters are too present-minded (think of the dogs in the movie “Up” when someone shouts ‘Squirrel!’) to notice they are being chumped.

  103. stonetools says:

    @gVOR08:

    Yeah,the next move will be that the Democrats will try to introduce a public option and the Republicans will say “This market-oriented universal health insurance plan which Mitt Romney pioneered and which I always supported is perfect just the way it is.”

  104. stonetools says:

    Another important point here is that the MSM totally underestimated the size iof the enrollment surge. They concluded tthat the Administration had no chance of meeting even the 6M target and dismissed the Administration strategy of focussing on the internet and social media. They were flabbergasted when the Aministration proved that hey, the way to contact and move millenials to act is to go where they are.
    Maybe this opens up a new opportunity for the Democrats in the midterms. Maybe one way to get millenial women to the polls is to go on Facebook and tell them that there are five conservative Catholic old men in some place called the Supreme Court who think companies ought to dictate whether their health care dollars should go to contraceptive care, and that the way to change the Court is to vote in Democrats.

  105. al-Ameda says:

    WELL, considering the fact that about half the nation’s political establishment refused to implement it, and in fact have attempted nearly 50 times to repeal, rescind, or otherwise de-authorize the Act, it is amazing that we have still managed to enroll 7 million.

    ALSO, where were all these (so-called very concerned) Republican critics, now decrying increases in premium costs, when for nearly 15 consecutive years, premium costs were rising on average at annual rates of at least 3 times the rate of inflation, usually ranging from 9% to 15% each year. I know this because in previous finance positions I was responsible for benefits contracts and those annual notices of premium increases came to my attention.

    Unfortunately, the fact is that this country is too dumbed down to move to a Single Payer system.

  106. al-Ameda says:

    @Stan:

    @Jack: 5 million people lost their policies? What’s your source?

    As Jack himself says:

    “This entire 7,000,000 number is a ruse. A fabricated construct of total falsehood. Lies. Propaganda…”

    Basically, Jack is making it up.

  107. C. Clavin says:

    @stonetools:

    Speaking of which….The Libertarian Police Department.

    http://www.newyorker.com/online/blogs/shouts/2014/03/libertarian-police-department.html

    Or why Libertarianism is such nonsense…

  108. C. Clavin says:

    Joan Walsh makes a great point…

    Imagine if all 50 states had implemented their own exchanges, instead of just 17 of them. Imagine if all 50 states had expanded Medicaid, instead of just 27. Imagine if a well-funded noise machine, from Fox to Rush to the online swarm hadn’t publicized every glitch and every allegation of someone losing their insurance, often fabricating the problems, sometimes lying outright, while ignoring every positive story. (She’s looking at you, OTB)

    http://www.salon.com/2014/04/02/blood_on_gops_hands_how_many_would_be_covered_without_its_sabotage_plan/

  109. anjin-san says:
  110. Rob in CT says:

    The 7 mil number is and has always been sort of silly to argue over. It was the CBO projection for signups on the federal exchange, right? It wasn’t some sort of tipping point number. It was a guesstimate. And it turns out that, problems and all, it was basically right.

    The question about the reduction in the uninsured is an open one. I’ll note, however, that the reduction would certainly be larger if the law had gone into effect as written, as opposed to as rewritten by the Supreme Court (it was SCOTUS that allowed states to opt out of the Medicaid expansion). With numerous GOP-run states refusing to expand Medicaid, a critical piece of the law designed to expand coverage of the previous uninsured was deliberately hamstrung with malice aforethought.

    This can be remedied quite easily: those states can reverse course and accept the expansion. The # of uninsured will drop quite a bit as a result.

    This bullshit where the GOP does everything in its power to obstruct and prevent the law from working as designed and then turning around and claiming “it’s not working well!” is disgusting, and cannot be allowed to stand.

  111. Mikey says:

    @C. Clavin:

    Imagine if all 50 states had implemented their own exchanges, instead of just 17 of them.

    This is kind of a weak point, IMO. The legislation gave the states the option for either their own exchange or the federal exchange, why fault those that took the federal one? And many of the states that are fully on-board with the ACA, including Medicaid expansion, have opted for the federal exchange or a state-federal partnership exchange.

  112. Moosebreath says:

    @Rob in CT:

    “This bullshit where the GOP does everything in its power to obstruct and prevent the law from working as designed and then turning around and claiming “it’s not working well!” is disgusting, and cannot be allowed to stand.”

    And who will cause it to fall? The press, with their commitment to reporting that opinions differ on the shape of the earth? The commentators, for whom no set of facts will cause to change their opinions? The elected officials, who were gerrymandered to be divided and disfunctional, and not going to change until (at the earliest) the redistricting after the 2020 census?

  113. Rob in CT says:

    @Moosebreath:

    Depressing questions. I don’t know. My statement was… let’s say aspirational.

  114. Moosebreath says:

    @Rob in CT:

    “My statement was… let’s say aspirational.”

    I know. And I was just venting.

    I think the answer will be that the electorate changes, with the Silent Generation dying out, and the Millennials becoming eligible to vote, and actually voting, in larger numbers. But that’s not going to be too big an effect until about a decade away from now.

  115. C. Clavin says:

    @Mikey:
    Perhaps.
    I don’t have the numbers at my fingertips…but I’m pretty sure the states that have set up their own exchanges have vastly increased enrollment…because they have skin in the game. I know that here in CT there were all kinds of ads up last week. Even in a small state (3.6M) we enrolled 200K and an additional 121K Medicaid enrollees.
    On a much bigger scale Cali enrolled 1M in private policies. Imagine if Texas cared about the 25% of it’s population without insurance?

  116. C. Clavin says:

    @Moosebreath:
    SCOTUS today pretty much insured rich Republicans will own politics for a long time…no matter the demographics.

  117. C. Clavin says:

    Boehner:

    “The president can go out there and tout about all the people he’s signed up…our job is to show the American people we have better solutions, and we’re working to build a consensus to do that. And when we have something to talk about, we’ll show you…I think when we outline how we would repeal this bill and what we would replace it with, you’d see that our intent here is to take care of the American people, as opposed to harm them, as the President’s bill has done…”

    In other words…4 years and 50 repeal votes later…we still got nuthin’

  118. grumpy realist says:

    @bill: If you are someone who kept finding herself barred by “existing conditions” from getting health insurance AT ALL under the old system, you will be extremely happy with Obamacare.

    The increases people are bitching about are peanuts by comparison to the benefit we’re going to get down the road. Of course, I realize a lot of people are perfectly happy with an “eff off and die” reaction. May you be treated exactly as you want others to be treated.

  119. grumpy realist says:

    P.S. And I’m for single-payer. I actually have lived under single-payer, both in Japan and the U.K. The US has about the most brain-damaged health-care system I’ve ever run into.

  120. C. Clavin says:

    Off-topic:
    Here’s a fantastic review of how today the Koch-Franchised Justices, in a typically hypocritical fashion, continued their ongoing evisceration of the American political system.
    http://www.thedailybeast.com/articles/2014/04/02/originalists-making-it-up-again-mccutcheon-and-corruption.html

  121. Mikey says:

    @C. Clavin: Connecticut did a good job with their exchange, no doubt. Maryland’s has problems and they’re reaching out to Connecticut’s provider to get things on the right track.

  122. Mikey says:

    @C. Clavin:

    And when we have something to talk about, we’ll show you

    Four years of blathering about how much better the GOP solution would be and they still don’t have anything to even talk about? Really?

    And the GOP wonders why people don’t take them seriously…

  123. Rob in CT says:

    @Mikey:

    I noticed this a while back: apparently CT (via our Lt. Gov) is hawking our exchange to other states ’cause it works so well. How about that! We did something right! It makes me smile.

    Re: Boehner…

    And when we have something to talk about, we’ll show you

    And it will either be F off and die or smoke & mirrors. The problem here is not technical. If you accept the premise that we should try and extent healthcare coverage to all Americans (which the ACA doesn’t even do, though it moves us in that direction), then the range of options you have that might work is pretty limited. It’s well-trod ground. The issue here is that most Republicans reject the premise.

  124. humanoid.panda says:

    @C. Clavin: The states with their own exchanges had vastly divergent outcomes: some incredible successes (CT,CA), some total failures (MD, HI,MA). The key issue though is not only the software though, but the fact that some states made it actively harder for the outreach to proceed, for example by inducing all sorts of ridiculous demands on navigators, or not taking federal money for promoting the program. If all states had cooperated in the wider outreach efforts, the technical side of things would not have been that important.

  125. Barry says:

    “Megan McArdle points out that there’s still a lot we don’t know:”

    McArdle is a bullsh*tting wh*redaughter, who’s paid to write political propaganda disguised as analysis (when it’s not astroturfing fraud), and will be writing those things for the next thirty years, wondering why young people look at her as a bizarre oldster.

  126. Barry says:

    @James Joyner: “That’s possible. But the flip side, as you yourself may have pointed out, is that this likely constitutes the last bite at the apple for 20 years.”

    James, we sorta know how hard it is. The reason, of course, is that **your party** fights tooth and nail against it.

  127. Barry says:

    @Rob in CT: “The ACA is an improvement over the status quo ante. If the critique is now entering the “but, but, it’s not perfect!” phase, I can only smile and shake my head. Of course it’s not, silly.”

    Seconded. I’m also awaiting the internet meme ‘Lying Liberals! It’s RomneyCare/HeritageCare!’.

  128. Rob in CT says:

    @Barry:

    Goddamn right.

  129. Barry says:

    @mattbernius: “Hopefully John’s Son’s accountant has directed him to the related information. If not, I was able to come up with this info based on a quick internet search. ”

    It’s amazing how many of these Savvy, Street-Smart Businessmen aren’t aware of any facts at all.

  130. SC_Birdflyte says:

    Interestingly enough, a young woman who until recently lived in my hometown died last month after a 5-year battle with melanoma. Her family and friends are raising funds to pay off her unpaid medical bills. Had Obamacare (which I personally find far from perfect) been effect for that entire period, her family might not be in such a bind over the cost issue.

  131. anjin-san says:

    @ SC_Birdflyte

    I have a friend who’s wife died recently after being ill for about two years. No only is he broken hearted, he is ruined financially due to medical bills. He is almost 60, too late to start over. It’s stunning to me that so many people in our country find this sort of thing to be acceptable.

  132. grumpy realist says:

    @anjin-san: Because none of them have enough imagination, let alone empathy, to understand a similar tragedy could happen to them.

    “There but for the grace of God go I…” is a very powerful understanding.

  133. David M says:

    Serious question. How long can the GOP keep up the Obamacare trutherism? Whether it’s claiming the signup numbers are inflated, or the people harmed outnumber the ones helped by the ACA, or ignoring the Medicaid expansion, or pretending it did nothing to address the growth of health care costs…

  134. anjin-san says:

    How long can the GOP keep up the Obamacare trutherism?

    Well, it’s 2014 and they are still saying that Obama only won the election because of Hurricane Sandy…

  135. bill says:

    @humanoid.panda: there’s approx 320 mil people here, obama said about 30 mil were uninsured and would benefit from his plan. even if the alleged 7mil (of which nobody knows are all previously uninsured) actually pay for it then that’s what, 2%.
    @David M: i imagine they will, but will they ever come close to the 30 mil, and was all this bickering really worth it?

    @anjin-san: i don’t “vanish”- i have a life/career/girlfriend/kids/motorcycle and great weather/candycrush/etc. but here’s a few morsels to chew on until next time i re-appear 1) the web site. 2) the “you can keep your plan/doctor…. 3) the cancelled policies and increased premiums/deductibles. 4) the effects on big/small businesses 5) the “gaming the system” that’s just waiting to happen. (see Mass. for examples) 6) tax increases.
    i could go on, but you don’t buy any of it.