The Death of the Death of Obamacare

New York Magazine ^ | 1/16 | Jonathan Chait

[nickcarraway]

Last night, Douglas Kamerow and I debated Megan McArdle and Scott Gottlieb at Intelligence Squared over the notion, “Obamacare is now beyond rescue.” Intelligence Squared picked the topic two months ago, when the website was still broken, insurers were frantic, congressional Democrats were in a full-scale panic, and it seemed genuinely possible to many people that the law would simply fail. The arguments McArdle and Gottlieb made last night bore little resemblance to the sorts of failure predictions that were widely circulating last November. Many of their arguments simply took issue with the law’s goals; they argued that Medicaid does not make people healthier, that healthy people ought to be able to enjoy the financial benefits of being skimmed out of the insurance pool, and that politicians will reverse all the mechanisms needed to finance the law. In other words, they argued that the law was doomed for the reasons opponents had argued it was doomed in 2010, or for reasons a conservative could offer to suggest Medicare and Social Security are also doomed.

In the frantic autumn days, conservatives were offering a gorier prognosis — a rapid death, not an extended, ideologically preordained demise. The botched website rollout forced insurers and allies of the law to cancel their outreach campaign, leaving the new exchanges filled only with the customers most desperate to obtain insurance. In a caveat-laden yet still breathless report, Republican adviser Yuval Levin wrote that insurers were furious and contemplating “unthinkable options”: “At this point, it looks as though we may be witnessing a failure of the administrative state on a level unimagined even by its staunchest critics.” McArdle was writing columns with headlines like “Is Obamacare in a Death Spiral?” and “Why Obamacare Is Like Three Mile Island.” Today, the website is working (though still not flawlessly). News stories recently emphasized that the exchanges have attracted disproportionately older customers to date, but that is expected. The website failure in October and November compressed the rollout time, and the age composition of the exchanges is following the same pattern as Massachusetts — older people enrolling first, and then the proportion of younger customers steadily rising.

The enrollment surge from December is continuing. Sarah Kliff reports that once-panicky insurers are now expressing satisfaction with the customers they’re enrolling. And even if none of the optimistic projections are borne out — even if, unlike Massachusetts, the age distribution of the exchanges freezes into place — a death spiral still will not occur. The Kaiser Family Foundation crunched the numbers and found that even this worst-case scenario would result in a 2.4 percent premium hike. That’s a trivial increase, nothing like the kind of premium hike that would chase healthy customers away and trigger a death spiral. The website botch may mean that the exchanges enroll fewer customers for 2014 than originally hoped. But the effect on the long-term prognosis of the law turns out to be essentially nil. With the grand threats of a massive technical failure and an actuarial death spiral dispatched, what remains? In the feverish autumn panic, Democrats in Congress appeared ready to stampede away from Obamacare. The Hill panic peaked out with the Upton bill, a Republican proposal that would have genuinely impaired the functioning of the law, and which attracted nowhere near enough support to override an Obama veto. The failure of the Upton bill marked the end of any nascent legislative threat to Obamacare while Obama still holds office. Meanwhile, a newer legislative challenge has lurked on the sidelines. Conservative legal activists had seized on a quirk in the legislative text of the law which, if taken out of context, could be read to deny tax credits to any customers in the exchanges run by the federal government rather than the states. Yesterday, a judge laughed this challenge out of court. The point I tried to make in last night’s debate — with limited success, at least as judged by the voting audience — was that Obamacare opponents had merely fallen back on their original, ideologically driven opposition to the law. To call their opposition ideologically driven is not to say it is wrong. It is merely to say that they philosophically oppose the goal of national health insurance. They have persuaded themselves the law can’t accomplish its goals, when their real fear is that it will. My favorite moment from the debate, and I’m obviously biased, occurred when McArdle denied that she philosophically opposes national health insurance, prompting me to quote the headline of this 2009 McArdle column, “Why I Oppose National Health Care.”

There will be no glorious triumph of Obamacare, no cinematic score playing in the background, and no concession of defeat by the law’s opponents. That’s not how politics and public policy work. In my opening remarks, I compared Obamacare’s progress to renovating a house. It’s a frustrating process with fits and starts, disappointments, and constant frustrations. Obamacare opponents have tried to paint the frustrations as a collapse in progress — every time an electrician fails to show up or a part is unavailable or a design plan has to be reijiggered, they use it as proof that the whole thing is going to collapse. But it was never going to collapse, because renovating a house, like having a national health-care system, is something that is fundamentally doable. Obamacare opponents are going to have to let go of their hopes that the law cannot work and face up to their honest belief that they don’t want it to.

[Uncle Miltie]

Someday, the shooting starts.

[JennysCool]

In my opening remarks, I compared Obamacare’s progress to renovating a house.

Renovating a house isn't necessarily fatal.

Whoa! Jonathan here gets his Kool-Aid in a continuous intravenous drip!

[Gen.Blather]

Can anybody put this into perspective? Is the author a screaming liberal or is this fair and balanced reporting? This is the first positive thing I’ve read about Democrat-care.

[nickcarraway]

The funny thing Chait is going against Obama. If ACA fails, then single payer is coming.

[Graewoulf]

Q: Who built Obamacare?

A: Obama built that. Period.

[nickcarraway]

Well, that’s not really true, the Heritage Foundation, Romney, and some dirtbag Congress people built it. Obama just stole the credit and lied about it.

[Fiji Hill]

Jonathan Chait used to write for New Republic, so caveat lector.

[henkster]

I knew that when 0bama won in 2012, that was the last chance to undo 0bamacare. It has become so entrenched in the fabric of our country it cannot be rooted out. Romney at least said he’d repeal it. From now on, we slide down the slippery slope to the sludge bucket of single-payer.

Whether or not this is what a nation of shallow thinking LIVs wanted is irrelevant; it’s what they voted for and what they got.

[Graewoulf]

What did Obama build?
Did he do “Hard Work?”
He didn’t build Obamacare!
“Somebody else built that!”

BTW, isn’t a symptom of a chronic victim that nothing is EVER his fault?

[Liz]

"Those Democrats leering over my shoulder owe me bigtime. This
healthcare bill insures we have a permanent Democratic majority."

"All except those Tea Party types, swallowed hook, line and sinker my promises that they could":
(1) keep their existing health plans,
(2) keep their own doctors that they like,
(3) keep their 25-year-olds on the family health plan,
(4) never be denied coverage for a pre-existing condition,
(5) sign up instantly on my tech-savvy government Web site,
(6) buy insurance only after becoming seriously ill."
(7) save $2,500 in annual premiums in the bargain....
(8) All without any new taxes.

"Them sonovagun Tea Partiers will rue the day they criticized my wonderful bill."

[The Great RJ]

Obamacare will continue to stumble forward and the complicit GOP leadership will do nothing to stop or even slow it. The next shoe to drop will be this fall when millions covered by group plans get dropped. We can hope that the voters will notice before the elections.

[2ndDivisionVet]

Take this with a HUGE grain of salt...

Jonathan Chait, member, Obama front group Journ-o-list:
http://www.newrepublic.com/blog/jonathan-chait/75877/the-secrets-journolist

http://www.freerepublic.com/focus/f-bloggers/2559245/posts

[Liz]

Pelosi Says Dems Focusing on 3 ‘R’s to Win 2014
Midterms: Recruiting, Raising Cash, Raising Issues...

Yoo hoo, Nancy you forgot "Obamacare"---the signature legislation of your president----how come you Dems forget that, Nance? Huh?

=================================================

Maybe this is why Dems wont run on Obamacare?

As far back as 2008, at the presidential debate in Nashville, Democrat candidate Obama advanced his signature plan that was ultimately enacted (by an historic straight Democrat party-line vote) into the "Affordable Care Act :

OBAMA: "No. 1, let me just repeat, if you’ve got a health care plan that you like, you can keep it. All I’m going to do is help you to lower the premiums on it. You’ll still have choice of doctor.”

Repeated over and over ---- with the promise that every American family would be saving $2500.00 on healthcare costs.

LOCK-STEPPING PARTY LOYALTY NOT SEEN SINCE 1940's ERA EUROPE Obama And The Dumbos marching in lockstep. The persistent Dumbocrat drumbeat ---- in obeisance to Obama ---- kept ringing reassuringly in our ears: "If you like your plan, you can keep your plan."

[Robert357]

The real issue is how many additional personal problems are voters going to face before the next election and before ObamaCare becomes so ingrained that it can not be canceled.

Federal implementation documents project that “most” employer health care plans will need to be canceled and replaced with plans developed under the exchanges. Since the vast majority of people get their health care through employer health insurance and employer requirements have been delayed a year, what will happen in late 2014?

When will either the costs of health insurance plans start to skyrocket? Or will the cost sharing (i.e. subsidy from the federal government to health insurance company's start?)

Similarly, when will doctors start saying they will not take new medicaid patients whose number has been swollen with the exchanges? When will the IRS start penalizing individuals and garnisheeing their earnings when they fail to pay the fines for not having health insurance.

Those are the things that will kill public support. However, by the time those real issues are felt by enough people it could be impossible to unroll the ObamaCare regulations as too many people will be “hooked” both from the standpoint of insurance companies, medical providers, and individuals.

This is a really bad law, but it may or may not be too late to kill it. The real question will be how many negative headlines doe it get between now and the November elections.

[Mount Athos]

Don’t insurance companies stand to win hundreds of billions of government dollars from Obamacare?

Would they let it go away quickly and easily if so?

We have a lot of passion here, but they have a lot of lobbying money.

[Vanbasten]

“There will be no glorious triumph of Obamacare, no cinematic score playing in the background, and no concession of defeat by the law’s opponents. That’s not how politics and public policy work.”

Well, somebody needs to tell Boehner and every moron RINO that, because they are under the mistaken impression that law is simply going to implode or some such nonsense.

Yet another article illustrating that Ted Cruz was right....

[The_Media_never_lie]

Why did I waste my time reading this?

[al baby]

Can anybody put this into perspective?

Its like using a rectal thermometer orally Good enough for you !!!

[C210N]

Romney at least said he’d repeal it....

Yes, he did say that prior to losing the election. Since they he has stated how he would repeal it: by REQUIRING ALL states to mandate insurance.