Wednesday, November 6, 2013

Study suggests politics of Obamacare could shift against GOP

Morning Plum: Study suggests politics of Obamacare could shift against GOP

Barack Obama  (Reuters/Yuri Gripas)
Barack Obama (Reuters/Yuri Gripas)
Obamacare’s rollout problems have hit the White House with a political double whammy. The problems themselves feed a narrative, justifiably, about administration incompetence in managing Obama’s most important domestic initiative. Meanwhile, media coverage gives more weight to the “rate shock” and “losing coverage” storylines, because fewer have accessed exchanges — and fewer are aware of benefits such as subsidies to keep replacement coverage cheap.
But a new study released by the Kaiser Family Foundation suggests that if the website does get fixed, the politics of Obamacare could shift against its foes.
The study finds that roughly 17 million Americans will be eligible for tax credits to buy coverage in the exchanges, out of 29 million who might seek insurance from them. This includes those who are currently uninsured or are insured in the individual market. Estimating this is complex, because of multiple varying factors, but Kaiser employs a state-by-state analysis using 2012 and 2013 federal data.
Many experts believe the law will ultimately benefit significantly more people than it will hurt, because it will expand coverage to the uninsured and many who lose coverage will find the replacement cheaper thanks to subsidies and standards designed to minimize financial and medical risk from crappy coverage.
But now,  Obamacare’s foes have the advantage in the political argument. They can marshal knowable facts against the law: 300,000 Blue Cross and Blue Shield customers in Florida bumped!  Proponents must respond with predictions, or where possible, by pointing to people who may be finding a better deal, thanks to the law. This dynamic is heightened, as Jonathan Cohn notes, by coverage that downplays or ignores subsidies altogether.
But the Kaiser study suggests this could change. “Much of the discussion is now driven by anecdote,” Larry Levitt, a senior vice president at Kaiser, tells me. “There has been a lot of focus on sticker prices. But the fact is that most of the people buying in this market will be eligible for subsidies, and won’t be paying those sticker prices. We’ve lost sight of the people who will benefit from the law. As the website starts to work better, we’ll likely see more anecdotes on the other side.”
To foes, of course, this is largely beside the point. There is a legitimate policy argument at the crux of this battle: Many Republicans don’t believe the federal government should regulate the individual market, or spend money redistributively, in the fashion Obamacare aspires to, whatever the result. As Cohn says:
You can set higher standards for insurance, even though it means forcing some people to get better coverage. Or you can leave the standards as they are, even though those standards expose people to financial and medical calamity. Obama and his allies chose the former. Those who disagree should explain why they prefer the latter.
The latter could prove a tougher case to make over time. The de facto GOP position is to return to the old system, and polls suggest low public support for it. If those millions begin gaining subsidies, and Republicans begin to lose their advantage in the battle of anecdotes, the politics of Obamacare could shift once again.
Of course, the administration has to fix the damn website first.
 * A BAD OMEN FOR OBAMACARE? The Wall Street Journal is getting attention today with this:
Insurers say the early buyers of health coverage on the nation’s troubled new websites are older than expected so far, raising early concerns about the economics of the insurance marketplaces. If the trend continues, an older, more expensive set of customers could drive up prices for everyone, the insurers say, by forcing them to spread their costs around.
As it happens, the Kaiser study addresses this, too, concluding that it’s likely that those with a preexisting condition who have been excluded from the individual market will be among the earliest sign-ups, so this is expected. But if more “young and healthies” don’t sign up over time, that’s obviously a problem.
 * OBAMACARE WORKING IN KENTUCKY: Abby Goodnough has a good piece on how Obamacare enrollment is working just as it’s supposed to in Kentucky, including this anecdote:
The woman, a thin 61-year-old who refused to give her name, citing privacy concerns, had come to the public library here to sign up for health insurance through Kentucky’s new online exchange. She had a painful lump on the back of her hand and other health problems that worried her deeply, she said, but had been unable to afford insurance as a home health care worker who earns $9 an hour.       
Within a minute, the system checked her information and flashed its conclusion on Ms. Cauley’s laptop: eligible for Medicaid. The woman began to weep with relief. Without insurance, she said as she left, “it’s cheaper to die.”
As Goodnough notes, this demonstrates “how enrollment could work once the technical problems of are resolved.” That is, if they are resolved.
 * WATCH THE TEA PARTY/BUSINESS SPLIT IN TODAY’S ELECTIONS: Today in the Virginia gubernatorial election, Dem Terry McAuliffe is backed by some GOP-aligned business interests who shunned Tea Partyer Ken Cuccinelli. And in Alabama, there’s a House special election primary pitting a Tea Partyer against an establishment candidate backed by business figures who think the insurgent would harm the business climate, which both sides view as a “battle for the heart and soul of the national Republican Party.”
If McAuliffe wins, it will be seen as another clear case where the nomination of a Tea Partyer led the GOP to blow what should have been a winnable race.
* WHAT TO WATCH FOR IN VIRGINIA: As the Fix crew notes, keep an eye on McAuliffe’s margin among women, after aggressively attacking Cuccinelli over abortion, contraception and other issues important to them:
In 2009, Republican candidate Bob McDonnell was more trusted by women on such issues. Cuccinelli is unlikely to beat McAuliffe among women voters, but a losing margin larger than Mitt Romney’s nine-point deficit to President Obama in 2012 could prove insurmountable.
Also watch turnout among other constituencies increasingly important to the Democratic coalition of the future, particularly (as Ron Brownstein notes) given that McAuliffe ran a campaign emphasizing liberal social issue positions designed to appeal to them, even in a purple state.
* WHAT THE TEA PARTY HATH WROUGHT: Michael Gerson has a good one here:
Liberal Republicanism has essentially ceased to exist. This means that tea party conservatives are revolting against a more uniformly conservative party. The RINOs they hunt are actually an endangered species. So they have transformed tactical disagreements — over, say, a hopeless attempt to defund Obamacare — into defining ideological struggles.
And, of course, the Obamacare rollout problems — which have only deepened the Tea Party conviction that its epic collapse is underway — will only increase demand for more such intra-party defining ideological struggles later.
* FACT OF THE DAY, ENDA EDITION: The Employment Non-Discrimination Act cleared its first Senate hurdle late yesterday, and Jeremy Peters adds this:
Nondiscrimination legislation including sexual orientation and gender identity has languished in Congress for nearly 40 years.
And it will likely continue doing so, because John Boehner and the House GOP leadership is unlikely to even allow a vote on ENDA this time.
 * OPPOSITION TO ENDA IS SOFTENING: With ENDA unlikely to get a vote in the House, Paul Kane makes a smart point:
Most opponents, including Boehner, have focused their concerns on allegations that the legislation would benefit trial lawyers and have shied away from the morality and family-values questions that once dominated the issue.
And yet, social conservatives still appear to wield enough sway over GOP leaders to block a vote from happening at all, at least for now.
* AND GOP CAN ONLY STAND ATHWART HISTORY FOR SO LONG: Roll Call’s David Hawkings has a terrific look at the Congressional politics of ENDA, with proponents so confident of long term victory that they will not drop the current proposal’s transgender protections:
Advocates of the bill — which would outlaw workplace discrimination against gay, lesbian, bisexual and transgender people — are working to create something of a self-fulfilling prophecy: The metaphoric arc of history is bending so quickly toward this measure of justice that, by the time midterm Election Day arrives in one year, Republicans in close races will appear dangerously out of touch unless they have become part of turning ENDA into law….the gay rights community now looks united behind a strategy of waiting for the comprehensive victory it is confident will come before too long.
What else?

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