Monday, November 18, 2013
Brimming Over With Enthusiasm
How to silence GOP nuts? Charming to the last. Beutler sure knows how to get the opposition ready to be convinced.
He follows the well known outline--acknowledge a shaky start of the Orwellian named ACA but bring on the criticism of the opposition and finish off with undeserved optimism. The sun will come out, tomorrow! Well, let's go to the actual words
That leaves two possible futures for the Affordable Care Act. One in which it limps ahead. Another in which it undertakes a swift reversal of fortune.Let me be so bold as to suggest a third possible future for the ACA. It keeps on getting worse. Plausible? Possible? Likely? Doesn't exist in Beutler's bubble world.
The nightmare scenario isn’t that Obamacare will be repealed. It’s actually hard to imagine a scenario in which Obama leaves office in 2017 without having overseen a massive expansion of health insurance coverage in the U.S. But getting there could be excruciatingly difficult.Nightmare for whom? Obamacare never signs up many enrollees in the first year. Tens of Millions lose employer supplied healthcare plans. The law's unpopularity approaches 75%. The Democrats lose the Senate in 2014 and the White House in 2016 and the first Republican bill to pass and be signed is the the complete repeal of the ACA. Scenario imagined.
A net reduction in individual market coverage would be politically humiliating. It would also raise the moral question of whether it’s fair to impose penalties on people for not entering a system that they can’t access and probably don’t trust. At that point, Democrats would face intense pressure to vote for a delay of the individual mandate. They might do it, too. To stave off a full-scale rebellion, the administration would probably act unilaterally, agree to provide hardship exemptions en masse, and hope to hold the votes for a universal delay below a veto-proof threshold, to protect markets in states like Kentucky with functioning exchanges.
Administration acting unilaterally to change the bill without congressional involvement is the problem. It's an unconstitutional act (not that the Constitution has ever mattered much to this Administration). See Art. II, Sec. 3, Clause 5. With a 2010 government prediction of up to 2/3 of employer provided health insurance plans being cancelled (now in 2014), this move to traitorous, hostage taking delay of the ACA is very likely. Democrat legislators are already openly talking about delaying the individual mandate. I'm praying Republicans fail to help accomplish that. Why should we have to wait for the wonderfullness of Obamacare?
Vastly preferable is a “nowhere to go but up” scenario where the website works pretty well in a couple of weeks, enrollments shoot upward, quickly overtaking the number of people whose policies have been canceled. Ideally many of the people who just lost their coverage (motivated insurance purchasers) turn to the exchanges and find policies that they like, or at that they’re happy enough with to quiet their anger over the cancellation of their old plans.
Vastly preferable to whom? Yeah, the people could flock to the exchanges and everything will turn out swell.
And monkeys.... Notice that no Democrat still talks about cheaper plans or saving the average family $2500 a year, a promise the President constantly repeated over the past 4 years or so. The best scenario is that the multitude thrown off completely satisfactory plans might find new plans that don't cause them to feel nothing but anger. Setting the bar about a millimeter off the ground, that is.
In this scenario, aggregates will begin to matter. The media’s bias toward anecdote and hardship — which has dominated the news for the past month and a half — will have to contend with raw numbers. If total enrollments, including new Medicaid beneficiaries, approach anywhere near the 16 million the Congressional Budget Office initially projected, the tale of the ACA’s success will be impossible for the media to ignore.
16 million enrollees including new medicaid patients? At current rates, even doubled current rates, that number of enrollees will be reached in mid 2025 or so. Not the sunny scenario of "success" Beutler seems to imagine.
Starting Dec. 1, opponents of the law will screen-grab and disseminate every website failure they happen upon. But if the law truly is working well “for the vast majority of users” as the administration likes to say, it will be reflected in swelling enrollment figures and regular updates on the law’s improving progress. That’ll take the sting out of “you can keep it” attacks. Democrats won’t have anything to run from anymore. You can even imagine them repurposing the Upton bill, to put Republicans on the record against stripping new beneficiaries of their health plans.
Swelling enrollment figures starting December 1 and running deep into the election cycle in 2014. That's the hopeful prediction Brian Beutler is selling. Too bad the government shut down InTrade betting site for American users at least.
This is a very optimistic imagined future. Thank God the internet is around to record these predictions for comparison with reality some, what, 9 and a half months from now. I'll be checking back in by then.