Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts

Monday, December 16, 2013

Glitch Gloating? Good

I'm not sure whether it was in response to my earlier item or not, but Andrew Sprung tweets:
So constructive to have all hands in a major political party poised to highlight & gloat over every glitch in major new gov service.
Presumably he's being sarcastic, but you know what? It is constructive! It's absolutely a good thing to have a major political party poised to highlight every glitch in what government is up to. Not so much the gloating, but that's not doing any harm. The highlighting is definitely a good thing. One of the strong points of the two-party system is that it leaves an out party with every incentive to identify everything that's going wrong. Not just in government, but in the nation as a whole.

The problem isn't highlighting the glitches, or even gloating about them. The problem is that the current radical GOP is actively opposed to fixing ACA problems, to the point of obstructing attempted fixes. That's a problem. But it's also not normal at all. A healthy party would either promote fixes in order to get more mileage out of their claim that the administration botched thing, or at the very least use glitches and needed fixes as an opportunity to get its own policies adopted. Flat-out rejectionism is definitely a problem, but it only comes up because the normal party incentives of winning elections and enacting public policy don't seem to be working as well as they should for the radical GOP.

But seeking out poor public policy and calling attention to it? That's extremely healthy for the system.

Blame Obamacare/Disappearing Obamacare

Kevin Drum notes that everyone is blaming Obamacare for things that would happen anyway, and that the incentive structure calls for this to continue, for a while at least. Sam Baker had a longer, and also good, item about this last week.

I'm gonna be churlish and say: Called it! Way back when I was a wee baby blogger, and months before the ACA passed:

On health care, it's safe to predict (if the bill passes) that even though few provisions will go into effect before the 2010 and 2012 election, Obama and the Democrats will totally own health care, at least for high-information GOP primary voters. We can expect lots of medical horror stories (true ones -- there are always true medical horror stories) that are attributed to Obamacare. On top of that, there will be death panels; not real ones, of course, but newly invented scary future effects of the newly passed bill. Any Republican who cut a deal and voted for that bill will be risking the blame, along with all Democrats, for every medical horror story that happens for the rest of their careers, but especially over the next couple election cycles (I should note that Republicans are hardly alone in that; for the past forty years Democrats have pinned all medical horror stories on reform-blocking GOP candidates. The special genius of the 2010 and 2012 cycles is that the responsibility will flip, at least for GOP primary voters, even though reform won't yet be implemented).
Okay, so I should have added the 2014 cycle, too, and probably 2016 as well.

I still believe, by the way, that "Obamacare" will eventually disappear, at least assuming it's reasonably successful. Of course, the fiasco in October wasn't good for making "Obamacare" disappear; I've always said that it disappears if it succeeds. It's possible, too, that the conservative information bubble is so obsessed with the law that they'll still be blaming everything up to and including the common cold on Obamacare decades from now. On the other hand, sooner or later there will be another Democratic president, and once that happens Fox News and all are sure to compare the radical socialist leftism of that new president to the reasonable moderation of Obama. Will "Obamacare" survive that? Hard to guess.

I'd really love to know what percentage of people who have new insurance through the exchanges think it's "Obamacare." Whatever that is -- and it's surely lower than 100% -- it's certain to decline over time. And I'm guessing that only a small fraction of those with new expanded Medicaid insurance think of it as Obamacare (or ACA). Hardly anyone with employer-based insurance thinks of it as related in any way to Obamacare, I'd assume; nor do they think it has anything to do with government policy.

Back to the blame thing...the point isn't whether ACA is a success or not; the point is that it's going to be blamed for lots of things, many of which it has nothing to do with, whether it's a success or a failure. That's just the nature of the thing.

Sunday, December 15, 2013

Sunday Question for Liberals

Same question, plus a bit more. What's the general consensus of neutral experts going to be by, oh, the end of March on how the ACA is working? Series of disasters? Surprisingly successful, given the fiasco in October? Too soon to know? Or something else?

And what of Barack Obama's job in implementing the law. Presumably he'll still be knocked for October, but among liberals, will it look not so bad in retrospect? Sign of all that is wrong with his presidency? Demonstration that he makes at least his share of mistakes, but is good at recovering from them? Or something else?

Sunday Question for Conservatives

What's the general consensus of neutral experts going to be by, oh, the end of March on how the ACA is working? Series of disasters? Surprisingly successful, given the fiasco in October? Too soon to know? Or something else?

Wednesday, December 11, 2013

Dogs, Not Barking

Right to it:

1. Ross Douthat mentioned this one today: as far as we know, it turns out that employers are not dumping their employees on the exchanges. At least so far. I do think it's likely that over time the ACA will wind up pushing people out of employment-linked insurance, but it appears that a fast, destabilizing dump isn't happening. Good Douthat piece, by the way, especially in that he's absolutely right that the best way to think about the ACA now is in terms of potential outcomes and the future policy questions they will raise, not "success" or "failure."

2. I talked about this yesterday...this one is less a dog not barking than a dog barking in the wrong direction, or something like that. Republican Senators are apparently doing a "filibuster" stunt today to protest the nuclear option (or maybe it's more of a "what have you got?" protest)...but they're really not shutting down the Senate. @Mansfield2016 nailed this one (and really, follow if you're interested in judicial nominations at all, including Senate procedure and reform issues): Republicans haven't objected to overnight time counting towards post-cloture time, something they could do. The same was true yesterday for the recess for party meetings. In addition, Republicans haven't objected to having committees meet. And as other have noted, the budget wars have semi-thawed, with Senate nukes apparently having no effect at all. Yes, they have forced a few votes which weren't necessary, and by not yielding back post-cloture time (so far!) they're definitely delaying and obstructing. But remember that GOP obstruction of nominees has been the norm for years now. This very much appears to be ordinary delay, not nuclear fallout. I'm increasingly confident that I was right on this one.

3. Afghanistan casualties continues to be, in my view, a very big and very undercovered story -- especially when troop deaths aren't happening. The last coalition troop death was back on November 17, and there were only four in November (3 US deaths). For the year, the coalition total is 148 (118 US), down from 402 (310) last year. This year will be the fewer coalition troop deaths in Afghanistan since 2005 (US since 2007); it will be fewest combined (Afghanistan plus Iraq) troop deaths since before the Iraq war began. I don't think we've really spent enough time thinking about how being at war for over a decade matters, or how it will matter when the Afghanistan adventure ends, or at least mostly ends, in just a few more months.

4. And the real reason I did this one today: the Fairness Doctrine is back! Well, not the Fairness Doctrine itself, of course, but conservative paranoia that it's coming back any second now. Via friend-of-blog John Anderson.

Tuesday, December 10, 2013

Catch of the Day

Jonathan Chait:
The problem here is that their definition of who would “benefit” is exceedingly narrow. You “benefit,” by his way of thinking, only if your actuarial costs exceed your financial contributions. But that isn’t how most people think about insurance. Insurance isn’t a kind of gamble where you bet you can beat the house by consuming more in medical care than you pay in premiums and deductibles. It’s protection from risk. People like that protection. They will pay to acquire it.
Yeah. I really do think that one thing that's happened in the continuing reaction to the ACA is that a lot of conservatives have convinced themselves that people don't really want health insurance after all -- that health insurance per se is some sort of liberal hoodwinking of an otherwise sensible popular. As far as I can tell, that's just simply not true. People do want insurance: old people, sick people, young people, healthy people. And, also as far as I can tell, they don't just want catastrophic protection; they want comprehensive, "good," insurance.

Now, it's true that if it's too expensive, people won't buy it -- so questions about young healthies and death spirals are perfectly legitimate.

But that legitimate question, as I read a lot of conservatives, seems to have transmogrified into skepticism of the entire idea of health insurance -- a refusal to believe the very obvious point that, as Chait says, people will pay to avoid risk.

Example? I see it in several of Ross Douthat's recent items, including today's (generally smart) comparison of Medicare Part D and the ACA. I basically agree with him about the rollout comparisons, but when it comes to ACA customers he just doesn't seem to see that the peace of mind insurance gives people is really a massive benefit, and therefore of course one should expect people to want (within reason) to pay for it.

Or at least that's how I read Douthat and other smart conservatives.

Also: nice catch!

Friday, December 6, 2013

Ignore Those Polls!

The "Millenials" poll out earlier this week showing (among other things) younger people unenthusiastic about the ACA has sparked a fair amount of discussion, but there's one particular point I haven't seen made. I'm highly suspicious of the reported finding that only a third of the uninsured from ages 18 through 29 intend to enroll through the exchanges.

There are just too many things out there for me to believe that there's any kind of predictable relationship between what they tell a pollster and what they'll actually do.

Let's see...first of all, I'm pretty skeptical about asking the younger part of this cohort about personal intentions with regard to health insurance at all. Perhaps I find it hard to put myself in their shoes, since I was a full-time college student at that age and from a middle class family; I didn't have to think about health insurance at all until after graduation. At any rate, for those at ages 18 through 25, the survey asked what they would do "after you are no longer eligible to stay on your parents plan." As far as I can tell from the survey, that was used for everyone in that age range, regardless of whether they had insurance on a parent plan now.  If that's case, then I'd suggest it's totally meaningless what a 18 year old tells a pollster she expects to do about obtaining health insurance over five years into the future.

And then there's the question of what they're signing up for. The poll used a split sample to ask about both "Affordable Care Act" and "Obamacare," which is great. But there's no mention of Healthcare.gov in either case; instead, it refers to only "government-run exchanges." I'm really not confident that most young people know what that means -- or that they would need to in order to sign up. Then there's the issue of the state-run exchanges; people in Kentucky or California may believe that they're not signing up for "Obamacare" at all. It's also true, although again there's no way to know how it affects polling responses, that a fair number of uninsured young people will be eligible for expanded Medicaid. Would they say they are planning on using "government-run exchanges" or not? That's not even figuring out what to think about those who would be eligible for Medicaid but have the bad luck to be in Texas or some other state that didn't participate.

One more thing: even for those who are eligible for the exchanges now and understand what they are, it's still not clear how well what they tell pollsters of their intentions will match what they eventually do. Some may say they intend to sign up but then never get around to it, or start shopping and then decide it's a bad deal for them. Others may not intend to and then find out that subsidies make it a good deal.

My guess is that for most young people, at some point they'll confront the question of "how do I get health insurance?" for the first time -- in many cases, because a parent is nagging them about it -- and unless they have employment-linked coverage, the answer is going to be to go to Healthcare.gov or their state exchange. And, yeah, it won't really feel like signing up for Obamacare; it's just going to be how you get (private) health insurance.

Which, I should add, is not a prediction about how many will sign up and at what age, and how that will affect the overall pool (and thus the degree to which the ACA exchanges work or don't work).

At any rate, I don't think the poll tells us anything about what young people are going to do when they get to that point of seeking insurance. General point: be very suspicious any time people answer polling question about intentions they might not have had until they were asked. Ignore those polls!

Wednesday, December 4, 2013

HealthCare.gov, Amazon, and Health Care as Normal Politics

I made the point yesterday that what we're starting to see is the re-emergence of health care as a normal political issue, along with the end fight over passing and then repealing the ACA.

I think that's the right lens through which to understand the conversation about the remaining visible problems at Healthcare.gov. as discussed by Jonathan Cohn and others. Philip Klein, criticizing the improved web site, noted that it still compares unfavorably to typical commercial sites; Cohn considers the evidence.

Here's the thing, though. None of this has anything at all to do with the "success" or "failure" of the ACA. Yes, if Amazon was down every night for scheduled repairs and then occasionally the rest of the time, Amazon wouldn't last long. But, as I said the other day, not a single state motor vehicle registration or driver's licence program has every failed because local DMVs are typically a mess.*

Which doesn't mean it won't matter, going forward, whether Healthcare.gov is well-run or not. It's just that it will be a normal political issue. No different from whether the VA is well-run, or whether Pentagon procurement wastes a ton of money or not.

I'm confident that's true of front-end problems. I think it's probably true of back-end problems, at least within reason. Yes, it's going to be a big deal for the individual people involved if a small percentage of customers have miscalculated subsidies, or if the insurance company they thought they signed up for doesn't ever hear about it. It's the kind of mismanagement scandal that can and should create big headaches for an administration. But it's not the kind of thing that causes a government program to "fail" or to be repealed.

I suppose there might be some level at which things are so bad that customers really don't show up, or at least that effects are more than at the margins. But fundamentally, people want health insurance, and Healthcare.gov (and the state exchanges) are where people are going to go if they're on the individual market. Whether it's relatively easy or relatively difficult.**

Again: I'm not saying that mismanagement at Healthcare.gov is a non-issue. It's absolutely an issue, and a big story. It's just almost certainly a normal politics story about how well (or badly) government is working. It may even be a part of the story of the next generation of government health care reform. It's just not part of a battle over the survival or repeal of the ACA, because that battle ended a while ago.




*Is this no longer true, by the way? And is the reputation no longer true, regardless of the facts? My last experience in Texas -- in a newly opened office -- was just fine, and a few years ago I had an excellent customer experience in Indiana.

**Old guy moment: I was going to say: just as people shop at malls even if they hate malls, because that's where the stores are. Dated! And, yeah, maybe the miserable experience many people believed that circa-1980s shopping malls gave them had a lot to do with the demise of malls. But not before an awful lot of stuff was purchased.

Read Stuff, You Should

Happy Birthday to Jerome Williams, 32. I was a big fan, and I'm really glad he got to have a career. Belongs on some sort of team with Solomon Torres, Ryan Vogelsong, and I suppose Jason Grilli.

Good stuff:

1. More on ACA, Obama, and the presidency from Scott Lemieux. By the way: I'm open to arguments that Obama (and Waxman, and Pelosi, and Dodd, and Harkin) could have done marginally better overall, if "better" is defined as getting more of what they were fighting for. My overall assessment, however, is that there was a lot more downside than there was upside; the whole thing could definitely collapsed, but better presidenting would have made very small differences. As for the question of how much agency Obama had...yes, he certainly could have pulled the plug at a few key points. But I strongly suspect that the incentives were overwhelmingly in the direction he wound up in, and that pretty much any plausible Democratic president would have gone down (and stayed on) the same path.

2. Kevin Drum is probably right about White House responsibility for the October Healthcare.gov fiasco. I do think successful GOP obstruction is an underrated factor, though.

3. "Pervasive sexual harassment and violence against female reporters, editors, and writers is rarely aired publicly, but it is an open secret in the field." Amanda Hess discusses.

4. And Josh Huder on the Embarrassing 113th.

Tuesday, December 3, 2013

Catch of the Day

To Scott Lemieux for (once again) shooting down liberal fantasies that the only thing preventing Congress from passing single-payer health care insurance in 2009-2010 was a failure of will from the president.

It's an excellent job, and sadly necessary, over and over again.

One key point that Lemieux doesn't mention this time: in one sense, this really isn't about 2009 at all. It's about 2007 and 2008, when the three leading Democratic presidential candidates converged on essentially the same plan (with Obama famously omitting the individual mandate). That says a lot. It says that none of those three candidates believed that adopting single-payer would have given them a serious edge in a closely contested nomination fight -- and that no other candidate was able to leap to the top tier by embracing single-payer. In other words, it tells us that in the world of 2007-2008, at least, the ACA was mainstream within the actual Democratic Party as it was, and single-payer was a fringe position in the actual Democratic Party as it was. Maybe lots and lots of Democrats preferred single-payer in some sense, but virtually none of them, either elites or electorates, did anything about it. And that's what counts.

What this also means is that ACA vs. single-payer had virtually nothing to do with Barack Obama himself. And so Obama-centric explanations for it are clearly, 100%, wrong.

I'd further argue, although here it's not quite as clear, that there was very little about the way that Obama fought for the ACA that had much to do with Obama himself. Yes, a Hillary Clinton WH would have looked a little different from the Obama WH...but not all that very different. Yes, presidents themselves do make key decisions, and not their staff or their party. But not only are they often severely constrained by their party (and by Congress, and by lots of other things), but they're also highly influenced by the incentives of the job, and those are the same whether we're talking Obama, Clinton, or George W. Bush.

In short, there's an excellent chance that both the good and bad outcomes on health care reform would have wound up more or less the same whether the winner of the 2008 Democratic nomination was Obama, or Hillary, or a hypothetically unscandaled John Edwards, or for that matter John Kerry or Al Gore.

Meanwhile: nice catch!

Read Stuff, You Should

Happy Birthday to Damon Berryhill, 50. I mentioned Jamie Moyer recently. Moyer is a big deal for my larger cohort; Berryhill was a big deal, for roughly the same reasons, for me personally. Hey, you could do worse. I mean, if you have to pick a player who you want to have a long, long, long, career, you could do worse than a professional backup catcher who switch-hits. Alas, despite a very respectable 1997 season, he didn't get another shot.

Good stuff:

1. Annie Lowry on ACA costs continuing to be less than anticipated, both for consumers and for the government.

2. Dan Drezner on "The Hard Limits of Economic Power."

3. More on parties and politicians in Colorado politics, from (natch) Seth Masket. Two questions about this story. One: what rewards, if any, did Colorado's Democratic governor (or even Barack Obama) have to offer? And: what kind of campaign and governing staffs do Colorado state legislators have -- and where were their loyalties and career interests in this story?

4. And: "I get questions from virtually all over the country regarding GPO style..." Great short profile of GPO's Mike Abramson, by Roll Call's Hannah Hess.

Monday, December 2, 2013

Hey, Pollsters!

Three topics I'd love to know more about:

1. How many people know that Healthcare.gov is Obamacare? Especially the people who actually use it. Also, the associated questions: how many know that it's the Affordable Care Act, and how many know that there's more to the ACA than the exchanges? I'm assuming that the number of people who associate Healthcare.gov with Obamacare is higher than it would have been if it had worked smoothly from the start...I'd expect the number to be relatively high now, and start to shrink as time goes on. But either way, I'd love to know about it.

2. How many people know that the US is still involved in a shooting war in Afghanistan? How many know that the US is no longer involved in a shooting war in Iraq? I saw another reference today somewhere to "two wars"...I suppose that might have meant Afghanistan and the general "war on terror," or it could have been just a error while writing quickly, or that there was an implicit "over the last decade" that I didn't read properly, but really I have no idea. I'm fairly certain that some people think the US is still occupying Iraq, and that some people don't know there are still US troops (and US casualties) in Afghanistan, but whether it's a tiny fraction or something more substantial? I have no idea.

3. An old standby: What do people mean when they talk about the "deficit"? Or, to put it another way: what do people hear when pollsters ask them about the deficit?

Generally: I find myself curious about political knowledge (in the electorate, but sometimes among elites) at least as often as I am curious about political opinions. That might just be because there's plenty of available information about opinions and much less about knowledge; I can't tell.

This worked once! So: Hey, pollsters: I bet I'm not the only one curious about these things.


Repeal is Still Dead

A few bullet points on health care reform at the start of December...

*The brutal truth of "repeal" is that whatever the politics, every day a flat-out repeal of the ACA becomes more and more nonsensical. The status quo ante no longer exists; changing the law back to how it was in 2009 wouldn't bring back the health care situation that existed then.

*Hey, health care wonks! I've been using this line about how repeal no longer makes policy sense for some time now, but while I'm confident that's correct, I'm certainly not enough of a health care wonk to write up all the details that make a return (via repeal) to 2009 just plain gibberish -- what I called the Humpty-Dumptyness of the situation. Someone want to take a crack at it?

*It's also true, as Brian Beutler says today (and Kevin Drum said last week) that in simple political terms flat-out repeal is less and less plausible every day, with more and more people having insurance through the exchanges.

*All of which is to say that the US health care system has now been (almost) fully Obamacare-ized, and future changes will build on the ACA. That might even had been true after a GOP landslide in 2012, but it's certainly true now.

*Which in turn means that radicals who insist that Republicans who deviate at all from the hard-line repeal message are asking those Republicans to (continue to) absent themselves from the real debate over what's next.

*Of course, that would be less true if there really was a Republican alternative to the ACA -- if "repeal and replace" had ever become a true alternative. But even so, any alternative to Obamacare will, at this point, have to build on Obamacare.

*It also means that all-or-nothing assessments of the ACA (or of Healthcare.gov) are not only inaccurate, but particularly unhelpful because nothing is really at stake in whether the law "succeeds" or "fails." What matters is what current, Obamacare-ized health care does well, does not so well, and does badly, and what new laws/regulations/practices can help where improvements are needed.




(Yes, I did try to come up with an appropriate Humpty Dance title for this one, but alas I couldn't make it work. Partially because I don't mean to imply that post-ACA health care is broken; what I mean, as I hope is clear, is that the status quo ante can't be put back together again. But mostly because I couldn't find the right quote...I could, however, have opened with "Stop whatcha doin' 'cause I'm about to ruin the image and the style that ya used to.")

Read Stuff, You Should

Happy Birthday to Lucy Liu, 45. The hardest thing about getting Holmes right has to be the precise gradation of just how smart he is. Too smart and there's no drama (or else you need to keep coming up with cheats, and what's the point of that?). Not smart enough, and why are we watching? I think Sherlock set it a bit too high, and Elementary just a tad too low. Two first-rate Watsons, though, although I'm a die-hard Nigel Bruce fan.

Hey, it's Monday, isn't it? How about some good stuff:

1. Scott Porch with suggestions about how campaign coverage could improve if the media took findings from political science seriously.

2. John Sides is correct that analysis of nomination politics should distinguish between elite and mass opinion. The important thing to note is that at this point (and throughout the invisible primary, at least), it's elite opinion that matters. If a politician is popular among the rank-and-file of some group but unpopular among opinion leaders for that group, the odds are strong that by Iowa, he or she will be unpopular among that group's voters.

3. Good Paul Kane overview of what the pathetic 113th has on its to-do list for December -- and exactly how pathetic this session of Congress has been.

4. Sarah Kliff on "vast majority" day.

5. And Philip Klein with a critique. Overall, I think his criticisms of the consumer experience are not unreasonable, but probably mostly irrelevant; most state DMVs had terrible service, but very few people decided to pass on getting a license because of it. On the other hand, the back-end problems...that's the critical question, and I agree with him (and Kliff) that we just have very little idea of what's going on -- and there's a scary possibility that no one will know what's going on until more people get through the system (which should happen in the next few weeks).

6. And it's 2014 filing deadline time in Illinois.

Sunday, December 1, 2013

My Glitch is Fixed!

I tweeted about this last night, but why not make a post out of it: I've been stuck at the same place at Healthcare.gov since mid or late October, and now they've fixed my glitch! I tried last night for the first time in a week, and suddenly the program didn't hang at the spot it's been hanging. Exciting!

For what it's worth: the problem was in the initial family information, towards the end. It asked about whether my eldest was a full-time student (she is), and then whether she had a parent in the same state in which she attends school (she doesn't), and then it couldn't save and continue after I answered it. Now? It can. I was able to complete the family information. Next step is income, and I wasn't prepared for it last night, so I bailed; I'll try to continue sometime soon.

Realistic interpretation: It's silly to try to extrapolate from one customer's experience to anything at all about the system. The odds that I'll finish the process and actually have exchange-purchased health insurance are definitely much higher now, but what that says about anything else is probably a stretch.

Pessimistic interpretation: this is one small glitch which probably applied to a handful of people, and isn't really related to the big-deal back-end problems (correctly calculating subsidies, communicating accurately with health insurance companies) which could cause massive and serious problems.

Optimistic interpretation: if they got around to fixing my glitch, which probably applies to a tiny handful of people, then there's a good chance they're doing an even better job of dealing with the big-deal back-end problems which could cause massive and serious problems.

The correct one is...the realistic interpretation, of course. There's really no way to know what it means that one customer was able to get through one glitch.

Now, they're definitely improving it: logging in has been easy for weeks now after being on-and-off for a while, for example. On the other hand, they claim that response time is better; maybe it is, but the "save and continue" function is still very slow (and the system is designed to force a "save and continue" frequently, so putting in all family information for a four-person family takes quite some time). And I've only just now completed the first step, so I have no idea how the next parts will go.

Still, my glitch is fixed!

Saturday, November 30, 2013

What Mattered This Week?

Not much up on a Thanksgiving week. Plus with travel and all I'm sure I missed plenty. I'm sort of tempted to go with "blue slip" obstruction breaking through into national news, but I'm not sure yet whether it matters or not....I'll be dull and just repeat one of my items from yesterday about the ACA end-of-month deadline: fixes (or failures) certainly matter to the individuals affected, but I still don't think the future of the program is at stake, or that how close healthcare.gov is to fully functional in the next week (or even month) will have much effect on the 2014 or 2016 elections.

That's what I have. What do you have? What do you think mattered this week?

Wednesday, November 20, 2013

Elsewhere/Housekeeping

My TAP column this week argues that Republicans could have tried out some of the ideas that conservatives have been pushing if only they had decided to run their own state exchanges. I'm pretty confident that Democrats, either in 2009-2010 or later, would have been willing to cut deals to allow that sort of experimentation on a state level.

Meanwhile, I packed way too much into a short post over at PP yesterday -- including an outline of the filibuster deal I'd like to see (but has no chance of happening, even though the core of it actually makes sense for both parties). Yes, there's a Superbill! appearance.

Housekeeping: I'm traveling today; I might sneak in another post, especially if something happens with the filibuster, but probably not. And might as well get this out of the way now...posting is going to be hit or miss from now through Thanksgiving week, since there are a bunch of days next week I'll either be traveling, or trying to have some family vacation time, or filling in for Greg. I'll try to have something here every (non-holiday) weekday, but it's just hard to plan out exactly what or how much. I'm sure I'll be writing about the Senate showdown, though, one way or another. Beyond that, things should be back to normal the first week of December. 

Read Stuff, You Should

Happy Birthday to Ming-Na Wen, 50.

Good stuff:

1. Sean Trende is right about ACA and the future of liberalism.

2. Adam Serwer on closing Gitmo.

3. Potentially big good news: CMS is now saying that they've fixed "two-thirds of the high priority bugs responsible with issues with 834 transactions." This is about the crucial communications between the exchanges and insurance companies, and it was an even bigger problem in October than the visible problems at Healthcare.gov. On the other hand? They're apparently nowhere close to being ready to pay subsidies to insurance companies. But delaying that will just be costly; the 834s could be a system-destroying disaster. Sarah Kliff is covering the daily ACA updates.

4. Scott Lemieux with the case against judicial filibusters. I (more or less) disagree, but the more practical issue here isn't really about whether filibusters are good for democracy or liberals or conservatives; it's that they're good for individual Senators, and (again, like it or not) they're going to be reluctant to surrender them.

5. And Brendan Nyhan on the ACA press frenzy.


Monday, November 18, 2013

Obamacare Press Frenzy Stuff

Oy, Kraushaar. Oy, Galston. Oy, half the damn press corps. It's ugly out there, folks.

The two that set me off in particular today are Josh Kraushaar's massive overinterpretation of the events of last week, leading him to believe that Democrats are close to abandoning the ACA. And then Todd Purdom on the imminent collapse of "Big Government progressivism" if the ACA doesn't work well (complete with supporting quotes from William Galston). Anyway, here are some links to what I've written in response.

There's just a lot of nonsense right now. Which is pretty much what happens when these press frenzies get started, but it's very frustrating. As I wrote over at Salon over the weekend, a good comparison here is Whitewater, of all things; yes, there is a substantive story on health care reform here, but what the press are up to is mostly just fantasy.

Today, I took on Kraushaar's argument that the Upton vote was about Democrats turning against the ACA. As I said last week...no, it really isn't.

Oh, and then there's the "doom for liberalism" argument. On Friday, I pointed out that public opinion doesn't work that way.

I'll dredge up a couple of other relevant posts from a while back. At the beginning of the month, I argued that "repeal" really is dead; the status quo ante has been disrupted far too much to ever return to it. Whatever happens in the future, it will be building on the new, ACA status quo, not repealing it and returning to the past arrangements. And I've also been saying that the spin at this point is irrelevant; what matters is whether the law works.

Sunday, November 17, 2013

Sunday Question for Conservatives

When, if ever, do you think a significant number of (elected) Democrats will turn against the ACA? Between now and 2014? After the 2014 elections? After the 2016 elections?
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