The health exchanges established under the Affordable Care Act, also known as Obamacare, opened on October 1, 2013. An analysis by Bloomberg Government shows that competition among health insurance companies on the Health Exchange Marketplace is driving down premiums by as much as a third.
Rates released by the Department of Health and Human Services (HHS) show that the price of policies offered in “rating areas” with 10 or more participating insurers are between 31 percent and 35 percent lower than those for the same policies in areas with only one issuer.
A preliminary review of rates in the remaining 14 to 16 states and the District of Columbia that will run their own exchanges suggests that a similar pattern holds in most.
The pattern shows that at least for 2014 exchanges probably will live up to one of their advocates’ key claims: that the ACA can expand coverage while constraining costs.
House Republicans and the Tea Party are going to extreme lengths to delay, defund, and/or repeal Obamacare. Our question is: Why? The health insurance exchanges are, in some ways, a triumph for market-based conservative ideals.
After all, Republicans supported Obamacare…before Obama. Seriously. Lots of them.
Quick history lesson: In 1986, President Ronald Reagan signed the Emergency Medical Treatment and Active Labor Act (EMTALA), which required all hospitals participating in Medicare (pretty much all of them) to provide emergency room treatment to anyone who showed up. Policy experts began to worry about the “free rider problem,” where people wouldn’t pay for health insurance because they could just show up at the ER if they got sick (this was passed at the same time as COBRA, for those of you keeping score at home).
In 1989, Stuart Butler of the Heritage Foundation, a conservative think tank, wrote a paper called “Assuring Affordable Health Care for All Americans,” in which he proposed the “individual mandate.” That’s the idea, that ended up in Obamacare, that all Americans be required to have health insurance or pay a fine. It’s also the idea that makes the exchanges work: private insurance companies can accept the regulations and “managed competition” of the Health Insurance Marketplace because Americans are required to be customers.
And, of course one-time Obama opponent Mitt Romney included an individual mandate in his health care plan as governor of Massachusetts. Here’s what he said in April 2006:
…we’ve come up with something that’s much closer to Republican ideals: reform the market to make the health-insurance marketplace work better. Insist on personal responsibility instead of government responsibility.
Now, since that time, Romney, Gingrich, and even Heritage’s Stuart Butler have twisted themselves into pretzels saying how different their ideas are from Obamacare, detailed here by Forbes’ Avik Roy. And yes, the Affordable Care Act is a large bill containing various components that some people like and some don’t. But the idea of private health insurance companies competing for customers in the free market is a (small-c) conservative idea, an idea supported by the Republican Party in various ways over the past 30 years.
So instead of shutting down the government and throwing tantrums, conservatives should be beaming with pride. You got Democratic President Obama and a Democratic Congress to pass one of your ideas into law. And so far, it ain’t half bad!
Newt Gingrich, who says child labor laws are “truly stupid” and wants to put low-income children in poor neighborhoods to work cleaning schools after he fires “all the unionized janitors,” has found an acolyte—Donald Trump.
Billionaire Trump—who most Republican presidential candidates are genuflecting before in hopes of a laying on of hands—endorsed Gingrich’s call to put poor kids to work. He told reporters, “I thought it was a good idea” and suggested they also work for him—as “apprenti.”
Gingrich apparently thinks all poor kids are lazy and says his plan will “get them into the habit of showing up and realizing that effort gets rewarded and that America is all about the work ethic.”
Last week he also inferred that low-income kids are crooks. He said, “They have no habit of ‘I do this and you give me cash,’ unless it’s illegal.”
It wasn’t enough for presidential wannabee Newt Gingrich to push child labor by proposing that poor kids clean schools. Now he says children from low-income families only work when the “job” is illegal. This from CBS NEWS:
“Really poor children in really poor neighborhoods have no habits of working and have nobody around them who works,” the former House speaker said at a campaign event at the Nationwide Insurance offices. “So they literally have no habit of showing up on Monday. They have no habit of staying all day. They have no habit of ‘I do this and you give me cash,’ unless it’s illegal.”
As talk show host Stephanie Miller said last night on the Ed Schultz Show, the corporate media has focused a lot on Gingrich’s odious personal behavior. But what hasn’t been given enough attention–and what clearly needs to be–is Gingrich’s extremist policy agenda, one that includes child labor.
Last week we learned that Newt Gingrich has a plan to fire union janitors in schools, and replace them with low income students. As Laura Clawsonwrote about a speech he made in Iowa yesterday where he’s still beating that same drum. Poor kids don’t have any work ethic. Rich kids, apparently, have worked darned hard to get everything handed to them.
In that same speech in Iowa, Newt made some bizarre assertions about food stamps, including the statement one could use food stamps to fly to Hawaii. The folks at Politifact decided to investigate his claims:
“Remember, this is the best food stamp president in history. So more Americans today get food stamps than before. And we now give it away as cash — you don’t get food stamps. You get a credit card, and the credit card can be used for anything. We have people who take their food stamp money and use it to go to Hawaii. They give food stamps now to millionaires because, after all, don’t you want to be compassionate? You know, the Obama model: isn’t there somebody you’d like to give money to this week. That’s why we’re now going to help bailout Italy because we haven’t bailed out enough people this week, the president thought let’s write another check. After all, we have so much extra money.”
Can food stamps “be used for anything”?
No. The food stamp program — which, we should point out, has officially been known as the Supplemental Nutrition Assistance Program, or SNAP, since October 2008 — has very precise rules about what can and cannot be paid for.
Gingrich is partly right when he says that today, “you don’t get food stamps. You get a credit card.” The old system of using coupons is past; recipients now receive what’s called an electronic benefits transfer card, or EBT card. This looks like a credit card, but it doesn’t allow for purchases on credit. It’s really more like a debit card, with the government periodically uploading the proper amount of cash.
The cards cut way down on administrative costs, and streamline the process. The card also helps to cut back on the stigma of using food stamps in the checkout line at the supermarket.
“We have people who take their food stamp money and use it to go to Hawaii.”
If the food stamp system bars beneficiaries from buying decorative gourds rather than pumpkins, you can be sure it also bars the purchase of airline tickets. (Our guess: The benefit amount would be less than the tickets anyway.)
and his final outrageous claim:
“They give food stamps now to millionaires.”
Food stamps have always been a means-tested program. Benefits vary by household size — the full details are here — but the national rule is that you can’t earn more than 130 percent of the poverty line. That would clearly rule out millionaires.
Politifact finds each of his claims to be utterly ridiculous.
A quick online search for a round trip flight to Hawaii from NH found the cheapest flight was $1035. According to CNN Money:
The average food stamp benefit was $133.80 per person and $283.65 per household in May.
That’s May 2011. In order to save up for that trip to Hawaii, I’d have to go hungry for seven months. And even then, I still wouldn’t be able to use my SNAP card to pay for the flight.
It’s nice of Newt to leave Planet 1% to visit the rest of us, but he certainly lacks even a basic sense of reality of what life is like for those of us who don’t have revolving charge accounts at Tiffany’s. Perhaps we can buy breakfast there with food stamps.
We noted yesterday that Newt Gingrich wants “get rid of unionized janitors” and hire poor kids to clean the in schools low-income neighborhoods. Today AFSCME says it’s time to tell Gingrich that his ”model” to lift kids out of poverty is outrageous dangerous and downright hogwash.
Click here to sign a letter that reminds Gingrich that
“doing janitorial work in a school entails sanitizing toilets, handling hazardous cleaning chemicals, and scrubbing floors hunched over a mop for hours. It’s hard to imagine a nine-year old doing any of those tasks. Come on.”
You can also tell the oh-so- brilliant Gingrich—at least in his mind—that when he fires all those janitors,
a lot of them are parents. That job puts a roof over kids’ heads, food on the table, and provides them with health care and the chance to get an education. That job is the only thing between a kid and poverty. Firing someone’s mom and hiring the kid for less money isn’t exactly the “process of rising.”
Click here to tell Newt he’s out of his mind and click here for a video look at his plan.