Tag Archives: health care

GOP Staffer on Vitter Amendment: "Congress Literally Threw Staff Under The Bus"

by Reinold Keillor Posted on September 30, 2013

Mother Jones

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There’s a new front in the battle over Obamacare: Republican congressional staffers are angry at their bosses for trying to deprive them of affordable insurance.

Like many Americans, most Congressional staffers receive health insurance through their employer, the federal government. And like most employers, the government covers a big portion of the cost: 75 percent. The Affordable Care Act changed this, requiring members of Congress and their staff to obtain coverage via the the health insurance exchanges created by the law. But the language in the law was unclear as to whether lawmakers and their aides would be able to keep using government money to purchase heath insurance. To clear this up, the Obama administration issued a proposed rule in August stating that the government would continue to cover 75 percent of congressional health benefits. The GOP latched onto this new regulation as an “outrageous exemption for Congress” and a “big fat taxpayer funded subsidy.” Sen. David Vitter (R-La.) and Rep. Michael McCaul (R-Tex.), introduced bills that would strip out those employer contributions.

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GOP Staffer on Vitter Amendment: "Congress Literally Threw Staff Under The Bus"

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How Proton Beams Are a Metaphor for Our Broken Health Care System

by Glory Miche Posted on September 30, 2013

Mother Jones

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Via Austin Frakt, here’s a lovely little chart from a Brookings report that helps explain why health care costs in the United States are so stubbornly hard to control. It shows the growth in proton beam facilities, which Kaiser Health News describes as an “arms race” between hospitals. These facilities are the size of a football field and cost hundreds of millions of dollars to construct.

Which might be OK if PRT were truly an advance in treating cancer. Unfortunately, there’s not much evidence that it is, even though it costs far more than old-school IMRT radiotherapy. Here’s the conclusion from a recent study of prostate cancer cases:

Although PRT is substantially more costly than IMRT, there was no difference in toxicity in a comprehensive cohort of Medicare beneficiaries with prostate cancer at 12 months post-treatment.

In other words, the supposed advantage of PRT—that it targets cancers more precisely and has fewer toxic side effects—doesn’t seem to be true. It might be better in certain very specialized cases, but not for garden variety prostate cancer.

And yet, new facilities are being constructed at a breakneck pace. Why? Because if they build them, patients will come. “They’re simply done to generate profits,” says health care advisor Ezekiel Emanuel. Roger that.

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How Proton Beams Are a Metaphor for Our Broken Health Care System

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Jennifer Hudson Promotes Obamacare, Impersonates Olivia Pope in New Funny or Die Video

by wjtydf3g Posted on September 30, 2013

Mother Jones

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It’s the first video from Funny or Die’s new series of pro-Obamacare videos. The above two-minute segment, titled “Scandalous with Jennifer Hudson,” is a playful spoof of Scandal, ABC’s hit political-thriller series starring Kerry Washington. “I prefer covert scandal manager,” Hudson says when people refer to her as a “fixer.” But the main point of the video is to promote the benefits of Obamacare and to show viewers how to sign up. The sketch ends with this image, with the narrator encouraging you to visit the website:

funnyordie.com

On October 1, the Affordable Care Act’s health insurance exchanges—in which uninsured Americans will be able to buy coverage using federal subsidies—open up for business. While conservative groups are emphasizing doom and government excess (this includes the Koch brothers-backed young-conservatives group Generation Opportunity, which recently released this creepy, sort of rapey anti-Obamacare ad), Funny or Die, Will Ferrell and Adam McKay‘s comedy site, has planned a short series of comedic celebrity web videos aimed at educating American twenty-somethings about the law.

In July, a cluster of Hollywood big-names attended a meeting at the White House to chat about how they could help spread the word about Obamacare. (President Obama swung by for roughly half an hour to mingle and hear some of their ideas.) The meeting was run by senior advisor Valerie Jarrett, who gave a presentation on health care reform and talked about pushing back against conservative memes surrounding the law. Here is Jarrett tweeting about Funny or Die’s Scandal-themed PSA, using the hashtag “#GetCovered,” a hashtag that appears in the video:

And here’s the White House sharing it:

Hudson and Mike Farah, president of production and “ambassador of lifestyle,” were both present at the July meeting. “We want to make the right amount of videos—ones that are smart and break through the clutter and rhetoric,” Farah told Mother Jones. “If we can help make signing up for Obamacare a normal thing, something that isn’t politicized, something that comes second nature to younger people (like putting your seatbelt on), that is something we’d want to do…It’s not like one Funny or Die video can change the world—it’d be nice if it could! But people have to hear about this issue from all sorts of directions.”

Funny or Die has generated and promoted Obamacare-related content before, including “The Mis-Informant” (starring Jack Black as a “professional mis-informant who gets paid a buttload of cash” to lie about Obamacare) and “Injured Americans Against Obamacare.” The website pumps out a lot of political satire in general. Shortly after the 2008 election, it released the star-studded “Prop 8 – The Musical.” More recently, Funny or Die produced a sketch warning of the dangers of sequestration, and worked with actress Alyssa Milano on her “sex tape” that turned out to be all about the bloodshed in Syria.

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Jennifer Hudson Promotes Obamacare, Impersonates Olivia Pope in New Funny or Die Video

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Obamacare Subsidies Act Like an Effective Marginal Tax of About 15 Percent as Your Income Goes Up

by AllanThurston Posted on September 26, 2013

Mother Jones

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Atrios:

Something I’m looking for and not finding is an estimate of the effective marginal tax rates on people in the exchanges who are eligible for subsidies. A problem with means-testing programs is that as you earn more income, your benefits go away, meaning that effectively you’re paying a pretty high tax on each additional dollar earned. Your company giveth, and Uncle Sam taketh away.

That got me curious. The subsidies are calculated so that you never have to pay more than a certain percentage of your income in health premiums. That percentage rises with income according to a formula, so it’s pretty easy to figure out the subsidy at different income levels and then calculate the effective marginal tax rate caused by the fact that the subsidy level goes down.

I used the Kaiser subsidy calculator to get the subsidy for a family of three at various income levels. (The exact subsidy level varies depending on family size, but this provides a pretty good estimate for an average family.) As you can see, as you gain more income, you get less subsidy, which produces an effective marginal tax rate of 12-16 percent at most income levels. When your income gets high enough, the subsidies are so low that there isn’t much left to lose, so the effective marginal rate goes down. At 400 percent of the poverty level, the subsidies decline to zero.

The moral of this story, of course, is that you should avoid means testing if you can, since it provides a negative incentive to earn more money. Unfortunately, means testing is often the only practical way of providing benefits to the poor, so we put up with it even though everyone agrees it’s suboptimal. However, in the case of health care we could solve this problem easily by simply adopting a national health care plan that provided coverage for everyone at no charge. Since it’s a flat benefit, it wouldn’t distort work incentives. Taxes would have to go up to pay for this, of course, but those taxes would almost certainly produce less distortion at low income levels than Obamacare does.

Someday we might have a sensible system like that. Someday.

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Obamacare Subsidies Act Like an Effective Marginal Tax of About 15 Percent as Your Income Goes Up

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The Way We Live Today: From Tweet to Meme in 14 Hours

by gammak Posted on September 25, 2013

Mother Jones

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The political branch of the intertubes today has been consumed by the question of whether the media is hopelessly biased because it treated Wendy Davis’ abortion filibuster more sympathetically than Ted Cruz’s kinda-buster on Obamacare. The whole fuss is so mind-crushingly inane that it’s enough to make one fear for the future of the human race, but still I’m curious: where did this meme get its start?

It apparently went mainstream in a Dylan Byers column posted today at 10:00 am. Dave Weigel says the meme was “codified” in a Tim Carney column posted a few minutes earlier at 9:44 am. Tom Kludt of TPM noted the invention of the meme an hour before that, at 8:57 am. He’s got tweets from Erick Erickson and Byron York from even earlier in the morning, and one from Richard Grenell late last night. But the earliest mention is from Laura Ingraham, who tweeted about this an hour before Grenell, at 8:20 pm last night.

But wait! Ingraham was retweeting Chad Seiter, who was responding to a dismissive tweet from Jennifer Rubin. Seiter’s tweet went up at 8:10 pm:

So as near as I can tell, that’s where it came from. A guy in Kentucky with 187 followers on Twitter got retweeted by Laura Ingraham, and by the next morning his tweet had morphed into a media bias meme that went viral. Congratulations, Chad! You won the internet today. Isn’t social media remarkable?

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The Way We Live Today: From Tweet to Meme in 14 Hours

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Let’s Compromise Over Obamacare!

by Romona Traywick Posted on September 25, 2013

Mother Jones

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Among other things, Ted Cruz’s long-but-not-actually-a-filibuster-speech happened to hit on an actual problem with Obamacare: the employer mandate. Basically, it requires employers to pay the subsidy costs for low-income workers who end up getting health insurance through the exchanges. It’s designed to be an incentive for employers to continue providing health coverage of their own, but it also provides an incentive not to hire workers from low-income families and not to hire workers for more than 30 hours a week. That’s bad. As it happens, there’s not much evidence in the data that it’s actually having a substantial effect, but it’s still a bit of a mess. Ezra Klein comments:

If Republicans are really worried about these businesses and these workers, they could help them. Unlike defunding or delaying Obamacare, or even delaying the individual mandate, this is a concession Republicans really might be able to get the Obama administration to agree to. They’d be on the right side of both the policy and the public. The question is whether they actually want to help these workers or just grandstand against the law.

Well, I think we all know the answer to that question. Republicans want Obamacare to fail, and they want it to be unpopular, so they’re actively opposed to doing anything that would make it work more smoothly. Reforming or repealing the employer mandate doesn’t fit that strategy.

But this suggests an interesting exercise: What aspects of Obamacare could be genuine targets for compromise between Democrats and Republicans who were operating in a semblance of good faith? Democrats already agreed to jettison the CLASS Act, for example, after it became clear that it was unworkable. They’d probably be willing to do something about the employer mandate, and the business community would certainly support that. Democrats would probably also agree to fix a glitch that excludes church health plans from eligibility for the exchanges.

What else? The big ticket stuff, like the individual mandate and the subsidy levels, is off the table, but there must be plenty of smaller items that could be horsetraded over. Somebody should make a list and see if any Republicans are willing to engage in actual conversation about it. I’m not in much doubt about the outcome, but all the opinion in the world isn’t as good as actually checking to find out.

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Let’s Compromise Over Obamacare!

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Government Releases Obamacare Premium Levels for 36 More States

by John Grit Posted on September 25, 2013

Mother Jones

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With the start of open enrollment in Obamacare a week away, HHS today released a report summarizing the cost of premiums in states where the exchanges will be run by the federal government. In general, the news was pretty good. As with most of the state exchanges, the premiums are coming in below the predictions of the Congressional Budget Office:

Individuals will have an average of 53 qualified health plan choices in states where HHS will fully or partially run the Marketplace.

….Premiums before tax credits will be more than 16 percent lower than projected. The weighted average second lowest cost silver plan for 48 states (including DC) is 16 percent below projections based on the ASPE-derived Congressional Budget Office premiums.

….Tax credits will make premiums even more affordable for individuals and families. For example, in Texas, an average 27-year-old with income of $25,000 could pay $145 per month for the second lowest cost silver plan, $133 for the lowest cost silver plan, and $83 for the lowest cost bronze plan after tax credits. For a family of four in Texas with income of $50,000, they could pay $282 per month for the second lowest cost silver plan, $239 for the lowest silver plan, and $57 per month for the lowest bronze plan after tax credits.

I don’t suppose Ted Cruz will be mentioning any of this in his speechifying on the Senate floor tonight. But it’s worth taking a look at those numbers. After tax credits, that family of four in Texas will pay $3,384 per year for the second lowest-cost silver plan. According to the Kaiser Family Foundation, the average family with employer health coverage pays $4,565 per year in contributions. Those aren’t directly comparable, but they’re close. What it means is that although Obamacare is hardly free, it does allow individuals to buy coverage for roughly the same amount they’d have to pay with an employer plan. No one is shut out of the market any longer.

The entire report is here. An excerpt of one of the tables is below, showing how much coverage will cost for individuals and families in various states.

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Government Releases Obamacare Premium Levels for 36 More States

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Sen. Ted Cruz Compares Conservative #DefundObamacare Skeptics to Nazi Appeasers Because Why Not?

by dtynpwb Posted on September 25, 2013

Mother Jones

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During Tuesday’s anti-Obamacare “fauxlibuster,” Sen. Ted Cruz (R-Texas) whipped out an analogy:

There are key differences between the Affordable Care Act and Hitler. But, you know, whatever.

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Sen. Ted Cruz Compares Conservative #DefundObamacare Skeptics to Nazi Appeasers Because Why Not?

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The Collected Poems of the Affordable Care Act

by SelenaKil Posted on September 24, 2013

Mother Jones

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The Patient Protection and Affordable Care Act, signed into law by President Obama in 2010, was an attempt by Democratic lawmakers to reform the health care system by creating an individual mandate to purchase insurance. But since then, the law has morphed into a specter seemingly larger. It is alternatively an abomination and a document worthy of adulation; the death of the Democratic party and the yoke by which it will cling to power; the socialization of medicine and a gift-basket to private insurers.

Do these pundits contradict themselves? Very well then, they contradict themselves—Obamcare is fractal; it contains multitudes. As a service to our readers, we have rearranged the most vivid and hyperbolic descriptions of the Affordable Care Act below as a collection of short poems. Read them in your best Donald Berwick voice:

I.

Obamacare is barreling down on us,

like a jet landing into San Francisco,

or a cat with nine lives—

neither alive nor completely dead.

Obamacare is a zombie,

it will nationalize our soul.

Obamacare is a big fucking deal.

II.

Obamacare is a crack pipe.

Obamacare is addictive.

Obamacare is the Titanic.

Obamacare is the iceberg.

Obamacare is the DMV.

Obamacare is slavery.

III.

Obamacare is fascism.

like the Jews boarding the trains to concentration camps,

like a failed rental car reservation,

like pressing the button for the elevator and stepping forward before the car arrives;

Obamacare is a locomotive.

It is a trainwreck.

IV.

Obamacare is Apple.

Obamacare is an iPad.

Obamacare is a broken iPhone app.

Obamacare is a Ford Pinto.

Obamacare is New Coke.

Obamacare is Alex Rodriguez.

Obamacare is a sharknado.

V.

It is an ugly, socially awkward kid who transfers into grade school at mid-year,

and then spends the rest of the semester eating alone in the cafeteria while being giggled about,

by all the other pupils.

Obamacare will question your sex life.

Revolutionary wars have been fought over less.

VI.

Obamacare is like a box of chocolates.

Obamacare is Waterloo.

Obamacare is the Iraq War,

or its domestic equivalent.

Obamacare will kill more people than 9/11.

Obamacare is the War of Yankee Aggression,

Obamacare is the hill to die on,

Obamacare is Gettysburg.

Obamacare is the Fourth of July.

Obamacare is Christmas,

like being forced to purchase a book of cowboy poetry,

or a Barry Manilow album.

Obamcare is like this health insurance/medical aid kind of thing,

like a military draft.

Obamacare is the best bill you could have passed.

Obamacare is here to stay.

Obamacare will survive.

Obamacare is the moon.

VII.

Obamacare is like the inside of a clock.

Obamacare is a malignant tumor.

Obamacare is an abscessed tooth.

Obamacare is like getting teeth pulled without novocain.

Obamacare is 17th-century Britain.

Obamacare is the first thing Hitler did.

Obamacare is a civil rights struggle.

Obamacare is a lemon.

Obamacare is the law of the land.

VIII.

Obamacare is the Right’s worst nightmare.

Obamacare will live in infamy.

Obamacare is like kale.

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The Collected Poems of the Affordable Care Act

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The Public Is Massively Opposed to Shutting Down the Government Over Obamacare

by AmberPkk Posted on September 23, 2013

Mother Jones

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The public is generally opposed to defunding Obamacare, but it’s a close call. However, when the question is whether it’s worth shutting down the government in order to defund Obamacare, it’s not a close call at all according to a new CNBC poll:

Opposition to defunding increases sharply when the issue of shutting down the government and defaulting is included. In that case, Americans oppose defunding 59 percent to 19 percent, with 18 percent of respondents unsure.

….When including the issue of a government shutdown and default, [] 48 percent of Republicans oppose defunding Obamacare, while 36 percent support it. However, a 54 percent majority of Republicans who also identify themselves as Tea Party supporters want the new health care law defunded even if it means a government shutdown — the only demographic measured in the poll with such a majority.

….Independents are more troubled by the prospect of defunding Obamacare and shutting down the government than the broader population. In general, they oppose defunding by a slight plurality of 44 percent to 40 percent. However, when the issue of shutting down the government is included, opposition to the measure swells to 65 percent, while support drops to just 14 percent.

Nobody wants to shut down the government over Obamacare except for hard-core tea partiers. Among independents, opposition to hostage taking is an amazing 65-14 percent. Now tell me again about how Republicans are somehow going to convince the public to blame a shutdown on Democrats?

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The Public Is Massively Opposed to Shutting Down the Government Over Obamacare

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