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The rollout of healthcare.gov has been a disaster. But what about the rest of the implementation of the Affordable Care Act? There are a couple of sticking points, many of them related to the way in which the individual insurance market has been overhauled.
Sarah Kliff writes that as a result of the new requirements mandated by the ACA, employers have raised premiums slightly (by less than 3%), and about 2 million people -- mostly on the individual market -- will lose their plan and will have to shop for new coverage. (President Obama is getting widely criticized for saying this wouldn’t happen).
The plans that those 2 million were under don’t meet the requirements of the ACA -- some plans do things like exclude those with pre-existing conditions or have annual or lifetime treatment cost ceilings. Brookings fellow Henry Aaron says this is a good thing over the long term: “Obamacare is removing insurance products from the market that are bad for your health”.
from Jack Shafer:
At midweek, the Department of Health and Human Services released its report on the health plan choices and insurance premiums available under the Affordable Care Act, which opens for enrollment on Oct. 1 in 36 states.
The HHS press release accompanying the report glistened with the positivity of a group hug, starting with its headline, "Significant choice and lower than expected premiums available in the new Health Insurance Marketplace." The press release's feel-good theme of "lower than expected premiums" ricocheted up and down many news columns the next day.
from The Great Debate:
It's been a while since we've had good news about our economy, so the recent upbeat reports are welcome. The deficit picture for 2013 has brightened a bit, along with an upturn in the housing market. Yet those developments don't tell the full story. Our economic horizon remains cloudy due to serious structural challenges.
from Stories I’d like to see:
1. The Times hits a home run in the Bronx:
This item comes under the category of stories I loved seeing. On Sunday the New York Times did a front pager (continued on two full pages inside) by veteran reporter William Glaberson on the collapse of the criminal courts in the Bronx that was about as close to perfection in execution and impact as journalism can get.
Glaberson’s chronicle of epic incompetence and sheer laziness among the judges, prosecutors and just about everyone else mixed mountains of impressive data (endless delays, startlingly low conviction rates) with the kind of personal stories that give the data indelible meaning: A murder defendant who was held in jail for nearly four years before being acquitted recounts how court officers, lawyers and prosecutors would be “laughing and giggling” while they scheduled postponement after postponement, ignoring him so completely that he “felt almost invisible inside the courtroom.” There’s a running narrative, artfully sprinkled in italics throughout the piece, of the agony of the family of a murdered bodega proprietor that is forced to wait five years for the accused killer to come to trial, only to have to face a new trial later this year because stale evidence and the witnesses’ foggy memories resulted in a hung jury.
from Reihan Salam:
One of the core ideas behind the Affordable Care Act (ACA), President Obama’s ambitious and very controversial effort to expand access to medical insurance, is that state governments will work with the federal government to make high-quality care more accessible and affordable by creating subsidized state-based insurance exchanges. For those who aren’t covered by employer-sponsored insurance or Medicare or Medicaid, the exchanges are meant to offer a range of affordable insurance plans, with subsidies varying by household income.
The architects of the ACA believed the exchanges would be one of the more politically attractive aspects of the law, as they were designed to give states considerable latitude and to harness the power of market competition. But 34 states, representing two-thirds of the U.S. population, have thus far refused to establish their own exchanges, and the federal government is scrambling to create its own exchanges in the states that have refused to play ball.
The media have focused on the recent Affordable Care Act (ACA) deadline for states to decide whether they will create health insurance exchanges. It’s an important issue, but if a state does not agree to build an exchange, the federal government will step in and create one. So either way, all 50 states will end up having health insurance exchanges.
But the other ACA choice that states have to make is whether to expand Medicaid in their states to include more beneficiaries. According to the ACA law, states will not have pay for the expansion until later years:
from The Great Debate:
As national attention focuses on the devastation inflicted on Atlantic states by megastorm Sandy, polls show the same basic electoral reality that has prevailed throughout the presidential campaign: Without a strong turnout among young voters, President Barack Obama loses on Nov. 6.
So, Obama may need more than fiery “go vote!” entreaties to students to overcome his presidency’s disorganized, mixed record on youth issues.
By Rob Cox and Daniel Indiviglio
The authors are Reuters Breakingviews columnists. The opinions expressed are their own.
Who is best suited to be the next compromiser-in-chief? That may be the most important question American voters will have to answer when they head to the polls to elect a new president on Nov. 6. A sweeping, bipartisan agreement to reform the tax code, cut spending and ensure the safety of entitlement programs is an essential precondition for stabilizing the country’s finances and getting the economy back on track.
from The Great Debate:
We can only hope the final presidential debate Monday provides less heat and more light than the previous two. Especially with regard to fiscal matters, the debates have so far not provided the substance and solutions that voters need and deserve to hear.
Our nation's escalating deficits and debt represent the biggest threat to our national security, as I said in early 2007. Admiral Mike Mullen, former chairman of the Joint Chiefs of Staff, said much the same in 2010. So the topic of the third debate, foreign policy and national security, needs to include a frank discussion of fiscal issues.
from Reihan Salam:
One of the strangest aspects of the 2012 presidential campaign is that President Obama has barely bothered to make the case for the Affordable Care Act (ACA) and Mitt Romney has only rarely summoned the will to make the case against it. This is despite the fact that ACA is arguably the most consequential domestic policy legislation since 1965, when President Johnson presided over the creation of Medicare and Medicaid.
The usual explanation for why we haven’t had a serious debate over ACA is that Democrats recognize that the law is not wildly popular and that Romney is boxed in by his continued support for the universal coverage law he backed as governor of Massachusetts. All of this may well be true. But the foundations of America’s patchwork health system are unraveling before our eyes, and conservatives need to make the case for a more cost-effective reform sooner rather than later.