November 13, 2013

 

HHS Secretary Kathleen Sebelius (AP Photo/J. Scott Applewhite)
HHS Secretary Kathleen Sebelius (AP Photo/J. Scott Applewhite)

Signs are everywhere this morning of the mounting pressure on the White House — much of it from Democrats — to produce some kind of administrative fix for those who are losing their health coverage due to Obamacare.  The New York Times reports this morning that administration officials are continuing to refuse to detail the fixes they are considering, except to reiterate that they oppose the House GOP’s own “fix” to the problem, which will be voted on this week.

That GOP proposal — the “Keep Your Health Plan Act,” which is championed by Rep. Fred Upton — would allow insurers to continue to offer coverage for all of 2014 outside the exchanges. Democrats and outside observers say the bill would undermine the law’s protections, sow public confusion and undermine the exchanges.

A senior Democratic aide tells me opposition to the Upton plan will be increasingly difficult to maintain among House Dems if the administration doesn’t offer a workable fix of its own. The aide adds the need to maintain House Dem opposition has been made more urgent by another problem: Senate Dems (the latest being Dianne Feinstein) supporting their own politically expedient “fixes” that could also undermine the law.

“Now that Feinstein has broken off, that makes it even more important that House Democrats stay together as much as possible — to keep Senate Ds from caving,” the senior Dem aide says. But the aide adds, in a reference to this week’s House action: “We need an administrative fix that works before the vote.”

The big picture remains that all that really matters is whether the policy known as the Affordable Care Act works over time. If it does, the short term political skirmishes of the moment will be mostly forgotten, and Republicans will have to balance the base’s inevitable insistence that they continue to wage Total War against the law with the fact that repeal would mean taking Obamacare benefits away from lots of people.

Brian Beutler explains that the current GOP embrace of Upton’s “fix” will only make that overall posture less sustainable later, since Republicans will be on record against pushing people off insurance, which is exactly what repealing Obamacare would do. But Dems have to walk through political fire to get to that point:

The Keep Your Health Plan Act would be immensely damaging to Obamacare if it ever became law, and preventing it from becoming law will require Senate Democrats and President Obama to sustain real political damage over the next few weeks. But looking ahead, it will be useful for them to have Republicans on the record against forcing people off of their insurance.

If enough Dems can keep the long view in sight, perhaps fracturing among them can be minimized. If not, the White House’s short term political problem will grow more serious, though again, it ultimately be overshadowed by the question of whether the law will work over time. For now, Dems are eager to see the White House’s next move.

* OBAMACARE MAY FALL SHORT OF DEADLINE: The Post scoops:

Software problems with the federal online health insurance marketplace, especially in handling high volumes, are proving so stubborn that the system is unlikely to work fully by the end of the month as the White House has promised, according to an official with knowledge of the project.

Of course, if this comes to pass, a lot will turn on what “fully” means. If the site still has serious problems by the end of November, all political hell will break out. However, the enrollment deadline is March 31st — which would still allow four months for enrollment — and the piece stresses that officials are now looking at pushing “alternative methods for buying health plans,” such as direct insurance sales to customers.

* STATE EXCHANGES ALSO FACING PROBLEMS: The New York Times has a good overview of some of the problems facing the state exchanges, which mirror the federal one, albeit not with the same level of seriousness. The main takeaway: Enrollment for Medicaid expansion is far outpacing those who have enrolled for private plans. However, this quote is worth keeping in mind:

“We are not even in the first inning of a nine-inning game,” said Kevin Counihan, chief executive of Connecticut’s exchange, Access Health CT. “For people to throw out all kinds of inferences on success or failure at this point, I think, is really, really naïve.”

Have I mentioned that if the policy works over the long haul – which is anything but assured, obviously – all of the spin wars of today will be completely forgotten?

* OBAMACARE PROBLEMS DISSUADING ENROLLMENT: Also in the same Times piece, this nugget is important:

Some insurers say the confusion over some of the websites, along with the political noise, may be dissuading some people from trying to enroll, even in states where the marketplaces are functioning well. Some, like WellPoint, whose Anthem Blue Cross plans are being sold in marketplaces in more than a dozen states, including California and Connecticut, said they were trying to time their sales efforts for when they think there could be the most response. The company has indicated it plans to spend tens of millions of dollars on marketing its plans.

And so, confusion over the website, plus GOP attacks over it, could be depressing enrollment, but if and when the exchanges are functioning, we’ll see a big marketing push to enroll folks by insurance companies.

* REPUBLICANS REITERATE OPPOSITION TO NEW REVENUES: With another meeting of the new budget conference set for today, this, from Paul Ryan, is not encouraging:

“One of the things we want to achieve in this moment is to advance tax reform, where we close loopholes in exchange for lowering tax rates for families and job creators,” he said.

Another focus for Ryan: a GOP alternative for health care reform. “I would anticipate that Republicans, myself included, are going to have a lot more to say about how we should repeal and replace Obamacare.”

So, no new revenues (loophole closures must be revenue neutral), and a new repeal push? Sounds like we’re right on track to a deal.

* DEMS SAY PUBLIC IS ON THEIR SIDE IN BUDGET TALKS: Meanwhile, Dem leaders are making sure Dem lawmakers see this polling memo from Dem pollster Geoff Garin, which finds that majorities support a mix of tax increases and spending cuts, as well as the prioritization of jobs, in budget negotiations. Meanwhile, the poll also finds the public rejects only cuts to reduce the deficit.

I’d only add that the 2012 election was all about tax fairness and the need to close loopholes enjoyed by the wealthy and corporations, and all about whether our fiscal problems should be resolved through a balance of tax hikes on the rich and spending cuts. Not that it matters in the least, but Dems won that argument.

* GOP NOT FEELING MUCH URGENCY ABOUT BUDGET TALKS: This quote, from a Paul Ryan spokesman, on why Republicans might not feel obliged to compromise in the talks before the deadline for a deal, is remarkable:

“It’s a deadline without any consequences, obviously. If we don’t do anything, the government doesn’t shut down, there’s not a second sequester that hits, there’s not a debt limit, so if we fail to reach an agreement by December 13, the world keeps spinning and everything’s fine.”

Yes, okay, but then we’d get another fight over a continuing resolution to fund the government, which didn’t reflect all that well on Republicans last time. Still, good to know there’s no urgency here.

* AND THE QUOTE OF THE DAY, OBAMACARE DERANGEMENT EDITION: Mitch McConnell, at a presser in Kentucky:

“I’m probably not going to be answering questions about anything else, but I’m happy to respond to questions about Obamacare…I prefer the news of that day to be what I’d like for it to be rather than what you all may be interested in pursuing.”

Priorities…

What else?

Greg Sargent writes The Plum Line blog, a reported opinion blog with a liberal slant -- what you might call “opinionated reporting” from the left.