Wonkbook: How was Obamacare on Day One?

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(Photo by Karen Bleier/AFP/Getty Images)

Wonkbook's Number of the Day: 7,000. That's how many people used the Obama administration's special allowance if tech problems delayed your registration for insurance.

Wonkblog's Graphs of the Year: The latest from Joe Biden, Emanuel Saez and Thomas Piketty, Jared Bernstein, Hillary Clinton,

Wonkbook's Top 5 Stories: (1) first day of Obamacare, zero death panels so far; (2) economic outlook for 2014; (3) appropriators gonna appropriate; (4) the libertarian West; and (5) zombie immigration reform.

1. Top story: How was Obamacare on Day One?

Obamacare’s 2013 tally: Six million signed up for coverage. "2.1 million people have signed up for private coverage through the exchanges. That was the biggest news out of today's conference call, where Health and Human Services Secretary Kathleen Sebelius told reporters that 2.1 million have signed up for coverage through Dec. 28. That includes the 1.1 million that the White House had announced this past Sunday, who had enrolled through Dec. 24 on HealthCare.gov. There are also 3.9 million people who have been found eligible for Medicaid...7,000 people have called a special hotline because they had trouble enrolling by January." Sarah Kliff in The Washington Post.

What 2014 means for Obamacare. "It's hard to overstate how much the health-insurance market changed at midnight: The Affordable Care Act has essentially flipped a multibillion-dollar industry upside down. For decades and decades, the best way to run a health-insurance plan in the individual market was to simply exclude the people who have really expensive health conditions. They got left out of the market, the insurer picked up the cheaper patients, and that was pretty much it." Sarah Kliff in The Washington Post.

Explainer: Everything you need to know about life under ObamacareSarah Kliff and Ezra Klein in The Washington Post.

Key read: 8 Obamacare wonks share their predictions for 2014Jonathan Cohn in The New Republic.

Watch: Obamacare’s important new deadlines, explained in two minutesSarah Kliff in The Washington Post.

Consumers start using coverage under Obamacare. "Kathy Hornbach of Tucson is not wasting any time before using her new health insurance coverage, which took effect on New Year’s Day. Ms. Hornbach, 57, has an appointment with a cardiologist on Thursday for a stress test...Ms. Hornbach, who has had breast cancer and retired early from the technology industry, said that insurance companies in Arizona had refused to cover her until about two years ago, when she got a policy with monthly premiums of $285 and a deductible of $5,500 a year. Last month, using the federal insurance exchange, she bought a midlevel silver plan with lower premiums and deductible." Robert Pear and Abby Goodnough in The New York Times.

All heck did not break loose. "Hospitals nationwide reported a relatively quiet day, without any surge of newly insured people filling emergency rooms with pressing medical needs. The White House reported no problems." Sandhya Somashekhar, Robert Barnes and Michelle Boorstein in The Washington Post.

@haroldpollack: Someone, somewhere, has actually used his Obamacare insurance card. Or has at least tried to.

Obama’s OFA begins effort to showcase personal health care testimonials. "OFA’s digital push, titled “This Is Why: Health Care Reform Matters,” comes as the White House, congressional Democrats and their allies try to shift the public’s attention from the botched rollout of the HealthCare.gov website to the real-life benefits of the law for those who previously were uninsured or underinsured. The site, which will expand in coming days with more personal testimonials and videos, is designed to make sure people see not just the Affordable Care Act enrollment statistics, but also specific ways in which the law is benefiting everyday Americans, an OFA spokeswoman said." Philip Rucker in The Washington Post.

Supreme Court temporarily allows religious groups not to cover birth control. "The Obama administration faced a fresh challenge to its health-care law just as many of its key provisions took effect Wednesday, after an 11th-hour Supreme Court ruling temporarily allowed some Catholic groups not to cover birth control in their employee health plans...Justice Sonia Sotomayor issued the stay late Tuesday. It came at the request of an order of nuns from Colorado, who said the rule violated their religious freedom...The injunction could expire as soon as Friday, which is when Sotomayor has asked for a response from the federal government." Sandhya Somashekhar, Robert Barnes and Michelle Boorstein in The Washington Post.

Contraception challenge opens new front. "To understand the context of Justice Sotomayor’s decision, it helps to look at the details of the Affordable Care Act. The law distinguishes among three kinds of organizations: religious employers, for-profit corporations and nonprofit groups affiliated with religious organizations but not owned or controlled by them...The dispute in the new case is whether that certification itself amounts to conduct that violates the groups’ religious faith." Adam Liptak in The New York Times.

Obama administration runs from 7-million goal. "White House adviser Phil Schiliro downplayed an earlier projection of 7 million 2014 ObamaCare signups on Tuesday and said the administration was working hard to overcome problems with insurance applications...In February, well before the technological problems that marred the rollout of the law, the Congressional Budget Office projected that 7 million people would enroll through the exchanges in 2014." Peter Sullivan in The Hill.

With new year, Medicaid takes on a broader health-care role. "Medicaid embarks on a massive transformation Wednesday — from a safety-net program for the most vulnerable to a broad-based one that finds itself at the front lines of the continuing political and ideological battle over the Affordable Care Act. Already the nation’s largest health-care program, Medicaid is being expanded and reshaped by the law to cover a wider array of people...On Wednesday, people who have signed up for coverage under the new law will become eligible to receive it, in what supporters have hailed as a historic moment for health care in the United States." Sandhya Somashekhar and Karen Tumulty in The Washington Post.

Medicare pricing drives high health-care costs. "Medicare may be best known for paying the medical bills for millions of people 65 and older, but recent studies show it plays another gargantuan role in American health care: It helps determine prices for everyone. For virtually every procedure and service — from routine colonoscopies to brain surgery and hospice care — Medicare comes up with a dollar figure that the government considers a fair price. But economists are finding that, largely because of the program’s vast scale, Medicare prices substantially shape what all Americans pay for health care." Peter Whoriskey and Dan Keating in The Washington Post.

MOORE: The Obamacare we deserve. "Now that the individual mandate is officially here, let me begin with an admission: Obamacare is awful. That is the dirty little secret many liberals have avoided saying out loud for fear of aiding the president’s enemies, at a time when the ideal of universal health care needed all the support it could get. Unfortunately, this meant that instead of blaming companies like Novartis, which charges leukemia patients $90,000 annually for the drug Gleevec, or health insurance chief executives like Stephen Hemsley of UnitedHealth Group, who made nearly $102 million in 2009, for the sky-high price of American health care, the president’s Democratic supporters bought into the myth that it was all those people going to get free colonoscopies and chemotherapy for the fun of it." Michael Moore in The New York Times.

@noamscheiber: One Obamacare saving grace: Unlike Moore, I think it brings us closer to single-payer. Once more and more people on exchanges

COHN: Five rules for talking about Obamacare. "Consider the real counterfactual...It will be tempting to judge Obamacare by comparing it to the status quo. But the status quo was changing already. Preserving it was simply not an option. If we want to make a judgment about Obamacare, we have to consider the changes that would have taken place in the law’s absence—and then decide which would have been better.  It’s a more difficult standard, because nobody knows what the future would have been like. But it’s also a more honest standard." Jonathan Cohn in The New Republic

Music recommendations interlude: Bright Eyes, "First Day of My Life."

Top opinion

The latest issue of National Affairs is out today, and two excerpts follow. More here

STRAIN: A jobs agenda for the right. "Republicans are, if anything, worse off. They often refuse to even acknowledge the problem, or to acknowledge the fact that it requires ambitious policy solutions. They, too, mostly repeat familiar formulas from their party's glory days which offer proposals that do not seem well connected to today's economic realities. Some of their ideas — fostering a more stable business climate and financing lower tax rates by shrinking a few tax loopholes, for example — could help, but they are not nearly adequate for the challenge America confronts. To offer the public a plausible agenda for a true recovery of the labor market, Republicans will have to dig deeper." Michael R. Strain in National Affairs.

GERSON AND WEHNER: A conservative vision for government. "[Conservatives] have therefore been fairly clear, and quite emphatic, about what they believe the government should not be doing. But if it is true, as they have argued, that the Democrats' vision is a travesty of American government, then what is the proper and appropriate extent and purpose of that government? Conservatives in recent years have not done enough to answer this question, and as a result have offered voters an oppositional view of government that, while perhaps stoking worry and resentment, is insufficient to build public trust in the prospect of a conservative government" Michael Gerson and Peter Wehner in National Affairs.

DELONG: The strange case of American inequality. "When income inequality began to rise in the 1980’s and 1990’s, those of us who cut our teeth on the long march of North Atlantic history expected to see a political reaction. Democratic politics, we thought, would check the rising power of a largely parasitic economic over-class, especially if its influence caused governments to fail to live up to their commitments to provide full employment with increasing – and increasingly shared – prosperity...Why can’t America launch similar movements today? To the extent that this has become a valid question, most Americans should be as worried today about the quality of their democracy as they are about the inequality of their incomes." J. Bradford DeLong in Project Syndicate.

SCHEIBER: Economics and politics good on the minimum wage. "The bottom line is that backing the numbers with sound logical arguments is an important insurance policy against flukish-ness, and Card and Krueger identify a few. The first is that employers simply pass along the higher wages to customers rather cutting back on workers...Card and Krueger then nodded at a second, more interesting rationale, albeit one they buried deep in their paper. The idea is roughly as follows: A lot of companies have bargaining power when they hire employees." Noam Scheiber in The New Republic.

TAYLOR: The economic hokum of secular stagnation. "I suppose the emergence of the secular stagnation hypothesis shouldn't be surprising. As long as there is a demand to pin the failure of bad government policies on the market system or exogenous factors, there will be a supply of theories. The danger is that this leads to more bad government policy." John B. Taylor in The Wall Street Journal.

TYSON: Which policies reduce income inequality? "Among developed countries, the US does have the most unequal distribution of disposable income after taxes and transfer payments. That is not because the US has the least progressive tax system; indeed, its tax system is considerably more progressive than those of most European countries, Canada, and Australia, all of which rely on regressive value-added taxes as an important source of revenue. But, among developed countries, the US has the least generous and progressive transfer system. The US spends a much smaller share of GDP on family-assistance programs – including cash transfers, tax breaks, and direct government services – than its developed-country counterparts, where reliance on regressive consumption taxes to fund progressive transfer programs has kept income inequality significantly lower." Laura Tyson in Project Syndicate.

WESSEL: Surprises from 25 years of economic reporting. "In a 1998 book, my colleague Bob Davis and I argued the U.S. was on the cusp of an era of broadly shared prosperity that would boost the middle class. We were wrong. We correctly saw the potential of information technology, but we expected the gap between winners and losers to narrow. It didn't.." David M. Wessel in The Wall Street Journal.

DIONNE: Why a reinvigorated left is good for the center-left. "The reemergence of a Democratic left will be one of the major stories of 2014. Moderates, don’t be alarmed. The return of a viable, vocal left will actually be good news for the political center. For a long time, the American conversation has been terribly distorted because an active, uncompromising political right has not had to face a comparably influential left. As a result, our entire debate has been dragged in a conservative direction, meaning that the center has been pulled that way, too." E. J. Dionne in The Washington Post.

NELSON: The charter forest. "Certain federal forest lands, while still "owned" by the federal government, would be managed independently as charter forests. A decentralized charter forest would operate under the control of a local board of directors, which might include local government officials, economists, environmentalists, and recreational and commercial users of forest resources...Charter forests would operate under federal oversight, including broad land-use goals and performance standards relating to the maintenance of environmental quality. But they would have the flexibility to develop and implement innovative solutions to the severe problems of forest fire, spreading disease and other threats." Robert H. Nelson in The Wall Street Journal.

Super important interlude: Presenting the third annual Wonky awards.

2. Here's how the economy will do in 2014. Maybe. We think. 

Hopeful economic signs for 2014. "Few forecasters, if any, foresee a boom. Instead, they predict an economy that performs better in 2014 than it has for the past several years. In a Wall Street Journal survey, forecasters expect unemployment, last reported at 7%, to fall to 6.5% by year-end...Asked in the Journal survey if the economy is more likely to do worse than their forecast for 2014 or better, 70% said worse and only 30% said better, an extraordinary sign of unease." David M. Wessel in The Wall Street Journal.

Minimum wage rises in 13 states. "The centre of the push to increase minimum wages at the state level is in the US northeast, where New York, New Jersey, Connecticut and Rhode Island are making the move, cheered by Democrats and liberal groups but opposed by many Republicans and business groups. At least nine other US states will also see minimum wage increases take effect automatically because of cost-of-living adjustments." James Politi in The Financial Times.

Home prices rise again, but maybe will do so less in the future. "In 2013’s last glimpse at the housing market, figures released on Tuesday showed that home prices in major metro areas kept rising in October. Year-over-year, prices were up 13.6 percent, the biggest gain in more than seven years...Prices in 20 major American metro areas increased a modest 0.2 percent between September and October, without seasonal adjustment, evidence that the quick rebound in prices is slowing, according to the closely watched S&P/Case-Shiller data. Higher mortgage rates might continue to slow the pace of improvement going forward, analysts say." Annie Lowrey in The New York Times.

What happens if oil prices collapse in 2014? "Many believe 2014 will be the year in which rising output finally overwhelms modest demand growth, sending prices lower and testing Opec’s resolve to balance the market and keep prices stable...Many analysts see Opec output as a wild card once again." Neil Hume in The Financial Times.

Interview: Jamie Dimon’s harried JPMorgan Chase pushes campaign for worker trainingJim Tankersley in The Washington Post.

Here’s what we got right, and wrong, about the economy in 2013. ""Will 2013 bring a genuine, no-holds-barred recovery?": This was the headline on our piece. "Will this be the year that the economy finally breaks out of its pattern of sluggish growth that has held since the recession ended in 2009?" we asked. The answer is a resounding no. On jobs, for example, the nation added an average of 183,000 jobs a month in 2012--and 189,000 a month through the first 11 months of 2013. GDP growth was 2.8 percent in 2012, and has averaged a 2.6 percent annual pace through the first three quarters of 2013. There is no disputing: In terms of overall growth rates, 2013 has been a more-of-the-same kind of year." Neil Irwin in The Washington Post.

Via reddit interlude: Sweet magic trick, bro.

3. Appropriators gonna appropriate

Omnibus appropriations bill taking shape. "December’s budget agreement set the overall spending number, but the devil’s in the details now — with little sugar to help the medicine go down. Earmarks are gone. It’s a cold-turkey exercise in governance, the likes of which Washington hasn’t seen in years...Does the Energy Department really need to spend billions to extend the life of 400 B-61 nuclear bombs? Should U.S. Customs and Border Protection proceed with a new passenger pre-clearance program at Abu Dhabi — funded largely by the United Arab Emirates but opposed by American airlines? Who has $400 million to spare to compensate Western towns surrounded by federal forests and parks exempted from local property taxes?" David Rogers in Politico.

Roberts says the courts need more money. "Supreme Court Chief Justice John Roberts used his year-end report for 2013 to call for more funding for federal courts and lambaste sequestration’s effect on the judiciary. In the New Year’s Eve missive, Roberts referenced the seasonally appropriate “A Christmas Carol” by Charles Dickens to guide a “look at what has made our federal court system work in the past, what we are doing in the present to preserve it in an era of fiscal constraint, and what the future holds if the judiciary does not receive the funding it needs."" Tal Kopan in Politico.

Peak Awl interlude: Roman Emperors, Up To AD 476 And Not Including Usurpers, In Order Of How Hardcore Their Deaths Were.

4. That libertarian West

Utah asks Supreme Court to stay decision on same-sex marriage. "Utah brought the battle over same-sex marriage back to the Supreme Court on Tuesday, asking it to block a federal judge’s ruling that the state’s ban on such unions was unconstitutional, a decision that has resulted in a rush to marriage in the conservative state. The state said U.S. District Judge Robert J. Shelby of Salt Lake City had created a new constitutional right for same-sex couples with his Dec. 20 ruling that the state’s ban violated federal guarantees of equal protection...Utah’s application went to Justice Sonia Sotomayor, the justice designated to receive requests from the circuit. She quickly told attorneys for the three gay couples challenging the state’s ban to respond by Friday to Utah’s filing." Robert Barnes in The Washington Post.

Marijuana sales commence in Colorado for recreational use. "The first-in-the-nation law was greeted with long lines at retailers and a lot of “Rocky Mountain High” jokes. But beyond the buzz, the measure represented the institution of a major new public policy in America — one opponents fear will turn the state into a dangerous land of debauchery and that backers hope sets a nationwide precedent. If Colorado is able to successfully legalize marijuana without causing a social backlash, the tourism, tax and other considerations are likely to compel several other states to quickly follow suit." Niraj Chokshi in The Washington Post.

Jos Leys interlude: The images of mathematics.

5. Immigration reform comes back from the dead

Boehner backs immigration reform. "Speaker John A. Boehner of Ohio has signaled he may embrace a series of limited changes to the nation’s immigration laws in the coming months, giving advocates for change new hope that 2014 might be the year that a bitterly divided Congress reaches a political compromise to overhaul the sprawling system. Mr. Boehner has in recent weeks hired Rebecca Tallent, a longtime immigration adviser to Senator John McCain, the Arizona Republican who has long backed broad immigration changes. Advocates for an overhaul say the hiring, as well as angry comments by Mr. Boehner critical of Tea Party opposition to the recent budget deal in Congress, indicates that he is serious about revamping the immigration system despite deep reservations from conservative Republicans." Michael D. Shear and Ashley Parker in The New York Times.

Reading material interlude: The best sentences Wonkblog read today.

Wonkblog Roundup

What 2014 means for ObamacareSarah Kliff.

Everything you need to know about life under ObamacareSarah Kliff and Ezra Klein.

Hillary Clinton’s graph of the year. Wonkblog.

Et Cetera

U.S. judge upholds most N.Y. gun limitsThomas Kaplan in The New York Times.

Got tips, additions, or comments? E-mail me.

Wonkbook is produced with help from Michelle Williams.

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Washington Post · January 1, 2014