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The rollout of the health-care law has been troubled, to say the least. But are Americans turned off by what they've heard?
Not yet. Monday saw two new polls released on Obamacare. Both contain good news for the law. Here are the takeaways:
- Obamacare's as popular, or unpopular, as ever. Both The Washington Post/ABC News poll and the Pew poll found views of the law mostly unchanged. The Post poll, in fact, saw a slight uptick in support for the law, from 42 percent in September to 46 percent in October.
- Make D.C. listen! For comparison's sake, that makes Obamacare significantly more popular than the Republican Party (32 percent) or the tea party (26 percent). It makes it a bit less popular than President Obama (50 percent) and exactly as popular as the Democratic Party (46 percent).
- Americans are confused about whether the insurance exchanges are working. The Pew poll found that 46 percent of Americans know the online insurance portals aren't working well. But 29 percent think they're working fairly or very well. And 25 percent don't know. So a majority of Americans either don't know how the exchanges are working or think everything is going fine. Given that the exchanges are working quite badly, that's good news for the law.
- People who use the exchanges like them. About one in seven Americans say they have tried using the exchanges. Fifty-six percent found them easy to use. Three out of five people who've tried the exchanges were just curious about them.
- The uninsured want insurance. Sixty-five percent of the uninsured say they plan to get insurance within the next six months. Those numbers are reflected in the visits to HealthCare.gov: Among the insured, 12 percent have visited the exchanges, and 19 percent plan to. Among the uninsured, 22 percent have visited the exchanges and 42 percent plan to. That's great news for the law. It's much easier to sign up people who want insurance than to sign up people who don't.
- A majority want the law to keep going. Obviously the 46 percent who approve of Obamacare in the Washington Post/ABC News poll want to see it implemented. But so do many of those who disapprove of the law. The result is that 66 percent want to see the law implemented.
This is, of course, just a snapshot in time. It's possible, and perhaps even probable, that with the shutdown over and attention refocusing on the law, the public will grow more dismayed over the technical problems. Or perhaps the problems will abate -- it's already much easier to get into the Web site than it was two weeks ago -- and the law's poll numbers will rise.
That just underscores the reality that what matters for the law isn't messaging or the early polls. It's whether and when it begins working for people. If that date is a week or two from now, Obamacare is likely fine and the troubled first weeks will fade into the background, becoming a story CMS employees tell around the campfire to scare children. If it stretches beyond a month, Obamacare's prospects are dicier.
Speaking of health care! You can now subscribe to Sarah Kliff's "Health Reform Watch" by e-mail! DO IT.
Wonkbook's Numbers of the Day: 275,000 to 330,000. That's the ballpark range of how many people could be covered under Ohio's new Medicaid expansion.
Wonkbook's Graph of the Day: Alexa, the Internet-tracking Web site, has traffic data for HealthCare.gov.
Wonkbook's Top 5 Stories: (1) Obamacare in trouble; (2) the econ-data deluge; (3) the NSA is Not Supported Abroad; (4) tech and the middle class; and (5) immigration reform is dead.
1. Top story: Obamacare needs to be fixed by Thanksgiving
Obama: Yeah, we know, and we're working on it. "President Obama gave a consumer-friendly defense of the health-care law Monday and assured the country that the problems many have faced while trying to enroll in new insurance plans would be fixed quickly.... In his remarks, Obama was clear about his disappointment with the site’s launch. “There’s no sugarcoating it: The Web site is too slow; people have been getting stuck during the application process,” he said. “And I think it is fair to say that no one is more frustrated by that than I am. “There’s no excuse for the problems,” he added, “and they are being fixed.” He said the government is “doing everything we can possibly do” to repair the site, including 24-hour work from “some of the best IT talent in the country.”" Scott Wilson in The Washington Post.
Transcript: President Obama’s Oct. 21 remarks on problems with the Obamacare rollout. The Washington Post.
Obama’s speech underplayed Obamacare’s problems. But it doesn’t matter. "The problem with President Obama's Rose Garden address on the Affordable Care Act was that it was basically identical to the speech Obama would've given if the law's launch had been smooth.... In the end, though, Obama's speech doesn't matter. Either the Web site will be fixed in a reasonable time frame, and the law will work, or it won't be fixed and the law will begin to fail. The Affordable Care Act is no longer a political abstraction." Ezra Klein in The Washington Post.
Health insurance exchange launched despite signs of serious problems. "Days before the launch of President Obama’s online health insurance marketplace, government officials and contractors tested a key part of the Web site to see whether it could handle tens of thousands of consumers at the same time. It crashed after a simulation in which just a few hundred people tried to log on simultaneously. Despite the failed test, federal health officials plowed ahead. When the Web site went live Oct. 1, it locked up shortly after midnight as about 2,000 users attempted to complete the first step, according to two people familiar with the project." Lena H. Sun and Scott Wilson in The Washington Post.
@esoltas: HealthCare.gov went from the ~50,000th most pop site to the ~500th.
Obamacare’s drop-dead date: Thanksgiving, experts say. "There's a point where not having a functional Web portal actually does interfere with consumers' ability to gain coverage through the marketplace. I've spent most of Monday talking to experts about when, exactly, that happens and, perhaps more importantly, why it matters. Most of them point to sometime around mid-November, or even Thanksgiving, as the crucial moment where the health insurance marketplace needs to be working." Sarah Kliff in The Washington Post.
Sebelius to testify before House panel Oct. 30; two top HealthCare.gov contractors to appear Thursday. "House Republicans had been pressuring Sebelius to appear at a hearing on the health-care law, also known as Obamacare, on Thursday. But she was scheduled to be in Phoenix, and has agreed to come next week instead. The two top contractors involved in the HealthCare.gov Web site, CGI and QSSI, as well as Serco and Equifax, have confirmed they will appear at Thursday's hearing." Juliet Eilperin in The Washington Post.
White House won’t say whether Web site glitches will delay mandate. "White House press secretary Jay Carney was bombarded with questions Monday about whether the glitches will lead the Obama administration to withdraw penalties for people who don't comply with the requirement that they carry insurance. "Americans who have access to affordable insurance would need to have insurance by March 31," Carney said. "People who do not have access to affordable care due to a state not expanding Medicaid, for example, or due to other factors will not be penalized." Reporters pressed Carney on whether having trouble with the Affordable Care Act Web site also qualified as another exemption." Aaron Blake in The Washington Post.
@pourmecoffee: It may be time for Obamacare to bring in the true experts at Internet high demand, high complexity user selection, the porn people.
‘Keep checking your e-mail’: a conversation with the HealthCare.gov hotline. "On Monday morning, the Department of Health and Human Services added a new "apply by phone" button to the home page on the HealthCare.gov insurance Web site. My colleague Ezra Klein and I decided to give the phone number a try. Ezra tried calling twice and was put on hold. His hold music then went silent, and eventually his calls were dropped by the system. I fortuitously ended up on the phone with a consumer representative right away, spending, at most, about 10 seconds on hold." Sarah Kliff in The Washington Post.
Ohio will expand Medicaid. "Ohio Gov. John Kasich pushed through an expansion of Medicaid Monday over the objection of fellow Republicans in the state legislature, using federal money to add hundreds of thousands of state residents to the health-care program.... Mr. Kasich this year proposed adding an estimated 275,000 residents to the Medicaid rolls under the provision." Mark Peters and Louise Radnofsky in The Wall Street Journal.
Ohio’s new Medicaid expansion could cover 330,000 people. "This might not be the end of the story: Some Ohio House Republicans are prepared to sue the Kasich administration for moving forward on the Medicaid expansion after they did not approve the program. But, at least for the moment, Ohio is the 26th state (and fourth controlled by a Repubilcan governor) to sign onto the Obamacare program." Sarah Kliff in The Washington Post.
@ReformedBroker: All I know is Obamacare paid for my dog's liposuction, so I'm down.
The White House has put ‘the best and the brightest’ on Obamacare. So who was on it before? "The Obama administration should have figured out a way to tap the tech world's "best and brightest" from the beginning. But at this point, there's really no way for Silicon Valley to come in and save HealthCare.gov.... The obvious question is why is CMS still in charge? The most popular suggestion I've heard for fixing the federal health-care exchanges is for President Obama to reach out to a buddy in Silicon Valley, or tap his campaign tech people, to come in and manage the project. It's a nice thought, but an unrealistic one." Ezra Klein in The Washington Post.
But what, you may ask, about the incentive to work? "A new paper -- the latest to come out of the famed Oregon Health Insurance Experiment -- finds that Medicaid turns out to have little short-term effect on the labor-force participation or earnings of low-income Americans.... In a new batch of findings, Ms. Finkelstein and her co-authors say that Medicaid had no significant effect on labor-force participation or earnings. That means that the newly covered were not leaving or joining the labor force much more than their uncovered peers were, nor were they making much more or less." Annie Lowrey in The New York Times.
@jbarro: Confidential to TruthRevolt: OPM gave a special Obamacare exemption to Friends of Hamas. Look it up.
The way government does tech is outdated and risky. "As we learn more about what went wrong with the design and launch of Healthcare.gov, a few broad principles have emerged about how to fix the procurement system so this kind of debacle -- which isn't the only non-functional Web site the government's bought, just the highest profile -- doesn't happen again. One of them is the willingness to entertain innovative proposals from companies that might not have years of federal contracting experience." Lydia DePillis in The Washington Post.
KLEIN: The right doesn’t want Obamacare fixed. But it’s even worse for them if it fails. "The part of Obamacare that's troubled is the part Democrats lifted from Republican policymakers. It's the part that tries to integrate private insurance companies with government systems in order to create a universal insurance system that's subsidized by the state but run by private companies. The part that's working well is Medicaid -- which is to say, the part that's working well is the part that expands an existing, government-run, single-payer system." Ezra Klein in The Washington Post.
SUDERMAN: Obamacare may be more than a Web site. But it needs the Web site. "The exchange network is the vehicle through which the law’s authors envisioned people choosing Obamacare-approved, publicly subsidized coverage. If it doesn’t work, then that can’t really happen — even with manual workarounds like phone or paper applications. That’s because those entries still have to be entered into the online system." Peter Suderman in Reason.
BARRO: If you like your health plan, you probably shouldn't be able to keep it. "One of the key reasons that America needed health care reform is that a lot of existing health plans were bad. There are a lot of health plans that Americans shouldn't be able to keep. You might say "if people liked these plans, why not let them keep them?" Well, in the case of gold-plated plans, the problem is that the tax exclusion for employer provided health insurance allows these plans' beneficiaries to effectively shift up to one-third of their health care costs to taxpayers. You should be able to get a very generous health plan, but not with a generous taxpayer subsidy." Josh Barro in Business Insider.
BAGLEY AND FRAKT: Saving Obamacare without Congress. "The federal government has the legal flexibility to waive the penalty for people subject to the mandate but unable to access a functioning exchange website. Nestled in the health-care law is a “hardship exemption.” It waives the penalty for anyone who “is determined by the Secretary of Health and Human Services under section 1311(d)(4)(H) to have suffered a hardship with respect to the capability to obtain coverage under a qualified health plan.” In turn, section 1311 requires exchanges to “grant a certification” for particular individuals attesting that “there is no affordable qualified health plan available through the Exchange.” Putting the two provisions together, it could be a “hardship” if there’s “no affordable qualified health plan available through the Exchange.”" Nicholas Bagley and Austin Frakt in Bloomberg.
KRUGMAN: Lousy Medicaid arguments. "The real threat remains the effort of conservative groups to sabotage reform, especially by blocking the expansion of Medicaid.... [I]t’s not just money: the right has also rolled out some really lousy arguments. And I don’t just mean lousy as in “bad”; I also mean it in the original sense, “infested with lice.”...Sick people are likely to have low incomes; more generally, low-income Americans who qualify for Medicaid just tend in general to have poor health. So pointing to a correlation between Medicaid and poor health as evidence that Medicaid actually hurts its recipients is as foolish as claiming that lice make you healthy." Paul Krugman in The New York Times.
Music recommendations interlude: Talking Heads, "Don't Worry About the Government." 1978.
LEW: Lessons from a crisis. "It is time to put an end to governing by crisis and focus on accelerating economic growth and job creation. If we are open to what we can achieve together rather than simply setting our sights on our divisions, there is a lot we can do to support America’s workers and businesses.... We can start by hammering out a budget agreement that builds on the progress we have already made to lower our budget deficits. This is an opportunity to improve our nation’s long-term fiscal health, and it should be achieved through a comprehensive package that shrinks our deficits, protects Medicare and Social Security for those who rely on it, and expands our economy well into the future." Jacob L. Lew in The New York Times.
CHETTY: Yes, economics is a science. "I’m troubled by the sense among skeptics that disagreements about the answers to certain questions suggest that economics is a confused discipline, a fake science whose findings cannot be a useful basis for making policy decisions. That view is unfair and uninformed. It makes demands on economics that are not made of other empirical disciplines, like medicine, and it ignores an emerging body of work, building on the scientific approach of last week’s winners, that is transforming economics into a field firmly grounded in fact." Raj Chetty in The New York Times.
Adorable animals interlude: The giant river otter.
2. After the shutdown, the deluge of data
Economic data starts flowing again. "The Bureau of Economic Analysis said on Monday that it would announce its first estimate of third-quarter economic growth on Thursday, Nov. 7, while personal income data for September will be disclosed the day after, on Nov. 8. The statistics had originally been set to come out at the end of October, but were delayed by the government shutdown.... On Tuesday, the Bureau of Labor Statistics will announce long-awaited data on unemployment and job creation in September." Nelson D. Schwartz in The New York Times.
Existing home sales drop 1.9 percent in September. "The National Association of Realtors said on Monday that sales of previously owned homes fell 1.9 percent last month to a seasonally adjusted annual rate of 5.29 million. That is down from a pace of 5.39 million in August, which was revised lower.... The sales pace in August equaled July’s pace. Both were the highest in four years and are consistent with a healthy market.... [E]conomists expect home sales will remain healthy because rates have stabilized. Final sales in September reflected contracts signed in July and August, when rates were about a percentage point higher than in May." The Associated Press.
Justice Dept. sees $13 billion JPMorgan deal as a template for future bank settlements. "Justice Department officials plan to expand the use of a 1980s law that carries a relatively low burden of proof and gives prosecutors 10 years to pursue such cases, twice as long as under standard securities law.... The strategy will give the Justice Department several more years to extract multibillion-dollar fines from banks eager to rid themselves of crushing legal burdens...While other banks may not pay as much as $13 billion, Justice Department officials said it is not going to be cheap for firms to settle civil cases, especially since JPMorgan is not considered the worst actor of the financial crisis." Danielle Douglas and Sari Horwitz in The Washington Post.
Explainer: Everything you need to know about JPMorgan’s $13 billion settlement. Neil Irwin in The Washington Post.
Why JPMorgan took the deal. "J.P. Morgan Chase & Co. is willing to pay a steep price to settle with the Justice Department over soured mortgage securities, but it is getting one thing it wanted: It won't have to pay heavy penalties for the sins of two companies it bought during the financial crisis. J.P. Morgan will pay roughly $2 billion in penalties that apply to its own conduct during the years before the financial crisis, and not any for problems it inherited from Bear Stearns Cos. or Washington Mutual Inc." Devlin Barrett and Dan Fitzpatrick in The Wall Street Journal.
Extra music recommendations interlude: Arcade Fire has a new song out, "Afterlife."
3. NSA stands for Not Supported Abroad, apparently
The French have had enough with us spying Americans. "The French government castigated the United States on Monday for carrying out extensive electronic eavesdropping within France, the latest diplomatic backlash against the National Security Agency’s wide surveillance net and another example of how disclosures about the program have strained relations — at least temporarily — with even the closest of Washington’s allies. The Foreign Ministry summoned the American ambassador, Charles H. Rivkin, who met with ministry officials after an article Monday in Le Monde, the authoritative French newspaper, that the N.S.A. had scooped up 70 million digital communications inside France in a single month, from Dec. 10, 2012, to Jan. 8, 2013." Alissa J. Rubin in The New York Times.
Contractors fight over delays at NSA data center. "The lead contractor on the project says it has uncovered the cause of the explosions — a defect in electrical switches provided by a subcontractor — and is installing a fix. Outside investigators from the Army Corps of Engineers, which is overseeing the $1.4 billion construction of the center, say the contractors' explanation, and proposed fix, remain unproven. Government officials managing the project are split over which side is right. Representatives from the lead contractor — a joint venture of Balfour Beatty Construction, DPR Construction and Big-D Construction Corp. — are scheduled to present their case at the NSA's Fort Meade, Md., headquarters on Tuesday." Siobhan Gorman in The Wall Street Journal.
In memoriam interlude: Lawrence R. Klein, Nobel laureate economist.
4. Debate: Will tech destroy the middle class?
Arguing in the negative, James Bessen in The Washington Post: "People have been predicting that technology will kill the middle class since Karl Marx. They have generally been wrong. True, middle class wages do stagnate sometimes, as has been the case for the last couple of decades. But over the long run, technology has made large numbers of ordinary workers relatively wealthy.... We're likely to see the information revolution follow a similar course. So far, the gains have mostly flowed to the most talented and entrepreneurial workers. But as these technologies mature, we're likely to see increasing demand for moderately-skilled labor that complements the capabilities of computers."
...As well as Brad DeLong on his blog: "[Technological change] will leave us with personal services, actual planning and control, elite education/journalism/marketing, and research and development as things that humans can do in the future to add value. Our society will then be enormously rich: our collective and average productivity will be awesome. But the society will only be a good society if we can figure out how to employ each other in high-value [personal-services] activities -- only if we find ways to organize life so that most of us can actually add a lot of value by amusing, pleasing, and encouraging others will we have a society of mutual respect, and of only tolerable inequality."
Arguing in the affirmative, Tyler Cowen in his book, "Average Is Over."
...And also in the affirmative, Kevin Drum in Mother Jones: "To say that "intelligent machines per se are not new," as Bessen does, wildly misrepresents both intelligence and machines. No machine built before about 2010 has had anything even remotely resembling true intelligence. Not spinning machines that stopped if a thread broke, and not ATMs or accounting programs. Even now, the smartest machines out there display only the barest glimmers of intelligence. We simply don't have either the software or the hardware to do it. The machines that people like Cowen and I are predicting for the 2030s just flatly have no analog to previous machines...What happens to human labor when machines are smart enough that they need virtually no human guidance at all?"
Advice you can use interlude: A foolproof method to parallel park.
5. The chances for immigration reform are faint at best
Immigration reform groups resume fight. "The more aggressive wing of the immigration reform community is launching a “week of escalation” that will target the top three House GOP leaders and roughly two dozen other Republican lawmakers. Their goal is a vote on immigration reform this year. And the Evangelical Immigration Table is releasing a letter Monday signed by top faith leaders — a missive that comes amid a nationwide prayer blitz for reform. There’s a glimmer of hope that the House will pass immigration reform this year, but after the shutdown’s end, it’s faint at best. Although the Senate passed comprehensive reform in June, most House Republicans remain highly skeptical of such sweeping overhauls, and there’s no indication that chamber will move its own package of reform bills anytime soon." Seung Min Kim in Politico.
With shutdown over, attention turns to immigration reform — but is it too late? "During the last few weeks, however, Case says a handful of lawmakers have continued to work behind the scenes on smaller immigration measures in the House, adding that he has had productive discussions with leaders on both sides of the aisle, including Reps. Nancy Pelosi (D-Calif.), Eric Cantor (R-Va.) and Paul Ryan (R-Wis.)." J.D. Harrison in The Washington Post.
Reading material interlude: The best sentences Wonkblog read today.
Ohio’s new Medicaid expansion could cover 330,000 people. Sarah Kliff.
The way government does tech is outdated and risky. Lydia DePillis.
Here’s what ‘Gravity’ gets right and wrong about space. Caitlin Dewey.
Obamacare’s drop-dead date: Thanksgiving, experts say. Sarah Kliff.
No, technology isn’t going to destroy the middle class. James Bessen.
Christie drops appeal of gay marriage ruling. Aaron Blake in The Washington Post.
Wonkbook is produced with help from Michelle Williams.