Littwin: Because being uninsured is horrible

[dropcap]Y[/dropcap]ou’ve heard the numbers. You’ve seen the smiles. The axis has shifted, if just slightly. And the Obamacare narrative — once all about the bad news — has taken a dramatic turn.

Suddenly, at least for the moment, the news is all good.

The eight million who have enrolled in the exchanges. The 12 million — according to Gallup — who were uninsured last fall who are insured today. The Congressional Budget Office report that premiums are coming in lower than expected — and that the Republican prediction/hope of double-digit increases next fall is unlikely.

In a victory-lap-redux news conference Thursday, Barack Obama was asked whether Democrats should take their own dramatic turn — and embrace Obamacare as they head to the November elections.

Unsurprisingly, he said they should. OK, what else would he say? He was saying much the same thing for a while, even as vulnerable Democrats have been running as fast as they could not just from Obamacare but also from Obama himself.

But here’s the surprise: At this point, Obama might be right.

And here’s how we’ll know: When/if Mark Udall makes the call.

[pullquote]The people arguing about what uninsured people would do are insured themselves and have always been insured. So they didn’t see it coming when, as the deadlines approached, 3.7 million Americans signed up –because the subsidies are generous, because there are penalties for not signing up, because being uninsured is horrible.[/pullquote]

The Republican strategy against Udall is pretty obvious — a heavy dose of anti-Obamacare and then more anti-Obamacare and then more anti-Obamacare still. It’s as obvious as the $850,000 Koch brothers’ ad buy just after Cory Gardner shocked the political world by agreeing to take on Udall. It’s the same strategy vulnerable and semi-vulnerable Democratic Senate incumbents are seeing everywhere in a year when prognosticators give Republicans a better-than-even chance of winning the Senate.

Maybe you remember how the Koch brothers commercial ended: The actress looks into the camera, with sadness in her eyes and seeming regret in her voice, to say, “Obamacare doesn’t work. It just doesn’t work.”

But what if it does work?

In a purplish-trending-blue state like Colorado, where Obama and Obamacare have been taking a beating in the polls, a change in the dynamic could well change the dynamics of the Senate race, where Udall is generally considered only a slight favorite. If the polls on Obamacare move significantly, you’ll be able to tell. That’s when Udall would begin defending the law instead of defending himself for voting for it.

I don’t know what Udall — who is, to put it nicely, careful — will do. But what’s clear is that Gardner is unlikely to win unless a solid majority of Coloradans continue to consider Obamacare a loser.

Sarah Kliff, who writes about health care for Vox, the new Ezra Klein project, did the perfect job explaining how the 8 million came to enroll on the exchanges. They enrolled, she noted, despite the disastrous rollout, despite the scary cancellation notices, despite the death panels, despite the death spirals, despite 50 votes in the House to repeal, despite the unanimous doom-saying from the Republican side, despite the display of fear from red-state Democrats, despite glitches, despite confusion, despite a law that is so much more complicated than it has to be, despite all the predictions otherwise.

And why did they enroll?

There’s a very simple reason, she wrote: “Being uninsured is horrible.”

It is so horrible that when uninsured or underinsured people couldn’t get through on the broken exchanges, they didn’t give up. They tried again. And, if they didn’t get through the next time, they tried again. And again. Because being uninsured is horrible.

As Kliff explained, most of the people arguing about what uninsured people would do are insured themselves and have always been insured. And so nobody saw it coming from either side that in March and April, as the deadlines approached and even passed, 3.7 million would sign up. They signed up because the subsidies are, in fact, generous. They signed up because there are penalties for not signing up. They signed up because being uninsured is horrible.

The critical 18-to-34 age group account for 28 percent of the enrollees — around the same number who signed up for Romneycare in its first year in Massachusetts. The 18-to-34 group is important because you need young and healthy people to make the complicated system work. The target is closer to 40 percent, the experts say, but Romneycare history suggests that the number is in reach. Remember: Being uninsured is horrible. And the non-partisan CBO predicts that, after this first year, the sign-ups will come more quickly.

The Republican argument now is about the cancellations — even though they were delayed — and about Obamacare cutting Medicare benefits (does anyone really believe that?) and how the sign-up numbers must be skewed and how there’s a conspiracy involving the Census Bureau to cook the books on the newly insured.

What Republicans have been unable to argue is that they have an alternative to Obamacare. How is it possible that in all this time they’ve come up with … nothing? They have no plan to make sure people with pre-existing conditions can get insurance. They have no plan to do anything about the lifetime caps. They have no plan. It’s embarrassing, but not surprising.

One of the really interesting things that Gallup discovered in its polling is that 54 percent of the newly insured are Democrats and only 24 percent are Republicans. In other words, Obamacare is so political that people are deciding to sign up for health care insurance according to party membership.

The question now is: If Obamacare seems to be working, do those numbers change, too? Because if they do change, that’s when the narrative will end.


  1. Mr. Littwin has always been very dismissive of the idea that Obamacare could decide the winner of this November’s race for the U.S. Senate between Senator Mark Udall and Representative Cory Gardner.

    When Representative Gardner entered the race Mr. Littwin cavalierly asked “How many TV ads will it take before people start to tire of hearing Udall being blamed for (Obamacare) for which he provided little more than his own vote?”

    Well, in Florida it was enough to defeat a Democrat that didn’t even provide that.

    Ah yes, the March 11th election held in Florida’s 13th Congressional District to fill the seat vacated by the death of Republican Bill Young or, as it’s known to Mr. Littwin, The-election-that-will-not-be-mentioned-in-my-column-unless-things-change-drastically-and-I-can-totally-dismiss-the-results-as-an-outlier-or-something.

    But Mr. Littwin’s opinion of the effect of Obamacare on election results seems to have, well, evolved in large part because of rising enrollment numbers which he equates with rising popularity. He believes Americans are signing up because “Being uninsured is horrible.”.

    Well, maybe Americans are signing up because “Being uninsured is against the law and subject to fines”.

    Mr. Littwin seems to believe that being forced into an unpopular program will make that program popular although he fails to cite an instance where that actually occurred.

    As Byron York of the Washington Examiner puts it: “When it comes to the politics of Obamacare, there’s really only one question that matters: How many Americans are benefiting from the new health care system, and how many are hurting? Problem is, we know more about the first part of the question than the second.

    Even what appears to be Obamacare good news can mean bad news for potential voters. For example, this week the Congressional Budget Office released a report, much noted by Obamacare supporters, announcing that the program’s subsidies will cost the government less than originally forecast. But Obamacare advocates didn’t dwell on how that came about.

    The plans being offered through the exchanges in 2014 appear to have, in general, lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers’ use of health care than employment-based plans do,” the CBO said. “Those features allow insurers that offer plans through the exchanges to charge lower premiums (although they also make plans somewhat less attractive to potential enrollees).”

    Look at the phrase “tighter management of their subscribers’ use of health care.” Does that sound like something that will satisfy millions of patients — or set off renewed fears of rationing?”

    Memorial Day – May 26, 2014

  2. Thanks Mike! You are spot on with this article.
    I’m a consumer (RN, doing PRN work) who had gone without health insurance for a few years because the plans that were affordable were total junk. In 3 years I will be on Medicare, which I consider to be even better. The Colorado Exchange was fine, much better than past experiences purchasing health insurance. I was happy to see the prices and yes, I did qualify for a tax break (just as I do with mortgage interest,etc.) so of course I’m taking advance of a tax break to purchase health insurance. I’m healthy, try to eat right and workout every day. This month, however, I ended up in the ER at 4am with a kidney stone. I’m happy with my final bill after insurance coverage. It did suck to be without insurance but with insurance I was able to retire early and get insurance for a price that is fair, I’m loving it!
    The US can do better, we need to look at how other countries handle health care, they are far superior to the US. A family member lives in France and another friend lives in Germany, both systems in these countries care about their citizens and are doing it right.
    The ACA has many areas that could be improved but it is a start, it won’t be repealed and states that decided not to expand will be paying for their decision. Unfortunately the people residing in those states are hurt the most. I have a family member with health problems and on disability that missed qualifying for Medicare by less than $20 year (yes, per year) was able to get Medicaid and get the health care needed.
    If the GOP wants to keep running against the Obamacare they will lose…people want it. Many people could have been helped by the Medicaid expansion in states that refused, hospitsls in those states will suffer, the people that could have been helped will suffer. It’s a lose/lose.
    I hope the people that signed up the the last few days will remember who helped them get insurance and who blocked it, I hope they get out and vote to make sure they keep it. People don’t stand in line for hours to sign up and the decide to “not” pay the premium either…no matter how many republicans wish that this would be true.

  3. Thanks RN. You are “spot on” with your comment. It’s obvious by now people want and need health insurance. The Affordable Care Act is here to stay.

  4. Don Lopez is a talking head who knows not what he is talking about regarding the Affordable Care Act. He slobbers over right wing nonsense concerning the ACA and tries to pass himself off as credible. Here’s a few facts for Don to quack about according to the latest poll taken by the Kaiser Foundation a credible organization when it comes to health care issues.

    The overall favorable unfavorable gap over the ACA is closing. In December 50% opposed and 34% favored. As of March 46% oppose and 38% now favor the ACA.

    Overall the public want to keep the law in place and improve it.
    10% want the law as is.
    44% want to keep the law and improve it.
    11% want the law repealed and replace by a republican alternative.
    18% want the law repealed period.

    63% of the public favors subsidies for low to moderate income individuals.
    60% approve of medicare expansion.
    54% favor prohibiting insurance companies from denying coverage.

    One last point. Seven in ten Americans including Democrats, repubs, and Independents favor the ACA’s provisions that allow families to keep their kids on their health insurance policies to age 26. They also favor the policy that is closing the “donut hole” for prescription drugs under medicare.

    Donald Quack Lopez, full of himself and his looney obsessions with MIke Litwin’s great writing and reporting. Go Mike!

    Obamacare is going to be with us for a long time to come regardless of what the repub hordes think about it.

  5. Hey ScreenSniffer (aka Crumbcatcher),

    I see you’re off your meds again!

    Were you wearing your Easter Bunny ears when you wrote your latest comment because it sure reads like it?

    Look, I understand you’re upset that Mr. Littwin’s name didn’t appear on the recently released list of 2014 Pulitzer Prize winners but he’s learned to live with disappointment and you should, too.

    Not every columnist can be a George Will. Or even a David Harsanyi.

    I thought you might be on the road to recovery when you wrote one entire comment without mentioning my name but it didn’t last long did it? Couldn’t stay away, could you?

    Well, keep trying and I hope you had a Happy Easter.

    PS: You can take the bunny-ears off now.

    “The White House says it has surpassed its goal for people enrolled in Obamacare. It’s amazing what you can achieve when you make something mandatory and fine people if they don’t do it and then keep extending the deadline for months. It’s like a Cinderella story. It’s just a beautiful thing. You make everyone do it. If you still haven’t enrolled, you might have to pay a penalty called the ‘Individual Shared Responsibility Payment,’ which is 1 percent of your salary. Then Americans said, ‘hey, good thing I don’t have a job.”

    Jimmy Fallon

    Memorial Day – May 26, 2014

  6. My goodness. Mr Lopez is slipping. Facts seem to ignite his emotions.

    David Harsanyi and the Easter Bunny. I can’t imagine a better combination.

  7. ScreenSniffer,

    You quack me up.

    “David Harsanyi and the Easter Bunny. I can’t imagine a better combination.“

    Really? Well, I can: Mr. Littwin and Pinocchio.

    But seriously, you can take off those bunny-ears now.

    “The White House says it has surpassed its goal for people enrolled in Obamacare. It’s amazing what you can achieve when you make something mandatory and fine people if they don’t do it and then keep extending the deadline for months. It’s like a Cinderella story. It’s just a beautiful thing. You make everyone do it. If you still haven’t enrolled, you might have to pay a penalty called the ‘Individual Shared Responsibility Payment,’ which is 1 percent of your salary. Then Americans said, ‘hey, good thing I don’t have a job.”

    Jimmy Fallon

    Memorial Day – May 26, 2014

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