David Weigel: You start off every morning at 4 a.m. or so, reading national news, so I assume you read the New York Times editorial calling for clemency for Edward Snowden. Do you agree with the Times? Would you grant clemency?He's also making anti-Iraq war statements the center of his stump speeches. Count me as interested.
Brian Schweitzer: If Edward Snowden is a criminal, then so are a lot of people that are working within the CIA and the NSA who have been spying illegally on American citizens. They ought to grant Snowden clemency. Now, let me say this: Shame on us if we had a person working for a private contractor, without a high school diploma, who was in possession of our most delicate secrets. We look like Keystone Kops! But I don’t have any problem with the NSA and their mission of collecting information on foreign leaders. They spy on us; we spy on them. I’ve got a real big problem with American neighbors spying on American neighbors.
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DW: Do you think the Affordable Care Act can be made to work?
BS: I will give you not just how this thing should have been written, but what it will get to be, because what we have right now will not work. No. 1: You pass national health insurance laws that say you can’t discriminate against women, charge them higher premiums than men of the same age, you can’t discriminate against people with pre-existing conditions, you can’t have annual caps. Then you allow insurance companies to compete wherever they want, in any state. Boom. The second thing is, you say to every citizen in the United States, now you have the option to buy into Medicare.
I believe Obamacare’s rocky start — clueless planning, a lousy website, insurance companies raising rates, and the president’s telling people they could keep their coverage when, in fact, not all could — is a result of one fatal flaw: The Affordable Care Act is a pro-insurance-industry plan implemented by a president who knew in his heart that a single-payer, Medicare-for-all model was the true way to go. When right-wing critics “expose” the fact that President Obama endorsed a single-payer system before 2004, they’re actually telling the truth.
What we now call Obamacare was conceived at the Heritage Foundation, a conservative think tank, and birthed in Massachusetts by Mitt Romney, then the governor. The president took Romneycare, a program designed to keep the private insurance industry intact, and just improved some of its provisions. In effect, the president was simply trying to put lipstick on the dog in the carrier on top of Mitt Romney’s car. And we knew it.
By 2017, we will be funneling over $100 billion annually to private insurance companies. You can be sure they’ll use some of that to try to privatize Medicare.
For many people, the “affordable” part of the Affordable Care Act risks being a cruel joke. The cheapest plan available to a 60-year-old couple making $65,000 a year in Hartford, Conn., will cost $11,800 in annual premiums. And their deductible will be $12,600. If both become seriously ill, they might have to pay almost $25,000 in a single year. (Pre-Obamacare, they could have bought insurance that was cheaper but much worse, potentially with unlimited out-of-pocket costs.)
And yet — I would be remiss if I didn’t say this — Obamacare is a godsend. My friend Donna Smith, who was forced to move into her daughter’s spare room at age 52 because health problems bankrupted her and her husband, Larry, now has cancer again. As she undergoes treatment, at least she won’t be in terror of losing coverage and becoming uninsurable. Under Obamacare, her premium has been cut in half, to $456 per month.
Let’s not take a victory lap yet, but build on what there is to get what we deserve: universal quality health care.
Neo-Liberals turn prog goals into shitty corporate laws, law becomes unpopular, neo-libs theb say we can't advance prog goalsThis was one of my biggest concerns and things that was pushing me towards opposing the law. I agree with what Chris Hayes said last week that we need to work our hardest to make the ACA work because it's going to be hung on "our side" no matter what happens, but this is still so annoying because you could see lots of these issues coming from miles away and so much of it was preventable.
— Jon Walker (@JonWalkerDC) November 15, 2013
Just applied online for Medicare. Took 5 minutes. Single payer anyone?This is no radical, this is the former president of the Center for American Progress and Bill Clinton's former chief of staff.
— John Podesta (@johnpodesta) November 14, 2013
Across the country, insurance companies have sent misleading letters to consumers, trying to lock them into the companies' own, sometimes more expensive health insurance plans rather than let them shop for insurance and tax credits on the Obamacare marketplaces -- which could lead to people like Donna spending thousands more for insurance than the law intended. In some cases, mentions of the marketplace in those letters are relegated to a mere footnote, which can be easily overlooked.
The extreme lengths to which some insurance companies are going to hold on to existing customers at higher price, as the Affordable Care Act fundamentally re-orders the individual insurance market, has caught the attention of state insurance regulators.
The insurance companies argue that it's simply capitalism at work. But regulators don't see it that way. By warning customers that their health insurance plans are being canceled as a result of Obamacare and urging them to secure new insurance plans before the Obamacare launched on Oct. 1, these insurers put their customers at risk of enrolling in plans that were not as good or as affordable as what they could buy on the marketplaces.
TPM has confirmed two specific examples where companies contacted their customers prior to the marketplace's Oct. 1 opening and pushed them to renew their health coverage at a higher price than they would pay through the marketplace. State regulators identified the schemes, but they weren't necessarily able to stop them.
It's not yet clear how widespread this practice became in the months leading up to the marketplace's opening -- or how many Americans will end up paying more than they should be for health coverage. But misleading letters have been sent out in at least four states across the country, and one offending carrier, Humana, is a company with a national reach.
"If you're an insurance company, you're trying to hang onto the consumers you have at the highest price you can get them," Laura Etherton, a health policy analyst at the U.S. Public Interest Research Group, told TPM. "You can take advantage of the confusion about what people get to have now. It's a new world. It's disappointing that insurance companies are sending confusing letters to consumers to take advantage of that confusion. The reality is that this could do real harm."
This is an "834 EDI transmission." Insurers sometimes call it, more simply, "an 834." It is a technical, back-end reporting tool that consumers never see. It is meant to be read by computers, not human beings. It's the form that tells the insurer's system who you are and what you need. And it might be the new health-care law's biggest problem.
Insurers report that, in some cases, 834s are coming in wrong. That's a much more serious problem than the online traffic bottlenecks that have dominated coverage of the health-care law's rollout.
If people can't get into the Web site, then they simply have to come back later. But if they believe they've signed up for a plan but their 834 is a garbled mess -- or, even worse, clear but wrong -- it could mean chaos when they actually go to use their health insurance. For that reason, inside the health-care industry, the 834 problems are the glitch that is causing the most concern.
To back up a moment: 834 transmissions aren't new. They have been around for decades as the standard form that employers use to tell their insurance companies which workers are on their health insurance plan each month.
An 834 transmission contains enrollment data like an individual's social security number, their dependents and the plan that they picked. That data is, obviously, critical: If it comes in wrong, an applicant may not get the right plan, or family members may not be covered, or identity may not be verifiable.
...The 834 transmission is the one form, in the giant machinery of HealthCare.gov, that lets insurance companies know who signed up for their product. It is the electronic file that lets them get to work printing member cards, mailing them out and, eventually, paying claims.
The 834 transmissions have begun filtering out to health insurance plans. The only problem? A lot of them are wrong.
The Wall Street Journal reported that one insurance plan got an 834 for a subscriber who, according to the data, had three spouses. This was surprising because the individual was not a polygamist. Two dependents had been incorrectly coded as spouses.
Others have gotten reports for people joining the plan, unenrolling and re-enrolling multiple times in the course of a week -- or even the same day.
Right now, health-insurance plans say they can manage these problems. Few enough enrollment forms are coming in that they're able to hand-check each one. "What our company, and I'm assuming others, are doing is throwing people at it," one insurer told Wonkblog. "We're overcoming the tech flaws with manual reviews and manual rigor and manual processes. That's fine right now, but when you start looking at the scale of what the Obama administration wants to do, that's just not going to scale up."
This approach undermines the very point of 834s, which is to make it possible for the computer system to automate the process of enrolling tens or even hundreds of thousands of applicants each day.
"The purpose of the electronic transaction is to be able to do this with a minimum amount of human intervention," says Stanley Nachimson of Nachimson Advisors, a health IT consulting firm. "The hope would be that the health plan's computers will be able to understand the transaction and do all the processes automatically."
Some in the industry believe HealthCare.gov's traffic problems have been a blessing-in-disguise for the program: If applicants were being able to sign up easily but the 834 forms were coming in with this many errors the results could be disastrous.
"Some days its going to be 100,000 coming in," Laszewski says. "The good news right now is there is a small enough number that they can scrub the data manually."
As I've written plenty of times, I remain somewhat optimistic that Obamacare will be a modest improvement over the current system, though I do think there are some worries about how it will evolve long term. On one hand I support decoupling insurance from employment, but on the other hand if the decoupling happens without genuinely affordable substitutes being available then we aren't improving things. This stuff should be easy, not complicated, but DC is allergic to doing anything to help people without adding a Rube Goldberg layer on top of it, and funneling money to the Rube Goldberg machine operators in the process.At the time of passage I was extremely torn on how I would have voted if I was in congress. In the end I figured I would have voted for it, because crappy private insurance is better than no insurance and there are a lot of people with no insurance. With that said, I have huge concerns of how it will evolve going forward having permanently cemented the private insurance industry's role in this process when they serve no beneficial purpose for anyone and should not exist.
WASHINGTON — Restaurant chains like McDonald’s want to keep their lucrative tax credit for hiring veterans. Altria, the tobacco giant, wants to cut the corporate tax rate. And Sapphire Energy, a small alternative energy company, is determined to protect a tax incentive it believes could turn algae into a popular motor fuel.
To make their case as Congress prepares to debate a rewrite of the nation’s tax code, this diverse set of businesses has at least one strategy in common: they have retained firms that employ lobbyists who are former aides to Max Baucus, the chairman of the Senate Finance Committee, which will have a crucial role in shaping any legislation.
No other lawmaker on Capitol Hill has such a sizable constellation of former aides working as tax lobbyists, representing blue-chip clients that include telecommunications businesses, oil companies, retailers and financial firms, according to an analysis by LegiStorm, an online database that tracks Congressional staff members and lobbying. At least 28 aides who have worked for Mr. Baucus, Democrat of Montana, since he became the committee chairman in 2001 have lobbied on tax issues during the Obama administration — more than any other current member of Congress, according to the analysis of lobbying filings performed for The New York Times.
“K Street is literally littered with former Baucus staffers,” said Jade West, an executive at a wholesalers’ trade association that relies on a former finance panel aide, Mary Burke Baker. “It opens doors that allow you to make the case.”
Like Ms. Baker, many of those lobbyists have already saved their clients millions — in some cases, billions — of dollars after Mr. Baucus backed their requests to extend certain corporate tax perks, provisions that were adopted as part of the so-called fiscal cliff legislation in January. Baucus aides who later became lobbyists helped financial firms save $11.2 billion in tax deferments and helped secure a $222 million tax benefit that is shared with the liquor industry.
The one upside to the Supreme Court making the Medicaid expansion in the Affordable Care Act optional is that it has stopped the Obama administration from trying to cut it. Senior economic adviser Gene Sperling confirmed that the administration sees taking Medicaid completely of the table as necessary to make Obamacare function; but since President Obama is still obsessed with deficit reduction, he will instead focusing on cutting Medicare. The Hill:The Obama administration is clearly going to be floating benefit cuts to medicare every chance they get. They've done it quite consistently so far during his presidency, and there's no reason to believe he'd stop trying now. All we can do is be prepared to take him on next time he puts the idea out there.
“We have come to believe that it is not the time to make even those savings,” Sperling said, referring to the cuts the White House had proposed. “Not when this is the critical moment in implementing the Affordable Care Act.” [...]Given that our health care system is bloated, it would be possible to cut Medicare spending without hurting beneficiaries, but there seems to be little interest in Washington for doing that. Instead, everyone seems to be only focused on “tough choices,” i.e. looking tough by making older people poorer regardless of how little it would change overall spending.
But the administration has decided to accept a fight over Medicare in order to protect Medicaid, Sperling said.
“It means we’re going to have to look harder for Medicare savings, and those savings may be more difficult politically because of he choices we’ve made,” Sperling said. “If you decide you are going to protect Medicaid more, it means you’re going to have to make some tough choices in other places.”
The alternative to PPACA isn't "a health system reform that seeks to contain cost growth through progressive cost-sharing." It's nothing.
— Josh Barro (@jbarro) July 3, 2012
If Republicans had any interest in an alternative model of health reform, they would have done it when they ran the government.And these are things that need to be said. As much as a bitch about the Democrats on this site, there is literally only one side of this equation that even gives the slightest fuck about making sure people have health care they can afford. The irony about Obama's legislation being written by the Heritage foundation is extra irony-y-y (not a word but stay with me) because there is no way in hell any national republican would ever try to pass this type of bill. Why? Because they don't care in the slightest about making sure people have affordable health insurance, because there is no constituency in the Republican party that demands it either.
— Josh Barro (@jbarro) July 3, 2012
As I explained yesterday, the part of the ruling around the Medicaid expansion, where 7 justices agreed that this was basically a new program, and existing Medicaid funds could not be taken back by the federal government if states declined to comply, has the most near-term consequences for health care itself. Given that Medicaid expansion created half of the coverage increases in the bill, this offered half of the states the opportunity to really take an axe to the program by simply refusing to expand their Medicaid programs. And it leaves the poor between around 50% and 133% of the poverty line in a real no man’s land, because they would both be ineligible for Medicaid AND the coverage subsidies in the exchanges (and ineligible for the mandate, but that just puts them in the status quo, which is terrible).There is no way to know for sure, but I agree with Dayen's prediction here. To me, the high speed rail is a perfect example. That was a free gift to those states that they could not afford on their own and do wonders for economic productivity in the long run. And they turned it down. They actively made their states shittier places to take a stand against insanely popular high speed rail. Why would they turn down a chance to make their state shittier and take a principled stand against a law that is unpopular in the abstract?
This has been dismissed by the Democratic establishment as implausible. But it’s such a good deal for those states, they say. But everyone’s in Medicaid now, they say.
. . .It’s true that it’s a very good deal for states. As Pelosi says, the first three years is basically free, and after that the state only has to pick up less than 10% of the costs. In the example of Texas, by 2019, the state will have spent a mere $2.6 billion on the expansion, while the federal government will have shelled out $52.5 billion. And Pelosi even hinted that the feds could pick up more of that cost (which sounds close to federalizing Medicaid, which is really the killer app here).
Furthermore, looking to history, Medicaid itself was created in 1965. It remains a voluntary program, and Arizona held out for 17 years, until 1982, becoming the last to create their own program for their state. So if all states, including the red states, have Medicaid now, doesn’t that suggest all states will take the expansion over time?
Perhaps. But Pelosi’s response strikes me as the typical Democratic dismissal of conservative ideological intransigence. This is a far more conservative era than 1965. These state governors are well to the right of the crop that held out in Arizona. And Obamacare is seen as the devil’s handiwork. I’d argue that these governors are ideologically far to the right of even 2009, when all of them took stimulus money eventually. The resisters just paid lip service and eventually took the funds. But there wasn’t a Tea Party to pressure them to the right on these grounds. Scott Walker and Rick Scott and John Kasich came right into office and denied the high speed rail funds for Wisconsin and Florida and Ohio, for example. That’s the crop we’re talking about.
Drugmakers led by Pfizer Inc. agreed to run a “very significant public campaign” bankrolling political support for the 2010 health-care law, including TV ads, while the Obama administration promised to block provisions opposed by drugmakers, documents released by Republicans show.The hypothetical that usually follows this discussion "was this deal needed to pass Health care reform?" isn't known. But now we do know the details of this deal that was previously denied, and that's significant in it's own right.
The internal memos and e-mails for the first time unveil the industry's plan to finance positive TV ads and supportive groups, along with providing $80 billion in discounts and taxes that were included in the law. The administration has previously denied the existence of a deal involving political support.
The documents were released today by Republicans on the House Energy and Commerce Committee. They identify price controls under Medicare and drug importation as the key industry concerns, and show that former Pfizer Chief Executive Officer Jeffrey Kindler and his top aides were involved in drawing it up and getting support from other company executives.
“As part of our agreement, PhRMA needs to undertake a very significant public campaign in order to support policies of mutual interest to the industry and the Administration,” according to a July 14, 2009, memo from the Pharmaceutical Research and Manufacturers of America. “We have included a significant amount for advertising to express appreciation for lawmakers’ positions on health care reform issues.”
The goal, the memo said, was to “create momentum for consensus health care reform, help it pass, and then acknowledge those senators and representatives who were instrumental in making it happen and who must remain vigilant during implementation.”
His pledge to renegotiate NAFTA was important in gaining support from manufacturing workers in many key primary states. This pledge was clearly never taken seriously once he got in the White House.My way of choosing the candidate to support in any primary has always been to pick the one with the most progressive record and the one whose stated positions most closely reflect my own. During the 2008 election I thought it was silly when people picked their candidate based who they trusted the most, often with little evidence that that candidate supported the policies of their liking. Well, promises don't matter, not in the slightest, and I would feel differently in 2016 if someone told me they're voting for someone because they "have a feeling" they'll be more progressive while in office. If their stated positions and backgrounds are all relatively similar, why not?
President Obama also promised to push for legislation that would allow for judges to rewrite the terms of home mortgages in bankruptcy. Any effort in this direction has been all but invisible since he entered the White House.
