You Won’t Believe What These 10 Democrats Said About ObamaCare!

By Lambert Strether of Corrente.

Barack Obama, President of the United States (June 23, 2007).

I have made a solemn pledge that I will sign a universal health care bill into law by the end of my first term as president that will cover every American and cut the cost of a typical family’s premiums by up to $2500 a year. That’s not simply a matter of policy or ideology – it’s a moral commitment.

The facts: The PPACA (“ObamaCare”) does not cover “every American,” as was known when the law was passed. In 2017, as many as 40 million could still be uncovered.

And the PPACA does not save the “typical family” “$2500 a year” in premiums (see also).

Barack Obama (March 3, 2010).

[E]very idea has been put on the table. Every argument has been made. Everything there is to say about health care has been said and just about everyone has said it.

The facts: Single payer was not put “on the table” in hearings.

And in White House health care town hall transcripts, what single payer advocates had “to say” was censored.

Barack Obama (March 23, 2010).

Once this reform is implemented, health insurance exchanges will be created, a competitive marketplace where uninsured people and small businesses will finally be able to purchase affordable, quality insurance. They will be able to be part of a big pool and get the same good deal that members of Congress get.

The facts: Far from being “affordable,” quality” insurance, PPACA plans are marked by high co-pays, high deductibles, narrow networks, and narrow formularies.

And the PPACA marketplaces establish one Federal pool and many state pools, not “a big pool.”

Finally, “members of Congress and designated congressional staff will choose from 112 options in the Gold Metal tier” to retain the “Government contribution … for their health insurance coverage” for plan year 2014 (Office of Personnel Management). This is not the deal “uninsured people and small businesses” get, since they choose between Bronze, Silver, Gold, and Platinum tiers, where only Silver (not Gold) can be subsidized.

Barack Obama (July 24, 2013).

[S]tarting on October 1st … you’ll be able to comparison-shop online. There will be a marketplace online, just like you’d buy a flat-screen TV or plane tickets or anything else you’re doing online.

The facts: “What we’re also discovering is that insurance is complicated to buy,” most unlike “a flat-screen TV” (Barack Obama, November 14, 2013).

Joe Biden, Vice President of the United States (March 23, 2010).

You have turned, Mr. President, the right of every American to have access to decent health care into reality for the first time in American history.

The facts: The PPACA regards health care not as a “right,” but as a “shared responsibility” between “the federal government, state governments, insurers, employers and individuals” (IRS, “Questions and Answers on the Individual Shared Responsibility Provision”; see also 42 U.S. Code Chapter 157, Subchapter V – SHARED RESPONSIBILITY FOR HEALTH CARE).

And the PPACA does not cover “every American,” as was known when the law was passed. In 2017, as many as 40 million could still be uncovered.

Nancy Pelosi, Speaker of the House of Representatives (March 22, 2010).

And we are here now to be — along with the Congresses that — enacted Social Security, Medicare, Civil Rights Act, health care for all Americans. All of that on a par.

The facts: The PPACA does not cover “all Americans,” as was known when the law was passed. In 2017, as many as 40 million could still be uncovered.

Kathleen Sebelius, Secretary of the Department of Health and Human Services (April 6, 2010).

So here are the facts: if you like your doctor, you can keep your doctor. If you like your health plan, you can keep your health plan.

The facts: “They might have to end up switching doctors in part because they’re saving money” (Barack Obama, March 14, 2014).

And “with respect to the pledge I made that if you like your plan you can keep it … the way I put that forward, unequivocally, ended up not being accurate” (Barack Obama, November 14, 2013).

Kathleen Sebelius (March 7, 2010).

Every cost cutting idea that every health economist has brought to the table is in this bill.

The facts: Single payer wasn’t “on the table,” and single payer’s “cost cutting idea” adds up to $400 billion a year in savings, conservatively.

Todd Park, United States Chief Technology Officer and Assistant to the President (October 10, 2013).

These bugs were functions of volume. Take away the volume and it works.

The facts: The “bugs” that appeared when the Federal website was launched were caused by poor system architecture, poor implementation, and management failure by the White House team (Time).

Nancy-Ann DeParle, Assistant to the President and Deputy Chief of Staff for Policy (March 23, 2010).

Under health insurance reform, Americans will be ensured access to the care they need.

The facts: “Access” will be limited by high co-pays, high deductibles, narrow networks, and narrow formularies.

Paul Krugman, Op-Ed columnist for The New York Times (February 27, 2010).

So will reform seriously hurt people who would have had insurance coverage anyway? No.

The facts: Those who lose cancer coverage because of the PPACA’s narrow networks will be “seriously hurt.” Union members with multi-employer Taft-Hartley plans are being “seriously hurt.” Those who could not “keep their plans” because their individual plans were cancelled would have been “seriously hurt,” had not the White House backed off.

Ezra Klein, creator of the Washington Post blog Wonkblog (March 21, 2010).

Sickness and health might be capricious, but access to health care doesn’t have to be. It isn’t in other countries, and if Democrats win the vote tonight, it won’t be in ours, either.

The facts: “Capricious” is exactly what the PPACA is, as NC has exhaustively documented here, here, here, here, here, and here. The provision to claw back costs from the estates of over-55s forced into Medicaid by ObamaCare’s income eligibility formula is especially “capricious,” because it discriminates against poor elders.

Kevin Drum, Democratic blogger at Mother Jones (March 29, 2010).

Linking healthcare to employment has always been ridiculous, and anything that pushes in the direction of breaking that link is a positive development.

The facts: “Anything”? Universities cutting hours for adjunct professors is not a “positive development. The public sector cutting hours for “police dispatchers, prison guards, substitute teachers, bus drivers, athletic coaches, school custodians, cafeteria workers….” is not a “positive development.”

Jonathon Chait, Democratic blogger at The New Republic (March 21, 2010).

Historians will see this health care bill as a masterfully crafted piece of legislation.

The facts: “ObamaCare is a Rube Goldberg device” (Paul Krugman, April 5, 2014).

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.


  1. hunkerdown

    Bad transcript. As we now know, we were only promised affordable-quality insurance. Crapification at work!

  2. Chris Maden

    All words and no analysis.

    Yes, the bill that Obama promised is not the bill that the House delivered. Given due democratic process, I’d be more worried if that was not the case than that it is the case.

    Yes, the implementation of the website was a mess. Obviously you regard this as a first in the history of government IT projects everywhere. I’m in IT; I regard it as the norm.

    Yes, 40 million could be uncovered in 2017. Or maybe they won’t be. Or maybe some will choose not to be.

    Summing up: politicians over-promise and under-deliver. Mission accomplished; man bites dog. Let us know when you have an analysis which is actually interesting.

    1. Yves Smith

      This is both inaccurate and lame. Lambert backed up what he said with links and arguments. That is analysis. And if you were to bother reading the post with any attention, you’ll see that most of the representations took place AFTER the ACA was passed, so you can’t blame it on political processes.

      And your “oh this is normal democracy” is pre-refuted by Lambert. It was Obama who chose to let industry lobbyists write the ACA, assuring they could game it successfully. It was Obama that refused to propose single payer and was never serious about the public option, it was a talking point he withdrew quickly.

      And you also airbrush out completely that Obama came to office having sold the country on change with the US desperate for leadership in January 2009. He had majorities in both houses. He could have gotten a vastly bolder plan through had he been willing to push for it, as part of his stimulus.

      But Obama has consistently governed as a pro-corporate President who has sold out ordinary people, with his only gestures to the left on social issues.

      1. NotTimothyGeithner

        And Obama’s gestures to the left on social issues largely came after periods of embarrassment.

        -DADT was repealed after a Federal Judge told the Administration lawyers she was tired of their arguments and was going to strike it down. This was a year long process. This would have been an epic embarrassment.

        -Obama’s state right’s stance (never mind the gross hypocrisy) on gay marriage only came after OFA refused to help North Carolina opposition to the anti-marriage and anti-women referendum and Joe Biden forced the issue because he has some political sense beyond the cult of Obama. Its part of the reason he lost North Carolina despite the real desire to win there with the Convention in Charlotte.

        -Sending the LGBT delegation to the Olympics was announced in October of 2013 after Putin embarrassed Obama on the world stage.

        -As for Lily-Bedletter, the legislation was delayed for the new President when it became apparent Dubya was going to sign off anyway.

        Other than that, I’m sure he has taken a bold stand against “bullying,” not the wealth inequality and lack of resources which leads to a great deal of the problem, but he can stand up to kids.

      2. Teejay

        Respectfully Yves, everyone needs to drop the claim that the Dem’s had majorities in both Houses. If there were 60 Democrats (Dino and Blue Dog don’t count) in the Senate then you could legitimately say they had majorities. How many votes did the R’s need to pilfer on a cloture vote, 1, 2? Ben Nelson called himself a Democrat. No really he did.

          1. Joe Firestone (LetsGetitDone)

            Yes, if he started off by pressuring Reid to get the filibuster, he then could have gotten a much more effective and larger stimulus bill, including homeowner relief in February 2009, with mostly high multiplier deficit spending, and then followed in March with a credit card reform act holding credit card interest rates to 5 points over prime, and then very quickly with enhanced Medicare for All, to be implemented by the end of 2009.

            At that point, he and the Democrats would have been heroes and there would have been no Republican sweep in 2010. So, unless Obama and the Democrats intended to sell out to the plutocrats, one has to conclude that they were guilty of the worst political malpractice in living memory.

            1. NotTimothyGeithner

              Obama started off by pressuring Reid to keep Lieberman, not just in the caucus, on as the Chair of Homeland Security.

              One minor quibble. The filibuster expires as the Senate rule on its own at the start of each new Congress. Reid and the Democrats reauthorized the filibuster in the wake the GOP advertising non-stop they would do nothing but obstruct. The filibuster is a gentleman’s agreement. We have no standing to challenge it because there is nothing to challenge, but 50+1 is the constitutional organizing principle which supersedes any grand tradition.


              One conclusion can be reached, the Democratic elite is composed of people too stupid to vote or simply corrupt. I imagine there is crossover.

              I would draw special attention to this quote by Axlerod:
              ““Our feeling was, we were dealing with a potential disaster of epic proportions that demanded cooperation. ”

              Whatever they thought, these Democrats are clearly unfit for office of any sort if they didn’t think ending Senate tradition was more important than solving problems within the constitutional framework.

        1. NotTimothyGeithner

          Again only 50 are necessary to pass legislation*, and what marginal Democrat would oppose the President. All Obama had to do was hold a rally in 2009 and thank Senator Convenient Straw X for supporting his initiative and invite him to share the stage. No white male Senator was going to oppose Obama if he had pulled that. He would have the Senators in line and jumping to be seen as the most ardent Obama supporter much like they were for ACA despite the crumminess of that legislation.

          Of course could have opened up Bush era war crimes and put the obstructionists on the defensive, but then that might have worked.

          *”Mr. Smith goes to Washington” is not an accurate movie. The filibuster is an organizing alliance of the Democrats which amounts to a gentlemen’s agreement. It has no force above 50+1.

          1. Nathanael

            I think the real problem is that we never had 50 real Democrats in the US Senate.

            We never had a real Democratic Majority in the NY State Senate either — we’ve discovered in three consecutive elections that a bunch of the people running on the “Democratic” party line are actually Republican supporters.

        2. Lambert Strether Post author

          You’re confusing majority with supermajority; if the Dems hadn’t had majorities in both houses the bill would never have passed. Two points:

          1) The filibuster can be abolished with a simple majority; the post shows how.

          2) In any case, ObamaCare was passed with a reconciliation bill, which agsain requires a simple majority.

          The “they needed 60 votes!” is a canard and an excuse for inaction (or, rather, an excuse for avoiding action that serves public purpose).

          1. Robert Hurley

            I lobbied for single payer because I thought it gave would cover almost all citizens at the lowest per person cost, but it never would have past. Although the Affordable Care Act, has the flaws you pointed out, it does cover more people. I would rather have a half a loaf than none.

            1. NotTimothyGeithner

              The Obots are bringing out all the oldies. “Half a loaf.”

              If you bothered to read any of these articles, you might grasp that the “half a loaf” argument is an invalid metaphor as many people are net losers because of ACA, and since the politics of ACA have delayed genuine reform for a very long time, many people are being kicked because they aren’t lucky enough to be winners.

              With your arguments, why aren’t you a Republican? You clearly don’t believe in a just society except one where some people are born lucky and everyone else can eat shit and die.

              1. Robert Hurley

                Why the ad hominem attack. That is a tactic I expect of the wingnuts. Point is that many will gain, though some will lose. You have not proved your premise that we fouls have had universal coverage. All Republicans and some Democrats would not vote for such a bill.

                1. Yves Smith

                  No, more are losing. This is crappy insurance with very high copays. It’s economically a very bad deal. Everyone I know who has had to buy an Obamacare policy is upset, and I also know people who are paying the penalty instead.

                  1. Nathanael

                    Yves: here in New York State, the Obamacare marketplace policies are cheaper than, and just as good as, the outrageous individual market policies which existed before.

                    Of course we had a completely broken individual market here. Anyone being thrown off group insurance onto the indidivual market is still getting a much worse deal than before.

                2. notexactlyhuman

                  Reinforcing both the grifting, for-profit health insurance racket and the runaway inflation of actual healthcare and pharmaceutical costs is bad. Bad bad bad. ACA does nothing to address cost, which means your premiums and deductibles and co-pays will continue to rise (presuming you can afford any of those to begin with). So, unless your income increases at the same rate as healthcare and thus health insurance, the affordable part of the ACA is dribbling in the wind. In fact, the ACA is nothing but steroids for the predatory capitalist system.

                  1. notexactlyhuman

                    Bring on the FTAs, so that we can be sure that costs cannot and will not be addressed, and the working class will forever be beaten down like a sick dog:

                    Exclusive: Costs to public of $84,000 hep C drug ‘outrageous’ – Kaiser

                    “But Gilead has come under fire, from insurers and Congress, for Sovaldi’s $1,000-a-pill price at a time when U.S. healthcare spending is under scrutiny and President Barack Obama’s Affordable Care Act aims to make health coverage accessible to everyone.”


                    Gawd bless the profiteers and the poor people who inadvertently defend them.

    2. Lambert Strether Post author

      1) The bill the House Congress delivered was the one the Senate wrote, and the Senate bill was designed by Liz Fowler, a Wellpoint VP on secondment to Max Baucus’s office as his chief of stafff. I’m glad to see that you regard industry lobbyists crafting legislation as “due democratic process.” It tells me a lot about how Obots see the world, and explains a lot about the administration.

      2) The website obviously didn’t have to be a mess; the administration could and should have done the right thing before the debacle, instead of afterwards. So why the administration bungling? My guess is a combination of Obama’s personal fecklessness and indifference, combined with underlings fearful of brining bad news. The links provided give ample evidence on both points. This sorry episode as well tells me a lot about how Obots view the world, and explains a lot about the administration.

      3) “Or maybe they won’t be.” Leaving aside the callous indifference, what is it about Obama’s rump faction of Democrats that makes them so willing to throw others under the bus? The same is true of the permanently disemployed, for which the administration has done squat. Ditto people who lost their homes and were supposed to be helped by HAMP. I’m genuinely curious to know.

      Smarter Obots, please.

    3. diptherio

      Let us know when you’ve actually read the links included in the article. You see, Lambert and NC have been covering these issues in depth for quite awhile. If you bothered to check out all of the background information so helpfully provided, you might learn something.

    4. NotTimothyGeithner

      Spare us the nobility of House Democrats argument. They had plenty of power to demand a healthcare bill which would work as Obama would not be President in a primary system and Nancy Pelosi is a women and a leader in a party which is 65% female. The House vote was purely a stunt for the rubes. Instead of proposing counter offers, they lined up behind Obama as soon as they covered their backs.

    5. Jim Haygood

      ‘Summing up: politicians over-promise and under-deliver.’

      Yes. But in only two areas do they do so on a ruinous scale: war and social programs. Though still in its ‘teething troubles’ phase, Obamacare in the fervent imagination of Nancy Pelosi is, or will be, ‘on a par’ with Soc Sec and Medicare. Which means trillions in negative NPV, and swingeing tax increases for the victims … errr, ‘consumers.’

      Your lack of interest exemplifies the well-known phenomenon of neural adaptation. If O-care’s timeline were a video with each frame being a day, its mammoth cautionary tale would be more dramatic than a cargo jet plunging into a tank farm beside the NJ Turnpike and lighting up the Big Apple with a lurid tower of flame. Burn, baby, burn!

        1. Nathanael

          On other topics, Obama vastly over-promised.

          Also: remember “no individual mandate”? Obama has a record of just lying through his teeth.

    6. jrs

      Kind of agree with the cynicism about I.T. (yes some companies do it right but many don’t). Not so much the rest of it.

  3. trish

    If you put a republican face on Obama or any of these other insurance industry shills, can you imagine the liberals’ anger? All those who still regurgitate the “Obama’s done the best he can in the face of those (big bad) republicans.” Never mind that single-payer was off the table despite being favored by most americans and Obama had wide-spread public support back then with the anger at the banks- great chance to use the bully pulpit and push through many of those hope-and-changey things he campaigned on- all that…what lies…my young son and I use the obama hope-and-change t-shirt I got him for a cleaning rag now…

    I still seethe. Great post, as always.

    1. NotTimothyGeithner

      I can imagine the anger from Democratic followers, but their leaders would use the “fix it later” meme or whine about “keeping the powder dry*.” Much like the Iraq War, the current Democratic establishment would have lined up to vote for anything in favor of corporate America, much like their support for the Iraq War, deregulation, the general MIC buildup.

      *Ah, our illustrious Harry Reid on why Democrats can’t organize against Dubya’s supreme court nominees.

    2. Jess

      Seethe. Perfect description. Lot of people out there seething over Obama and the plutocracy.

  4. DolleyMadison

    Thanks for bringing the heat….not sure it will thaw the Dems ice-cold resolve to enrich the Health are cartels.

  5. allcoppedout

    Great collation on this one Lambert. The scary thing is the extent to which lying is now conflated with argument. Health care should be part of a free-table for all, but across our so-called developed countries very odd claims are being made on welfare.

    1. hunkerdown

      What’s the name of that theory, anyway? The one that decrees body, soul, and all matter everywhere to be subordinate to what you *believe*? “Crackpot realism of the present” or something like that?

  6. Ned Ludd

    Ezra Klein pitched ObamaCare to conservatives as a way to “break the two largest single-payer health-care systems in America”.

    Ironically, bringing ObamaCare to Medicare is an obvious long-term compromise on health care. If Republicans can make their peace with the Affordable Care Act and help figure out how to make the Affordable Care Act’s exchanges work to control costs and improve quality, it’d be natural to eventually migrate Medicaid and Medicare into the system. Liberals would like that because it’d mean better care for Medicaid beneficiaries and less fragmentation in the health-care system. Conservatives would like it because it’d break the two largest single-payer health-care systems in America and turn their beneficiaries into consumers. But the implementation and success of the Affordable Care Act is a necessary precondition to any compromise of this sort. You can’t transform Medicaid and Medicare until you’ve proven that what you’re transforming them into is better. Only the Affordable Care Act has the potential to do that.

    So Bachmann is perhaps right to say that the president is moving us towards a day when ObamaCare — or, to put it more neutrally, “premium support” — might come to Medicare. He’s seeing whether it works in the private health-care market first and, if it does, there’s little doubt that the political pressure to extend it to other groups will be intense. The question is why Bachmann and her party are doing so much to stand in his way? The corollary to Bachmann’s accusation that the president has a realistic plan to privatize Medicare is that the Republicans, for all their sound and fury over the Ryan budget, don’t.

    1. Banger

      Let’s look at why very conservative Republicans opposed and still oppose Obamacare. The idea that the government can offer some kind of umbrella over the health-care system means that, eventually, the government can impose controls on that an many other things. Right-wingers oppose government as a guarantor of any economic result–they believe in markets regulated only by major corporations. They are, in short, fanatical believers in neo-feudalism. Their vision of this sort of society is, sadly, ignored by almost everyone. So that any government involvement in health-care or any other aspect of life other than war and police/prisons is a travesty.

      1. DolleyMadison

        Obamacare is the antithesis of “market forces” – “market forces” were killed off long ago by the facist regimes of the last three presidents…what is Obamacare but “neo-fuedalism” on steroids?

        1. notexactlyhuman

          Hmpf. Here and I thought market forces were drones, missiles, automatic rifles, and destabilization efforts.

    2. JohnnyGL

      Wow, that is one heckuva link!

      Here’s another eye-opener:

      “The president’s plan for senior citizens is Obamacare,” Bachmann said. “I think very likely – and I’m speculating – I think very likely what the president intends is that Medicare will go broke, and ultimately that answer will be Obamacare for senior citizens.”

      Even Bachmann can see that the plan is to starve the beast and drown it in the bathtub! And she’s prepared to oppose that! That’s some serious up-is-down type stuff :)

      1. hunkerdown

        No, she’s prepared to be seen opposing it because she needs to tick the “pandered to old people” box for this election cycle. 100% of everything said by power for public consumption is said for effect. Performative speech doesn’t work without an actual performance.

        1. NotTimothyGeithner

          I think the GOP was scared off of Medicare/Medicaid/Social Security after their polling plummeted in 2005. They had to run the Terri Schaevo mess to stem the bleeding. The gallup tracking polls confirm that GOP popularity rose during the Schaevo mess. The GOP base is seniors and boomers, and they don’t want the government messing with their budgets as they knowingly move to a point where they lose much of their power as an individual.

          Obama’s appeals to cut Social Security were always a waste because the GOP both believed in obstruction of anything Obama does and was permanently frightened of AARP.

          Bachmann has been in Washington for some time (does anyone remember when she tried to molest Dubya during the SOTU), but I think the newer GOP electeds who are similar to Bachmann come from the sentiment that turned against the GOP very rapidly when Dubya started making noises about privatization. They are wary of changing their programs so close to the expiration date.

          1. NotTimothyGeithner

            “Their programs” is wrong, but I should say, “the programs they intend to use or use.”

    3. jrs

      Well it failed. Or more precisely it can only suceed if Medicare is simultaneously made worse and worse (and they are trying), because otherwise Obamacare is just nothing anyone would *choose*.

  7. Chromex

    “And the PPACA does not cover “every American,” as was known when the law was passed. In 2017, as many as 40 million could still be uncovered.”

    And ,as CANNOT be said often enough, “coverage” does not “cover’ a whole buncha stuff that normal and sane humans would think would be covered as part of health care. Insurance is not care. The problems the US was having with health care were copays.coinsurance and deductibles. all of which continue to flourish under this abomination.
    Now think for just a second about “medicare for all”. Think of the amount of time and money many employers now spend navigating the health insurance maze. Think fo the effect that might have on wages and productivity..

    1. jrs

      It would only have an effect on wages if workers had any bargaining power in this economy. Ok well that’s clearly false. Productivity yea maybe (that will go to the top 1% just like all productivity gains in the last 30 years). Peace of mind and healthcare coverage perhaps.

  8. dbak

    Lambert’s unending attempt to discredit ACA is based on assumptions. Has he ever actually tried to sign up for it? What kind of insurance does he have and how much does he pay for it? As a retired federal worker I am in the federal employee plan so I am well set but my son is stuck in a low wage job with no coverage so I helped him apply for it. Despite all the stories of the troubles with the website I had no trouble logging on. The local Blue Care website had very good information on the plans available. My first impressions were that the deductions were rather high, and the monthly costs were more than he could afford but when his yearly earnings were factored in (13000) the deductions and monthly costs were reduced by a large amount. In a recent post Lambert derided the president for stating ACA costs could be as little as 22 dollars a month but guess what, that is the my sons insurance will cost. The policy will cover 90 percent of his expenses and out of pocket costs are limited to $750. Obviously a substantial raise in his earnings would increase these numbers but he would more able to afford them. It is possible to look at this program and poke holes in it but for people without insurance it is a godsend.

    1. Lambert Strether Post author

      Did you notice the links in this post? Comparing Democratic words to outcomes? No? Good.

      Smarter Obots, please.

      Adding… I don’t have to work all that hard to “discredit” ObamaCare. The program itself does most of the work for me.

      1. NotTimothyGeithner

        I would give the Obots credit for one newer argument. Its a bit rehashed, but it did disappear for a time. They have been pushing the House of Representatives vote sham vote on a healthcare proposal as if they were betrayed by shadowy forces over which they have no power. Since I don’t remember the particulars of that bill, they can get away with calling it Manna from Heaven while offering no evidence.

        At least one DNC staffer has a part of a brain.

    2. JohnnyGL

      So, using your numbers $22 a month with a $750 deductible, that means your son will be shelling out over $1,000 for medical care before his insurance company kicks in anything. Is there any Co-insurance? Because that’s the real killer!

      I don’t think $1000 a year is a reasonable ask of someone who makes $13k a year. I actually find it horrifying. It’s enough to make him skip out on getting care to save money, so the incentives are all wrong, too.

      Also, are you sure he wasn’t eligible for Medicaid anyway? That’s a really low income.

      In any case, Americans were promised coffee and we got dirty water, and you’re HAPPY with dirty water??!?!

      1. NotTimothyGeithner

        Its important to remember the Democratic bots and Obot variety like their counterparts in the GOP derive their value from their association with the Democratic Party and Obama. Their sense of self worth are intertwined with Obama’s success and failure, not any policy concern.

        Obama’s promises are irrelevant to them. Their major concern is being proven how great their crush, Obama, is. Take the Syrian chemical weapons event. The Russians clearly jumped on a Kerry gaffe to deescalate, and the Obots hailed it as 853rd dimensional chess, ignoring the deaths of 150,000 created by escalating a conflict, because the outcomes in Syria aren’t as important as the perception of Obama in the zeitgeist.

    3. Katniss Everdeen

      Honestly, dbak, time to look ahead a few MONTHS.

      How long do you think that $22 per month price tag is going to last? Not to mention the taxpayer “subsidy.” (I’d be curious to know how much the taxpayers are “chipping in,” by the way.)

      I don’t know where you live, but there was a link here on NC recently saying that exchange insurers in IOWA expect a 100% premium increase for renewals next year. 100%!!! (That would be November, 2014.)

      The ACA is the “signature accomplishment” of the Obama administration. The same administration that pats itself on the back for engineering an economic “recovery.” An economic “recovery” that has nothing more to offer your son than a $13,000 a year “job.”

      How in the world do you have confidence that they even CARE whether your son has access to any “healthcare” he needs? He’s nothing more than a conduit of taxpayer funds to a ravenous insurance/healthcare cartel. He’d be better off buying $22 worth of “health” insurance company stocks every month, and paying the $750 for any “healthcare” he consumes annually, which is what’s going to happen ANYWAY.

      It would supplement his “income,” and he’d pay less tax on any gains.

      The information provided in these links is VALUABLE. You need to read it and understand it. YOU happen to be OK thanks to your government service, but your son undoubtedly will not fare as well.

      The point here is that the Democrats lied. They all lied. Why in the world would you start believing them, or worse yet DEFENDING them, NOW?

      1. Ed S.

        Here’s another way of looking at it (and for the sake of argument, let’s assume the numbers never change):
        1) Out of pocket expenses for “medical care” are $1014 per year before a dollar of benefits are received
        2) A moderately expensive medical “incident” (let’s say a broken leg that requires a surgical repair) will probably cost a minimum of $50,000. Even if the “insurance” pays 90%, that leaves a $5,000 liability.
        3) Sadly, the best “insurance” plan for somebody making $13,000 is bankruptcy. Even a trivial medical condition will leave them destitute for decades.
        4) As Lambert does mention – the son could be a winner. If (heaven forbid) he has a chronic condition that requires ongoing expensive care, the plan is a bargain.
        What’s the Navy saying : you can’t buff a turd?

          1. hunkerdown

            It’s easy, when one gets used to a politics made of an endless stream of apparently nonsensical and unconnected happenings, each accompanied by “this time it’s different” one-off explanations with zero predictive power.

            “You heard a noise, go back to sleep” is a comfortable hidey-hole in an environment where authority is in question.

        1. cnchal

          2) A moderately expensive medical “incident” (let’s say a broken leg that requires a surgical repair) will probably cost a minimum of $50,000.

          WTF? Really? Why so much?

          Like taking your car in to get a little work done on it, and because the mechanic is so special, one gets charged $7000 for a tire rotation.

          1. Nathanael

            Fraudulent pricing by hospitals and by doctors’ conglomerates. It’s a big problem but I haven’t seen any suggested solutions yet, except for single payer.

      2. jrs

        One possibly peacemeal response to this would be to get state insurance regulators, appoint them and give them the power if they don’t have it now, to put some break on health insurance costs (at the least make the insurance companies justifiy their price increases). Iowa ought to do this. It’s in the upcomign California election.

        1. human

          Part of the point of this Federal legislation is to kneecap states insurance regulators., furthering consolidation of power.

  9. Banger

    The argument always involves “it is better than nothing.” And it’s the same argument as “the lesser of two evils.” What can you say? Personally, I think we would be better off had the bill not passed. I believe the most egregious practices of the insurance industry could have been passed separately and quickly. My reasoning then as now was that the deal was basically made before and “debate” occurred thus limiting the debate thus the media did not feel obliged to offer us the full spectrum of choices available to us. There was little or not consideration of the scores of systems around the world most of which work far better than our own and all have interesting tweaks that keep costs down while improving care. Single-payer was one option that was not really looked at in terms of efficiency–what were the costs and benefits? Why was that not emphasized? Or what about the various Euro-systems that combine a strongly regulated insurance market with government guarantees–we could have copied the French system–very well run and considered by many the best in the world. But since Americans rarely travel outside of tour buses they don’t know how much better those Euro systems are in delivering HC. Obama is now and was then, obviously, an agent for the corporate sector (where the power is) the institution that failed us dramatically was the mainstream media which could have reported more honestly. There was never, to be blunt, any kind of “debate” on HC in this country.

    1. MaroonBulldog

      The deal was made before the debate occurred, and so the debate was limited to issues within the contours of the already-made deal: That’s how we got Obamacare. It’s also how we got the Iraq war. And TARP. And any number of other things that should not be done. You can call them all “deals” if you want; “corrupt bargains” would be more descriptive. In truth, it is because the bargains are corrupt that the debate must be limited. And conducted in FedSpeak.

      1. notexactlyhuman

        I posted it there this morning, but the Reddit Gestapo voted it down into a hole and then a mod completely removed it within a few hours; “too many links,” s/he said.

  10. Deloss Brown

    We never had a chance for the public option, and it was mostly Olympia Snowe’s doing on behalf of Republicans. Since Yves reasonably wants links:

    “Take Public Option ‘Off the Table,’ Snowe Says NYT 09/13/09
    Senator Olympia Snowe, a member of the Senate Finance Committee, where the most-watched version of the health care bill is being written, said on CBS’s “Face the Nation” that the so-called public option is “universally opposed by all Republicans in the Senate” and “therefore, there’s no way to pass a plan that includes the public option.”

    Let us give credit where credit is due.

    How come NC has not paid the slightest attention to the anti-austerity riot in Brussels on April 4?

    1. NotTimothyGeithner

      Awww…gosh if only those dastardly Republicans hadn’t been such obstructionists from their powerless, minority positions! Lets not hold the Democrats accountable for hiding behind the pro-Jim Crow of the filibuster which has authority above the constitutional requirement of 50+1. Hmm…how many votes were in the Democratic caucus? More than 50. They didn’t even need Joe to leave the Observatory.

    2. Joe Firestone (LetsGetitDone)

      Sorry, but your comment is based on the idea that Democrats were prisoners of the filibuster in the Senate and could not muster the 60 votes needed to get cloture for either the public option trick sparkle pony or what 67% of the people really wanted, Medicare for All legislation. However, the Ds could either have gotten rid of the filibuster by using the legislative “nuclear option,” or even by going around using reconciliation. Either of these methods could have been used anytime to pass a bill better than the ACA corporate giveaway between early 2009 and when the ACA was passed in the Spring of 2010. Face it! The Democrats wanted to pass the corporate giveaway.

      They decided that doing that would be better for them. For the swing state Democrats who got slaughtered in the elections of 2013 it was the biggest political miscalculation they ever made, since I can’t believe the plutocrats took care of most of them after they got beat.

      1. Banger

        The issue was not so much the Democrats as a whole as the Southern Democrats who could not vote for anything that could appear to be mildly socialistic. The great flaw in the Democratic Party has been that its tent is way too large–the RP’s smaller tent is more agile and unified.

        1. Joe Firestone (LetsGetitDone)

          It’s true that’s an issue. But the Dems could have let 8 or 9 blue dogs vote against a Medical for All Bill and still passed it. Some of the Dems who took that off the table like Baucus would have a very tough time voting against it, since he had said he favored Medicare for All often enough before 2009. There were many others who have had a tough time, including Ben Nelson, if the Ds has gotten a vote on it up or down.

          1. Nathanael

            I have eventually been convinced that there were at least 10, probably 12-15, “Democrats” in the US Senate who secretly supported the Republican Party.

            Like we have in the NYS Senate. Or like Rodney Tom in the Washington State Senate. (What is it with Senates?)

    3. Lambert Strether Post author

      The so-called “public option,” besides being a set of vacuous and ever-shifting talking points instead of a serious policy proposal, was a bait-and-switch operation run by career “progressives” to suck all the oxygen away from single payer. See here and here.

      1. Banger

        Absolutely! There was no intention of going in any other direction by Dem either in Congress or the WH.

  11. Andrea

    This thorough post by lambert helped me to better understand the ACA. No the act itself, but the posturing, influences, etc. around it. Thx.

    1. Lambert Strether Post author

      Thanks. I especially liked discovering that Sebelius was telling the same lies as Obama, in almost the same wordsd. So it wasn’t just Obama fecklessly making shit up for the mere pleasure of it — certainly a plausible hypothesis — but a coordinated disinformation campaign. Good to know!

  12. dbak

    Johnny GL
    Out of pockets costs are not the same as deductions. If his insurance at 90 percent leaves him with 10 percent of the cost of the total expenses for a year this amount cannot exceed $750. there are copays involved for things like prescription and doctor visits but they add to the out of pocket. In the state of Michigan medicaid is limited to parents of children. He is not eligible. Lambert likes the word obot. I.can think of a better word for him. It starts with a T.

  13. Joe Firestone (LetsGetitDone)

    Great post! Only one thing I disagree with, and that’s the $400 Billion per year savings estimate. The latest careful study from Gerald Friedman here: says that HR 676, enhanced Medicare for All would save $592 Billion per year in health care costs. In addition, I think the wonky, accounting-oriented estimates of how much can be saved, even includig Friedman’s efforts are deceptively mechanical and precise, while hiding easily accumulating errors in the various categories used to arrive at an estimate.

    I think a loose, less accurate, but more valid is the right one to take in estimating likely savings. Here’s what we know:

    1. The US spends about 18% of GDP on health care. Since it’s not deficit spending, it comes out of private sector pockets.

    2. Our GDP was at roughly $17.1 Trillion, according to BEA estimate so our medical costs are now up to roughly $3.1 Trillion annually.

    3. Canada spends about 12% of GDP on their Medicare for All system. Theirs is the most expensive system other than ours as a percent of GDP, and, if anything, our proposed national system under HR 676 is likely to be more efficient in the long run than is Canada’s provincially-oriented MFA system. Nevertheless, let’s assume that 12% of GDP is the best we can get from a shift to MFA. Note also that Canada is probably the most similar country to the US in the world today culturally speaking.

    4. Then $17.1 T X 0.12 = $2.1 T in MFA costs. That amounts to savings of $1 Trillion per year, based on those assumptions. Are they correct?

    5. The main barriers I see to this happening if HR 676 were passed is political factors organized around efforts of providers to maintain the inflated prices for services we see now. But over time, the monopsony factor is likely to win the day and slow down the annual increases in provider costs we’ve been seeing, and think that factor will eventually allow the US to get to that at least 12% of GDP we ought to have.

    Anyway, that’s the macro approach. It may not look as authoritative as Gerald Friedman’s more micro-based approach to estimation; but I think it makes more sense to reason from the experience in other nations that have tried MFA than to base our estimates on micro-analysis that relies on a categorization of types of expenses without taking into account the possible effects of monopsony on the system.

      1. Joe Firestone (LetsGetitDone)

        No. It’s better to go with one’s best estimate than it is to put in a conservative margin. In politics we are not researchers or bankers who get brownie points for being modest. Let’s say what we really think, and see if they can show we’re wrong!

    1. Katniss Everdeen

      MONOPSONY??? Really, Mr. Firestone????

      For those of you who may have been as baffled as I was, here is (Read to the end, if attempting to understand this post.)

      Definition: Monopsony is a state in which demand comes from one source. If there is only one customer for a certain good, that customer has a monopsony in the market for that good.

      Analogous to monopoly, but on the demand side not the supply side.

      A common theoretical implication is that the price of the good is pushed down near the cost of production. The price is not predicted to go to zero because if it went below where the suppliers are willing to produce, they won’t produce.

      Market power is a continuum from perfectly competitive to monopsony and there is an extensive practice/industry/science of measuring the degree of market power.

      Examples: For workers in an isolated company town, created by and dominated by one employer, that employer is a monopsonist for some kinds of employment. For some kinds of U.S. medical care, the government program Medicare is a monopsony.

      So, was “single-payer” just too low-brow? This kind of stuff REALLY pis**s me off.

      Rant off.

      1. Joe Firestone (LetsGetitDone)

        The point of using “monopsony” was that it emphasizes the favorable bargaining position of the single demand source in relation to the providers. That’s exactly what I wanted to because that’s why single-payer is effective in cutting costs. The providers have nowhere else to go if they want to work. That balances off the economic advantage they have in negotiating with people who badly need their help. And that’s the way it should be. Don’t worry, the Doctors in such system apparently make more than a decent living. They just don’t get a chance to be plutocrats anymore, and must be content with their original, presumably altruistic motivation for entering the field of health care in the first place.

  14. Fred Housel

    Hi Kate,

    I am going to abuse your invitation to contact you with an update on my healthcare saga in the ACA. Thanks for your patience.

    As I explained in my last letter my Lifewise “catastrophic care” policy was canceled when it did not meet the mandated requirements of the ACA. Without thinking about it too much (mistake!) I signed up w/Lifewise’s parent corporation Premera for the cheapest possible substitute…a Bronze HSA plan with a premium increase of about 40% (there goes the first “A”). And I signed up my mate for the same plan. We chose Premera because it covered our little local hospital in Friday Harbor. Perhaps not surprisingly the agent happily pointed us to the 100 page list of doctors who accepted the new coverage. There is no list of who does not. This I had to discover on my own…When Marita found out that Swedish Hospital system (one of Seattle’s best and where she had always been covered in the past) did NOT accept our new plan I got a bit grumpy. I did a little further research and found out how appallingly limited Premera’s network for its “metallic” plans is. Children’s Hospital in Seattle isn’t covered. The University of Washington Hospital system including Harborview Hospital (w/the only burn care center in the State) isn’t covered, and, of course, Swedish. There goes the “C”. I guess “Act” is all that is left. Yes, I have been acted on.

    I’m sure you realize how dangerously uncovered this leaves us. If I were to be severely burned and be so unfortunate to be taken to Harborview I am subject to unlimited liability for the bill. I doubt I would be in much shape to “shop” for coverage in the neo-liberal paradise of the “free market”. I will let you imagine all the new ways in which my considerable fortune might be exhausted in short order. Now please remember, one of the reasons for the ACA was to protect me from “junk” insurance! Premera and Lifewise are the largest insurance carriers in the State…by far. So I am left with my little local hospital that is a subsidiary of Peace Health of Bellingham. You may know this is a Catholic provider. The doctors and staff are bound by the Bishop’s “Ethical and Religious Directives”, that is to say, whatever healthcare the Bishop thinks his god approves of. Not mine…his. And he thinks god is a man…Never mind that the hospital is ALSO funded by a local hospital district funded by public taxes. So much for the separation of church and State.

    So. We will be switching to Regence, an insurance carrier with a wider network (I hope). That will, at least, allow Marita to get her mammogram at the office where she has been getting them for 20 years. But we are “informed” consumers. How many people will celebrate their new coverage with the largest provider by going bankrupt when they are burned? How many will understand (or can “afford”) the responsibility for the first $12,000.00 of their healthcare (premium + deductible)? Who, in their right mind, could see this as an improvement?

    We have managed to make a bad system even worse by adding a huge perverse incentive to do without insurance at all, for employers to have a staff of 29 hr./week workers and never more than 49 of those…to complicate an already baroque insurance product w/copays, deductibles, limited networks and religious prohibitions. Is my despair convincing?

    There was, and is, a simple solution, the one they refused to mention, the “public option”. Allowing people to “buy in” to Medicare, or, even better, to extend Medicare to every citizen and tax the people to pay for it. Universal coverage, the elimination of 15% overhead, the end of the Premera CEO’s $4 million dollar salary. This is doable. Perhaps not all at once. The Medicare buy in would be a fabulous first step. The ACA is definitely going to be reworked as the inherent difficulties become manifest. I urge Rep. Larsen to stand up for a solution that benefits his constituents, not the corporations whose money is speech in our Brave New World.


    Fred Housel

    1. Lambert Strether Post author

      Great story, but: There is a special place in hell for the career “progressives” who propagated the “public option” magic zombie sparkle pony. For the history, see here and here.

      * * *

      If you want to think through the public policy implications of the “public option,” just imagine a “Retirement Marketplace” where Social Security is “the public option” amidst the all the 401k scams. Because that’s where the logic leads. The “public option” is an especially virulent delusion exactly because it sounds so innocuous.

  15. dbak

    The only thing more stupid than supporting democrats is to vote republican as your state consistently does. I am fully aware if the GOP gains control of the government in 2016 they will do everything they can to kill ACA. Do you really think they will come up with any plan at all. Yes my son does get a government subsidy of about $220 per month not unlike many industries in your area receives. Its called a tax break,something that republicans are addicted to. As far as raising insurance rates this happens every year. My own insurance has gone from 100 dollars to 500 in the last several years and I’m in a group plan. Could ACA have been better? No doubt but consistent opposition from sources with a vested interest in killing the who idea with large amounts of money were the main cause. I’ll let you guess who those interests were.

    1. Katniss Everdeen

      OK, I didn’t call you “stupid,” and I didn’t say I lived in Iowa. And I certainly never mentioned the word “democrat.”

      Isn’t it just POSSIBLE that you misinterpret the ACA in the same way that you misinterpreted my comment?

      I’m not the enemy.

  16. Dbak

    Tell me about yourself. You seem to have an awful lot of time to nitpick ACA.
    Do you have a job of some kind? How old are you? How much money do you make? Do you already have healthcare? You may think this is none of my business, but since you continue to insult me and criticize my viewpoints I’d like to have an idea of what I’m up against. I don’t really expect you to respond, it’s much too easy to hide behind an internet wall.

    1. Yves Smith

      This is a direct effort to undermine the credibility of the post author, and nasty to boot. That is a clear violation of our written policies. This is private hosted space and commenting is a privilege, not a right.

      If the best you can who try to defend Obamacare can do is stoop to the worst sort of personal attack, and not deal with arguments on their merits, it’s an de facto admission that you can’t make a good faith rebuttal.

      1. allcoppedout

        I’m still wondering what an Obot is. Or how I might describe Lambert in a term beginning with T. ‘Trebmal’ has appeal given my dyslexia. Lambert is actually short on credibility, at least as exuded by the politicians he exposes in this post. I doubt he’d drink the stuff the credibility politicians use to excrete the stuff at we the credulous.

        UK NHS GDP spend is half that of the US and you can top up to private care if you can afford it. This is no doubt a less relevant fact than Lambert’s salary in the debate, but for some reason it Googles more easily. William Beveridge, who more or less devised our social security and NHS systems was a toff and Fabian lefty, yet invited by Churchill to do the work. Beveridge was even a prominent eugenicist. Personal credibility has little to do with argument other than in our repeated use of it as a means of decision because we can’t follow argument.

        Now, Lambert, do tell. Do you believe in fairies and have you lived with your mother all your life? These were the ‘personal qualifications’ of Hugh Dowding, the chap who ran Fighter Command in the Battle of Britain.

        1. NotTimothyGeithner

          “I’m still wondering what an Obot is.”

          Do you think this is a clever question or did you just discover the internet? The term “Obot” has been in use for quite some time. It likely goes back to the Hillary/Obama pie fights on Daily Kos which were quite nasty, and I’m assuming the creators of the term were referencing the GOPbots who would receive marching orders to swarm websites with misinformation and personal attacks whenever a Republican had an issue, much like how the OFA operates.

          If you need me to explain how Obot is a combination of “Obama” and “Robot,” I would have to assume you are very young or don’t speak English as your first language and miss the way native English speakers tend to coin words and produce slang. For most English speakers who are reading political-type blogs, they are able to understand what “Obot” means without needing an explanation. Do you need further clarification?

          1. allcoppedout

            I was merely supporting Lambert in the deconstructive margin NotTim. A sophisticated reading of even academic text revels a lot of ad hom at work, and in philosophy it is not now regarded, necessarily, ,as a fallacy. Rather, we regard the “eristic” as a ninth component of argument.

            Calling people Obots is ad hom. Of course, I may be sitting here in a smock, chewing on straw as a yokel, not being able to put the terms Obama and robot together as you suggest. The points, of course, are that even if Lambert did live with his mother and believe in fairies this would have no bearing on what he is saying on the health care farce in the USA, and that ad hom is often present, even silent in what passes as debate.

            Mines a pint of cider. That’s what yokels drink.

    2. Lambert Strether Post author

      What a crude attempt at deflection. The post speaks for itself, and I have little inclination to accept an assignment from you to provide material for ad hominem attacks. Smarter Obots, please. Check with your supervisor if you need help with any of the terms I’ve used.

  17. Hugh

    The ACA was a watershed event in that it showed that the Democrats as a party were corporatist and anti-progressive to their core. It contradicted once and for all the myth of the Good Democrat. It also showed up much of the progressive blogosphere for the dumb clucks and shills they really were. The ACA didn’t just sneak up on them. It unfolded over a year in all its seamy convolutions. At the end of it, Obama had been pushed around, forced to compromise, and out-maneuvered on nearly every point into a bill that looked exactly like the one he had originally wanted, minus the “public option” (which he had never wanted).

    Progressives had been deeply split between those, like lambert, who were right on single payer, the ACA, and Obama from the start and those who were exposed as Democratic operatives, wannabe political players, or just not real bright. Since this second group was comprised of the largest blogs and leading voices in the left blogosphere, the deception of the ACA left wounds from which the left blogosphere and the progressive movement have yet to recover. This is especially true when you consider that those who were most burned by the con of the ACA have still not broken with the Democrats, four years on.

  18. David Morris


    With regard to your statement about 40 million people still being uninsured in 2017 under the ACA, the estimates of total uninsured in 2014 are in the range of 50 million. Before the Supreme Court got in the way, the potential for Medicaid and CHIP expansion was in the range of 25 million. Of the 14-17 million individually insured, subsidies would cover something like 10 million. Which leaves about 15 million. It is unclear where the 3 million kids who are now covered by their parents health insurance to age 26 fit in. There is also the assumption that those uninsured who earn over the $95k a year or so needed to be subsidized would find a policy via the exchanges that would lead them to become insured although I can’t find any numbers for such estimates.


  19. David Morris

    Regarding your statement about 40 million people still being uninsured in 2017 under the ACA, estimates of total uninsured in 2013 were in the range of 50 million. Before the Supreme Court got in the way, the potential for Medicaid and CHIP expansion was in the range of 25 million. Of the 14-17 million individually insured, subsidies would cover something like 10 million. Which leaves about 15 million. It is unclear where the 3 million kids who are now covered by their parents health insurance to age 26 fit in to these numbers. Most also assumed that those uninsured who earn over the $95k a year or so needed to be subsidized would find a policy via the exchanges attractive enough to lead them to become insured although I can’t find estimates of how large that number was projected to be.


    1. Yves Smith

      I suggest you click thorough on the link. The source of the estimate is the Journal of Health Affairs, which puts the uninsured under Obamacare at 30 million, a higher number than the CBO’s estimate of 26 to 27 million. Joe Firestone adjusts that for population growth.

      And contrary to your assertion, had you bothered to check, the Washington Post article that summarizes the Health Affairs article stresses that the uninsured will not be the affluent, contrary to your claim:

      This analysis suggests that the uninsured under Obamacare will be heavily low-income, even though many of those people will have access to subsidized health insurance. Still, some might not find it affordable, and the health care law does allow for an exemption from the individual mandate for those who cannot find affordable coverage (defined as insurance that costs less than 9.5 percent of an individual’s income).

  20. Sanford Calef

    Certainly Medicare for all would have been best.
    Certainly ACA has issues.

    However… is better than the nothing we had before.
    And certainly better than the less than nothing the Republicans offered.

    If folks want to change healthcare for the better….
    We need more liberals elected.
    Since THAT isn’t happening….might as well chew on the bone we got,
    instead of complaining that we didn’t get steak.

    1. Lambert Strether Post author

      It will certainly never “happen” if we don’t make it happen. For myself, I’m tired of bring asked to vote for evil, and even more tired of people who are surprised or distressed when they get what they voted for.

      1. Oregoncharles

        And your alternative is? I know what mine is, but I’d like to hear yours.

    2. Joe Firestone (LetsGetitDone)

      Naaaah!!!!!! You’re ignoring the opportunity cost. If the Ds had gone to the mat over MFA, and been defeated, then they would have had something to run on in 2010 at a minimum. They would have won and then, assuming they kept their commitment, we would have had MFA by the end of 2011. The consequences are these:

      It would have been much better to push for MFA, and then, if necessary compromised on age of eligibility, say over 45 and under 26, other age groups for the year after.

    3. Jackrabbit

      “Certainly” its best for those who would con us that we ignore history – like the many times that “shared sacrifice” was just a scam.

      In the 80’s the “greed is good” mantra took hold – promising a brighter future via a buyouts that restructure the American economy (which still goes on via PE). Who reaped the benefits of that greed? After the Cold War we heard about a glorious “peace dividend”. In whose pocket did those dividends flow? And these are just some of the more obvious examples of why people should CERTAINLY NOT accept the ‘lesser evil’ from those who do nothing more than shovel sh!t.

      1. Jackrabbit

        And of course, GFC and ACA are just more fleecing from the lunatics who really are in charge of the asylum.

  21. Lafayette

    LS: The facts: The PPACA (“ObamaCare”) does not cover “every American,” as was known when the law was passed. In 2017, as many as 40 million could still be uncovered.

    Oh, come on – cheap shot.

    ObamaCare is what the guy could get from a Replicant HofR that told him to take his Public Option and shove it up a dark place.

    LS is barking up the wrong tree journalistically; and if he thinks politics is easy good -fun, he should try a little himself rather than sniping from the sidelines …

    1. Joe Firestone (LetsGetitDone)

      Have you read the discussion thread. We’ve already made it quite clear that the barrier to Medicare for All was Obama and not anyone else. Sure, there would have been resistance n the House in early 2009; but Pelosi had control of that and would have put up anything Obama wanted. As for the Senate we’ve already explained that Obama could have lost 8 or 9 votes from Ds there and still passed MFA. If you care to address our arguments about these claims you’re quite welcome to do so. But just don’t repeat unsubstantiated opinions that we’ve already refuted without addressing what we’ve said. That’s just talking past us rather than engaging in rational discussion.

    2. Oregoncharles

      “a Replicant HofR” – you really don’t know that the Democrats had lopsided majorities in BOTH the House and the Senate in 2009?
      Feel free to rejoin the discussion after you’ve had a 9th-grade education.

  22. Lafayette


    Whether you like it or not, ObamaCare is what you get – it’s greatest fault being that it is based upon Private Insurance.

    The Public Option was akin to the National Health Services of Western Europe and in other “developed economies”. It is the only really viable means for providing socially-fair health-care equitably across a large population.

    But our Replicants in the HofR were having none of it, puppets that they are of our Plutocrat Class to which most of them owe the financing of their election. Money does not just talk in American politics, it shouts!

    Rather than moaning about how “bad” ObamaCare is, was or ever will be, let’s focus on getting more progressives into the <a href= Congressional Caucus – which is the single largest political bloc in Congress. And it only contains about 15% of all Dem reps in the HofR.

    The way to more Social Justice in America is through the ballot box. That’s where we get the sort of progressive representation that can truly reform America – doing away with its present injustices like Income Disparity and highly expensive Health Care as well as very costly Tertiary Education.

    All three of which keep 15% of American households below the Poverty Threshold – that is, 50 million men, women and children – in which they presently must subsist.

      1. Nathanael

        The most important problem in Congress is apparent when you look at the membership of the Congressional Progressive Caucus, and realize that it has ONE member in the US Senate — and that member is Bernie Sanders, who isn’t a Democrat.

        If you want to vote for progressives, you may be able to vote for Democrats in the House, but in the Senate, apparently you have to vote third party.

  23. Joe Firestone (LetsGetitDone)

    The Public Option was akin to the National Health Services of Western Europe and in other “developed economies”. It is the only really viable means for providing socially-fair health-care equitably across a large population.

    Not so, the NHS provides both insurance and health care to all who want it as an entitlement. The public option was only a Government provided insurance plan which would have been set up to compete with private insurance plans in the market. That’s not even a single payer enhanced Medicare for All plan as in HR 676.

    As for the progressive caucus, they are a joke. They had some 85 people in 2009-2010 Congress, and the all caved in to a Republican originated plan without even making the Republicans vote for it, rather than insisting on Medicare for All. They could have gotten Medicare for All if they had pushed the President and the leadership into a corner and said they would not vote for anything else. Grijalva is absolutely gutless. Lynne Wolsey, is co-chair at the time was always under Pelosi’s and a wet noodle to boot, and everyone else in that caucus buckled under including Conyers, Kucinich, and Alan Grayson. We don’t need anymore progressives like these people. What we must do is to vote every incumbent out, while making clear that none of them have been representing us, and also making it clear that we wil continue to do that until the incumbents start representing most of the people all of the time..

    1. Lafayette

      Not so, the NHS provides both insurance and health care to all who want it as an entitlement.

      Agreed: I said “akin”, meaning “of similar character”. I did not say “identical”.

      Get a dictionary.

      They could have gotten Medicare for All if they had pushed the President and the leadership into a corner and said they would not vote for anything else.

      Not a snowball’s chance in hell. The Replicants would have been VERY PLEASED to stonewall it in the HofR. Americans would have got nothing/niente/rien/nichts/tipota as government subsidized health-care (beyond Medicaid).

      As for the progressive caucus, they are a joke

      You would do what? Storm the Bastille?

      Thanx for our daily-dose of puerile negation … unless, of course, you’re shilling for the Replicants? Voila!!!

      1. Joe Firestone (LetsGetitDone)

        First, it’s not “akin.” The public option s a neoliberal compromise proposal to make a market-based solution to national health care palatable to “liberals.” It was a trojan horse designed to stop them from pushing for either National Health Insurance through Medicare for All, or National Health Care through an NHS type program. The distinctions between a public option, MFA and NHS are critical distinctions and not one of these is “akin” to the other.

        Second, in 2009 – 2010, the Republicans couldn’t block a damned thing in the House. They were in an even worse position than the Democrats are today. If Obama had wanted MFA it could have had it passed in the House within ONE WEEK after the passage of the ARRA. Conyers perpetual HR 676 MFA bill was introduced in January of 2009. All Obama had to do was to ask Pelosi for an up or down vote on it and apply party discipline to that vote. Then the Senate would have had the bill sitting on their plate, making things very difficult for any Democratic Senators who had run on Medicare for All for years not to pass it. As I said earlier, If Reid had gotten rid of the filibuster by then, which he would have done if Obama had called for it, there’s no way it would have been defeated.

        Third, yes the progressive caucus is a joke, but that does not mean there are no alternatives using the electoral process that will work, or that I am advocating “storming the Bastille,” though I hope you do understand that both actual revolutions and threats of revolution in the background have been historical forces advancing the cause of democracy all over the world. So, when tyranny develops to the point where there isn’t any alternative, then that is what decent people with a love of freedom will do. I hope I don’t have to go any further by quoting the Declaration of Independence for you.

        Apart from this, however, we have many recourses to pursue right now besides the gutless and toothless progressive caucus. Here are two. First: and Second, see the series ending here:

  24. allcoppedout

    I have to support Lambert’s view on being sick of voting for evil. We don’t get enough information in the UK to comment on the who has done what aspect of US domestic politics. We can empathise with the not being able to vote for choices that matter

    The baselines in the health debate are drawn in ideology. I find it easy to agree with Joe or Lambert and would like to see a US NHS. This would remove some of the dreadful threat of white collar crime (an old Red Feather view) in the US and also the constant drive to open up European health to the insurance and medical gangsters (though NHS fraud runs somewhere between 7 and 15%). What’s lacking is any politics in which any leader in the US can stand up and say, ‘look, even in backward Britain they manage pretty well on a health care spend half of ours’.

    What we aren’t understanding is how they have so many we don’t agree with as turkeys voting for Xmas. The evidence is obvious to us. I’d say the facts. Yet what are we doing in our beliefs here? Part of it is projecting the opposition as ‘idiots with the wrong world view’, much as CalPERS defames Yves as obsessive (and the rest). How anyone not in the top 5% of wealthy could not want an NHS free at point of use is beyond me. And how anyone in the top echelon be so mean as to deny what is obviously an achievable practice makes me wonder what state of deluded evil they live in. Yet grounds for consensus hardly lie in thinking of others such.

    Lambert has banged on, quite rightly, on the fact even “our side” is part of the problem and making false claims. Yet in the autopoetic (a yokel term Tim) world, how do we work our way through various hegemonies of self-interest? Gramscians might talk of moving from common sense to good sense here. Yet point me to the forum for such persuasive discussion. In more Freudian form we’d be talking of organisations as hot beds of projections (tell me this isn’t true of our clown politics). All such intellectual systems require an education similar to science – you really can’t see the data without the ability to spin in theory.

    In short we are operating as though persuasion by argument happens. There is little evidence this is the case. The UK NHS was formed (as far as an individual ever does anything like this) by a eugenicist, who In 1909, proposed that men who could not work should be supported by the state “but with complete and permanent loss of all citizen rights — including not only the franchise but civil freedom and fatherhood”.

    Even socialists had vile views on the underclass (GB Shaw) and Keynes thought eugenics the most important science. I suspect those who are against decent health care for all harbour vile views. These are hardly as inconsequential as Lambert having a tea-party every night with the pixies at the bottom of his perma-garden (please people, I don’t believe this and would ask for an invite if I did). I suspect most of us would fess up personal things that are no business of other people if we thought them important in the argument. The problem is that there are many personal protocols that are important in the argument that remain “secret”. People need to be encouraged to bring them out for Wittgenstein’s version of therapy. This is not an FOI request on “Lambert’s pixies”. It’s about respect for the opposition and ourselves in breaking the set. The opposition is winning the dark argument hands down, and slapping down the ad hom writ is not the answer.

    1. Joe Firestone (LetsGetitDone)

      Actually, I prefer enhanced MFA for now, to an NHS type of program. MFA has been just about as successful as NHS where it’s been tried. Some would say that it’s worked better in Canada and Australia then NHS has worked in the UK. So, since MFA has been working well where it’s been tried, I see no reason to go to NHS since that would be a heavier political lift.

  25. tongorad

    Dean Baker shilling for Obamacare –

    “…the Affordable Care Act (ACA) may be providing security to workers they did not previously have. By allowing people to get health insurance through the exchanges, workers no longer feel tied to their jobs. Due to the ACA, workers who have jobs they dislike can quit and look for a better job without worrying about losing insurance coverage.

    The March jobs report provided some evidence that we are beginning to see the sort of labor market shifts from the ACA that would be expected. First, voluntary part-time employment in March increased by 230,000 to 18.9 million.

    It is reasonable to think the number of people opting for part-time employment would increase under the ACA because many people were previously forced to work full-time in order to get health insurance through their job. Since the ACA allows people to get health insurance through the exchanges, many people will decide to work fewer hours.”

    Who’d of thunk it, high premiums, high deductibles and shitty coverage – a boon for workers!
    Just goes to show you how out of touch these “progressive” goons really are.

  26. Lambert Strether Post author

    Kind of amazing, except not, to watch the Obots dragging this thread onto the “lesser evil” permathread without addressing one of the key facts shown by the post: The Democrats, and the Democratic nomenklatura, wouldn’t know the truth if it bit them in the absolute majority, and this is true from the top down; seeing Sebelius repeat Obama’s lie on “keep your doctor” is an especially juicy example of this. How a party with foundational problems like that expects to govern in the long term is an interesting question, and shows how useful the Republicans are to Democrats as a foil, to keep the kayfabe moving. From the outside, it all looks as sclerotic, decayed, and corrupt as the former Soviet Union, another imperial police state of continental scope that people thought was a permanent part of the landscape, and that collapsed when people no longer believed in it.


    Shorter: Democrats, “moral commitment.” BWA HA HA HA HA!!!!

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