Category Archives: The President

What Obama’s Done For You Lately: Lower Insurance Premiums

The number of people who love health care reform plus the number of people who hate health care reform is considerably larger than the number of people who actually understand health care reform. John and Jane Q. Public were outraged that Congress voted on a bill that “they hadn’t even read” although Mr. and Mrs. Public didn’t read it, either. It’s unfortunate, because the Affordable Care Act, despite some of its shortcomings, actually does a lot of wonderful things. One of those things is put some regulations in place on the health insurance industry.

In particular, the ACA requires insurers to be more transparent about how they’re spending your premium dollars and places caps on the rate at which insurers can increase your premiums. This might not seem like a huge deal to you at first, because most of us get our insurance through our employers, and our employers pick up the majority of the tab, but according to the Department of Health and Human Services, these regulatory provisions are adding up. According to a recent report, the ACA has saved consumers $2.1 billion over the last year.

The savings come from two different provisions of the law. First, insurers are prevented from raising their premium rates by more than 10% without submitting public justification for the rate hike and receiving approval from state insurance departments. This, according to HHS, has slowed premium growth and saved $1 billion since September 2011. Second, the ACA requires insurers to devote at least 80 cents of every premium dollar to providing health care. This also provides an incentive for insurers to hold rates down, but more importantly, it puts money back into consumers’ pockets. If an insurance company doesn’t meet the 80% threshold, they have to refund the difference to their beneficiaries. This, according to HHS, adds up to another $1.1 billion since September 2011.

Of course, most of us probably won’t be getting a refund check in the mail, but those who do can expect it to average around $151. So, what has Obama done for you lately? Well, for many of you, go look in your mailbox, because his administration may just have arranged for you to get a refund check from your insurance company. If there’s anyone out there who doesn’t like that, might I suggest that you cash your check, send me the proceeds, and vote for Mitt Romney?

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Posted by on September 13, 2012 in Private Insurance, The President


The Supreme Court Ruling Is Finally Here

After many months of speculating on the outcome of the Supreme Court’s ruling on the Affordable Care Act, the decision was finally announced today. The ruling essentially upholds the entire Affordable Care Act as constitutional. While this is certainly the outcome that I had been hoping for, I am also convinced that it is the correct one. I haven’t read the dissenting opinions yet, but I’m anxious to see how they justified that. I, for one, am glad to have this piece of the puzzle put in place, because it helps us to move forward with the goal of improving our health care system. Call it the ACA or call it “Obamacare” it is the constitutional law of the land, and there is no appealing that, so perhaps it’s time to get used to it, and figure out how to make it work for you.

That said, while Supreme Court majority and dissenting opinions are not terribly complex, they do have to be read rather carefully to be well understood. Perhaps that explains why CNN made me nauseous with its incorrect headline proclaiming “Breaking News: Supreme Court Strikes Down Individual Mandate” for about 10 minutes before it got the story straight. I just printed out the opinions, all 193 pages of them. I’m not surprised that someone skimming got it wrong in their attempt to be first, but they should have sensed something when they saw Chief Justice Roberts aligning with Justice Ginsburg.

Rather than exercise a similar rush to judgment, I’m planning to spend the weekend reading through everything and formulating my thoughts, which I will post here on Monday. For now, I’m going to go bask in the glow that comes from a conservatively appointed chief justice putting the law before partisan politics. This has renewed my faith in America a little bit.


Would More Americans Support Health Reform If Obama Was White?

Would more Americans support health reform is President Obama was white? According to a recent study conducted by Michael Henderson of the University of Mississippi and D. Sunshine Hillygus of Duke University, the answer is yes. The researchers modeled changes in support of health reform between 2008 and 2010, and what they found was striking. According to Henderson and Hillygus, among a group who supported health reform in 2008, whites were 19 percentage points more likely than blacks to be opposed to health reform by 2010. Keep in mind that this race effect is seen after controlling for party affiliation and political ideology. It also controls for income, age, gender, education, and worry over the cost of health care. Said another way, this race effect isn’t likely to be biased by the usual suspects.

Moreover, the researchers included a measure of racial resentment, and those with the highest levels of racial resentment were 29 percentage points more likely to go from supporting health reform in 2008 to opposing it in 2010. These effects are additive. That means that whites with high levels of racial resentment are a whopping 48 percentage points more likely to switch from supporting to opposing health reform in the course of two years, compared to their black counterparts with low levels of racial resentment. That’s a big deal, to paraphrase Joe Biden for a general audience.

That doesn’t mean that people’s concerns over health reform aren’t legitimate. It’s perfectly reasonable to be opposed to an individual mandate, for example. The question opponents of health reform need to ask themselves, though, is how they would feel about the Affordable Care Act if the man who signed it into law looked like them. I don’t think opposition to reform would disappear–after all, when Clinton tried to pass reform legislation in the 1990s, it failed spectacularly–but I do think the tone of the debate would have been a little different, and I don’t think we’d be seeing the continued opposition after passage that we’re seeing now. Just look to the recent past for proof: Medicare Part D is all the evidence you need that a white President can pass a budget-busting piece of legislation without so much as a second glance from the American people. If George W. Bush had been black, perhaps America’s seniors would still be without adequate prescription drug coverage.




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How Wealthy Should America’s President Be?

I’m venturing away from health policy for a moment and into the world of politics more generally, and with that I feel the need to make it clear that I am not endorsing any candidate through this post. Rather, I want to pose the question: How wealthy should America’s president be? The fact of the matter is that no one with truly modest finances has ever actually been elected president. That’s because getting elected requires education, intelligence, work and leadership experience, connections, and campaign finances. The positive association between these things and wealth is generally strong. So, a wealthy president is likely to excel in at least some of these other areas that we consider integral to effective executive leadership.

But presidents are also supposed to be accountable to the public. That’s why they are elected, not appointed. That’s why we have term limits, not dictatorships.Yet how accountable can someone be when they cannot even begin to relate to the average member of the populace? In other words, is there a point at which a candidate’s wealth stops being an indication of their fitness for the office and starts becoming an indication that they are out of touch with mainstream America? Again, all presidents are “different” from the majority of us, and in that sense, they are all at least a little bit out of touch. But might some be far more out of touch than others, and might wealth be a good way to tell them apart?

If so, Mitt Romney looks to be so out of touch with America that he ought to just pick up and move to the colony that Newt Gingrich wants us to build on the moon. According to a recent Associated Press article by Connie Cass, Mitt Romney’s wealth is approximately double that of Richard Nixon’s, Gerald Ford’s, Jimmy Carter’s, Ronald Reagan’s, George H.W. Bush’s, Bill Clinton’s, George W. Bush’s, and Barack Obama’s, combined. Considering for a moment that Obama alone is worth something like $5 million, that’s pretty astounding.

Indeed, Romney may be worth up to $250 million. There is discussion of the fact that even though he no longer works, he earns more in a day from capital gains (investment income) than most Americans make in a year. I’m afraid that he can no more identify with my financial situation–or that of tens of millions of Americans who have it far worse than me–than I or they can identify with his financial situation. Seriously. I can’t even begin to know what I would do if I made over $50,000 a day. I wouldn’t have to work, that’s for sure. Perhaps I’d run for president.

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Posted by on February 3, 2012 in The President


Presidents and Health Reform: Quote 5

“The Republican counter to the Clinton plan, sponsored by Republican Senators Bob Dole (R-KS) and John Chafee (R-RI), is now known as Obamacare. Moreover, the largest extensions of Medicare came from our most conservative presidents, Ronald Reagan (catastrophic coverage) and George W. Bush (prescription drugs). If the fledgling Obama reform survives, Republicans may very well feel the pressure to defend, protect, and even expand it.”

Somebody, somewhere just fell out of their chair. But, again, this is all true. Here’s the thing: party platforms do shift over time. Today’s conservatives are ultra-conservative by comparison to their predecessors. If you don’t believe me, read this. So, the fact that the health care reform that, with a great deal of compromise–even if it was all within the Democratic party–became law, looks so much like Republican plans from the Nineties isn’t too far-fetched.

The most interesting thing, though, is that the passage of health care reform means a new status quo. And, as the quote indicates, after enough water has passed under the bridge, people will be less concerned with which party passed the original legislation and more concerned with what’s happening with it today. Even though not a single Republican voted for the bill, they probably won’t find it too popular to repeal. In fact, several polls are already bearing that out. On the contrary, they’ll probably feel compelled to leave their mark on the program. After all, if they can expand the program when they’re in power, they’re likely to be all for it and the political capital it will garner them. As I’ve said before, a lot of the opposition stemmed not from opposition to the substantive policies, but from an aversion to letting the other team score political points.

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Posted by on July 19, 2010 in The President


Presidents and Health Reform: Quote 4

“The implementation of this complicated legislation introduces almost as many challenges as passing it did–and will be just as crucial to the program’s success. However, implementation introduces a very different kind of politics largely outside the media spotlight, without the dramatic votes or tight schedules.”

Oh, man, is this a key point. A lot of people seem to assume that the health reform law marks the end, when it is much more of a beginning. Of course, you can’t fault those people, because as the quote acknowledges, the media’s coverage of health reform has all but ceased entirely. That stems from the absence of a dramatic story–there are no back-and-forths between Senators, or looming deadlines for down-to-the-wire votes. In a sense, the “sport-like” aspects of politics have ended, and with it, the public’s interest. Perhaps more accurately, it’s shifted to the upcoming mid-term elections and the idea that some Republicans are running on promises of repealing the legislation–the idea of a contest sparks public interest.

I might disagree to an extent with the idea that tight schedules are no longer. Because the legislation wasn’t amended in conference committee, there are a number of dates specified in the legislation that the Department of Health and Human Services is working around the clock to try and meet. I would not say, however, that the public is generally aware of these efforts in the way they were aware that the Senate would be voting on health reform on Christmas Eve. So perhaps that’s the point.

But the real substance of this quote is that the nature of the politics now playing out has changed. It’s no longer a debate in the public domain. Instead, the HHS staff are busy drafting rules and regulations to flesh out the broad authority contained in the law. This is a lengthy process, and one in which lobbying arms of various stakeholder groups will make comments (i.e., raise objections) about proposed regulations. This tug of war can go a long way in determining what health reform actually looks like at its implementation. But most Americans aren’t familiar with this process, and would be quickly overwhelmed by its detailed complexity. These next steps matter, but they will all take place behind the scenes.

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Posted by on July 16, 2010 in The President


Presidents and Health Reform: Quote 3

“In the past, opposition came from well-oiled, deep-pocketed corporate lobbies. This time, with many of those corporate stakeholders explicitly in favor of health reform, the opposition exploded from the grass roots. Moreover, the inevitable wheeling and dealing–there is no other way to pass legislation–was easily ridiculed by the bill’s opponents.”

Talk about loaded quotes. The only thing is, it’s entirely true. In the past, it was the likes of the American Medical Association that led the opposition to health care reform. Not so this time around. In part, that was because the Obama administration reached out to these groups in order to neutralize them. That gets to some of the “wheeling and dealing” in the quote, but more on that later. The corporate lobbies also came on board, because the amount that the corporations they represent were paying for health care was eroding their bottom lines, and they figured that something had to give. When they expected reform to be inevitable, they saw it as in their best interests to be involved in shaping it rather than fighting it.

But with the traditional opposition out of the picture, the grass roots opposition appeared. Perhaps that’s in keeping with the principle that nature abhors a vacuum. When the corporate lobbies backed down, the people stood up in their stead. But that forces one to ask the question: If the corporate lobbies saw fit to change their tune, why didn’t the people? I think the answer to that one is that the people aren’t as acutely aware of the realities of our health care system and the need for reform. They got caught up in the politics of the matter rather than the substance of the policy.

Finally, there’s the inevitable wheeling and dealing. It might sound cynical to some, conjuring up notions of our political system as a corrupt body where votes are sold, kickbacks are commonplace, and ethics are absent. To be certain, not everything that happens in Washington is above board, but that doesn’t mean that deal-making is always inappropriate. Our system is simply rigged with too many checks and balances–places in the process where breakdown can occur–that without careful negotiations nothing would ever happen. Ironically, many of the people who say “Congress never does anything” are the same people who say “I’m tired of all these back room deals in Congress.” Which do you want? A Congress that never makes back room deals or one that never gets anything done? Because you can’t have your cake and eat it, too.

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Posted by on July 15, 2010 in The President

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