The numbers may not lie, but Howard Fineman, eh
A Democratic senator I can't name, who reluctantly voted for the health-care bill out of loyalty to his party and his admiration for Barack Obama, privately complained to me that the measure was political folly, in part because of the way it goes into effect: some taxes first, most benefits later, and rate hikes by insurance companies in between.
Besides that, this Democrat said, people who already have coverage will feel threatened and resentful about helping to cover the uninsured—an emotion they will sanitize for the polltakers into a concern about federal spending and debt.
On the day the president signed into law the "fix-it" addendum to the massive health-care measure, two new polls show just how fearful and skeptical Americans are about the entire enterprise. If the numbers stay where they are—and it's not clear why they will change much between now and November—then the Democrats really are in danger of colossal losses at the polls.
Yeah, I don't know what "sanitize for the polltakers" means either. But anyway, first let's put that in to perspective. A man paid to punditize American national politics thinks that poll numbers taken in March will be fixed until November, and who also believes he can predict in which direction those numbers will take in the next eight months, well, that man should not be paid to do so.
But let's look at his basic contention, that the law is all pain now (in the form of taxes and higher premiums, all before November) for a little gain later. Um, I think debaters have a Latin term for that: Bullshitius Ignoramitus.
As for these immediate taxes, not sure what he means by that, unless he's referring to eliminating tax breaks on federal subsidies to huge corporations. In 2013, by the way.
While the biggest changes will not take effect until 2014, some important provisions will begin as early as June, while others will kick in by the end of the year. These include significant new restrictions on the insurance industry and new protections for consumers who already have health insurance. There are also perks for Medicare recipients and help for young adults. And in just 90 days there will be new coverage for people who have lost health insurance and can’t qualify for an individual policy.
“The basic thrust of this law is that all of these nooks and crannies, all these gaps where private insurance has left you without any option, those are going to be taken away,” said DeAnn Friedholm, the campaign director of health reform for Consumers Union, the nonprofit publisher of Consumer Reports. “It’s complicated, but it does establish a very key, important policy that you’re going to have options, regardless of your health situation or your employment situation.”
If you haven’t had insurance for six months, and you can’t afford or don’t qualify for insurance because of a pre-existing medical problem, you may be eligible for a new federal “high risk” pool to be offered by the end of June.
Beginning in September, the new law is expected to stop insurance companies from rejecting children or excluding coverage because of pre-existing medical problems. That’s what happened to Diane Knight, 52, of Orem, Utah, when she tried to get health insurance for her 17-year-old daughter.
Although Ms. Knight and her husband had family insurance in the past, they lost it when they left their jobs to start a small business. When they discovered that they were unable to get new insurance because both had a past cancer diagnosis, they sought an individual policy just for their daughter. But she was rejected, too, because she had used expensive prescription acne cream when she was younger and the insurance company did not want to pay for that in the future.
This year Medicare recipients with high drug costs will get a rebate of up to $250. And in 2011, the plan will pick up a larger share of brand-name drug costs. In addition, Medicare recipients won’t be charged co-pays or deductibles for preventive care like immunizations and cholesterol screening.
Starting in September, adult children younger than 26 can be added to their parent’s health policy. Some plans already extend coverage to adult dependents as long as they are full-time students. Although Health and Human Services still must announce the exact eligibility requirements, Congress deleted a restriction related to marital status.
Beginning in September, insurance companies will no longer be able to rescind a policy once someone gets sick, nor can they impose lifetime limits on coverage.
Today, honest mistakes on a lengthy insurance application — like forgetting to disclose a parent’s high blood pressure — could be grounds for losing your insurance.
Under the new rules, companies generally can’t rescind a policy for a minor application error. “The law takes away the incentive for insurance companies to look for application mistakes,” said Marian Mulkey, senior program officer with the California HealthCare Foundation. “There have been some egregious examples of someone getting cancer triggering a review of years of health history that seems very targeted and punitive.”
How the changes will affect existing insurance costs is a source of fierce debate. Over all, the Congressional Budget Office has said that by 2016, the provisions in the new law will result in little if any increase in premiums for people with employer-sponsored plans. People with nongroup plans (those not offered by employers) may see increases, but more than half the enrollees in nongroup plans will qualify for federal subsidies, lowering costs for middle- and moderate-income families on average by about 60 percent, the C.B.O. said.
Beginning in September, insurance firms will face new limits on administrative costs and executive compensation. Violations will trigger rebates to consumers. In addition, the overhaul package includes additional money for states to review unreasonable increases in insurance rates.
This year tax credits as high as 35 percent of premiums will be available to many small businesses that offer health coverage to employees.
As for taxes on the middle class, there is a lot of talk, such as in this hit piece for Business Week, about "hidden taxes" that may come to pass at some point in the future:
True, most won't see direct tax hikes, per se. Few believe Obama will go back on his vow to keep income tax rates the same for all but the top brackets when the Bush tax cuts expire at the end of 2010. And top White House economic adviser Lawrence H. Summers says Obama can keep his pledge while finding more than enough cost cuts and revenue elsewhere. "There is substantial scope for expenditure reductions in health care and for raising enough revenues from people with incomes over $250,000 and from companies," he says.
A key question, though, is whether over the next couple of years, middle-income families will face a host of surcharges, fees, reduced tax breaks, or other increased costs. Daniel Clifton, a Washington-based policy analyst for Strategas Research Partners, argues that Congress has purposely loaded onto the corporate sector the increased taxes needed to pay for the reforms to avoid politically unpopular individual tax hikes. But the added costs will eventually be shifted to customers. "It all depends on what your definition of 'tax' is. Everyone is mincing words here," says Clifton. "There isn't enough money available in just extracting more from corporate taxes or rich Americans."
But beyond all that nonsense stands Fineman's main area of concern trolling for Democrats, that the health care bill is wildly unpopular and a killer for Dems in the fall. First, if you look at the polling data, many respondents who say they don't like the bill say they don't because it doesn't go far enough. I doubt that will send them into the arms of Republican candidates. But even more broadly, as we expected, once the legislative process ended and the bill signed into law, people stopped hating it so much and Dems are now seen as having accomplished something, particularly among their base voters.
I'm not sure that there's yet been enough time to assess whether the Democrats' passage of health care reform seven days ago could mitigate -- or broaden -- their losses. Most polls suggest that the health care reform bill itself has become somewhat more popular since passage. But President Obama's approval ratings are little moved, and there has thus far been little new polling on the generic ballot or perceptions of the Democratic congress. Moreover, any changes in the polling may prove to be temporary.
Still, there is one set of numbers that potentially contain relatively good news for the Democrats. These concern the enthusiasm gap, which may be lessening. Daily Kos / Research polling has found that while Republican voters remain exceptionally engaged by the midterm election cycle, Democrats are becoming increasingly engaged as well. Rasmussen, meanwhile, has found that about 5-7 percent of voters nationwide have gone from being somewhat approving of to Obama to strongly approving of him -- and almost all of the movement is accounted for by Democrats. (Obama's disapproval -- including his strongly disapprove numbers -- are little changed in the poll).
I don't want to say that health care legislation is going to be the wave that gives Democrats their permanent majority, but it is worth noting that people's views change as time goes on, that enacting legislation is typically better than cravenly refusing to because of bad poll numbers, and that Obama and the Dems are only now beginning to make the case for the legislation, while Republicans have had well over a year to denigrate it.
Quinnipiac found about a 4-5 point bump in support for the health care bill itself, although a larger bump (8 points) in Obama's handling of the issue. Obama's overall approval rating, on the other hand, was little changed.Fineman, you know, comes from a long line of fools.
What's a bit more surprising is that Quinnipiac also found a decent-sized bump in approval of the Democrats in Congress: from a pathetically low 30 percent to a not-quite-as-awful 36 percent. And most of the bump came from independent voters, among whom approval increased from 19 percent to 33.