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Thursday, April 23, 2015

Moving the goal posts on ACA success UPDATED

Right. So the the same day that I posted about the substantial fall in the uninsured rate for adults that we have seen since Obamacare went into effect, a conservative writes at the Wall Street Journal making exactly the same arguments that Matt Yglesias had refuted. Cliff Asness writes in the WSJ:
That more people would be insured was never in dispute. If you mandate that people buy something, penalize them if they don’t and give it away to some, more people will end up with it. The proper response to this is: Duh.
So, as I said, Yglesias had already refuted this, giving a number of examples of conservatives who predicted there would be no reduction in the number of uninsured Americans. Today, Paul Krugman takes us to Jonathan Chait's response to Asness, where of course he piles on more examples of conservatives predicting a failure to improve the uninsured rate. Then he goes further. Asness wrote that a critical issue was "how many people covered by ObamaCare were previously uninsured." You can probably guess Chait's answer: "Well, that’s why you measure the net number of uninsured people, not just the gross expansion of coverage under Obamacare." Which leads us back to the chart showing the substantial fall in the uninsured rate that was in my last post (and Yglesias', Krugman's and no doubt many more besides).

The latest round is that yesterday Asness responded to Chait. Here is where the goal post move comes in:
In contrast the rise in coverage is heralded by a myriad of Obamacare supporters as one of two major pieces of proof the law is working. But, how can something we knew before the fact be proof of anything?
Did you catch that? If we predict that something good will happen as a result of a new law, and that good thing happens, it doesn't count as proof that the law was good. This is silly. We didn't actually know the insurance rate would fall, but we had economic models that told us it would. So not only is the fall evidence that the law is working, it's evidence that the models were right!

Somebody wake these people up.

UPDATE: @HaroldPollack points me to a new J.D. Power survey finding that people who signed up for insurance on the exchanges were more satisfied (696 out of 1000) than people with non-exchange plans, usually through employers (679 out of 1000). People re-enrolling on the exchanges scored even higher, with a score of 744 for people who re-enrolled on the Exchanges. Private plans offering multiple options were able to reach the 696 average for Exchange enrolees, which means that companies offering one insurance option had to be doing substantially worse than 679. Not surprisingly, new enrolees for 2015 were a large 55 points more satisfied than 2014 enrolees, who of course went through the disastrous rollout of healthcare.gov.  So people like their subsidies and they like their actual insurance policies, on average. Maybe that's why Republican Senators are getting antsy that there will be hell to pay if the Supreme Court rules for the plaintiffs in King v. Burwell.

Cross-posted at Angry Bear.

15 comments:

  1. Why should Republicans get antsy about King v. Burwell. Democrats wrote the law, not Republicans.

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    1. Perhaps you should ask some Republicans, since it is a fact they are getting antsy.

      My best guess is that if millions of people lose their health insurance due to King v. Burwell, they will blame Republicans. And Republican Senators like Kirk, Johnson, Ayotte, Portman, and Toomey will be in especially precarious situations in their 2016 elections, since they live in states that President Obama won twice.

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    2. The challengers in 'King' are arguing FOR the law. They want it enforced as it is written.

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    3. Patrick, now you're just being silly.

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    4. Yeah, silly because what he's saying is exactly right and it doesn't fit your paradigm so you blithely dismiss it as "silly". Though, you're right - if the law is enforced as written and designed it is Republicans at large who will be blamed, not the people who wrote the law in the first place.

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    5. Anonymous/Patrick, conservatives kept complaining that the PPACA was over 2000 pages long, but in "King," suddenly those 2000+ pages have nothing to do with statutory interpretation. What is silly is your claim to be "for" the law, when plaintiffs are trying to eviscerate the subsidies in healthcare.gov states, ensuring that it is no longer tenable there. I have very little tolerance for such disingenuousness.

      However, I see you did post an attack on me on your blog as I requested, so I will give you more slack here. Regarding your post (http://hisstoryisbunk.blogspot.com/2015/04/fools-for-proof.html), it does seem that the new service could be efficiency-enhancing. But you didn't mention this tidbit: “We expect there will be a great demand,” Spain-Remy said. “As more and more people have insurance, there is a pent-up demand for care.” The PPACA is definitely the most market-oriented reform for universal insurance, just as its designers at the Heritage Foundation designed it to be.

      And it still remains the case that the most marketized system in the industrialized world is the most expensive.

      Cheers.

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  2. Jack, This is a Republican law one they supported years ago. If Democrats could have passed the law by themselves we would have single-payer, which would have cutout the middle-man. Republicans have nothing in there bag of tricks to replace it with. And Republicans this past week, if they win the case in the court want to extend Obamacare until 2017. They have no game for 16 million that have insurance now. How sad they have become!

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    1. Democrats did indeed pass the ACA by themselves. It got zero GOP votes in the House and zero in the Senate. (it did get Arlen Specter's vote, and he had been a Republican until he switched parties 8 months before the ACA vote)

      There was no single payer because Democrats like Ben Nelson refused to vote for it. Joe Lieberman even refused to vote for an ACA that included a public option. Nelson and Lieberman would have preferred there to be no ACA at all than for there to be a single payer system. And they had the power to get their wish.

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    2. Really? Show me the bill number. The congress.gov site is searchable back to the 93rd Congress.
      https://www.congress.gov/legislation?q=%7B%22congress%22%3A%22114%22%7D

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    3. Jack, Larry means it is Republican in the sense that it was designed by Republicans. One Republican governor even put into practice in Massachusetts. I have traced the individual mandate back as far as a Stuart Butler report for the Heritage Foundation in 1989. And that was the revised version; I haven't yet gone back to find the earliest version. http://www.middleclasspoliticaleconomist.com/2012/10/conservative-refutation-of.html

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    4. He said, "they supported years ago," but cannot show any bill where it was even PROPOSED? Please.

      This was not DESIGNED by republicans. Not a single republic had anything to do with drafting the legislation. Not one. You go back to a paper one republican wrote years ago, which was never acted on by any Republican in Congress, and you want to call it a Republican idea?

      ROMNEY? He had a DEMOCRAT-run legislature. Anyway, just because the States can do something does not mean that the feral government is allowed do it.

      So why would you want to say it's a Republican Idea -- to push the blame off the Democrats, perhaps? If it's so great, why not take full credit for it?

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    5. Jack, here's your bill. Orrin Hatch, Chuck Grassley, Richard Lugar, Dave Durenberger, and lead sponsor John Chaffee, Republicans all, introduced a bill in 1993 with the individual mandate and vouchers for the poor to buy insurance. Politifact doesn't mention the bill number, but I'll leave a trip to the THOMAS database to you: http://www.politifact.com/truth-o-meter/statements/2011/feb/14/cenk-uygur/hatch-once-supported-individual-mandate-said-cenk-/

      I found it in less than a minute Googling "Republicans who supported individual mandate."

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    6. Maybe like Pelosi he never actually read the bill. It was never passed, so he never knew there was a mandate in it!

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  3. How much longer can Republican'ts keep promising an alternative to Obamacare--and failing to deliver one--before they get laughed off the stage?

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  4. Speaking of expensive, Oregon's insurance rates are now out for 2016;

    http://www.bendbulletin.com/slideShows?layout=2&storyId=3115701&currSlide=1

    With some companies needing increases of almost 40%. And the WaPo isn't exactly shouting 'success for Obamacare!', either in this piece;

    http://www.washingtonpost.com/national/health-science/almost-half-of-obamacare-exchanges-are-struggling-over-their-future/2015/05/01/f32eeea2-ea03-11e4-aae1-d642717d8afa_story.html

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