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The Affordable Care Act is working. 2.5 million more young adults ages 19 to 26 now have health insurance. The shrinking of the Medicare "donut hole" allowed 3.6 million seniors to save $2.1 billion on their prescription drugs last year. And the ban on insurers refusing to cover pre-existing conditions is saving lives (even among those who opposed so-called "Obamacare"). And even though most of its provisions don't go into effect until 2014, the data from Oregon and Massachusetts strongly suggest the 30 million people who will gain coverage will be much healthier and more financially secure.

In Massachusetts, the 2006 health care reform Governor Mitt Romney signed into law lowered the uninsured rate from 10 percent to a national low of two percent. Even with its individual mandate, "Romneycare" is extremely popular, enjoying a 3 to 1 margin of support from Bay State residents. Now, a new study by Charles J. Courtemanche and Daniela Zapata published by the National Bureau of Economic Research (NBR) shows that universal coverage in Massachusetts is indeed making people there healthier. As Ezra Klein of the Washington Post summed up their findings:

The answer, which relies on self-reported health data, suggests they did. The authors document improvements in "physical health, mental health, functional limitations, joint disorders, body mass index, and moderate physical activity." The gains were greatest for "women, minorities, near-elderly adults, and those with incomes low enough to qualify for the law's subsidies."

Importantly, the researchers concluded that "the general strategies for obtaining nearly universal coverage in both the Massachusetts and federal laws involved the same three-pronged approach of non-group insurance market reforms, subsidies, and mandates, suggesting that the health effects should be broadly similar." (Or MIT professor and architect of both laws Jonathan Gruber put it bluntly last year, "they're the same f--king bill.") It's no wonder Mitt Romney used to recommend his Massachusetts reform as a model for the nation.

If the individual mandate is one of the highest profile (if contentious) aspects of the 2010 Patient Protection and Affordable Care Act, the expansion of Medicaid is among the most important in enabling 30 million currently uninsured Americans to get coverage. By extending Medicaid coverage to families earning up to 133 percent of the federal poverty level (FPL) and providing subsidies to those up to four times the FPL, starting in 2014 the Affordable Care Act passed by Democrats in Congress will bring insurance to millions more Americans. A March 2011 analysis by the Commonwealth Fund revealed that when fully implemented, the ACA will bring relief to "nearly all of the 52 million working-age adults who were without health insurance for a time in 2010."

As it turns out, America's future is Oregon's present.

Continue reading »

Ann, I know you're down because another season of American Idol has ended, but please. Put down the wine and take a nice rest. It'll do you some good because this post about you wanting to sue so you can find out if anyone is defaming you on the now defunct Journolist is really a cry for help, I believe.

I'd still like to know. Don't I have a right to know what a gang of 400 journalists are saying about me, as they endeavor to shape my reputation, decide that all the good people must avoid linking to me, or whatever it is they do?

If I were to bring a defamation suit based on Ezra Klein's lie "Ann Althouse sure has a lot of anti-semitic commenters," I would seek access to the Journolist archive, and I believe I would get it. There is no privilege that would shield this information from discovery. Lawyers, argue with me if you think I'm wrong.

One of her readers told Ann the unvarnished truth about her frivolous charade:

I would think a law professor might have a better grasp of this. But on what grounds would you seek the archives? To borrow a popular argument of the right, where in the Constitution does it say you have the right to know what others are saying about you, especially when you have no proof they are saying anything defamatory about you?

I'm here to help you. Really. After the Jessica Valenti incident, I thought you would have calmed down.

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Eric Boehlert is very worried too.

Modern Newt

Ezra Klein takes a little looksie at the new and improved Newt; which is the same as the vile, old Newt.

God Bless This Mess

Ezra Klein talks about a new ABC pilot that has Drudge (and the Drudgekateers) up in arms. Commander-in-Chief, starring Democrat activist Geena Davis as the President of the United States, for the fall schedule.

Jesse Taylor talks about it here: You do, however, have to love the unironic link to the Newsmax summary of the Joe Klein article in which Klein points out that it might be a bad idea for Hillary to run because publications like Newsmax will go batshit crazy.

via Ezra Klein:

EJ Dionne's firing on all cylinders today with a blistering column on the Paris Hilton Benefit Act, otherwise known as the estate tax...read on

Dionne argues for explicitly tying the tax to the Social Security shortfall. According to the CBO, even a reduced estate tax would cover fully 1/2 of the program's deficit, which means Republicans are going to have to decide between protecting Paris Hilton's inheritance and paying Grandma Millie's Social Security check. Democrats should be all over that choice, making sure it's made as publicly as possible. Go git' em.

Weird wingnuttery

or (A little Powerline bashing is always a good thing)

via Ezra Klein

Powerline's Hindrocket has a strange post about an apparent error that the NYTimes made in posting its article about the pope's death. They seem to have accidentally published it before it was finished, and so it read as follows: go to the article

I don't think I understand what the big deal is. The NYTimes article is very fair ("he defied easy definition: For all his conservatism on social and theological issues, he was decidedly forward-looking"), and Powerline's statement that they had their criticism ready to go, but had to go looking for a good quote is speculative at best. The only thing, in fact, that is clear is that the NYTimes intended to present more than one side. In the context of Heather's post below about the Washington Times' one-sidedness below, Hindrocket just looks like he's trying to pick a fight.

Michelle Malkin cites it as an example of how

The death of the Pope just couldn't stop the libs in the media from showing their true colors.

What are their true colors? That they wanted to make sure they had a quote from a supporter? Those crazy liberals, always trying to be fair...

And of course every time Galbraith says this, wingnut heads explode. Ezra Klein interviews economist Jamie Galbraith:

EK: You think the danger posed by the long-term deficit is overstated by most economists and economic commentators.

JG: No, I think the danger is zero. It's not overstated. It's completely misstated.

EK: Why?

JG: What is the nature of the danger? The only possible answer is that this larger deficit would cause a rise in the interest rate. Well, if the markets thought that was a serious risk, the rate on 20-year treasury bonds wouldn't be 4 percent and change now. If the markets thought that the interest rate would be forced up by funding difficulties 10 year from now, it would show up in the 20-year rate. That rate has actually been coming down in the wake of the European crisis.

So there are two possibilities here. One is the theory is wrong. The other is that the market isn't rational. And if the market isn't rational, there's no point in designing policy to accommodate the markets because you can't accommodate an irrational entity.

EK: Then why are the bulk of your colleagues so worried about this?

JG: Let's push a bit deeper on the CBO forecasts. They publish a baseline set of projections. One of those projections holds the economy will return to a normal high-employment level with low inflation over the next 10 years. If true, that would be wonderful news. Go down a few lines and they also have the short-term interest rate going up to 5 percent. It's that short-term interest rate combined with that low inflation rate that allows them to generate, quite mechanically, these enormous future deficit forecasts. And those forecasts are driven partially by the assumption that health-care costs will rise forever at a faster rate than everything else and by interest payments on the debt will hit 20 or 25 percent of GDP.

At this point, the whole thing is completely incoherent. You cannot write checks to 20 percent to anybody without that money entering the economy and increasing employment and inflation. And if it does that, then debt-to-GDP has to be lower, because inflation figures into how much debt we have. These numbers need to come together in a coherent story, and the CBO's forecast does not give us a coherent story. So everything that is said that is based on the CBO's baseline is, strictly speaking, nonsense.

EK: But couldn't there be a space between the CBO being totally correct and the debt not being a problem? It seems certain, for instance, that health-care costs will continue to rise faster than other sectors of the economy.

JG: No, it's not reasonable. Share of health-care cost would rise as part of total GDP and the inflation would rise to be nearer to what the rate of health-care inflation is. And if health care does get that expensive, and we're paying 30 percent of GDP while everyone else is paying 12 percent, we could buy Paris and all the doctors and just move our elderly there.

EK: But putting inflation aside, the gap between spending and revenues won't have other ill effects?

JG: Is there any terrible consequence because we haven't prefunded the defense budget? No. There's only one budget and one borrowing authority and all that matters is what that authority pays. Say I'm the federal government and I wish to pay you, Ezra Klein, a billion dollars to build an aircraft carrier. I put money in your bank account for that. Did the Federal Reserve look into that? Did the IRS sign off on it? Government does not need money to spend just as a bowling alley does not run out of points.

What people worry about is that the federal government won't be able to buy bonds. But there can never be a problem for the federal government selling bonds. It goes the other way. The government's spending creates the bank's demand for bonds, because they want a higher return on the money that the government is putting into the economy. My father said this process is so simple that the mind recoils from it.

EK: What are the policy implications of this view?

JG: It says that we should be focusing on real problems and not fake ones. We have serious problems. Unemployment is at 10 percent. if we got busy and worked out things for the unemployed to do, we'd be much better off. And we can certainly afford it. We have an impending energy crisis and a climate crisis. We could spend a generation fixing those problems in a way that would rebuild our country, too. On the tax side, what you want to do is reverse the burden on working people. Since the beginning of the crisis, I've supported a payroll tax holiday so everyone gets an increase in their after-tax earnings so they can pay down their mortgages, which would be a good thing. You also want to encourage rich people to recycle their money, which is why I support the estate tax, which has accounted for an enormous number of our great universities and nonprofits and philanthropic organizations. That's one difference between us and Europe.

The progressive "journo/blogospere" is sharply split over the Senate health bill. Some, like Jane Hamsher and Matt Taibbi, are saying "kill it." Others, like Paul Krugman, Ezra Klein, and Jonathan Cohn, are saying "pass it" - as is. Steve Benen says " it's worth appreciating the vibrancy, energy, and seriousness with which progressives are engaging in the debate."

I say maybe - but there's been a lot of condescension and hostility, too. And what bothers me even more is the tendency of some bloggers - good people, people who are seen not only as advocates but as as information gatherers on health policy- to ignore data that undercuts their position while pushing a false political choice. I'm not saying their decisions are deliberate, and I assume they're not. But it's disappointing, and it's worth discussing.

It's difficult for me to name names, since I respect their work a lot, but I'm talking about people like Jonathan Cohn, David Leonhardt of the New York Times, and Ezra Klein (who has been very friendly and helpful to me since the beginning.) Since I know they're people of good will, I can't help wondering if the polarized nature of this debate has something to do with what's been going on.

I've been working on a campaign to resist the excise tax, which I have long thought was based on flawed logic and would turn out to be counterproductive both as politics and policy. (Let the first part of that statement - "I've been working on a campaign" - serve as a disclaimer and full disclosure regarding what follows.) Both Klein and Leonhardt have written admiringly about the tax's ability to "bend the cost curve," but a broad range of studies have been released that challenge that assumption, whole polls have shown that its likely to be highly unpopular politically.

These are not unscientific, flaky studies. Two papers were published in the highly respected journal Health Affairs. These are studies from respected firms that seem to overturn the conventional economic wisdom behind the excise tax. Citizens for Tax Justice has reviewed data from the Joint Committee on Taxation (pdf) and drawn negative conclusions about the tax. Other studies by top benefits consulting firms like Martin E. Segal, Watson Wyatt, Mercer, Towers-Perrin, and Hewitt (whose livelihood depends on a corporate clientele) challenge the arguments made in support of the tax, while polling from a well-regarded firm suggested the tax would have a devastating political impact in front-line states. So how much have Klein, Leonhardt, or Cohn written about all of this new and revelatory information?

As far as I can tell, not a word.

The silence bothers me more than disagreement ever could. These guys are viewed as experts in health policy and as gateways and interpreters of the latest research. Sure, they've come out foursquare for accepting the Senate bill, but does that really excuse the silence? Maybe they're too busy to write about these reports. Maybe they haven't seen them (although I sent a few links to one of them.) Maybe - and I hope this isn't true - they're so concerned about ensuring that a bill passes that they'd rather not muddy the waters with new data that undercuts that position.

Or maybe I'm out of line. Maybe people don't see them as reliable sources for all the new health policy info. Perhaps they're perceived as strong advocates for a certain position, with no newsgathering brief. If so, I apologize - sincerely. But, if I'm right, they really need to address these studies. They can argue that they're methodologically flawed , or that they're inconclusive, or that it's too late to change anything now. But ignore them? That's disturbing.

"Gah," writes Paul Krugman, who also presses for passing the Senate bill. "I see that some people are still using the Rasmussen polling on MA’s health care reform. You shouldn’t do that ..." I'm one of those who has used those polls - but I've written about and linked to his critique, which includes another poll he likes better. That's what we should all be doing if we want to have a serious debate. (Now, as it turns out, I don't interpret the poll data the same way he does - but I'm acknowledging its existence, responding, and letting people decide for themselves.)

I identify with Prof. Krugman's frustration, though. Gah, why are people still saying the excise tax "bends the curve"?

There's a basic structural flaw in the Klein/Cohn/Krugman position, too: that it's either this health bill or nothing. I believe that's a false choice. Opponents of the Senate draft don't all believe that no reform is better than this bill. But they should act as if they do. Once you say the Senate bill is good enough, the negotiations with the left are over.

The Senate health bill has been improved in some areas, including strengthening the Medicare cost containment commission and - most critically - once again lifting lifetime caps on coverage. Like McJoan, I believe that's a direct result of the outcry on the left. Fear of a progressive backlash has already improved this bill, and it may continue to do so - if we don't back down too soon. In a very practical sense the Deans, Hamshers, and Taibbis are accomplishing more than any other progressives to get a better bill.

There are many people who disagree vehemently with that statement. By all means, let's keep talking about it. But let's do so openly, with all the information at our disposal, and without either hostility or manipulation. I'm not out to antagonize anyone here. I'd really like to see debate that's based on data and grounded in strategy - and not in false choices.

As Harry Reid tries to push through a health-care bill in the Senate before Christmas, the ConservaDems and Queen Snowe had to make sure to cut as much out as possible that liberals wanted. Ezra Klein tracks the process as it unfolded, which many of us have followed just as closely:

To move the process forward, Reid had three options. The first, many would say, was reconciliation. But that would have required going back to the committees to refashion a reconciliation bill, and going back to the House of Representatives so it could craft a reconciliation bill, and then going back through the votes. There wasn't time for that, and even if there was, throwing the process so far back onto itself would have been an enormous risk.

The next was to cut a deal with Olympia Snowe. But Snowe had made it clear that part of any compromise with her was a deceleration in the bill's momentum. "The more they try to drive this process in an unrealistic timeframe, the more reluctant I become about whether or not this can be doable in this timeframe that we're talking about," Snowe told reporters. "There's always January."

That left Joe Lieberman. And Lieberman's price for signing onto the bill was the destruction of the public option and, unexpectedly, the Medicare buy-in provision. There would be no triggers, no opt-outs, no compromises. Lieberman swung the axe and cut his deal cleanly, killing not only the public option, but anything that looked even remotely like it. Some on the Hill remain worried that Lieberman will discover new points of contention in the coming days, as they believe he had signaled that he wouldn't filibuster the Medicare buy-in. They worry whether his word is good. But assuming it is, he can provide the 60th vote Reid needs to move the bill by the end of next week, and keep health-care reform on some sort of schedule.

Lieberman is not interested in helping the millions of Americans who need help, but screwing liberals who held him accountable for the Iraq war. Even Jay Rockefeller, who has been so strong on the public option, defended Joe's behavior, seemingly as a way to get a bill passed as soon as possible. Then the Medicare buy-in came up and we celebrated, but of course resident Lieberman couldn't allow to happen.

Digby writes:

Senate Democrats signaled their intention Monday to back away from a plan to expand Medicare, in a bid to break a deepening impasse on sweeping health legislation.

The move came at an evening caucus convened just off the Senate floor, where Majority Leader Harry Reid (D., Nev.) and other party leaders made clear they wanted to head off a widening dispute -- pitting centrists against liberals -- over a proposal that would open Medicare to people below the age of 65.

There you have it. Everyone knows that liberals must lose, so down goes the public option and the Medicare Buy-in. The question remains whether King Joseph will allow the government to help older people with long term care needs or any of the other things that anyone could possibly construe as liberal policies.

I think we have a way to go before this bill is bad enough for him and his cronies to allow the Democrats to commit political suicide with it.

Reconciliation doesn't seem to be the way Harry Reid wants to go because it's a slow process that might not produce any meaningful results.

mcjoan has a nice wrap-up and adds:

At this point, the assistance to the people who need it most is the critical moral and policy decision. Would it be a band-aid? Yes, but even a band-aid can staunch bleeding, and right now that's what we desperately need. The insurance reforms matter a great deal, too, and can be passed through regular process. It will be a lot harder for Senators to stand up and vote to allow insurance companies to continue to deny coverage to the American people.

We have to keep fighting to strengthen the bill before conference. There are millions of people who need our help. We still haven't seen the bill yet, so we're not sure how much it would help America. Howie and I wrote a bunch of posts during the whole general election process that Barack Obama wasn't a progressive, but a moderate Democratic politician.

Anatomy of a Right Wing Myth: Obama is the most liberal Democratic Senator

Anatomy of a Right Wing Myth part II: Obama is the most liberal Democratic Senator

Anatomy of a Right Wing Smear III-Hannity calls Obama #1 Liberal Senator

And here: Anatomy of a Right Wing Smear IV: Steve Doocy: Obama could be the most liberal Senator

That's what his voting record told us. We focused on the National Journal article that tried to paint Obama as the most liberal Senator in Congress -- which was a lie -- and we wanted everybody to be aware of it during the election. And that's where we come in now along with all the other great liberal groups. Many of us believed that one of our major tasks was to keep pushing for as much progressive policies as we could as soon as we took the White House.

Conservatism has been a complete failure as an ideology to govern America. George W. Bush had to promote himself as a new kind of conservative, a Compassionate Conservative who would do things differently, but as soon as he took office that was proved to be another lie. What we witnessed for eight years of Bush was an utter disregard for working class families and a foreign policy that sanctioned torture and the "preemption doctrine." A straw man was needed so Bush and Cheney could manipulate the media to justify an invasion of Iraq that didn't attack us.

A financial bubble was allowed to proceed because without that bubble, Bush's tax cuts and conservative philosophy would have been exposed as another conservative failure before the 2004 election. The end result was a global financial meltdown.

And we can't forget about Hurricane Katrina. We witnessed firsthand how conservatives protected our country during a natural disaster.

We fight as progressives because we have to. America is not a Bill Kristol academic exercise. It's full of real Americans who are worth fighting for as they try to survive. If not for us, who will speak for them?

Via Ezra Klein, this heartening news. As Howard Dean said, there's simply no point without a good public option:

According to Congress Daily, the CBO says attaching the public plan to Medicare rates will save even more money than originally thought:

In a bid to wrangle concessions from the Blue Dog Coalition on healthcare reform, House leaders Thursday released CBO estimates for liberals' preferred version of the public option that show $85 billion more in savings than for the version the Blue Dogs prefer.

Rep. Stephanie Herseth Sandlin, D-S.D., a Blue Dog co-chair, said any possible new momentum toward a public option tethered to Medicare rates is, in part, "because of the cost issue" and the updated CBO score.

The original House bill required the public plan to pay providers 5 percent more than Medicare reimbursement rates. But as part of a package of concessions to Blue Dogs, the House Energy and Commerce Committee accepted an amendment that requires the HHS Secretary to negotiate rates with providers. That version of the plan will save only $25 billion.

In total, a public plan based on Medicare rates would save $110 billion over 10 years. That is $20 billion more than earlier estimates, a spokesman for House Speaker Pelosi said.

In other words, the conservatives want to spend $85 billion more than the liberals do. Moreover, the CBO is estimating savings to the government. That is to say, the $85 billion reflects reduced federal spending on subsidies because premiums in the public plan will be lower. Savings to individuals and businesses paying lower premiums will be much larger than $85 billion, and politically, much more important.