Friday, October 18, 2013

Saturday Satire: Dimwit Government Edition

Conan O'Brien: "Today John McCain said the shutdown was, quote, one of the most shameful things he's seen as a senator. That's from a guy who saw Lincoln get shot."

Jimmy Kimmel : "After 16 days the government shutdown is over. Right now a devastated Ted Cruz is filibustering a squirrel on the lawn of the Capitol building."
"Some of these guys in Congress are acting like this is a big achievement. If you pick up a gun and don't shoot yourself in the leg with it, that's not really an achievement."
"It's day 15 of the government shutdown. President Obama said he was hopeful an agreement would be reached tonight. Part of the problem is that Republicans can't even agree among themselves on what they want. Which means Obama doesn't know what to tell them they can't have."

Craig Ferguson: 'A lot of people got mad when Michelle Obama expanded the White House garden. That just shows you some people don't know their history. When Eleanor Roosevelt grew a garden, it was a 'victory garden.' But when Michelle Obama does it, it's a 'communist plot.'"
"When I first heard the White House was under attack by freaky rodents, I thought, 'What's Ann Coulter done now?'"

Thursday, October 17, 2013

Medicaid will help more souls thanks to Obamacare-- even in states that don't take the expansion

  By Fake Irishman on Wed Oct 16, 2013

Cross-posted at The Makeshift Academic

Any complicated federal law has a number of features that don’t get a ton of attention, yet turn out to be very important. The Affordable Care Act is no exception. Most of us know about the Medicaid expansion that was made optional by the Supreme Court. But there are many other quiet changes to Medicaid administrative procedures that weren’t touched by the court’s decision, detailed in this Kaiser Foundation Report released in October. These administrative tweaks will go a ways toward streamlining the Medicaid program, and significantly increase enrollment among the currently eligible.

There are two broad factors that indicate how many people have access to any Medicaid expansion. Obviously, the first factor is eligibility. States that don’t expand Medicaid won’t cover broad swaths of adults – about 5.4 million will get left out of Medicaid and not be eligible for subsidies. I might be one of them, at least temporarily.

That might seem like game over, but it’s not the whole story.

First, over time, political coalitions, institutional pressures, and flexibility on the part of HHS will likely shift a few more states in the Medicaid expansion (I’m looking at Maine, Montana, Missouri, and Virginia as potential short to medium-term examples).

This doesn’t help in states like Texas, or the usual suspects in Alabama and Mississippi, which seem hopeless when it comes to any chance of expanding Medicaid in the near or medium term. Millions of adults, disproportionately minority (of course), will be left out of insurance coverage.

But the eligibility is only part of the story. The second factor that helps gain access to services is the ease of with potential beneficiaries can apply. And the ACA helps ease this process considerably.

Currently, Medicaid utilization varies greatly by state. Some states actively try to make sure that all those eligible get services, while some states make the application process as difficult as possible to keep enrollment (and costs) down through making applicants submit to multiple in-person interviews, kicking people out of the program for making trivial mistakes. In states like Texas, this means that hundreds of thousands of people who are eligible for Medicaid aren’t enrolled.

The ACA contains a number of federally required administrative changes to the Medicaid application process that weren’t touched by the Supreme Court’s decision to make Medicaid optional. The changes will generally streamline the process for enrollees and can be summarized as follows:

1. All states must allow registrants to apply through phone, online, in person, or mail

2. All state must maximize the use of electronic verification of eligibility to speed applications

3. All states must use a simple form of eligibility calculation based on a recipient’s Modified Gross Adjusted Income

4. All states must allow applicants to apply for Medicaid through the state health exchanges

5. States are encouraged to use a single form for applications for SNAP (food stamps), SCHIP (Children’s health) and Medicaid.

True, the states that reject the Medicaid expansion are also more likely to throw up road blocks to helping people enroll for the exchanges, like blocking access of navigators, for example.  However, federal standards that simplify the application process across states will on net ease the access and increase enrollment.

Better administrative procedures aren’t a cure all. According to Kaiser’s numbers, 8.4 million people won’t be covered under the Medicaid expansion in the foreseeable future in states that opted out, thanks to the Supreme Court’s decision.  (As I mentioned earlier, about 5.1 million won't be eligible for the subsidies, on the exchanges, while the rest will at least have those).

But if Kaiser’s analysis is right, standardizing and easing application procedure across the board will significantly increase enrollees – by roughly 2 million people across the states that haven’t yet accepted the Medicaid expansion (more than 500,000 in Texas alone).

That's one heck of a silver lining.

Originally posted to Fake Irishman

Tuesday, October 15, 2013

Fox News Commentator Grumbles About Liberal Media Bubble

Hunter for Daily Kos  Tue Oct 15, 2013

Bill O'Reily 'Talking Points Commentary': 'The Far Left Running Wild: There are entire media operations that exist today solely to promote ideology. This is a bad situation that is getting worse.'

And here's Bubble Buddy Bill, just because this is a wonderful picture.

Here's former George W. Bush administration press secretary and current Fox News commentator Dana Perino, on Fox News Sunday, moaning that the mean Democrats these days live in a media bubble.

Democrats and the liberals live in the biggest mainstream media bubble ever created in the history of the universe. And so, if you look at Republicans across many of the states governors, or state legislators, Republicans are actually doing what a really good work, they just nationally they're taking a hit on their reputation.

I can't top that, so I'll just leave it there.

Sunday, October 13, 2013

Debunking Ryan's Zombie Lie: Obamacare Doesn't Add To The Deficit

As the Republican extortionists desperately thrash about in search of a rationale for their continuing government shutdown tantrum, Paul Ryan resorts to a zombie lie:

Medicare, Medicaid, Obamacare, those are the big drivers of our debt.
First of all, it would be hard for Obamacare to be a big driver of our debt, given that it just went live, but the bigger lie is that it would drive the debt at all. The Republicans claim this is all about fiscal responsibility and getting the deficit under control, which has no credibility at face value, given that Republicans themselves have no credibility on deficits, but specifically to the point, the Congressional Budget Office in 2011 scored Obamacare's budgetary impact (pdf):
Estimated Budgetary Effects from 2012 to 2021: Direct Spending and Revenues

The legislation will have a number of effects on the federal budget—including added
spending to subsidize the purchase of health insurance and increased outlays for Med-
icaid, as well as reductions in outlays for Medicare and added revenues from taxes,
fees, and penalties. On net, CBO and JCT’s latest comprehensive estimate is that the effects of the two laws on direct spending and revenues related to health care will reduce federal deficits by $210 billion over the 2012–2021 period (see Table 1).

Earlier this year, the right wing echosphere was abuzz because the new CBO score (pdf) supposedly projected a huge increase in the deficit. This was dishonest. The new CBO score did project that the health insurance coverage provisions will be enormously expensive, but the earlier score also projected that obvious fact. But that's not the bottom line. As you can read beneath the fold, the new CBO report made this explicit:
Those amounts do not reflect the total budgetary impact of the ACA. That legislation includes many other provisions that, on net, will reduce budget deficits. Taking the coverage provisions and other provisions together, CBO and JCT have estimated that the ACA will reduce deficits over the next 10 years and in the subsequent decade.
And in fact, the CBO now projects that the very expensive health insurance coverage provisions will cost $49 billion less than had been previously estimated. And the new CBO report then referenced its 2012 letter to John Boehner (pdf), which estimated the effect of the Republican bill H.R. 6079, which would have repealed Obamacare:
Assuming that H.R. 6079 is enacted near the beginning of fiscal year 2013, CBO and JCT estimate that, on balance, the direct spending and revenue effects of enacting that legislation would cause a net increase in federal budget deficits of $109 billion over the 2013–2022 period. Specifically, we estimate that H.R. 6079 would reduce direct spending by $890 billion and reduce revenues by $1 trillion between 2013 and 2022, thus adding $109 billion to federal budget deficits over that period.
That Obamacare would add to the deficit is one of the GOP's most insidious zombie lies. The CBO has been explict, both in its regular reports and in its letter sent specifically to John Boehner. The facts are clear, and must be repeated at least as often as are the zombie lies themselves. The truth is that Obamacare does not add to the deficit, it reduces it. The truth is that repealing Obamacare would not reduce the deficit, it would increase it.

The Republicans are lying. Again. The ostensible rationale for their attack on the ACA is exactly backward. Obamacare reduces the deficit. With Obamacare, the president and the Democrats not only are expanding the availability of health insurance, they are reducing the deficit.

Originally posted to Laurence Lewis on Thu Oct 10, 2013