Health law legacy eludes Obama as changes sink in

As a roller-coaster sign-up season winds down, President Barack Obama's health care law has indeed managed to change the country.
Associated Press
Mar 30, 2014

Americans are unlikely to go back to a time when people with medical problems could be denied coverage.

But Obama's overhaul needs major work of its own if it is to go down in history as a legacy achievement like Medicare or Social Security.

Major elements of the Affordable Care Act face an uncertain future:

• As a 6-month-long sign-up season comes to an end Monday the administration's next big challenge is to make 2015 open enrollment more manageable for consumers unaccustomed to dealing with insurance jargon. There's also concern premiums will rise next year.

• The new insurance markets created by the law are anything but customer friendly. After the HealthCare.gov website finally got fixed, more than 6 million people have managed to sign up, allowing the exchanges to stay afloat economically. But many consumers have bought policies with restricted access to top-tier hospitals and the latest medications. The website is seeing heavy traffic this weekend, and consumers may encounter a wait or last-minute glitches.

• Almost half the states are still opposed to or undecided about the law's expansion of Medicaid, the government's health insurance program for the poor. As a result, millions of low-income people who otherwise would have been covered remain uninsured.

• This year's pitch has been about the "carrots" in the law: subsidies and guaranteed coverage. But the "sticks" are just over the horizon: collecting penalties from individuals who remain uninsured and enforcing requirements that medium- to large-sized employers provide affordable coverage.

Many basic facts about the ultimate effects of the health insurance program remain unclear. It's not known how many of those who have gotten coverage were previously uninsured — the ultimate test of the law. Independent measurements by Gallup do show fewer uninsured Americans, but such progress hasn't won hearts and minds. The public remains deeply divided, with opponents of the law outnumbering supporters.

At a recent insurance industry conference, a top administration official acknowledged the huge job still ahead.

"The No. 1 thing that probably we've all learned from 2014 is that this is hard work," said Gary Cohen, outgoing director of the Center for Consumer Information and Insurance Oversight, the agency created to carry out the health care law. "It's not a one-year project; it's a multiyear project ... we're asking a lot, frankly, of consumers," he added. "This is new for them."

Among those consumers is Dan Luke of St. Paul, Minn., the owner of a small video production company who had been uninsured since he was turned down for coverage last year due to a pre-existing condition. The condition? Luke was born with one eye due to a birth defect, and he uses a glass eye.

"For 63 years I've had one eye," said Luke. "They had to dig deep to find that."

He's happy with the coverage he and his wife have bought; they're saving $300 a month on premiums compared with the last time they had insurance. But he said he had to endure weeks of website run-arounds.

"There is a lot of bureaucracy involved," said Luke. "It's sort of like taxes, filled with loopholes and pitfalls. They should make it easier for people to get insurance and pay for insurance, rather than have to prove so many things and jump through so many hoops."

Those comments echo sentiments broadly reflected in national opinion polls. Most Americans want lawmakers to fix the problems with the health care law, rather than scrapping it. A new AP-Gfk poll finds that only 13 percent expect the law will be completely repealed. Seventy-two percent say it will be implemented with changes, whether major or minor.

Republicans have again made repeal of "Obamacare" their official battle cry this election season. But even if the GOP wins control of the Senate and Congress were to repeal the law next year, the president would veto it. Opponents would then need a difficult two-thirds majority in both chambers to override Obama's veto.

"It's going to depend on the next couple of elections whether we stick with the current ACA models," said Brookings Institution health policy expert Mark McClellan, who oversaw the rollout of the last major federal coverage expansion, the Medicare prescription drug benefit.

"We are still a long way from a stable market and from completing implementation," he said. But "we're not going back to people with pre-existing conditions having no good options."

The administration will have to get to work quickly on a plan for next year. It is still struggling with such basics as providing consumers with clear information about the process and their options.

Until now, those signing up have skewed toward an older crowd. That could lead to higher premiums next year, making the program a harder sell for younger people.

Some Democratic lawmakers who voted for the law are frustrated.

"Instead of just circling the wagons against all the political arrows that are shot against this plan, we need a little more accountability, and we need to ensure the next enrollment period is not handled as poorly as the last one," said Rep. Lloyd Doggett, D-Texas.

DeAnn Friedholm, health reform team leader for Consumers Union, said her group still supports Obama's overhaul, but with concerns.

"The jury is out in terms of its long-term success," she said. "We still think it's better than the old way, which left a lot of people out because they were sick."

Comments

Dr. Information

Failure

samiam

^^^ Agree.

samiam

"As a roller-coaster sign-up season winds down, President Barack Obama's health care law has indeed managed to change the country.

but NOT for the BETTER!

The Big Dog's back

Yep, we still have right wingnuts.

wasthere

Let's just all agree with Big Dog and then maybe he'll stop the name calling and actually allow everyone to have an opinion.

Darwin's choice

Aw... then it'd be no fun pointing out his idiotacy....!

The Big Dog's back

Who haven't I let have an opinion? Where did I get that power?

Restless1

Higher premiums and higher deductables! Might as well not have insurance. What is the up side?

kURTje

The upside? You & I paid for Dick Cheney's new heart.

SamAdams

Obama should relax and stop worrying. Obamacare will, indeed, be his legacy. I just don't think he's gonna like it much! But then, that seems fair since a whole lot of the rest of us don't, either.

The Big Dog's back

Remember, at most right wingnuts make up 20% of the Repubs.

rbenn

God is that all you can say is wingnuts? How about hypocrite dems anti gun senators running guns? Harry Reid funneling money to his granddaughter, harry reid lying on the senate floor, bridges built to increase his property values, we can do this all day.

wasthere

When you have no legitimate point to make it's always easy to go to the name calling. It's hard to take anyone like that serious.

The Big Dog's back

And you want me to take either one of you serious?

rbenn

So you don't find those instances serious? You libs will attack when any issue with a conservative, but when its one of your own its no big deal, like I said liberalism is a disease which requires a lobotomy.

The Big Dog's back

Oh, BTW pot, what points did you make in your posts?

rbenn

The 10 richest House districts, according to the AP, are:

1. New York 12
Rep. Carolyn Maloney, Democrat
Per capita income: $75,479

2. California 33
Rep. Henry Waxman, Democrat
Per capita income: $61,273

3. New York 10
Rep. Jerry Nadler, Democrat
Per capita income: $56,138

4. California 18
Rep. Anna Eshoo, Democrat
Per capita income: $ 54,182

5. Connecticut 4
Rep. Jim Himes, Democrat
Per capita income: $50,732

6. Virginia 8
Rep. Jim Moran, Democrat
Per capita income: $50,210

7. New Jersey 7
Rep. Leonard Lance, Republican
Per capita income: $48,556

8. California 12
Rep. Nancy Pelosi, Democrat
Per capita income: $48,523

9. New York 3
Rep. Steve Israel, Democrat
Per capita income: $47,991

10. Virginia 10
Rep. Frank Wolf, Republican
Per capita income: $47,281
.

The Big Dog's back

10 Richest Congressional Districts

1. VA-11 (Gerald Connoly, D) - Northern Virginia: Mount Vernon, Dale City, West Springfield, Burke, Annandale.
Demographics: 71.4% White; 10.9% Asian; 10.3% Black; 9.1% Hispanic; 7.1% Other; 0.3% Native American.
Median Household Income: $80,397
2008 Election Result: Barack Obama (D) 57.02% - John McCain (R) 42.06%.
CPVI: D+2

2. NJ-11 (Rodney Frelinghuysen, R) - Morristown, Madison, Somerville, Dover, Hopatcong.
Demographics: 87.5% White; 6.8% Hispanic; 6.4% Asian; 3.2% Other; 2.8% Black; 0.1% Native American.
Median Household Income: $79,009
2008 Election Result: John McCain (R) 53.68% - Barack Obama (D) 45.36%.
CPVI: R+7

3. CA-14 (Anna Eshoo, D) - Silicon Valley: Redwood City, Palo Alto, Sunnyvale, Saratoga, Mountain View, Menlo Park.
Demographics: 67.4% White; 17.5% Hispanic; 16.1% Asian; 12.8% Other; 3.1% Black; 0.5% Native American.
Median Household Income: $77,985
2008 Election Result: Barack Obama (D) 73.11% - John McCain (R) 24.88%.
CPVI: D+21

4. CA-15 (Mike Honda, D) - Santa Clara, Los Gatos, Campbell, Cupertino, Milpitas.
Demographics: 54.7% White; 29.4% Asian; 17.2% Hispanic; 12.7% Other; 2.5% Black; 0.6% Native American.
Median Household Income: $74,947
2008 Election Result: Barack Obama (D) 68.39% - John McCain (R) 29.68%.
CPVI: D+15

5. NJ-07 (Leonard Lance, R) - South Plainsfield, Scotch Plains, Cranford, Westfield, Roselle.
Demographics: 83.4% White; 8.2% Asian; 6.9% Hispanic; 4.6% Black; 3.6% Other; 0.1% Native American.
Median Household Income: $74,823
2008 Election Result: Barack Obama (D) 51.16% - John McCain (R) 47.69%.
CPVI: R+3

6. CO-06 (Michael Coffman, R) - Littleton, Centennial, Castle Rock, Aurora.
Demographics: 91.1% White; 5.8% Hispanic; 3.8% Other; 2.7% Asian; 1.9% Black; 0.5% Native American.
Median Household Income: $73,393
2008 Election Result: John McCain (R) 52.48% - Barack Obama (D) 46.17%.
CPVI: R+14

7. NJ-05 (Scott Garrett, R) - West Milford, Ridgewood, Paramus, Dumont, Bergenfield.
Demographics: 89.3% White; 6.6% Asian; 4.5% Hispanic; 2.4% Other; 1.5% Black; 0.2% Native American.
Median Household Income: $72,781
2008 Election Result: John McCain (R) 53.55% - Barack Obama (D) 45.43%.
CPVI: R+7

8. GA-06 (Tom Price, R) - Vinings, Sandy Springs, Doraville, Dunwoody, Roswell, Alpharetta, Woodstock.
Demographics: 84.4% White; 6.8% Black; 6.2% Hispanic; 4.4% Asian; 4.1% Other; 0.2% Native American.
Median Household Income: $71,699
2008 Election Result: John McCain (R) 62.26% - Barack Obama (D) 36.56%.
CPVI: R+19

9. IL-13 (Judy Biggert, R) - Chicago Suburbs: Naperville, Bolingbrook, Downers Grove, Westmont, Woodridge, Orland Park
Demographics: 84.9% White; 6.6% Asian; 5.5% Hispanic; 5.0% Black; 3.3% Other; 0.1% Native American.
Median Household Income: $71,686
2008 Election Result: Barack Obama (D) 54.21% - John McCain (R) 44.60%.
CPVI: R+1

10. IL-10 (Mark Kirk, R) - Chicago Suburbs: North Chicago, Waukegan, Highland Park, Northbrook, Buffalo Grove, Arlington Heights, Glenview.
Demographics: 81.2% White; 12.3% Hispanic; 7.2% Other; 5.9% Asian; 5.4% Black; 0.2% Native American.
Median Household Income: $71,663
2008 Election Result: Barack Obama (D) 60.92% - John McCain (R) 38.13%.

grumpy

Don't know where you guys got your info... or from what year... but... this one is based on the new congressional district and the Census Bureau data.

From looking at the increase in median family income... it looks like old data.

http://go.bloomberg.com/politica...

The Census Bureau has begun to release demographic and economic data for redrawn congressional districts that became effective this year, yielding valuable insight about the constituencies of the 435 members of the U.S. House of Representatives.

1. Virginia’s 10th ($109,505): Republican Frank Wolf represents suburbs of Washington, including all of fast-growing Loudoun County and part of Fairfax County, including McLean. President Barack Obama lost the district by about one percentage point in the 2012 election.
2. Virginia’s 11th ($100,146): Democrat Gerry Connolly’s district abuts Wolf’s, enveloping parts of Fairfax and Prince William Counties. Connolly’s district became more Democratic-leaning in redistricting as Wolf’s became more Republican-friendly. Obama won 62 percent in Connolly’s district.
3. California’s 18th ($97,001): Democrat Anna Eshoo represents part of San Jose and all of Mountain View, including the corporate headquarters of Google Inc., and Palo Alto, where Stanford University is located. Obama won 68 percent.
4. New York’s 3rd ($95,699): Democrat Steve Israel’s district includes sections of Suffolk and Nassau counties on Long Island, plus a part of Queens.
5. New Jersey’s 7th ($95,189): Republican Leonard Lance’s district cuts across the north-central part of the state, taking in communities like Bridgewater and Summit.
6. New Jersey’s 11th ($93,655): Republican Rodney Frelinghuysen’s constituency includes most of Morris County.
7. California’s 17th ($92,030): Democrat Mike Honda represents Sunnyvale, part of San Jose and the corporate headquarters of Apple Inc. in Cupertino. Obama won 72 percent.
8. Virginia’s 8th ($91,027): Democrat Jim Moran’s district includes close-in suburbs of Washington, including Arlington, Alexandria and part of Fairfax County. Obama won 68 percent.
9. Maryland’s 8th ($90,959): Democrat Chris Van Hollen represents most of Montgomery County near Washington.
10. California’s 45th ($89,383). Republican John Campbell holds a district in central and southern Orange County that includes Irvine and most of Mission Viejo. Republican Mitt Romney won 55 percent of the district vote in 2012.

There you go again

Ok, Democrats, let's work together to fix this Obamacare crap. Start with page 1 and continue until you reach page 11,000. Hmmm, maybe then you'll see why it would be easier to repeal the entire project. The few reasonable parts are coverd in pork and taxes. Take the good parts and let's rewrite it. Just a reasonable solution.

Dr. Information

If you people would just IGNORE little puppy and not respond to him he would go somewhere else. You just play into his pathetic childish game.