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Suggesting the Republican Party should be a party of ideas rather than just attacks, former Speaker of the House Newt Gingrich told a gathering of GOP operatives that lawmakers who criticize Obamacare but offer no alternatives will be left with “zero answer” for constituents who ask for a policy solution to the president’s health care reform law.

“I would bet for most of you, you go home in the next two weeks while your members of Congress are home and you look at them in the eye and you say, ‘What is your positive replacement for Obamacare?’ and they will have zero answer,” Gingrich told state party chairs, activists, and operatives at the Republican National Committee summer meeting. “We are caught up right now in a culture – and you see it every single day – where as long as we are negative, as long as we are vicious, as long as we can tear down our opponent, we don’t have to worry, so we don’t.

“This is a very deep problem,” he added. “I’m being totally candid with you.”

Gingrich’s message at a luncheon on the first day of the RNC meeting was to stay positive and deliver alternatives to Democratic policy instead of just attacks. He said he will “probably spend the rest of my public life trying to drive this message both in the party, but also, in a broader way, in to the American community.”

“We need to build a new model of Republican answers that starts with the health system we need and [then be able to say] "that’s why I’m against Obamacare – in that order,” Gingrich said. “We need to get away from this, ‘I’m against Obamacare,’ and then stop – and that’s all you have to say.”

When asked directly if he agreed with Gingrich’s remarks that Republican lawmakers have “zero” alternatives to Obamacare, Priebus said “not completely,” pointing to some health care proposals some Republican members of Congress have put out on their websites. But he added that the party needs to do a “better job” in developing alternatives. http://abcnews.go.com/blogs/politics/2013/08/newt-gingrich-republicans
-rip-obamacare-but-have-zero-answer-for-alternatives/

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One Reform, Indivisible

Recent political reporting suggests that Republican leaders are in a state of high anxiety, trapped between an angry base that still views Obamacare as the moral equivalent of slavery and the reality that health reform is the law of the land and is going to happen.

But those leaders don’t deserve any sympathy. For one thing, that irrational base is a Frankenstein monster of their own creation. Beyond that, everything I’ve seen indicates that members of the Republican elite still don’t get the basics of health reform — and that this lack of understanding is in the process of turning into a major political liability.

On the unstoppability of Obamacare: We have this system in which Congress passes laws, the president signs them, and then they go into effect. The Affordable Care Act went through this process, and there is no legitimate way for Republicans to stop it.

Is there an illegitimate way? Well, the G.O.P. can try blackmail, either by threatening to shut down the government or, an even more extreme tactic, threatening not to raise the debt limit, which would force the United States government into default and risk financial chaos. And Republicans did somewhat successfully blackmail President Obama back in 2011.

However, that was then. They faced a president on the ropes after a stinging defeat in the midterm election, not a president triumphantly re-elected. Furthermore, even in 2011 Mr. Obama wouldn’t give ground on the essentials of health care reform, the signature achievement of his presidency. There’s no way he would undermine the reform at this late date.

Republican leaders seem to get this, even if the base doesn’t. What they don’t seem to get, however, is the integral nature of the reform. So let me help out by explaining, one more time, why Obamacare looks the way it does.

Start with the goal that almost everyone at least pretends to support: giving Americans with pre-existing medical conditions access to health insurance. Governments can, if they choose, require that insurance companies issue policies without regard to an individual’s medical history, “community rating,” and some states, including New York, have done just that. But we know what happens next: many healthy people don’t buy insurance, leaving a relatively bad risk pool, leading to high premiums that drive out even more healthy people.

To avoid this downward spiral, you need to induce healthy Americans to buy in; hence, the individual mandate, with a penalty for those who don’t purchase insurance. Finally, since buying insurance could be a hardship for lower-income Americans, you need subsidies to make insurance affordable for all.

So there you have it: health reform is a three-legged stool resting on community rating, individual mandates and subsidies. It requires all three legs.

But wait — hasn’t the administration delayed the employer mandate, which requires that large firms provide insurance to their employees? Yes, it has, and Republicans are trying to make it sound as if the employer mandate and the individual mandate are comparable. Some of them even seem to think that they can bully Mr. Obama into delaying the individual mandate too. But the individual mandate is an essential piece of the reform, which can’t and won’t be bargained away, while the employer mandate is a fairly minor add-on that arguably shouldn’t have been in the law to begin with.

I guess that after all the years of vilification it was predictable that Republican leaders would still fail to understand the principles behind health reform and that this would hamper their ability to craft an effective political response as the reform’s implementation draws near. But their rudest shock is yet to come. You see, this thing isn’t going to be the often-predicted “train wreck.” On the contrary, it’s going to work.

Oh, there will be problems, especially in states where Republican governors and legislators are doing all they can to sabotage the implementation. But the basic thrust of Obamacare is, as I’ve just explained, coherent and even fairly simple. Moreover, all the early indications are that the law will, in fact, give millions of Americans who currently lack access to health insurance the coverage they need, while giving millions more a big break in their health care costs. And because so many people will see clear benefits, health reform will prove irreversible.

This achievement will represent a huge defeat for the conservative agenda of weakening the safety net. And Republicans who deluded their supporters into believing that none of this would happen will probably pay a large personal price. But as I said, they have nobody but themselves to blame. http://www.nytimes.com/2013/08/19/opinion/krugman-one-reform-indivisib
le.html?_r=1&

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Why Obamacare is good for young people

Health insurance isn’t like other forms of insurance. It’s not protection against the unlikely; it’s insulation against the inevitable. Most people never use their fire insurance. Almost everyone uses their health insurance. Eventually.

The key is that not everyone uses their health insurance at the same time, or with the same frequency. Sick people use it more than healthy people. The elderly use it more than the young. Women use it more than men.

The trick to making any health-insurance system work is to attract enough healthy and young people into the insurance pool. Their low costs offset the care provided to elderly and unhealthy people, who drive costs up. This is the task that obsesses the Obama administration. It’s also the task that has begun to obsess its opponents.

“The whole scheme is enlisting young adults to overpay, so other people can have subsidies,” Dean Clancy, vice president of public policy for FreedomWorks, told my Wonkblog colleague Sarah Kliff. “That unfairness reminded us of the military draft.”

Clancy is wrong: The subsidies are funded by taxes on rich people and by cuts to Medicare spending, not by the premiums paid by young people. In fact, young people are likely to be the biggest beneficiaries of the subsidies because they’re more likely than any other age group to be poor and uninsured.

“The tax credit premium subsidies are disproportionately going to be helpful for the young adult population,” says Ron Pollack, head of Families USA. “They’ll get the largest tax credit subsidies of any age group.”

But there’s power in Clancy’s broader point: Some young people who don’t get insurance through their employers or a government program are being asked to pay more than the current market calculates they should. Consequently, some who don’t qualify for large subsidies will conclude that it’s in their interest to skip insurance coverage and pay the penalty — remember the individual mandate? — which is less expensive than purchasing insurance.

There is a disclaimer necessary here, as in almost every discussion of the Patient Protection and Affordable Care Act: It’s not for everybody. About 150 million Americans get insurance through their employers. Obamacare’s insurance reforms have basically nothing to do with them. Almost 100 million more get their insurance from Medicare or Medicaid or some highly subsidized government-insurance program. Obamacare doesn’t much matter for them, either. Discussions about premiums under Obamacare are about the 8 percent of Americans expected to get nongroup health insurance through Obamacare’s new marketplaces.

The nongroup market right now is a bizarre health-care system that works best for those who need insurance the least. The sick and elderly are charged sky-high premiums or denied insurance coverage altogether. The upside of that practice, awful as it is, is that premiums are lower for young, healthy people. Obamacare ends that practice; as a result, some young, healthy people will end up paying higher premiums. Why shouldn’t they walk?

First, because of subsidies, which the insurance marketplaces make available on a sliding scale to almost anyone making less than 400 percent of the poverty level. The Kaiser Family Foundation estimates that, among people currently buying nongroup insurance, the average subsidy will be $2,672. For poorer, often younger people, that check will be much larger. So while the young and the healthy might be subsidizing the old and the sick, they’re receiving an even bigger subsidy themselves from the federal government.

The number of young people who make too much money to qualify for subsidies but don’t receive health insurance through their jobs is pretty small (and also not easy to pinpoint). But they exist. So how about them — why should they sign up for health insurance?

The easy answer is they might get sick or injured. Accidents — in cars, on ski slopes, walking down the street — happen even to the affluent. And Obamacare is intentionally structured to prevent people who go without insurance from acquiring it only after they need it. You can only sign up for health insurance during an annual open-enrollment period. So if you get hit by a car two months after you ignored the open enrollment, you’re not going to want to wait for the next enrollment period before you get health care. It’s going to cost you.

Of course, car accidents are rare, so that might be a risk worth taking. Yet even the small group of people who are young, healthy or too rich to qualify for subsidies and don’t have employer-provided insurance have a compelling reason to purchase insurance: They will not be young and healthy — or even necessarily rich — forever. Young people grow old. Healthy people get sick. Rich people become poor. The people overpaying to keep costs low today are the people underpaying 10 or 20 years from now. It’s a terrible mistake to think of yourself as having a fixed relationship to the health-care system. Health needs, income, and demographic profile all change over time — and they can change unexpectedly.

Those young, healthy rich people will need a functional system in the future when they become older, sicker or poorer. So even for those least in need, health-insurance premiums are an investment — not in someone else’s future, but in their own. Only a cramped and narrow view of self-interest assumes that the status quo lasts forever. When it comes to health, change is inevitable. The only question is whether you’ll have insurance when it comes.

So that’s the breakdown: For most people — including young people — Obamacare doesn’t much matter one way or the other. For a lot of young people, it’s a great deal because they get large subsidies, or because they’re already sick and locked out of the system. But for the remainder, it’s worth remembering that being young, healthy, and rich now doesn’t mean you won’t be old, sick, and poorer later — and if and when that time comes, you’ll need a health-care system willing to accept you. http://www.washingtonpost.com/blogs/wonkblog/wp/2013/08/19/why-obamaca
re-is-good-for-young-people/?hpid=z11

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Forever 21 cuts hours, denies it's because of Obamacare

"Company-wide, Forever 21 recently audited its staffing levels, staffing needs and payroll in conduction with reviewing its overall spending budget," Carla Macias, associate director of human resources at the company, wrote in the memo to affected employees. "As a result, we are reducing a number of full-time non-management positions." http://www.cfnews13.com/content/news/articles/cfn/2013/8/19/forever_21
_cuts_hour.html]

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Forever 21, like all retailers, staffs its stores based on projected store sales, completely independent of the Affordable Care Act. After a recent evaluation, Forever 21 realigned its staffing needs to better reflect sales expectations. This realignment impacted less than 1% of all U.S. store employees. https://www.facebook.com/Forever21/posts/10151671883719550?comment_id=
27282872&offset=0&total_comments=2]

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According to a new study by the Center for Economic and Policy Research (CEPR), the Affordable Care Act has not forced employers to cut workers hours.

Obamacare requires firms that have 50 or more employees to provide a minimum level of health coverage to their full-time workers — defined as those who work 30 hours or more per week — or pay a $2,000 per employee fine after the first 30 workers. Since the overwhelming majority of companies that size already offer health care benefits, the provision only affects about 10,000 firms. Nonetheless, reform critics have latched onto the narrative that the requirement is a job-killer, citing the example of retail and service sector companies like Regal Theaters that are cutting back hours to avoid paying for workers’ health care benefits.

The CEPR report shows that to be a minority position among larger employers. Since 30 hours per week is the threshold for employees receiving benefits under the law, researchers expected companies that didn’t want to comply with Obamacare to roll back workers’ hours to just below that threshold. But only about 0.6 percent of the labor force worked between 26 and 29 hours per week in 2013. Since 2012, the number of part-time employees working that range of hours actually stayed statistically the same. Furthermore, less than a third of workers say they are working less than 30 hours because of an employers’ decision — most choose to work the limited number of hours. That led the authors to conclude that the trend “is in the wrong direction for the ACA as job-killer story.”

“While there may certainly be instances of individual employers carrying through with threats to reduce their employees’ hours to below 30 to avoid the sanctions in the ACA, the numbers are too small to show up in the data,” the CEPR researchers write. “It appears that in setting worker hours employers are responding to business considerations in much the same way as they did before the ACA took effect.” http://www.cepr.net/documents/publications/aca-job-killer-2013-07.pdf

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