New Data Settles the Debate: Obamacare Is Making Health Insurance More Affordable, Not Less

Change in Obamacare Premiums, 2014-2015

It’s that time of year again.

No, not the holiday season. I’m talking about Obamacare season.

In the second year of our new annual tradition, the exchanges are open for enrollment, which begs the question: What have we learned since last time? Were the naysayers proven right, or did Obamacare really make health insurance more affordable, as was intended?

With a new year of data to answer these questions, once more into the breach we go…

At this time last year, the inaugural enrollment period was not going well. The website was malfunctioning, people were losing plans they wanted to keep, and the media was running scare stories about “sticker shock.” I argued, on the contrary, that the website would get fixed in a hurry, most people were getting better plans, and the exchanges were actually reducing the cost of health insurance.

The first prediction was clearly vindicated. The website got fixed, and 8 million Americans enrolled.

The second prediction was also a victory for Obamacare. Before the exchanges opened, 16.4 percent of Americans were uninsured. A year later, only 11.3 percent were uninsured.

And this isn’t only due to the Medicaid expansion. In states that did not expand Medicaid, the uninsured rate fell from 18.2 percent to 13.8 percent. Clearly, the exchanges didn’t just replace old plans. They created new ones for people who didn’t have any.

They didn’t reduce coverage. They expanded it.

And according to the latest Gallup poll, the people who got that coverage are just as happy with it as the people with non-exchange insurance — and the people on the exchange are actually happier with their costs than everyone else.

Which brings us to the third prediction. This one was more controversial.

Earlier this year, I analyzed the many studies of pre- and post-Obamacare costs and came to the conclusion: “On average, Obamacare clearly lowered the cost of health insurance.”

Two of the experts who wrote one of those studies, Paul Howard and Yevgeniy Feyman, disagreed with me. They argued that I misinterpreted their estimates by comparing Kaiser’s estimate for all ages to their estimate for 27-year-olds. But they’re the ones who made the mistake. Apparently, they misread the Kaiser estimate I cited, which referred to 18-to-34-year-olds, not all age groups. I chose this estimate specifically because it was comparable to theirs.

Then, they cited other studies that used the same faulty methodology that they used, and they claimed that I “ignored” those studies — when in fact I explained exactly why those kinds of studies were inaccurate.

Finally, they suggested that I was conflating premiums before subsidies with the cost after subsidies, overlooking the price paid by taxpayers. At this point, I was wondering whether they even read my original article, where I made a clear distinction between the two. The evidence suggested, I wrote, that the average premium increase before subsidies was small — maybe zero. And even if it did increase, that increase was due to people buying more generous plans because now they could afford them. And the point of the subsidies was to make health insurance costs go down for the people who needed it the most — which is exactly what happened.

Whew. You can see what I meant when I said it was controversial.

The good news is, now we have a second year of data to settle the debate, and this data is better because we can compare the same level of plans with the same amount of coverage on the same exchanges, apples-to-apples, as opposed to the pre-Obamacare plans, which were all over the map. Literally.

The nonpartisan Kaiser Family Foundation has examined the “benchmark” silver plans in major cities in all 50 states, and they’ve found that the monthly premiums have increased 2 percent, on average, since last year. That is slower than health insurance premiums have grown in any year since we’ve started recording the data. Only a couple years ago, health insurance costs were growing 5 percent per year. During the Bush administration, they were growing more than 10 percent per year. Two percent is unheard of.

And that’s only the average. In nearly half of those cities, premiums are falling on the exchanges. That’s unprecedented. Health insurance premiums almost never fall. And when you compare premiums after subsidies, 90 percent of cities are paying less than they did last year!

Now, maybe you still don’t like Obamacare. Maybe you’d prefer a simpler, cheaper system. (Who wouldn’t?) But there is one thing you simply cannot deny: Over the past year, health insurance has become more affordable for the non-group market, and the result will be better health care for millions of Americans who need it and wouldn’t have it if Obamacare didn’t exist.

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This op-ed was originally published in today’s Huffington Post.

Guess Who Tried to Prevent the VA Crisis — and Who Stood in Their Way!

The Three Trillion Dollar War

Linda Bilmes and Joseph Stiglitz predicted the VA scandal.

Back in 2008, the eminent researchers — one a professor at the Harvard Kennedy School, the other a Nobel laureate in economics — published a book called The Three Trillion Dollar War, where they argued that most Americans were drastically underestimating the cost of the Iraq War. They didn’t specifically describe the events that have unfolded in recent weeks, but they did point out the enormous burden that would be placed on the VA system as veterans returned from Iraq — a burden that we were not preparing for.

And that was before the surge in Afghanistan.

Upon taking the oath of office, Barack Obama tripled U.S. troop levels in Afghanistan, sending over 60,000 troops into combat. Only now, five years later, have troop levels reverted to the level they were at when he took office. So you can add 60,000 troops for five years on top of the costs projected by Bilmes and Stiglitz — projections that were verified and replicated by the Joint Economic Committee of Congress, as well as Nobel laureate Lawrence Klein, the father of modern economic forecasting.

And yet, Congress refused to boost the VA budget.

For years, discretionary funding for the VA health care system had been growing at approximately 6 percent per year, slightly less than health care costs for the average American family, making it the most cost-efficient system in the country. Meanwhile, it ranked at the top of quality rankings, better than all its private competitors, year after year. It was the best medical care system in America.

That is, until the troops came home.

“Republicans beat back a Democratic attempt to provide almost $2 billion in additional health care funding for veterans,” reported the Washington Post in 2005, “rejecting claims that Department of Veterans Affairs hospitals are in crisis.”

The following year, Bilmes told ABC News, “In 2004, the VA had a backlog of 400,000 cases. Last year it was 500,000 cases. Now the backlog is 600,000 cases. That’s just in two years. And the big wave of returning Iraqi veterans has not even hit yet.”

And yet, the VA budget kept growing by 6 percent per year, as if the war didn’t exist at all.

As if that wasn’t a big enough problem… “Proposed cuts in Department of Veterans Affairs spending on major construction and non-recurring maintenance threaten to derail efforts to update the department’s aging infrastructure,” reported the Washington Post in 2012. And so, Democratic Senator Patty Murray led the charge to boost the VA’s construction funding, only to have it beat down by Republicans.

Later that year, Paul Ryan, the Republican chair of the House Budget Committee, released the party’s annual budget proposal. Had it become law, the VA would’ve sustained billions of dollars in budget cuts, forcing smaller facilities to shut down in rural areas.

So it wasn’t surprising to Senator Murray when allegations surfaced of VA hospitals lying about the number of veterans on their waiting lists because they didn’t want the world to know that they were unable to give their patients lifesaving treatments. “In an environment where everybody is told, ‘Keep the cost down. Don’t tell me anything costs more.’ — it creates a culture out there for people to cook the books,” she said in a recent interview.

Who would’ve ever thought, after years of relentless cost-cutting in the halls of Washington, that the federal government actually spends our money on important stuff? Who would’ve thought that wars cost money, and tax cuts cost money, and maintaining our infrastructure costs money? Not the Republicans, that’s for sure. While the Bush administration plunged us into two wars and cut taxes on the rich, who were already taking a bigger piece of the pie than they had since the Roaring Twenties, Republicans in Congress were blocking every Democratic attempt to give the VA the funding they needed to give our veterans the medical care they were promised. And then, when the Obama administration tried to correct this funding crisis, Republicans responded by proposing deeper spending cuts.

Let this be a warning to every politician and every voter who thinks we can cut our way to prosperity: Those dollar figures represent real services that the government provides to real people. Every cut has a cost, and not just in money. In lives.

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This op-ed was published in today’s South Florida Sun-Sentinel and Huffington Post.

Staying in Afghanistan Is a Recipe for More Terrorism

Global Opposition to U.S. Drone StrikesBarack Obama is daring the terrorists. He’s standing in their front yard. He’s calling them out.

Of course, that’s not how it’s reported. “U.S. ‘nowhere near’ decision to pull all troops out of Afghanistan,” was the understated Reuters headline. Under negotiation is an agreement keeping 8,000 to 10,000 American troops in Afghanistan “through 2024 and beyond.” Also on the table are night raids and drone strikes that Afghan President Hamid Karzai refuses to allow.

This is madness. “If the job is not done,” said the Russian ambassador to Kabul, “then several thousand troops…will not be able to do the job that 150,000 troops couldn’t do.”

The only thing worse than the hopelessness of this plan is the backwardness of it. In an effort to prevent terrorism, we are continuing the very thing that creates terrorism: our presence!

Al Qaeda “has been precise in telling America the reasons [it’s] waging war on us,” according to CIA analyst Michael Scheuer, who tracked Osama bin Laden from 1996 to 1999. “None of the reasons have anything to do with our freedom, liberty, and democracy, but have everything to do with U.S. policies and actions in the Muslim world.”

In his book Dying to Win: The Strategic Logic of Suicide Terrorism, political scientist Robert Pape analyzed every known case of suicide bombers from 1980 to 2005. He found that “what nearly all suicide terrorist attacks have in common is a specific secular and strategic goal: to compel modern democracies to withdraw military forces from territory that the terrorists consider to be their homeland.” Specifically, he discovered that “al Qaeda is today less a product of Islamic fundamentalism than of a simple strategic goal: to compel the United States and its Western allies to withdraw combat forces from the Arabian Peninsula and other Muslim countries.”

The Obama administration can’t pretend that it doesn’t know this fact. In 2004, the Pentagon concluded that “American direct involvement in the Muslim World has paradoxically elevated the stature of and support for radical Islamists, while diminishing support for the United States to single-digits in some Arab societies. Muslims do not ‘hate our freedom,’ but rather, they hate our policies. [In] the eyes of the Muslim world, American occupation of Afghanistan and Iraq has not led to democracy there, but only more chaos and suffering.”

Firsthand accounts confirm these conclusions. British journalist Johann Hari interviewed former Islamic militants who had since rejected jihad. He probed them, in independent interviews, about what made them join the cause in the first place. “Every one of them said the Bush administration’s response to 9/11 — from Guantanamo to Iraq — made jihadism seem more like an accurate description of the world.” One of them put it this way: “You’d see Bush on the television building torture camps and bombing Muslims and you think — anything is justified to stop this. What are we meant to do, just stand still and let him cut our throats?”

New York Times reporter David Rohde saw this attitude up close when the Taliban held him hostage for seven months. Looking back on his captors, he remembered, “Commanders fixated on the deaths of Afghan, Iraqi and Palestinian civilians in military airstrikes, as well as the American detention of Muslim prisoners who had been held for years without being charged.”

BBC journalist Owen Bennett-Jones found the same reaction in his research on the drone strike that killed Taliban leader Hakimullah Mehsud earlier this year. “Although many Pakistanis were happy that Mehsud was no long threatening them,” Bennett-Jones reports, “their relief was outweighed by the thought that the US’s use of drones in Pakistan was an unacceptable breach of sovereignty and a national humiliation.” The result was “a wave of sympathy in the country” for Mehsud and his fellow terrorists.

“As I travelled around the Middle East during the Arab Spring,” writes Bennett-Jones in this week’s London Review of Books, “the word that most often cropped up in the slogans in various capitals was not ‘freedom’ – the one the Western media recognised and highlighted – but ‘dignity.'”

These are the sad facts of a desperate region. We do not condone their violence, but we must understand their motives.

American troops, night raids, and drone strikes in Afghanistan will only make it easier for terrorists and insurgents to recruit angry young men to fight and die for their cause. By extending the occupation into perpetuity, we are not stopping terrorism at the source, as President Obama would have us believe. We are multiplying their ranks. We are taunting and humiliating them. We are endangering our nation.

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This op-ed was published in today’s South Florida Sun-Sentinel and Huffington Post.

Obamacare Is Not a Reason to Give Up on Government Programs

Health Insurance Enrollment Under Obamacare

The biggest myth of the Obamacare debate goes like this: The failures of Obamacare prove that the government can’t be trusted to run our health care system.

This single myth is so powerful that it has become the rallying cry of every Republican who’s considering a run for the presidency in 2016. It has single-handedly brought the Tea Party back to the forefront of American politics. It has been uttered on every cable news channel everyday since HealthCare.gov launched on October 1.

And it is wrong on every possible level.

First of all, the premise is wrong. Obamacare cannot be a litmus test for government-run health care because Obamacare is not government-run health care.

Obamacare creates an online exchange where people can buy private insurance. The government merely sets basic standards that every plan has to meet and gives consumers a place where they can locate those plans. The rest is up to the free market.

This simple concept has been so twisted and misunderstood that many Americans actually believe that the government will have access to their medical records. This is completely false. Under Obamacare, the IRS only needs to verify that you have health insurance. It does not — and cannot — see any of your private health information.

The second problem with this myth is that it’s too soon to judge Obamacare. All new software goes through a trial period. It’s frustrating, but it’s inevitable — and temporary.

Back in 2005, the same thing happened when the Bush administration launched the website for Medicare Part D. First, they had to delay the launch. Then, when they finally rolled it out, it didn’t work at all. Then they got it working, but it was too slow and full of inaccuracies.

Every major news outlet carried stories about the failures of Medicare Part D. According to polling data, the program was actually less popular than Obamacare is today.

Within a few months, the glitches were fixed. Medicare Part D now has a 90 percent approval rating. No one remembers the initial bugs in the system.

The third problem is that many of the so-called “failures” of Obamacare aren’t actually Obamacare’s fault. Remember that Obamacare wasn’t supposed to create one big national insurance exchange. Each state was supposed to create its own insurance exchange, but the Republican governors in half of the states refused to follow the law.

As I wrote back in May, “These Republican governors, who say the states are better at governing than the feds, ceded enormous power to the federal government, violating a core principle of their party’s ideology. And then they crowed that Obamacare was a failure because it required a massive federal bureaucracy — the very bureaucracy that they chose to create!”

What’s worse, these governors didn’t announce their decisions until 2013, so it’s completely false to assert that the federal government had three years to build a national online exchange. They really only had a matter of months.

The fourth problem with this myth is that Obamacare is not a failure. This week, the government announced that more than 500,000 Americans signed up for health insurance through Obamacare in its first month of operation.

Think about that. Obamacare, with all its kinks and snafus, has already improved the lives of over half a million people.

You’ve probably heard that 106,185 people have signed up for health insurance through the new online exchange, but even more impressive is the 396,261 people who got their insurance through Medicaid or CHIP.

In all the hubbub about HealthCare.gov, we seem to have forgotten the Medicaid expansion under Obamacare, and the media hasn’t bothered to remind us because…well, it’s going so smoothly.

And that brings us to the fifth and most fatal flaw in this myth: The biggest success story from Obamacare has been Medicaid, the one part of the law that actually is government-run insurance. To say that the government can’t be trusted is to say that the millions of Americans who benefit from Medicare and Medicaid and CHIP don’t count and don’t matter.

That’s an ugly thing to say, but if you listen closely, you can hear it all around you. Every time the government tries to help the less fortunate, there is always a contingent of Americans who oppose it. But that doesn’t mean we shouldn’t help them. And it certainly doesn’t mean we can’t.

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An abbreviated version of this op-ed was published in today’s South Florida Sun-Sentinel and Huffington Post.

What to Read on Iran

Iran’s Ties to the Taliban — Mohsen Milani

Iran’s views of the Taliban have changed considerably since 2001. Iran did not recognize the Taliban government and considered them an ideological nemesis and a major security threat that was created by Pakistan’s ISI, with generous financial support from Saudi Arabia partly for the purpose of spreading Wahhabism and undermining Iran. When the Taliban were in power in the 1990s, Iran, along with India and Russia, provided significant support to the Northern Alliance, which was the principal opposition force to Taliban rule and eventually dislodged them. Iran also contributed to dismantling the Taliban regime and to establishing a new government in Kabul in 2001.

Ironically, the strategic interests of Tehran and Taliban have converged today, as each, independent of the other and for different reasons, oppose the presence of foreign troops in Afghanistan and demand their immediate and unconditional withdrawal.

A Taliban-dominated government is clearly not in Iran’s long-term interests, since it would generate considerable tension and conflict between Iran and Afghanistan and would inevitably lead Pakistan, and to a lesser extent Saudi Arabia, becoming dominant foreign powers in Afghanistan, which Tehran vehemently opposes. At the same time, Tehran has for many years maintained that political stability in Afghanistan can be achieved only if the government reflects the rich ethnic and sectarian diversity of Afghanistan itself. Iran, more than anything else, wants to see a stable and friendly government in Kabul. Tehran now seems convinced that without Taliban participation in the government, as a partner but not as the main force, stability would be unattainable.

Tehran has attempted in vain to convince Karzai to call for the withdrawal of Western troops. Tensions between the two neighbors are likely to increase if there is a new agreement between Washington and Kabul about establishing permanent U.S. military bases in Afghanistan.

Mousavian: Iran Is Ready to Negotiate…If — Semira Nikou

The supreme leader, Ayatollah Ali Khamenei,…does not object to transparency because he already issued a fatwa in 1995 against weapons of mass destruction. But he is against discrimination, suspension [of uranium enrichment], and the deprivation of Iran’s rights under the Nuclear Non-Proliferation Treaty (NPT).

On the nuclear issue, the end state for the Iranians is full rights under the NPT, without discrimination over enrichment. Other countries enrich but do not face sanctions. The nuclear impasse will not be resolved as long as U.N. resolutions are enforced because they require Iran to indefinitely suspend enrichment and provide access to sites and scientists for an indefinite period. These conditions extend beyond the framework of NPT.

Iran views indefinite suspension as a way for the P5+1 (five permanent members of the U.N. Security Council plus Germany) to buy time for a long-term ban on Iran’s enrichment program and ultimately its discontinuation.

Iran and al-Qa’ida: Can the Charges Be Substantiated? — Flynt Leverett & Hillary Mann Leverett

[The] Iranians raised, almost immediately after the U.S. invasion of Afghanistan, the problem of al-Qa’ida personnel trying to make their way from Afghanistan into Iran…

…Tehran documented its detention of literally hundreds of suspected al-Qa’ida operatives, repatriated as many of these detainees to their countries of origin as it could, and requested U.S. assistance in facilitating repatriations of detainees whose governments did not want to cooperate (a request the Bush Administration denied).

…Iranian officials acknowledged that a small group of al-Qa’ida figures had managed to avoid capture and enter Iranian territory, most likely through Sistan-Balochistan, in 2002. The Iranian government located and took some of these individuals into custody and said that others identified by the United States were either dead or not in Iran. At the beginning of May 2003, after Baghdad had fallen, Tehran offered to exchange the remaining al-Qa’ida figures in Iran for a small group of MEK commanders in Iraq, with the treatment of those repatriated to Iran monitored by the International Committee for the Red Cross and a commitment not to apply the death penalty to anyone prosecuted on their return. But the Bush Administration rejected any deal.

Of the six al-Qa’ida operatives sanctioned by the Treasury Department last week, only one is alleged to be physically present in Iran — and, by Treasury’s own account, he is there primarily to get al-Qa’ida prisoners out of Iranian jails. Moreover, the United States apparently has no hard evidence that the Iranian government is supportive of or even knowledgeable about the alleged al-Qa’ida network in the Islamic Republic.