If the Affordable Care Act (“Obamacare”) is a success, it will probably follow the pattern of the prototypical “Romneycare” system in Massachusetts. In the latter case, young, relatively healthy people (“the invincibles”) were slow to enroll but did so in a rush as they neared the deadline for complying with the mandate for individuals to buy insurance. The clumsy rollout of Obamacare is raising concerns that history won’t repeat itself—and Obamacare has a heavier lift in that Massachusetts was much closer to universal coverage even before it enacted its health care reform.
But it will take months to find out if enough invincibles buy or upgrade insurance to subsidize the expansion of affordable policies to older, sicker Americans. (Think Progress’s Igor Volsky: “Without a mechanism that encourages younger and healthier individuals to buy coverage and spread the risk and cost of insurance, programs composed of very costly applicants are not sustainable.”)
Until then, both sides are furiously spinning the early numbers on how many are signing up and how many are getting cancellation notices for pre-existing policies that don’t meet the new federal requirements. (New York magazine’s Jonathan Chait writes that Obama “failed to convey the blunt reality that people in the individual insurance market who had skimpy coverage and wanted to keep it could not.”)
It feels like the morning hours of an Election Day, with misleading anecdotal reports on turnout (there’s almost always a surprisingly long line somewhere that turns out to be an aberration) and leaked exit polls (like the ones that predicted the John Kerry administration). Any data points that are tweeted this early must be eyed with suspicious, as they may be designed to influence an election that is still going on.
In this case, we’re getting anecdotes about people getting ridiculous increases in their premiums or first-time insurance buyers who are hunky-dory with the new systems (the latter, so far, are less frequent and mostly found through state-run exchanges rather than the federal exchange with the no-good, horrible website). Paul Waldman picks apart a couple of the stories here and here. There’s some irony in this on the conservative side, which generally likes to look at the big picture rather than individual sob stories. Remember Ronald Reagan complaining, “Is it news that some fellow out in South Succotash somewhere has just been laid off that he should be interviewed nationwide?”
We can expect a few more months of this, and even when we reach the date by which individuals must purchase insurance (and that date could shift), there probably won’t be a consensus which side has won politically, unless Tyler Cowen is right and President Chris Christie will have to salvage Obamacare for parts. This may be the longest and most tedious Election Day ever.
Conservative point vs. oddly different point: The New York Times’s Ross Douthat worries that Obamacare is raising overall health costs by pushing people onto more comprehensive plans: “If we want health inflation to stay low and health care costs to be less of an anchor on advancement, we should want more Americans making $50,000 or $60,000 or $70,000 to spend less upfront on health insurance, rather than using regulatory pressure to induce them to spend more.” Reason’s J.D. Tuccille worries that doctors will refuse patients because Obamacare is too aggressive in trying to lower health care costs: “acting as doctor-repellent are compensation rates far, far below those offered by existing health plans.”
Look away from Virginia, says national GOP
“We need people to know that Nov. 5 in Virginia is a referendum on Obamacare!”
That was Republican gubernatorial nominee Ken Cuccinelli a week before Election Day, while campaigning in Herndon, Virginia, with libertarian hero Sen. Rand Paul. Slate’s Dave Weigel writes that the national Republican Party does not want the media to see this as a referendum on Obamacare at all, since “what was supposed to be a competitive race for governor between two unpopular candidates is in danger of turning into a rout” by Democrat Terry McAuliffe—capitalizing on the growing electoral strength of the Washington, D.C. suburbs in the northern part of the state.
One indication of the limits of libertarianism here: This was the only early presidential primary in 2012 where Mitt Romney went one-on-one with Rep. Ron Paul (Rand’s dad). Paul won a handful of counties (and the cities of Lynchburg, Norfolk, and Portsmouth) but lost the state overall, 59.5 percent to 40.5 percent.
Boston tests its boundaries
Boston has a close but rather sleepy mayoral race coming to a close next week. Boston magazine’s Jason Schwartz grills candidates Marty Walsh and John Connolly and finds agreement on the awfulness of Martin Sheen’s accent in The Departed. And at WBUR, David Scharfenberg’s profile of John Connolly takes note of how neighborhood identity is still a big factor in this gentrifying city:
Connolly, 40, says the talk of a privileged upbringing is a bit overblown: Roslindale, he quips, is no Beverly Hills.
That’s a crucial corrective in a race against Walsh, a longtime labor leader who grew up in a triple-decker in Dorchester and has pitched himself as a champion of the working class.
Still, Connolly is acutely aware of the advantages he had — advantages that were particularly pronounced in the Boston of the 1970s and 1980s.
“There was a real polarization in Boston along racial and class lines,” he says. “There was just some real terrible hatred that often felt palpable. And I think it gave a lot of us a real sense that things weren’t right. Certainly for me, while I was very lucky to grow up in Roslindale, I knew that there were so many people in my generation who were not getting the opportunities I did.”
Meanwhile, CommonWealth’s Paul McMorrow takes note of what may be a more historically significant race, as South Boston, fabled for its political influence, may lose its grip on a City Council seat.