Health Law Commentaries: ‘A Reader’s Guide’ To Possible ‘Traumas To Come;’ California Shows The Way To Success

Commentators look at the rollout of the health law and the implications for the nation and individual states.

The Wall Street Journal: Manias, Panics And Obamacare Crashes
President Obama says not to worry about the Affordable Care Act's botched rollout because the country will love it once the website is fixed and subsidies start rolling. But what if the troubles are only beginning because they're built into the law? In the tradition of service journalism, we thought we'd offer a reader's guide to the many potential Obamacare traumas to come (11/22).

The Wall Street Journal: The Medicare-For-All Diversion
Many on the left tell us the solution is Medicare-for-All, because Medicare is so much more efficient than private insurers, spending a mere 2 percent on overhead compared to 20 percent or higher for private plans. Extraordinary claims require extraordinary proof, and the idea that a bureaucratic agency with no obvious incentive for efficiency is inexplicably efficient certainly qualifies. Yet many in the media are prepared to pass along this claim as a found item. This requires overlooking a lot (Holman W. Jenkins Jr., 11/22).

The Washington Post: Health-Insurance "Assisters" Comb D.C. To Educate, Sell
Hard as it might be to believe for those who've been pushing, pulling or just writing about the Affordable Care Act for years, not everybody has been following it, even within a couple of miles of Capitol Hill. So at several Washington Metro stops Friday, smiling "assisters" for the local insurance exchange, D.C. Health Link , were out with megaphones, calling themselves "fact mobs." "Good morning!" they shouted. "We are the D.C. fact mob, and we have facts for you!" (Melinda Henneberger, 11/22).

Politico: The Obamacare 'Fix' Is Illegal
The fix is not in. One week later, states are still wrestling with whether to implement Barack Obama's answer to the wave of dropped plans that greeted the launch of his signature health care initiative. The president's "fix," announced last Thursday in a somber news conference, allows insurance companies to renew policies that do not meet the minimum care standards of the Affordable Care Act (ACA), which go into effect on Jan. 1 (Eugene Kontorovich, 11/22).

The New York Times: California, Here We Come?
It goes without saying that the rollout of Obamacare was an epic disaster. But what kind of disaster was it? Was it a failure of management, messing up the initial implementation of a fundamentally sound policy? Or was it a demonstration that the Affordable Care Act is inherently unworkable? ... At a time like this, you really want a controlled experiment. What would happen if we unveiled a program that looked like Obamacare, in a place that looked like America, but with competent project management that produced a working website? Well, your wish is granted. Ladies and gentlemen, I give you California (Paul Krugman, 11/24).

Lexington Herald-Leader: Editorial Ignores Facts; New Health Law Is A Failure
I read with amusement your recent editorial twisting the facts of the disastrous Affordable Care Act. As much as this newspaper loves to root for Obamacare, the fact remains that most Kentuckians oppose it, and for good reason. For starters, the law has resulted in less coverage, causing 280,000 Kentuckians to lose the health insurance plans they already have. It's taking away many Kentuckians' ability to visit the doctors and hospitals they like. And it will increase health care costs and add so many new enrollees to Medicaid (read: paid for by taxpayers) that even Gov. Steve Beshear told The Paducah Sun in early 2011, "I have no idea how we're going to pay for it." In short, Obamacare is a failure (Sen. Mitch McConnell, R-Ky., 11/25).

Bloomberg: The Health-Care Spoiler In California's Rosy Budget
Despite a 30 percent increase in the top income tax rate, higher sales taxes and fees, and greater total revenue, the state is spending less on education, transportation, courts, welfare and parks than it was six years ago. The reason: State spending on health care, employee compensation and benefits, interest, and prisons is greater than it was six years ago. The largest spending growth is in Medi-Cal, which is California’s version of Medicaid. The program is the state's second-largest and fastest-rising expenditure, and accounts for most of the Department of Health Care Services' outlays, which grew 65 percent over the six-year period, to $24 billion a year, from $14 billion (David Crane, 11/22).

The Anchorage Daily News: Parnell's Medicaid Decision Affects 43,000 Alaskans
I was struck, however, by the governor's evident disconnect with the health care issues affecting Alaskans, or even how health care works. ... Here's one example from the briefing: "Medicaid expansion does not necessarily address the poor's actual access to health care. It does, however, affect their eligibility to have it covered financially ... The real issue in Alaska is, and always has been, access, not insurance ..." Huh? Insurance means access. Low-income Alaskans have difficulty accessing health care mainly because they can't pay for it. That's what health insurance does -- it assures access to care (Tim Bradner, 11/23). 

Charleston (S.C.) Post and Courier: Another Shaky Obamacare Pitch
The Obama administration's expansion advocates pitched the upward shift as a sweet deal for the states. They stressed that Washington would cover all of the extra costs of the expansion through 2017. Then the states' share of the additional financial obligation would rise in increments to a maximum of 10 percent. But some governors, including South Carolina’s Nikki Haley, were rightly wary about that guarantee from Washington. After all, the administration making the promise is led by the president who repeatedly assured Americans while pushing Obamacare: "If you like your health insurance plan, you can keep it" (11/24).

The Salt Lake City Tribune: No Amount Of Committees Can Justify Not Expanding Medicaid
Thus a great deal of effort has been expended by the Utah Legislative Health System Reform Task Force for it to come up with reasons why the state should not accept the challenge, and the federal money, to fully expand Medicaid health care coverage under the provisions of the Affordable Care Act. It is an effort designed to make it easy for Gov. Gary Herbert to reject or downsize the Medicaid expansion option included in the ACA and, by so doing, uphold ideological dogma for the well off at the expense of human suffering, bankruptcy and death for the working poor (11/24).

Deseret News: Utah Needs Balanced Medicaid Expansion
Utah must soon decide whether and how to expand Medicaid. It is a momentous choice. For two generations, Medicaid has provided health care to some needy Utahns -- children, women with children and the disabled. Many groups note the federal government's generous Medicaid matches and conclude that full expansion is a "no-brainer." ... the Utah Hospital Association (UHA) has carefully considered the various options for Medicaid expansion, including not expanding it at all. UHA supports a limited and balanced approach to Medicaid expansion (Greg Bell and David Entwistle, 11/24).

Concord Monitor: With No Medicaid Deal, Needy Residents Continue To Wait
In that context, the inability of New Hampshire political leaders to come to agreement last week on a proposal to extend health care coverage to some of the state's neediest residents is all the more discouraging. At issue was a remarkably generous deal by the federal government: expand the eligibility of the New Hampshire Medicaid program to cover another 50,000 residents, and the feds would pick up 100 percent of the cost for the first three years. After that, the federal share would drop to 90 percent. As has happened elsewhere, Democrats liked the deal, Republicans didn't (11/24).

St. Louis Beacon: Hard Lessons From The ACA Roll-Out
As a professor of public policy I am always on the lookout for events that I can use as Teachable Moments in the classroom. The rollout of the Affordable Care Act, aka Obamacare, certainly qualifies as a case study of what not to do when implementing a new public policy (Robert Cropf, 11/25).