Tag Archives: Health Insurance

Five Bad Men Screw Us Again

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I didn’t want to write about the Supreme Court decision in Burwell vs. Hobby Lobby Stores. That’s the recent case in which the Republican majority ruled that a corporation can refuse to provide health insurance for certain kinds of contraception on religious grounds. However, one way to stop thinking about something is to write about it, and this is not a subject that’s fun to think about:

1) It’s no coincidence that the five Republicans on the Supreme Court are prone to rule against and ignore the rights of women to end or prevent pregnancies. Those five Republicans are all Roman Catholics.

2) Having previously declared that corporations should be allowed to spend on political campaigns because they have the same right to free speech that people do, the Republican majority has ruled again that corporations are no different from people. The law at issue in Burwell vs. Hobby states that the government should not “substantially burden a person’s religious beliefs”. Although corporations are treated as persons in some legal contexts, and it’s proper for the government to respect people’s religion up to a point, it makes no sense to ascribe religious beliefs to a corporation.

In addition, people’s right to practice their religion as they wish does not give them the right to harm other people. According to the majority opinion, however, a corporation can not only have religious beliefs, those beliefs should be honored even though acting on those beliefs negatively affects the corporation’s employees, their families and the rest of society (one of the majority’s suggestions is that taxpayers pay for contraception if corporations won’t – as if the Republicans in Congress would agree to that). 

3) Religion can be a wonderfully flexible way to justify all kinds of behavior. In this case, the corporations claimed that dropping all health insurance coverage for their employees, so that their employees could instead get insurance through the government-run exchanges, would also infringe on their (the corporations’) religious beliefs, even though allowing their employees to use the government exchanges would save the corporations money and benefit their employees. “It is our firmly-held, specific religious belief that you should get your health insurance through our company instead of a government website, but it shouldn’t cover certain kinds of care.” Right.

4) Allowing employers to dictate which health insurance their employees have, on religious or any other grounds, is yet another reason the United States should join the rest of the industrialized world and adopt taxpayer-supported, government-regulated, single-payer health insurance.

5) The idea that the owners of a business shouldn’t be forced to spend money for something they don’t like assumes that the money in question is theirs, just like the money in your checking account is yours. However, economists have found that the money a company spends on health insurance would otherwise generally be paid to employees as wages. After all, health insurance is a form of compensation and businesses tend to offer as little compensation as possible (except for senior management, of course). As Uwe Reinhardt writes:

Evidently the majority of Supreme Court justices … believe that the owners of “closely held” business firms buy health insurance for their employees out of the kindness of their hearts and with the owners’ money. On that belief, they accord these owners the right to impose some of their personal preferences – in this case their religious beliefs — on their employee’s health insurance…. [But research shows that] the premiums ostensibly paid by employers to buy health insurance coverage for their employees are actually part of the employee’s total pay package — the price of labor, in economic parlance – and that the cost of that fringe benefit is recovered from employees through commensurate reductions in take-home pay.

6) This is a case in which religion is being allowed to trump science. These corporations object to particular kinds of contraception on the grounds that they are equivalent to having an abortion. But medical researchers have shown that the methods in question (certain intrauterine devices and the “morning after” pill) don’t actually work that way, as discussed here:

The owners of Hobby Lobby told the Court that they were willing to cover some forms of contraception but believed that the so-called morning-after pills and two kinds of IUDs can cause what they believe to be a type of abortion, by preventing a fertilized egg from implanting in the uterine wall or causing an already implanted egg to fail to thrive… The scientific consensus is against this idea…Most scientists believe that [these methods] interfere with the ability of sperm to get to an egg in time to fertilize it before they die….Research does not support the idea that they prevent fertilized eggs to implant.

If a religious belief is based on faulty science, that belief should be given less respect by the rest of us. It’s safe to assume, for example, that even this Supreme Court would have ruled differently if the religious belief in question had been that certain kinds of contraception cause droughts.

7) There have been a lot of dumb arguments in favor of this decision or suggesting that it’s not a big deal. The truth is that this decision could set a very bad precedent, opening the door to other claims for special treatment, especially given the Republican majority on the Court. In addition, trying to find a job with another company isn’t a great option for many people; getting pregnant is a very big deal; IUD’s are among the most effective form of birth control; it can cost some women a month’s pay to get one; the morning after pill is an important option for women; and choosing to have sex shouldn’t disqualify people from getting appropriate medical care (people also choose to smoke, spend a lot of time on their couches and eat at McDonald’s). As the saying goes, if men could get pregnant, abortion would be a sacrament.

8) It’s been clear since their decision in Bush vs. Gore, when the Republican justices decided that we didn’t need an accurate vote count in a Presidential election, that lacking proper legal justification for their decisions won’t stop them from advancing their political agenda. All Supreme Court justices issue rulings consistent with their political perspectives, but these particular justices are extremists. They may have some shame, but it’s hardly worth mentioning.

More Good News For America

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From the Los Angeles Times:

Driven by a last-minute flood of enrollments, particularly in California, sign-ups for health insurance through the Affordable Care Act’s online marketplaces hit 8 million in the law’s first year, President Obama announced Thursday.

That beats the forecast by 1 million people and caps a remarkable comeback from a disastrous rollout last fall that gave rise to predictions the law would collapse in its maiden year.

Instead, the health law, often called Obamacare, has helped bring about the largest increase in insurance coverage in the U.S. in half a century.

“This thing is working,” Obama said from the White House briefing room, taking a jab at Republican critics who continue to pledge to roll back the law. “The repeal debate is, and should be, over”….

Millions more Americans have signed up for health insurance without using the marketplaces, including through Medicaid, employers or directly from insurers. That has helped to dramatically drive down the nation’s uninsured rate, according to a growing number of national surveys.

Estimates of the total gain in insurance coverage nationally are still preliminary….But new Gallup survey data released this week suggest that as many as 12 million previously uninsured Americans have already gained coverage since last fall.

Republicans are still mouthing off about the numbers being inflated or misleading or whatever. To hell with them. And remember to vote in November.

“Obamacare” Not Such a Disaster After All; Republicans Reconsider Opposition

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The Congressional Budget Office (CBO) has issued a document entitled “Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act, April 2014”.

I quote (some posts are easier to write than others):

Relative to their previous projections, CBO and JCT [Joint Committee on Taxation] now estimate that the ACA’s coverage provisions will result in lower net costs to the federal government: The agencies now project a net cost of $36 billion for 2014, $5 billion less than the previous projection for the year; and $1,383 billion for the 2015–2024 period, $104 billion less than the previous projection….

CBO and JCT estimate that the insurance coverage provisions of the ACA will increase the proportion of the non-elderly population with insurance from roughly 80 percent in the absence of the ACA to about 84 percent in 2014 and to about 89 percent in 2016 and beyond… CBO and JCT project that 12 million more non-elderly people will have health insurance in 2014 than would have had it in the absence of the ACA. They also project that 19 million more people will be insured in 2015, 25 million more will be insured in 2016, and 26 million more will be insured each year from 2017 through 2024 than would have been the case without the ACA.

In other words, the Affordable Care Act will cost less and result in more people having health insurance than previously estimated. Given these very encouraging new estimates, leading Republicans are reconsidering their short-sighted, hypocritical opposition to “Obamacare”. (I made up that last part.)

Grasping at Flaws

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Republicans are doing whatever they can to attack the Affordable Care Act by highlighting people who are supposedly victims of the new law. When reporters look into the details of these sad cases, it turns out that the supposed victims are either lying or ignorant. In one such case, the middle-aged woman described in one of the Republican responses to the State of the Union didn’t know she was eligible for cheaper insurance because she refused to visit one of those evil “Obamacare” websites. One right-wing character responded to this revelation by arguing that it’s mean and unfair to question the story of somebody with cancer.

As Paul Krugman explains (we should all get together and buy this guy a beer or a really nice meal), the ACA does help some people and hurt others. The law tends to help those who are sicker, older and poorer.  It tends to hurt people who are healthier, younger and richer (many of whom will one day be sicker, older and poorer). That’s why the right-wing is having such trouble finding real sympathetic subjects to use in their propaganda. Krugman suggests that when you hear a terribly sad anecdote or see a disturbing advertisement about a sick person who can’t afford treatment anymore or a poor family who can’t afford health insurance because of the ACA, keep in mind that it’s almost certainly right-wing nonsense.

The Usual Fear Mongering Baloney

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Fox News headline: “ObamaCare could lead to loss of nearly 2.3 million US jobs, report says”.

Speaker of the House John Boehner tweets: “Pres. Obama’s [health care law] expected to destroy 2.3 million jobs”.

What the Congressional Budget Office really said:

CBO estimates that the ACA will reduce the total number of hours worked, on net, by about 1.5 percent to 2.0 percent during the period from 2017 to 2024, almost entirely because workers will choose to supply less labor — given the new taxes and other incentives they will face and the financial benefits some will receive….the largest declines in labor supply will probably occur among lower-wage workers….

The estimated reduction stems almost entirely from a net decline in the amount of labor that workers choose to supply, rather than from a net drop in business’ demand for labor, so it will appear almost entirely as a reduction in labor force participation and in hours worked relative to what have occurred otherwise rather than as an increase in unemployment (that is, more workers seeking, but not finding jobs) or underemployment (such as part-time workers who would prefer to work more hours per week)….

In other words, some people, especially low-wage workers, will decide to work less because of the ACA, mostly because of the benefits they’ll receive.

I don’t know why those who wrote the report believe this will result in fewer hours being worked. In the case of anyone but the self-employed, employers will presumably still want someone to work those hours. As the supply of labor declines, the demand for labor should increase, resulting in rising wages for some workers and job openings for others (and, of course, low wages and unemployment are still two of our major problems). 

You might even argue (incorrectly) that everybody should work as much as possible, because that’s the capitalist way. That’s very different, however, from saying the ACA is going to destroy millions of jobs. 

As usual, Paul Krugman offers thoughtful commentary on the economics and the social impact here and here.