Thank Goodness that Charles Krauthammer Can Strategize, Because Many Republicans Can't.

There is talk amongst Republicans about forcing a government shutdown in order to defund Obamacare. Krauthammer shows why the idea should be a complete non-starter:

This is nuts. The president will never sign a bill defunding the singular achievement of his presidency. Especially when he has control of the Senate. Especially when, though a narrow 51 percent majority of Americans disapproves of Obamacare, only 36 percent favors repeal. President Obama so knows he’ll win any shutdown showdown that he’s practically goading the Republicans into trying.

Never make a threat on which you are not prepared to deliver. Every fiscal showdown has redounded against the Republicans. The first, in 1995, effectively marked the end of the Gingrich revolution. The latest, last December, led to a last-minute Republican cave that humiliated the GOP and did nothing to stop the tax hike it so strongly opposed.

Those who fancy themselves tea party patriots fighting a sold-out cocktail-swilling establishment are demanding yet another cliff dive as a show of principle and manliness.

But there’s no principle at stake here. This is about tactics. If I thought this would work, I would support it. But I don’t fancy suicide. It has a tendency to be fatal.

As for manliness, the real question here is sanity. Nothing could better revive the fortunes of a failing, flailing, fading Democratic administration than a government shutdown where the president is portrayed as standing up to the GOP on honoring our debts and paying our soldiers in the field.

How many times must we learn the lesson? You can’t govern from one house of Congress. You need to win back the Senate and then the presidency. Shutting down the government is the worst possible way to get there. Indeed, it’s Obama’s fondest hope for a Democratic recovery.

I would only add that the GOP is not bothering to sell the American public on alternatives to Obamacare--and yes, excellent alternatives can be adopted and should be pointed to in order to show that Republicans have a plan on health care reform. Ramesh Ponnuru and Yuval Levin took the time to craft such a plan. (Ponnuru, it should be noted, is on Krauthammer's--and my--side in saying that any effort to force a government shutdown in order to defund Obamacare is a terrible idea that will backfire on Republicans.) If Republicans want to replace Obamacare, it would be helpful if they could point to an actual plan that would serve as an acceptable substitute. Until they do so, their efforts against Obamacare will be quixotic at best.

Bad News and Good News Regarding Obamacare

First the bad news: It may not work all that well

A top administration aide in charge of implementing Obamacare said on Tuesday that he would be "surprised" if it starts perfectly, the latest gloomy assessment of the massive revolution in how Americans get health insurance.

Gary Cohen, deputy administrator and director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare and Medicaid Services, told a friendly audience at the 
Brookings Institution that the early kinks in Obamacare should eventually even out, but that the beginning will be messy.

Citing critical press reports questioning whether the administration will be ready on January 1, the official kickoff of Obamacare, Cohen said, "Will it be as wonderful on the first day as it is on the 30th day, or the 60th day, or the 90th day, or year five? Maybe not."

Of course, the problem is that no one knows what "kinks" we will have to endure as health care "reform" is being implemented. In addition, no one knows for how long we will have to endure said kinks, or how many people will have their health care compromised because of the presence of kinks.

I did promise you good news as well, however. Here it is: Celebrities are going to help roll out Obamacare

Don't you feel better now? 

We Passed Health Care Reform . . .

And now, we are finding out what is in it

Democrats continue to try to dismiss the evidence that Obamacare will dramatically increase the cost of insurance for people who buy it on their own. But on Thursday, the Ohio Department of Insurance announced  that, based on the rates submitted by insurers to date, the average individual-market health insurance premium in 2014 will come in around $420, “representing an increase of 88 percent” relative to 2013. “We have warned of these increases,” said Lt. Gov. Mary Taylor in a statement. “Consumers will have fewer choices and pay much higher premiums for their health insurance starting in 2014.”

The rates that Ohio reported are proposed rates; the Department of Insurance still has to formally approve them. “A total of 14 companies proposed rates for 214 plans to the Department. Projected costs from the companies for providing coverage for the required [by Obamacare] essential health benefits ranged from $282.51 to $577.40 for individual health insurance plans.”

It’s called “rate shock,” but it’s not shocking to people who understand the economics of health insurance. In August 2011, Milliman, one of the nation’s leading actuarial firms, 
predicted that Obamacare would increase individual-market premiums in Ohio by 55 to 85 percent. This past March, the Society of Actuaries projected that the law would increase premiums in that market by 81 percent. Like good players on “The Price is Right,” they both came in just under the Dept. of Insurance’s figure.

I am pretty sure that the actuaries wish that they were wrong. But it would appear that they might have been all too accurate. My question is why we didn't hear more about this when Obamacare was being debated in Congress? I mean, I would hate to think that supporters of the Affordable (ha!) Care Act just decided to ram the bill through without letting the American people hear about the consequences that would fall on the country if the bill passed. That wasn't what all those honorable representatives and senators were aiming to do, was it?

Is Obamacare Affordable?

There has been some celebrating on the port side ever since stories like this one came out, indicating that premium costs associated with the Affordable Care Act--Obamacare--are, well, affordable. We are to believe that 

[b]ased on the premiums that insurers have submitted for final regulatory approval, the majority of Californians buying coverage on the state's new insurance exchange will be paying less—in many cases, far less—than they would pay for equivalent coverage today. And while a minority will still end up writing bigger premium checks than they do now, even they won't be paying outrageous amounts. Meanwhile, all of these consumers will have access to the kind of comprehensive benefits that are frequently unavaiable today, at any price, because of the way insurers try to avoid the old and the sick.

Paul Krugman is positively gleeful as he contemplates the political consequences that he expects to ensue should these findings hold up:

. . . think about the political dynamics. Because the Supreme Court decided to let states opt out of the Medicaid expansion, some states — notably Texas — will have a pretty dysfunctional version of Obamacare in 2014, although even those systems will provide significant benefits to many people. Still, the whole political calculus was supposed to be that Republicans in red states could point to the horrors of Obamacare and ride them to political victory. Instead, it looks as if we’re going to see blue-state residents reaping the benefits of a functional health care system, while red-state residents are denied many of those benefits, for what looks like no better reason than mean-spirited spite — because what’s going on is, indeed, mean-spirited spite.

Predictions that Obamacare will be a big political issue are probably right — but not in the way gleeful conservatives imagined.

Unfortunately for Krugman et al., these claims of triumph do not give us some very important details about the California findings. For those details, one must consult Walter Russell Mead:

On Wonkblog, a pro-ACA outlet that cheered loudly when the California numbers came out, Sarah Kliff argues that success in the Golden State might not be replicable elsewhere. According to Kliff, California is one a few states to take an “active purchaser” approach to the ACA. This means that a state board has the power to select which plans will be available in the exchange, and can reject any plan whose rates are too high. Most other states, however, do it differently:

The vast majority of states…operate under a “clearinghouse model.” In that scenario, any health plan that meets a set of criteria gets approval to sell on the health insurance exchange. All 33 state exchanges that the federal government will run operate under this  clearinghouse model. So do 10 of the 18 state-run health exchanges (this includes the District of Columbia). Two states, Kentucky and New Mexico have not, according to Kaiser Family Foundation, addressed the issue yet.

In the final count, only six states are currently “active purchaser” states, so nationwide might not be as low as California’s projections suggest.

If that’s not enough to temper any lingering optimism, consider that the state had to make some significant tradeoffs to keep rates so low, as an 
LA Times piece reveals. Under the plans offered on the exchange, consumers will have access to far fewer doctors and hospitals. Blue Shield of California, for example, will give its exchange customers access to only 36 percent of its regular physician network . . .

Mead ends his piece with the following words: "With Obamacare, even the good news is often bad." Quite so.