Showing posts with label Obamacare. Show all posts
Showing posts with label Obamacare. Show all posts

Monday, January 20, 2014

Chris Christie - Scandal or Unholy Media Alliance?, What Does Obamacare Success Look Like?

Chris Christie, New Jersey Politician
Just as the narrative was going the way Chris Christie wanted it - a resounding re-election of a relatively conservative Republican in the blue state of New Jersey, bipartisan praise for his efforts around Hurricane Sandy, the national media beginning to talk about him as the presumptive frontrunner for the GOP nomination in 2016, things took an ugly turn.

It started with the Fort Lee bridge scandal.  Christie crony David Wildstein, who had been appointed to a senior role at the Port Authority has been revealed to have intentionally caused traffic jams in Fort Lee by closing lanes on the George Washington Bridge in order to get back at the Democratic Mayor of Fort Lee for not endorsing Christie.

This story has several complex dimensions, so let me lead with some of my major observations:
First, that Wildstein intentionally took action to harm Fort Lee for political reasons is unquestionable based on the communications that have gone public.  It is also unquestionable that Wildstein is a close ally of Christie and that the role in the Port Authority was created for him as a reward for his loyalty.

What is not clear - and may never be clear - is whether Christie himself was aware of the actions being taken at the Port Authority.  Christie had a very well run press conference where he apologized, expressed embarrassment, fired Wildstein and promised full disclosure and reform.  All correct actions.

If all that is ever proven is that Christie appointed Wildstein as a political appointee and that Wildstein went rogue ordering the bridge delays, then it is a small mark against Christie for choosing poor friends, but hardly a major scandal.  That Wildstein was a political crony may be blown up, but the fact is, most political appointees are loyalists to the politicians that appoint them, so this is nothing new.  Some Democrats have argued that Christie created an environment where such actions were viewed as okay - this may or may not be true but it is a pretty thin argument absent any evidence of Christie's involvement in these types of operations.

So, by itself, Fort Lee as it stands will probably not have legs into the spring and summer.

The allegations made this weekend by the Mayor of Hoboken are a different animal.  Her allegation was that she received a direct message from Lt. Governor Kim Guadagno that Hoboken would not receive promised Hurricane Sandy relief unless she supported a private development deal supported by the Governor.

Mayor Zimmer's allegations have not yet been proven, but if true, are much worse than the Fort Lee mess for a few reasons.  One, she is claiming direct involvement of the Governor.  Second, what she alleges would essentially mean the Governor's office was leveraging public funds to support private investments of his friends, a far more serious allegation than simple political payback.  Third, it strikes at the heart of one of Christie's signature achievements, Hurricane Sandy restoration.

We have much to learn - as things stand now, there is no direct evidence of the Governor's involvement in either scandal.  Absent some form of proof, these allegations carry little more weight than conspiracy theories.  But rest assured, every media outlet in the country is looking for such proof.

The most fascinating angle of these stories is the amount of national attention that has been paid to these stories - they have been lead stories for national news outlets across the political spectrum for weeks.  Why?

One of the reasons is journalistically reasonable - that Christie is the presumptive front-runner for the GOP nomination and therefore scandals involving him elevate from local to national news.  But there is something else going on here - an unholy (or holy, depending on your point of view) alliance between the hard right and the hard left.  You see, Christie is a target from both sides of the political spectrum.  The right wing dislikes him because he is a relative political moderate in the party these days and doesn't want to see him get the 2016 nod, favoring more conservative candidates such as Rand Paul or Ted Cruz.  The left dislikes him because he is the presumptive frontrunner for the GOP nod in 2016 and they want to take him down a peg for a potential national election - particularly since they fear his chances of success a lot more than the far right candidates that they feel confident they can beat.  So both MSNBC and Fox News have been pounding away relentlessly at these stories and the more mainstream press has followed suit.

What all of this means for Chris Christie's political future is uncertain.  It all depends on what facts come out about his involvement.  At the very least, it momentarily halts his momentum towards 2016 and opens the air for other credible candidates to emerge.  Somewhere, Jeb Bush is smiling.

Obamacare - How Do You Measure Success?
When President Obama set out to do health insurance reform, his goal was to cover uninsured Americans.  His original goal was to cover everyone through a combination of public plans, including Medicare, an expanded Medicaid, SCHIP and a "public option" on insurance place markets and private plans through a combination of employer provided and privately purchased plans.

It was clear from the outset with the compromises made to secure passage of Obamacare that the bill would not cover 100% of Americans.  First, the public option was taken off the table.  Second, the penalties for not holding insurance were made modest enough that everyone knew some would not participate in the market.  Third, the medicaid expansion was made optional for states, meaning that in Republican-controlled states that chose to reject the expansion, there would be an automatic gap in the market.

So how are we to measure the success of Obamacare?

The internal benchmark set by the Obama administration was the coverage of 7 million people in the marketplaces by the close of open enrollment at the end of this March.  Additionally, 9 million new people would be covered by Medicaid, adding 16 million in total to the rolls of the insured.

By that measure, Obamacare is gathering steam.  Marketplace enrollment through December reached 2.2 million people - short of the internal benchmark set by the Obama administration of 3.0 million by that point in time, but a huge boost from the early months, when major issues with the website plagued enrollment.  Medicaid enrollment is up 3.9 million for the year so far, although it is impossible the way the numbers are reported to tease out how much of that is due specifically to Obamacare and how much is due to other factors like economic changes.

By these benchmarks, Obamacare certainly doesn't look like a disaster - it looks like a piece of governance that is building steam and covering more people.

The initial reactions of sticker shock also seem to be fading.  I did a quick search for insurance policies in Las Vegas, using the Nevada exchange (I picked Nevada because they have an easily searchable exchange, are a mid-sized state and have a sizable number of uninsured, so they are an ideal target of Obamacare), reveal the following unsubsidized rates for a 40-year old non-smoker:
Cheapest "Bronze" Plan - $182.50/mo
Cheapest "Silver" Plan - $237.13/mo
Cheapest "Gold" Plan - $259.97/mo
Cheapest "Platnium" Plan - $320.27/mo

These rates, to me at least, are astoundingly cheap.  The Platnium plan that is $320.27/mo plan provides primary care doctor's visits for $5 apiece and specialist visits for $25 per visit, both with no coinsurance.  Generic prescriptions have a $0 copay, formulary brand name has a mere $15 copay.  The calendar year deductible on the plan is $400 and coinsurance on things like major surgery is only 10% after the deductible, with preventative and prenatal care carrying no deductible and no coinsurance.  Best of all, the out-of-pocket maximum is only $2,000, meaning that beyond the cost of the premium, you are never going to pay more than $2,000 for health care.  Those rates assume that you use the provider network, there are higher rates for going out-of-network, very typical of all insurance policies.

In short, for $320.27/mo, if I lived in Las Vegas, I could get a phenomenally better insurance policy than the very good policy that I current get from my employer.  And keep in mind that if my income is less than 400% of the poverty level, I would get a subsidy against this rate.

By this measure, Obamacare plans seem phenomenally good at cost and benefit.

I picked a middle-of-the-road scenario - a tobacco user would pay a higher premium (although such premiums are capped at a 50% premium to the non-user) and if I lived in a smaller state, there might be less competition and higher prices.  If I'm 60, that same policy shoots up to $680/mo, if I'm 25 it is only $251/mo.

The ultimate success will not be measured by my view of the value of the policies, however.  I think the best metric, which we won't know for some time, is the NET change in the number of uninsured people.  Critics have rightly pointed out that the raw enrollment numbers don't tell us how many people who would have bought insurance anyway from private companies are enrolled.  It also doesn't account for the impact of policy cancellations.

It is WAY too soon to judge the success of Obamacare one way or another.  But we are definitely way past the point where it is about a non-functioning website, which I always believed was a short-term question.

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Friday, December 27, 2013

The Year of 2013 In Reflection

2013 was about as substantive a political year as one can have in an odd-numbered year in the United States.  Here is a look back at what, in my opinion, are the 10 biggest news stories of the year from a political standpoint:

10.  The Crazy New York Mayor's Race
Anthony Weiner's weiner was back on display with sexting abounding.  Christine Quinn was handed a gimme and proved to be an absolutely abysmal candidate.  Bill de Blasio, the boring looking white guy with the hip interracial family (I mean, come on, who doesn't love Dante and his afro?) sneaks in to win a resounding victory.

9. Cory Booker Takes the Next Step
There are quite a few of us in the political realm that have been watching Cory Booker for some time and think that he is probably Presidential timber.  Some in the past have questioned his sexual orientation, but I frankly think that is MUCH less of an issue on the national stage than it was 20 years ago and it is one he has handled adeptly.  Booker has moved his political career at a deliberate pace, choosing to stay as Mayor of Newark for over 7 years, when he almost surely could have moved to a larger office sooner than that.  With his election to the Senate by a solid (although less overwhelming than some imagined) 11 point margin, Booker immediately becomes at the top of the 2016 VP candidate list and near the top of the 2020/2024 Presidential prospects.

8. Democrats Win in VA, Republicans in NJ
The results of an actual election would typically top the year's stories, but this year's results were largely affirmations of things that we already knew.  First, in Virginia, when you run a wing nut in a swing state, as the GOP did, you generally lose, even when you are running against a horrible candidate, which Governor-Elect Terry McAuliffe certainly was.  In New Jersey, Chris Christie proved again that center-right pragmatism CAN win in the northeast - maybe a model for a national election?

7. The Death of Nelson Mandela
First, a word of explanation.  Nelson Mandela deserves to be much higher than number 7 on virtually any list that you could conceive.  His story is amazing, from violent revolutionary to prisoner to quiet, forgiving, strong leader that ushered South Africa peacefully and successfully into the post-apartheid era, Mandela is one of the largest figures on the global stage in the past century.  Mandela's story largely happened in prior years, however, with his biggest moments coming after his release from Robbin's Island and his rise to lead the first post-apartheid government and share a Nobel peace prize with apartheid leader F.W. De Clerk.  Mandela was a great man, worth remembering.  His death is a loss to the world.

6. Pope Francis
The first Latin American (although ethnically Italian) pope has made his mark early, casting a strong contrast with his predecessor by urging the church to de-emphasize condemnation of abortion and homosexuality (although he has maintained the existing church doctrine) and focus instead on serving the poor and presenting a more modern, positive image of the church.  This is a huge and badly needed shift for the church and one that will have political impact both in Europe and the US.

5. The Boston Marathon Attacks
For a brief moment, we were all reminded in a most horrific fashion how free nations will always remain vulnerable to terrorists.  This story hit me personally as I was staying in Boston at the time of the attack.  Since September 11 through a combination of good intelligence, smart preventative measures, a weakened Al Qaeda and some good luck, we have had a precious few damaging attacks.  The Tsarnaev brothers unfortunately changed that for reasons which are still not entirely clear.

4. Syria - Airstrikes / No Airstrikes
In one of the most bungled pieces of foreign policy in recent memory, President Obama declared that the US would conduct limited air strikes in Syria and that he didn't need Congress' permission to do so.  He then sought that permission, didn't get it and didn't conduct the air strikes.  Syria then bailed him out by agreeing to dismantle it's nuclear program (we'll see.)  It's an odd world.

3. Gay Marriage Everywhere
My favorite story of the year.  First, Maine, Washington and Maryland brought in the new year by becoming the first three states to legalize gay marriage by public ballot.  Then, Rhode Island, Delaware, Minnesota, Hawaii and Illinois all legalized gay marriage via bills passed by state legislatures and signed by their respective governors.  Then, the SCOTUS struck down a key provision in the Defense of Marriage Act and essentially forced the federal government to recognize gay marriages performed by states where it is legal for federal benefits.  While the ruling stopped short of legalize gay marriage nationally, the reasoning of the fifth vote for the 5-4 decision from Anthony Kennedy made it pretty clear to most of us that SCOTUS inevitably will make such a ruling but was simply buying some time.  On the back of the SCOTUS decision, judges in New Jersey, New Mexico and Utah have forced those states to legalize same-sex marriage.

All told, in December of 2012, there were only 7 states that had legal gay marriage.  There are now 18.  Anyone want to bet whether we make it to 50 in the next 2-3 years?

2. The Shutdown
In the most visible show of disfunction in at least 20 years, the federal government partially shut down as a budget deal seemed elusive.  We learned a few things in the debacle - the Tea Party was willing to push for its agenda even in the face of certain defeat, John Boehner was unable to control his caucus against the Tea Party (he has since lashed out at far right interest groups - I think he has had enough), shutdowns actually cost more than the government running and Democrats ruled the day....that is until our #1 story took place.

1. The Obamacare Mess
Oh what a disaster in the execution.  Democrats and the President have given up untold capital and the Affordable Care Act has given up massive credibility as the federal government failed to be able to design a website with over 3 years warning.  While I don't think that the initial execution is indicative one way or another as to the prudence or long-term success of the law, it will surely cost the President any hope of driving the congressional agenda next year and will undoubtedly cost the Democrats seats next fall.  Any dreams of regaining the House that Democrats may have had after the shutdown are gone and whether they retain the Senate or not is a open question at this point.

Happy New Year, everyone!

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Saturday, December 14, 2013

Why Everyone Punted on the Sequester

Deal
In a rare moment of bipartisanship, Rep. Paul Ryan (R-WI) and Sen. Patty Murray (D-WA) this past week reached a budget compromise that is actually quite moderate in nature.

Conservatives got the two things that were most critical to them - no tax increases (although there were some fee increases, which I feel are defacto tax increases - more on that later) and restoration of some of the sequester budget cuts.

Liberals got two more years without entitlement cuts as the agreement leaves Social Security, Medicare and Medicaid untouched.  They also got higher overall spending caps (by $63 billion) over the next two years than the sequester allowed, although part of that increase will go to defense.

In theory, the package is deficit reducing, but probably not in reality.  The package allowed $63 billion in additional spending over the next two years, offset by $85 billion in cuts (primarily from federal workers and military pension contribution changes) and fee increases (most notably an increase in the fee on airline tickets) over the next 10 years.  So if the world stays utterly static over the next ten years, the deficit will go down, but the reality is that the package increases the deficit by $45 billion over the next two years versus the sequester agreement and it is a near 100% certainty that budgeting over the following 8 years will change.

This is a small-ball bargain that largely preserves the status quo.  It does not touch in any meaningful way the three biggest drivers of the deficit, which are entitlement spending, defense spending and revenues.  But that might actually be okay - the federal budget last year was $680 billion, way down from the recession heights of $1.4 trillion+ and clocks in at only 4.0% of GDP, close to a reasonable level.  In order to keep the debt to GDP ratio constant, the deficit can be as high as the inflation rate plus the rate of economic growth.  If one assumes modest 2% inflation and 2% GDP growth, then a 4% deficit will essentially keep debt flat in real terms.

Unfortunately, the math above only works if you never have a recession.  Recessions cause huge spikes in spending and decreases in revenues that shock the system.  In order to pay for these approximately once per decade shocks, in the good years, governments need to be running deficits of a lot less than 4%, ideally budgets would be balanced or even slightly in surplus.

The brief modern history here is that the US exited World War 2 with major debt from war obligations, with debt to GDP running as high as 120%.  We steadily "paid down" this debt, no so much through absolute reduction but though inflation and economic growth and by the end of the Carter administration, debt had fallen to 35% of GDP.  The next 12 years of Reagan and Bush (although H.W. did eventually agree to tax increases) saw major increases in defense spending, no cuts to social spending and large tax decreases, all of which, combined with the 90-91 recession, spiked debt to almost 70% of GDP.  The Clinton administration saw tax increases (his idea) and large cuts in defense (his idea) and social spending (Newt Gingrich's idea) which combined for budget surpluses and took debt down to 55% of GDP.

Then W. Bush took over as President and immediately slashed taxes, instituted prescription drug benefits for Medicare and ramped up defense spending in the build-up to wars in Afgahnistan and Iraq.  Debt was already up to over 70% of GDP before the recession hit and spiked to over 80% of GDP by the time Bush left office as massive outlays for bank bailouts and social benefits hit the federal coffers as the recession hit.

The first year of the Obama administration saw continued large outlays for the bailouts coupled with a large stimulus bill that spiked the debt by almost 10% in a single year.  Now the debt has stabilized right around 100% of GDP.

We really need to get back to about 50% of GDP to be able to absorb comfortably the next recession, since debt levels over 100% of GDP are reaching towards the saturation point where credit downgrades and loss of investor interest cause a spike in interest rates.  And a 1% interest rate increase on a 100% of GDP debt increases the deficit by 1% of GDP, meaning that we are very susceptible to interest rate risk if rates rise off of their current historic lows.

This deal won't accomplish any of that - it doesn't deal with tax reform, entitlement reform or defense spending reform.  But it does give the markets certainty, prevents another government shutdown in the near term and at least maintains debts and deficit at a stable level.

It is also significant in that conservatives agreed to new sources of revenue.  An increase in the airline ticketing fee is effectively a tax, since it is a direct charge to you as a consumer when you purchase an airline ticket.  Calling it a fee and not a tax is politically expedient, but the effect is the same - airline consumers pay more to the government.

The deal passed overwhelmingly in the conservative-dominated House, by a roll call vote of 332-94 with 73% of Republicans and 84% of Democrats backing passage.  It seems likely to pass the Senate, although, oddly, Republican opposition in the Senate seems a lot stronger than in the House and the vote next week may be much closer than the House vote.

For Republicans, this deal provides political cover to focus the debate on Obamacare, where they perceive themselves to have a big advantage given the struggles with the website and anger over policy cancellations.  For Democrats, they get a higher spending level and clear the legislative agenda to discuss other items that are non-budgetary, such as immigration reform, where they perceive they have a public opinion advantage.

This deal was expedient bipartisanship, but welcome bipartisanship nonetheless.

Obamacare Enrollment Improves Some
Obamacare enrollment increased dramatically in November, with the total now enrolled nationally reaching 365,000 by the end of the month, up from under 30,000 in October.

The basic benchmark of success is 7 million enrollments by the time open enrollment ends on April 1st.  Clearly, enrollment will not happen evenly across the months and will ramp up as the deadline gets closer.  Even so, October was clearly a dramatic failure.  The November numbers are less clear.  On a straightline basis, if every other month (December, January, February, March) only saw the same level of enrollment as November, enrollment would reach less than 2 million.  But, as I said, that is not the likely scenario.  It is still TBD to me if the administration comes close to its goal.

An additional 803,000 people have qualified for expansions in Medicaid and SCHIP, another key element of the law's expanded access.

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Friday, November 8, 2013

Assessing the 2013 Actual vs. Expected Results and Exploring Why

Governor's races are so tricky.  Odd year races are even trickier.  Figuring out turnout in elections where there is no national decisions on the ballot is a bit of a guessing game.  Polls from reliable firms are harder to come by.  Hence, historically my margins of error have been greater in these races.  This year is no different.

Here is the rundown of actual versus projected results:
New Jersey Governor
Predicted Outcome: Christie +24.1%
Actual Result (preliminary): Christie +22.3%
Error in Projection: 1.8% bias for Christie

Virginia Governor
Predicted Outcome: McAullife +6.4%
Actual Result (preliminary): McAullife +2.4%
Error in Projection: 4.0% bias for McAullife

New York Mayor
Predicted Outcome: DeBlasio +41.2%
Actual Result (preliminary): DeBlasio +48.8%
Error in Projection: 7.6% bias for Lhota

First, the good news in the projection accuracy:
* All 3 races were called correctly
* The New Jersey race was actually very well called, considering the margin
* I was correct about Libertarian Robert Sarvis - his support did fade substantially versus the late polling, although he clocked in at 6.5%, above my projected 5-6% (but well below 9% or so that he was polling)

Now, the bad news:
* Like most, I dramatically overcalled the margin of Terry McAullife's victory in Virginia.  He simply underperformed virtually all of the polling.  A special call out to the Emerson College poll, which nailed the margin of the race, although it had Sarvis at a whacky 13%.  All of the other polls had McAullife ahead by far more.

So why did McAullife underperform?

Was it the scourge of Obamacare?  Republicans certainly think so and have been amping up the closing of the race as a precursor to a scorched earth campaign on Obamacare in 2014.  And they have some reason to believe.  Cuccinelli campaigned hard late on Obamacare and the news of the early failures of the website and of cancelled policies were happening right during the time when Cuccinelli was closing the gap.

A counterpoint to this would be depressed turnout.  Turnout for the 2013 Virginia Governor's race is estimated at 37%, down from 42% in the 2009 race, which may have formed the basis for a lot of poling models, and as in most elections, lower turnout tends to favor the Republican.  Still, 2009 was a historically high turn out race and 37% is not out of line for a more typical race.

My conclusion?  Voter turnout model error may be responsible for part of the result, but the Obamacare issue does loom large at the moment.  Whether it will work as an effective 2014 strategy for the GOP will depend largely on what happens in the next 12 months.  The story probably won't be about a broken website by then.  But whether it is about people paying more for policies that they don't want or having greater access, choice and value will decide whether Obamacare is an albatross to the Democrats or a boon.  We'll have to wait and see.

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Sunday, September 22, 2013

How Much Worse Can It Get?

The Republican party is torn between two factions at the moment.  The first, the traditional mainstream wing of the party, which seeks generally to implement conservative, free-market solutions to major problems and shrink the size and scope of government but recognizes that there is room for accomplishing these legislative goals through compromise and that their survival relies on the public viewing their work as somewhat functional.  This wing is led by the GOP's old guard, principally its Senate members.  John McCain is certainly a member of this wing.  I suspect John Boehner is a member of this wing as well, although he is navigating a minefield with a GOP House that is not mostly of this wing.

The hard-right members that dominate the GOP House caucus now have an entirely different agenda - win on every issue at every time at all costs.  If the goal is to defund Obamacare, there is no government agency that they won't shut down, no debt that they won't default on and no measure of loss to their party that is too great in the pursuit of their goal.

So, here we sit again, on the brink of shutting down the government (October 1st) and potentially defaulting on our debt (sometime in late October, although that date could conceivably push later if the government shuts down, since expenditures will fall quickly.)

All of this poses a number of key questions about the GOP strategy.  I'm not sure how many of these are real and how many are rhetorical, but I'll give it a try:
(1) If Obamacare will be so bad, why not let it happen?
The world won't end if our health insurance system is ineffective for a year.  If Obamacare is the wrecking ball of a disaster that the GOP claims it will be, then the public outrage calling for its repeal will be impossible to ignore, even for Democrats.  It will quickly be repealed, replaced, modified, etc.  The goal will be accomplished.

But that's not what the GOP thinks.  Ted Cruz thinks that if it isn't stopped prior to implementation - he has stated that once the subsidies start, they will be impossible to stop, with an American public addicted to the drug of free money from the government.

This is idiotic on multiple levels.  First of all, it is estimated that only between 4% and 6% of Americans will get the subsidies.  That is because most will continue to receive health care from their employers and those on Medicare and Medicaid (the second largest chunk of the population) will continue to receive benefits as before.

Second, it is a pretty direct insult to the intelligence of the American electorate.  We are so stupid that we will never oppose an entitlement, even a bad one?  Besides being elitist, it is historically false - welfare reform in the 1990s is a prototype for reforming entitlements.  So was raising the Social Security age by 2 years.

Could the real fear be that people will either ultimately like the program or at worst feel neutrally about it?

(2) Do they really think they will win?
I grant you, the President has shown extreme ineptitude at negotiating these sorts of situations in the past.  But does anyone honestly think he will agree to a defunding or a delay of his signature legislative accomplishment?  Particularly when Republicans are poised to be blamed for all the ill effects of a government shutdown or a default?

So if this isn't about winning, what is it about?  Why drive massive uncertainty into our economy over a battle that you will lose?

(3) How can they possibly think this is good strategy?
The GOP is sitting pretty for 2014 at the moment.  President Obama has an approve-disapprove in the -10 to -12 range, which would historically imply a very poor showing for his party in the mid-terms.  Republicans should be plotting their strategy to pad their House majority and to retake the Senate, both very achievable goals against this backdrop.

Instead, the GOP risks alienating the swing voters likely to vote for them out of disapproval of the President.  They risk, once again, giving the Senate away to the Democrats, which makes their positioning harder.

They should be thinking about how to control the House, the Senate and the White House in 2016.  Then they can repeal Obamacare without worry about causes defaults or shutdowns.  Instead, they seem intent on losing ground.

There is plenty to criticize about the President's handling of matters budgetary.  But House Republicans take the cake by a wide margin for irresponsibility.

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Saturday, June 30, 2012

The Latest 2012 Big Map, The Supreme Era of John Roberts

2012 Presidential Update
Days Until the Election: 129
Projected Popular Vote Total: Obama +3.2% (Obama down 0.3% from last week)
Projected Electoral Vote Total: Obama 332, Romney 206 (Obama +18 from last week)

The national polling was fairly flat last week, but the geographic dynamics shifted slightly but significantly from an electoral standpoint.

Ohio, was has switched back and forth over the past month, switches back to President Obama, as he establishes a narrow lead there.  New England, meanwhile, moves a little closer, with New Hampshire now only a Lean Obama state and Massachusetts shifting down one notch (although not seriously predicted to be competitive.)

Virtually all of the polling included in this update was conducted prior to the Supreme Court's ruling on the Affordable Care Act, which the effect of (whatever that may be) should show up in earnest next week.



John Roberts, Meet Warren Burger
The Supreme Court decision to uphold almost all of the Affordable Care Act, most notably the so-called individual mandate by a 5-4 vote was a minor surprise.  Most observers, myself included, expected the most likely outcome to be a 5-4 vote to strike the mandate, with the outcome that actually happened being the second most likely scenario.

What virtually all of us anticipated was the liberal wing of the court, including Ginsburg, Sotomayor, Kagan and Breyer on one side, with the conservative wing of Thomas, Scalia, Alito and Roberts on the other side and the fifth and deciding vote being cost by moderate Reagan appointee Anthony Kennedy.

But something happened on the way to a Supreme Court ruling.  Kennedy sided with the conservatives, as was narrowly expected.  But Chief Justice John Roberts broke ranks to uphold the individual mandate.

This tells us a few things.  First of all, Roberts has a deep-seated belief in the separation of powers.  There is virtually no question that John Roberts considers the ACA to be poor legislation.  Prior to his time on the bench, Roberts was a member of the steering committee of the right-wing Federalist Society, a libertarian/conservative think tank who are certainly no fans of the ACA.  Roberts worked for the Bush campaign in 2000 in the Florida Recount.  He is a political conservative - no question.
 
But Roberts clearly believes that a Supreme Court ruling striking down the health care law would be an undue exercise of judicial power - substituting the Supreme Court's judgement for the judgement of elected officials.

In fact, Roberts took great pains to make clear in his opinion that this was not a judgement in favor of the policies in the ACA, stating, "we do not consider whether the act embodies sound policies.  That judgement is entrusted to the nation's elected leaders."

In my opinion, Roberts got it exactly right on the constitutional question, ruling that the government does not have the authority to require people to purchase health insurance but does have the power to tax those who do not.  Roberts wrote:
"The federal government does not have the power to force people to buy health insurance.  The federal government does have the power to impose a tax on those without health insurance...It is reasonable to construe what Congress has done as increasing taxes on those that have a certain amount of income, but chose to go without health insurance."

There were two principal arguments for the constitutional authority of the law.  The first, and actually primary argument was under the commerce clause of the constitution, the federal government has the right to "regulate commerce among the several states".  This has been construed by the court in the past as a broad power, with the federal government having been seen to have a right to not only regulate trade that moves across state borders, but trade within the borders of states that impacts the marketplace of other states - for instance, regulate the growing of corn in Iowa even if that corn is being sold within Iowa because it impacts national prices.

What has never been tested before is the authority of the federal government to require people to DO things versus NOT DO them.  Requiring an affirmative purchase from an individual by requiring them to purchase something would be an expansion of historical power, one that the 4 liberal justices were comfortable with, but one that the other 5 more conservative justices were not.

In other words, the court ruled that it would be unconstitutional to, for instance, throw people in jail if they didn't purchase health insurance.  This seems to me to be a very prudent interpretation of the constitution as a ruling on the commerce clause that allowed the government to require people to do things would open the door to virtually unlimited power over individual actions by the federal government.

The taxation question is a different question as the governments authority on taxation is considerably more broad.  The clause in the constitution (Article I, Section VIII) states:
"The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States"
Note that the original text also went on to restrict taxes to only allow that the taxes be uniform (i.e. proportional to population or trade) but that this restriction was removed with the ratification of the 16th Amendment in 1913.

There are essentially no restrictions on the right of Congress to pass any tax it sees fit, so if you construe the financial fee charged in the ACA to those without individuals as a tax, which both Roberts and I see as a reasonable interpretation.

Some will argue that the issue is the same as with the commerce clause in that this is a tax on inactivity versus a tax on activity (say an income tax or a consumption tax), or, more bluntly that you are taxing people for NOT having health insurance versus taxing someone for purchasing something or earning income.

This argument falls flat to me for two reasons:
1.  It is a distinction without a difference - Congress creates tax credits all the time to provide incentives for behavior - tax deductions for charitable contributions, tax credits for education and solar panels, tax credits for oil exploration and many, many others.  If Congress had worded the health care bill as a general tax increase with a tax credit for those who purchase health insurance, the net effect would have been the same - an increase in tax costs for those who don't purchase health insurance and a net neutral tax position for all others.
2. Even if you construe this as a new and different tax on inactivity, there is no reasonable interpretation that I can make of the constitutional authority above that prohibits taxes on inactivity.  The taxing power of Congress is fairly absolute.

Roberts, in breaking with the conservative wing on this issue, follows a long tradition of judicial independence.  Few today remember Chief Justice Warren Burger.  Burger was appointed to the court by Richard Nixon in 1969, replacing the liberal Earl Warren, who had presided over many liberal decisions with the most famous being Brown v. Board of Education (which ruled racial segregation in public schools illegal) as part of what was, at the time, perceived as a conservative effort to stack the court.  Playing far from the script, Burger, once on the court, presided over several surprisingly liberal decisions, the most notable being Roe vs. Wade in 1973, which he wrote himself.  Burger also wrote the 9-0 ruling that the Nixon White House had to turn over crucial information about the Watergate break-in and wrote the 9-0 decision in a case that required expansive busing of school children in Charlotte to better integrate public schools.  Burger, in other words, became a reliable liberal on the court.

Similarly, David Souter, a George Herbert-Walker Bush nominee, was seen as part of a new conservative majority when he was appointed to the court in 1990.  Far from following script, Souter became a reliable liberal vote on the court.

This is exactly why the judiciary is independent.  And the system works, largely, whether you agree with you agree with all the courts rulings (and few do - most liberals detest the Citizens United ruling that allows essentially unlimited corporate spending in elections and most conservatives will detest the ACA ruling.)

In my opinion, Roberts did exactly what a Supreme Court Chief Justice should do.  He exercised independent judgement on a difficult constitutional question.  And in my opinion, he also got it exactly right.

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Sunday, June 24, 2012

The Big 2012 Electoral Map - Good Week for Obama, The Future of Obamacare, Commerce and Justice Departments in Disarray

Electoral Map Update
Days Until the Election: 135
Projected Popular Vote Total: Obama +3.5%
Projected Electoral Vote Total: Obama 314, Romney 224

Mitt Romney's closing of the gap against President Obama sure didn't last long.  Obama gained over two and a half points in the national polls (more on that and the outlier Bloomberg Poll later) and appears to now hold a small lead in Florida, a state he had been trailing Romney in marginally for some time.

The two bright spots for Romney are that he held onto a razor-thin lead in Ohio, a must win state, to be sure, and moved far closer in Michigan, which moves into the "lean" category for the first time.  Winning Michigan would be game-changing for Romney, as it takes him out of the narrow electoral box that I have been describing for several weeks.  Flipping just Michigan and Florida from the current electoral map would yield a 269-269 electoral college split, more than likely enough for Romney to win the Presidency, given the Republican house.  Of course, it would also make the couple of electors that I have not been closely tracking in Nebraska and Maine, the two states that are not winner-take-all, crucial.  If a winner-take-all scenario yields a 269-269 split, Obama need only win one congressional district in Nebraska (as he did in 2008) and Romney need only win one of the two districts in Maine (which certainly seems possible, given how much more competitive Maine is than in 2008.)  Deciding a Presidency on this basis would probably be extremely unsatisfying, but the rules are what they are.



National polling was thrown a big curve ball this week when the Bloomberg Presidential poll, which is a fairly respected non-partisan national poll, showed President Obama with a 13 point lead over Mitt Romney.  I've looked at the polling report and there is nothing obviously wrong with the sample selection or methodology, which is in line with other national polls.

So what are we to make of this poll?  Clearly I don't think President Obama has a 13 point lead, as every other national poll shows a much closer race, but this is a good lesson in poll sampling error and statistical outliers.

The way polling works, fundamentally, is by sampling a small portion of the population and using that to project the larger national picture.  Polling is a statistical science, by which taking a sample, if the sample size is large enough relative to the group that you are attempting to sample, you can provide an accurate picture most of the time.

There are two statistical elements which describe the possible variability of a poll - they are expressed statistically as the confidence interval level and the confidence interval range.  The confidence interval range is typically referred to in the media as the "Margin of Error".  This isn't strictly correct, since it ignores the confidence interval level, which is typically not published, but usually 95%.  National media also tends to ignore the fact that the confidence interval runs both ways...in other words if it is 3%, then you would have to subtract 3% from one candidate AND add 3% to the other candidate to find the outer range of the confidence interval, or a 6% swing.

In the case of the Bloomberg Poll, the confidence interval was a 95% confidence interval and the confidence interval range was +/- 3.5%.

The media would simply report "the poll had a margin of error of 3.5%".

A statistician would say "We have 95% confidence that each candidate's actual total is within 3.5% of the reported total in the poll".

So, the Bloomberg Poll could be the 1 time in 20 that the poll is just flat wrong.  Or it could be that the 13 point lead that it is reporting is really a 6 point lead and the poll, is, in fact, withing the "margin of error".

Regardless, other national polls from the week, show the following:
Pew Research - Obama +4%
Assocaited Press - Obama +3%
Gallup - Even
Rasmussen - Romney +5%

So, clearly the Bloomberg poll is a high outlier for Obama and the Rasmussen poll is a high outlier for Romney, with the other three showing somewhere between a 0 to 4% lead for the President.  Aggregating all the poll results gives us a 3.5% lead for the President, so the Bloomberg poll does have an impact on the numbers, but not an outsized one.

Monday Is the Day (Probably) for SCOTUS and Obamacare
Monday is the last scheduled day for the Supreme Court to issue rulings and is therefore the probable date for it to issue its ruling on Obamacare.  Now, the Supremes have utter discretion to extend the date if they need more time to finish the ruling, but the odds are still in favor that we will see a ruling early this week.

So what is likely to happen?  The Supreme Court appears to be the last institution that is highly effective at preventing leaks, so I don't have any intelligence that isn't public knowledge, but, like everyone else, I can speculate based on the questioning during the arguing of the case.

There appears to me to be a clear 5-4 majority that favors striking down the individual mandate.
George W. Bush nominees John Roberts and Samuel Alito plus George H.W. Bush nominee Clarence Thomas will join Reagan nominees Antonin Scalia and Anthony Kennedy to form the 5 vote majority, opposed by Clinton nominees Ruth Bader Ginsberg and Steve Breyer and Obama nominees Elena Kagan and Sonia Sotomayor.  I mention the nominating Presidents to make one simple point - this appears poised to be a straight party-line vote, rather than a debate of complex legal theories.

Kennedy was thought to be the swing vote, but made it fairly obvious by his questioning in the case that he is highly skeptical of the mandate.

What is very much in debt is whether striking down the mandate (assuming the court does) will lead it to invalidate the entire law or whether it will allow the law to stand without the mandate.  I don't really know, but I believe it is likely, also by a 5-4 vote, with Kennedy swinging the deciding vote, that it will rule that the rest of the law can stand.  To strike down the rest, in spite of a clear notice in the law of severability would be a massive overreach of power by the Supremes, and the fact that 4 "strict constructionist conservatives" appeared poised to do it largely invalidates their complaints of judicial activism.  There is certainly some chance that the court will rule 5-4 the other way, with Kennedy not swinging his vote, but I think it is more likely than not that the rest of the law will stay intact.

Hit and Runs and Fast and Furious
The now very well publicized Fast and Furious scandal at the Justice Department reached a new level of rancor this week, with President Obama asserting executive privilege over Justice Department memorandum related to the ill-fated program.

This is now a full-fledged scandal, with Holder for months denying the program, which sold guns to Mexican cartels, then subsequently lost track of the guns, which were used to slaughter Mexican civilians and a U.S. agent, then admitted it existed and has consistently dodged congressional inquiry.

Now, Republicans love to witch-hunt scandal in an otherwise clean Obama administration.  But they have good cause in this case.  Obama should stop letting Holder hide behind him, live up to his stated commitment of public transparency and release the information.  We have a right to know what is in those documents.  And Holder should resign for his role running the department.  Loyalty to Holder should not trump national interest.

In addition to the well-known Justice Department troubles, Obama continues to struggle with the Commerce Department.  The Commerce Department has plagued the President since before he took office.  It took three tries to get a suitable nominee to head the department, with Obama's first pick of Tom Daschle withdrawn due to a tax scandal, his second nominee, Republican Judd Gregg, withdrawn after Gregg decided he didn't want the job.  Obama' third nominee, Gary Locke, actually made it to running the department, but lasted scarcely two years before talking.  Obama's fourth nominee and second secretary, John Bryson, took office last October, but resigned under strange and questionable circumstances last week after being arrested for a hit and run and blaming the situation on a seizure.  With Bryson gone, we may never fully understand what happened during Bryson's traffic accident, but Obama has a hole in his cabinet again.  Don't expect any nominee to get approved before the election.

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Saturday, February 18, 2012

Employer-Provided Health Care: The Worst Imaginable Model, Why Santorum Would Lose to Obama by 20 Points

The Real Reason Obamacare Is All Wrong
The flap with the Catholic Church over contraception coverage for women has been quite an interesting ride.  First of all, who thought we would be debating condoms and birth control pills in 2012?  Second, the clear exposed divide between the Catholic church's (I believe honestly held) moral principles and its membership's beliefs was on full display.  Third, Rick Santorum's very socially conservative views being put on full display is a preview of things to come if he continues to be a serious candidate for the GOP nomination.

First, to the relevant controversy.  The notion that religious freedom extends to whether or not you have to obey legal regulations is patently absurd.  Bear in mind that we are not talking about Catholic churches themselves, simply the hospitals and schools that they own.  If you believe that religious freedom should exclude them from having to provide contraceptive coverage as a matter of moral belief, where would you stop?

Should Muslim-owned businesses be allowed not to pay taxes because they don't want to pay money to support wars against Muslims?

Should a mining company owned by Christian Scientists by allowed to ignore regulations requiring Doctors on site to treat workers in dangerous situations because they don't believe in modern medicine?

Should an Orthodox Jewish owned business be allowed to refuse to serve women because it has a belief about the role of women in society?

Religious freedom, as protected by the first amendment, is something that we should revere.  But it is not the only value in our society.  In fact, the constitutional protection itself was intentionally drawn narrowly.  All the First Amendment requires is that the Federal Government does not establish a state religion, not that it allows businesses owned by religious people to do whatever-the-hell they choose.

Birth control is broadly accepted in science, medicine and society.  It is safe, effective, legal, economical and prevents unwanted pregnancies and abortions.  There is zero reason not to include it in health care plans because a very small percentage of the population objects.

But the controversy reveals the broader problem with Obamacare in particular and our healthcare system in general.  The issue with Obamacare is that it reinforces the system that we have, once that exists primarily as an employer-provided health care model.

Employer-provided coverage is about the worst imaginable model for a number of reasons.  It leaves, all too often, the decisions around what health care you get up to your employer or to government regulation, which sparks the kind of controversies that we saw over the past two weeks.  Secondly, it makes your access to health care dependent on your job.  Get laid off?  No health care.  Change jobs?  Your health care might change.  Thirdly, it places a huge burden on employers.  Employers that provide good health care coverage can pay upwards of 15% of their payroll towards health insurance, a burden not borne in competing economies where the coverage is either government provided or non-existent.  Finally, it provides incentives that drive up cost, namely largely removing the patient from economic decisions related to health care.

Our backwards system is a product of our tax code.  Employer-provided health care is both income and payroll tax-exempt.  That means that if an employer and employee wanted to have an employee-purchased model, the employee would wind up paying far more in real dollars.

The simple solution, employed in the first-rate health care systems in Australia and France, is to have a basic level of coverage provided by the government and a secondary tier that is available to individuals to purchase out of pocket.  In other words, everyone has access to preventative and catastrophic care, care which is both cost-effective and morally essential to a first-world society.  Industry competitiveness and innovation is preserved through profit motive because of the second-tier of coverage, which is for more advanced coverage.

Obamacare's benefit is that it provides more access to the health care system to more people.  But it largely perpetuates what is broken about the system.

Would Santorum Be the Worst GOP Candidate Ever?
With Rick Santorum's wins so far in Iowa, Colorado, Minnesota and Missouri, his shocking lead in the polls in Michigan, his competitive polling in Arizona and his huge lead in Ohio, I guess we have to actually take the possibility of a Santorum nomination seriously (I'm still not betting on it, but to say I'm still as sure as I have been about Mitt Romney's prospects would be a lie.)

So what would a Romney candidacy mean?

Let's review - Santorum has likened homosexuality to sex with farm animals, has said contraception is morally wrong, is opposed to women in combat because of "emotions".  I actually have more respect than most for Santorum's economic message, which appears among GOP candidates to be uniquely courageous in discussing the needs of working-class Americans, but he certainly has the least distinction to draw versus Barack Obama because of his past support for government spending projects, unions and entitlement expansion. 

With an improving economy and more mainstream views, Barack Obama would utterly trounce Romney.  As we sit here today, Barack Obama is up 6 to 8 points head to head against Santorum, but that is before most of the general electorate really learns about Santorum.  I could easily see Santorum losing by 20 points nationally.  He would lose women massively, possibly by 30 or 35 points.  He would lose Reagan Democrats.  He would lose Northeastern Republicans.  Heck, Santorum lost his Senate re-election bid in Pennsylvania by 16 points.

He'd lose every single state Obama won in 2008.  He'd probably also lose Arizona, Missouri and Montana.  I could actually see him losing some classically solid Republican states such as Texas, the Dakotas, maybe even South Carolina and Georgia.  It would be a wipe-out.

The worst GOP wipe-out in history was Barry Goldwater's 1964 whomping, where he lost by 22 points, lost 44 states and won a mere 52 electoral votes.  My bet is that a Santorum candidacy might do even worse.

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Sunday, January 22, 2012

President Obama's Scorecard - After 3 Years, The End of Stimulus

President Obama - Center-Left Leader

Lost in the fervor of the primary season is the quiet passing of the 3 year anniversary of President Barack Obama's inauguration.

There is a lot of rhetoric on both sides around the President's performance.  Is he a European Socialist?  A moderate pragmatist?  A shrinking violet or a badass Commander-in-Chief who kills terrorists?  An ineffective President or a victim of Republican obstructionism?

I've made no secret over the past few years about how valuable fact-checking sites like Politifact are.  It's been a long time since we've reviewed the President's 2008 campaign promises, but his 3 year anniversary seems like as good a time as any.

Whether what the President stands for is a debate for those of us of varying political philosophies to have.  But whether he did what he said he would do is more or less fact.

Politifact kept meticulous track of the President's promises and were able to document 508 specific things that then-candidate Barack Obama said he would do if elected to office.  Of those 508, 2 were specific to how he would respond to a national disaster, so they can only be evaluated if one occurs, therefore we will focus on the other 506 promises.

Of those 506, Politifact rates him as follows:
162 Promises Kept
50 Compromise (partially implemented based on a deal he cut with Republicans or others)
56 Broken (he had a chance to execute them but did not)
64 Stalled (the President still advocates for this position but has been unable to secure action on it)
172 "In The Works" (basically have not been acted on, but he seems to still advocate for)

If you give the President a 1 point for Promises Kept and half a point for Compromises, he's effectively implemented 190 out of 506 things he said or 38% of his promises.

There is a fair argument to be made to exclude the "In The Works" promises from the calculation.  President Obama never said he would do everything in the first 3 years and it is fair to say that there are some issues he simply hasn't gotten to yet.

Excluding those 172, he gets 190 points out of a possible 334 or a completion rate of 57%.

Since "Stalled" promises for the most part represent things that Congress has blocked the President's preferred path, it would also be fair to say that of the things he has been able to influence, he gets 190 points out of a possible 270 or 70%.

So, basically, on the things the President has been able to control to some extent, he has been 70% consistent with what he's said on the campaign trail.

Frankly, that's not a bad record.  By and large, we got what we were promised from President Obama. 

Of the promises that he has broken, it is instructive to see that in most cases, they are basically he leaned further right than what he campaigned on.  Some of the key promises he broke include:
* Increasing taxes on high income earners including repealing the Bush Tax cuts
* Signing card check
* Greater worker rights including guaranteed sick days and expanded FMLA
* Closing GITMO / trying terrorists in civilian courts
* Increasing the minimum wage to $9.50/hour
* Implementing Cap and Trade
* Introducing comprehensive immigration reform

So, ironically, the left has a whole lot more to complain about than the right.  The things President Obama has done have largely either been in line with how he campaigned, or meaningfully to the right of how he campaigned. 

You will hear some pretty crazy rhetoric about President Obama in the coming season.  But President Obama has not acted as a liberal, he's operated as a left-center progressive, far more similar to Bill Clinton than Jimmy Carter.

The American Recovery and Reinvestment Act - Did It Work?
Not surprisingly, all of the most significant legislation that President Obama has signed into law over his term occurred during the first two years of his term, when Democrats at least nominally controlled both houses of Congress.  Clearly, in my mind, the most significant pieces of legislation were:
* The American Recovery and Reinvesment Act (aka The Stimulus)
* The Patient Protection and Affordable Care Act (aka Obamacare)
* Dodd-Frank Wall Street Reform and Consumer Protection Act

Of these, the stimulus package really set economic policy for the first three years of his administration.  As of today, the $741B of the $799B in tax cuts and spending set out in the bill has been spent or 93%.  So, the effect of the bill is almost complete.

Republicans will rightly complain that the President projected that unemployment would remain under 8.5% with the bill, a marker that it didn't even come close to meeting.  The President will argue that things would have been far worse without the bill.

The problem is, we don't have an alternative universe under which to gauge how things would have been different without the bill.  Definitely aspects of the tax incentives clearly worked, such as Cash for Clunkers revitalizing the auto industry or clean energy tax credits creating a boom in the installation of energy efficient windows and solar panels.  But the large quantities of transfer payments to states and enhanced entitlement spending are a lot more grey.  Did they simply shift the problems of states and individuals to problems of federal debt?  And how will we ultimately pay for all of this?

These are all issues to debate in the coming election.  It would help in that debate if either side had a real opinion about how to rein in the deficit.  President Obama seems content to talk about letting tax cuts expire while continuing to extend them.  Republicans seem to want even lower taxes without a real plan to cut the kind of spending that would be required.

Third party candidate, anyone?