First Thoughts: Obamacare Is Here to Stay

Image: A woman holds up a sign to call for the next person in line at a health insurance enrollment event in Cudahy, California

A woman holds up a sign to call for the next person in line at a health insurance enrollment event in Cudahy, California March 27, 2014. More than 6 million people have now signed up for private insurance plans under President Barack Obama's signature healthcare law known as Obamacare, reflecting a surge in enrollments days before the March 31 deadline, the White House said on Thursday. More than 1 million people have signed up for Obamacare in California, according to the Los Angeles Times. REUTERS/Lucy Nicholson (UNITED STATES - Tags: HEALTH POLITICS) LUCY NICHOLSON / Reuters

The health-care law is here to stay

As the Obama administration and the uninsured race to meet today’s (sort-of) deadline for Americans to have purchased health insurance, we can now say something we weren’t 100% confident about back in October in November: The health-care law is here is to stay. More than 6 million have now enrolled in a health-care plan under the federal and state exchanges, which is up from a mere 100,000 back in October. And given the recent enrollment surge, it’s possible the final number is close to 7 million. What’s more, when you add the folks who’ve gotten insurance via expanded Medicaid and those under 26 who are on their parents’ insurance, overall total could be as high as 15 million. (So even if you subtract the 5 million Republicans estimate had been insured before, the net new insured appears could be around 10 million.) And then consider that the Congressional Budget Office has projected enrollment in the exchanges to double in 2015 (from 6 million to 13 million) and nearly double again in 2016 (from 13 million to 22 million). Bottom line: Repeal is more unlikely than it’s ever been before. How do you negate the health-care plans for these millions of Americans? So now what?


So is the law’s unpopularity

But here’s another thing we’re confident to say: The political perception of the law isn’t going to change, at least anytime soon. The law remains fairly unpopular (46% had a negative view of it and 38% a positive view, per a recent Kaiser poll), and Republicans are going to try to exploit that unpopularity in the November midterm elections. So how do you reconcile these two things -- that the law is here to stay ,but that it remains fairly unpopular as the GOP is looking to win back the Senate in the midterms? Well, under the normal rules of politics, you’d expect that Democrats and Republican would come together after the November elections to pass some changes/fixes to the law that could be supported by both parties. That would allow Republicans to buy into the law and to take credit for some of the changes. Then again, we aren’t necessarily living in normal political times… And considering how focused some Republicans are on their base politics, they can’t be coming out with alternatives to the health-care law that help give Democrats a “choice” election to frame. If the GOP wants THIS NOVEMBER to be a referendum, their best political move is to do and say virtually nothing about how they would fix or change or replace health care.

What we still don’t know

So we know that the health-care law is here to stay and that it remains unpopular. But here’s what we DON’T know: How many of the 6 million (and counting) have actually paid for their plans (one health insurance survey puts the number at over 80%)? How many of these folks are healthy (to ensure a solid risk pool for insurers)? And how will the law look like next year, especially when factoring in premiums for next year? On that last question, opinions are divided, and it typically breaks down partisan lines. ”Next year is going to be interesting. What we're hearing from the insurers thus far is that they're expecting double-digit increases for the cost of these health plans on the exchange in 2015,” conservative health-care expert Avik Roy said on “Meet the Press” yesterday. “We still haven't heard about how much the plans are going to cost for employer-sponsored insurance under Obamacare as it was before. And those things are going to affect the election in November for sure.” Liberal health-care expert Jonathan Cohn countered, “We'll wait and see where those premiums come in. They are getting a lot of people in now,” he said on “Meet the Press” yesterday. “You know, there's been this pattern where they always predict the worst. You know, the website wasn't working: ‘No one will ever sign up.’ And then it was, ‘Well, no one will get to the doctor.’ And you know what? Things were okay. There were problems, but things worked out well. I'm pretty optimistic.”

HealthCare.Gov was down but is now back up

Oh, and one final health-care note: Want to know why the Obama administration extended today’s March 31 deadline for anyone trying to purchase health insurance before tonight’s deadline but unable to do so? Because of things like this: Per NBC’s Shawna Thomas, HHS released a statement earlier this morning saying that HealthCare.Gov had been unavailable since 3:20 am ET. But NBC’s Peter Alexander reported that the site is back up, yet it’s in queuing mode due to all of the traffic.

When one billionaire holds a cattle call, and four potential presidential candidates show up

We’ve become so numb to big money in American politics, but this angle from the weekend shouldn’t get ignored: A single billionaire (Sheldon Adelson) held a cattle call, and potential Republican presidential candidates showed up. As NBC’s Kasie Hunt wrote over the weekend: Who will the billionaire owner of the lavish Venetian and Palazzo casinos bet on for president in 2016? Four potential Republican hopefuls — all governors or former governors — flocked to Sin City this week to lay their cards on hotel mogul Sheldon Adelson's table. Among them: Former Florida Gov. Jeb Bush, Wisconsin Gov. Scott Walker, Ohio Gov. John Kaisch and New Jersey Gov. Chris Christie — fresh from a week of tough questions over an internal report that purportedly cleared him of responsibility in the scandal surrounding lane closures on the George Washington Bridge.” Seriously, billionaires financing national campaigns is now so important that one man -- not even an advocacy group -- can create a cattle call. This is a new day, folks.

Chris Christie

A man in a hurry to get back into the presidential sweepstakes: As for Christie and the bridge scandal, our big takeaway from that report released Thursday and the news conference he gave on Friday is that the New Jersey governor is a man in a hurry to get back into the 2016 presidential sweepstakes. If you weren’t sure he WANTS to run for the presidency, you now know. Just look at how fast he went from Trenton to Vegas for Adelson-a-pa-looza. But here’s the problem for Christie: The bridge scandal and the allegations from Hoboken Mayor Dawn Zimmer aren’t going away anytime soon. Indeed, don’t miss this statement released Friday from Bridget Kelly’s attorney: “The only credible investigation into the lane closings is being conducted by the U.S. Attorney’s Office. If Ms. Kelly were provided with the appropriate procedural safeguards, she will be fully cooperative and provide truthful and complete answers to any questions asked of her by the appropriate law enforcement authorities.” In other words, Kelly is willing to talk if she gets immunity from prosecutors. And by the way, considering how poorly the governor’s own investigation treated Kelly in the report, we’re guessing they won’t be looking forward to her response.

Buzzing over Jeb Bush

The Republican who DID NOT speak at Saturday’s Republican Jewish Coalition event but who instead spoke at a private VIP with Adelson on Thursday was the focus of a buzzy weekend Washington Post piece. “Many of the Republican Party’s most powerful insiders and financiers have begun a behind-the-scenes campaign to draft former Florida governor Jeb Bush into the 2016 presidential race, courting him and his intimates and starting talks on fundraising strategy. Concerned that the George Washington Bridge traffic scandal has damaged New Jersey Gov. Chris Christie’s political standing and alarmed by the steady rise of Sen. Rand Paul (Ky.), prominent donors, conservative leaders and longtime operatives say they consider Bush the GOP’s brightest hope to win back the White House.” More from the article: “Many if not most of 2012 GOP nominee Mitt Romney’s major donors are reaching out to Bush and his confidants with phone calls, e-mails and invitations to meet, according to interviews with 30 senior Republicans. One bundler estimated that the ‘vast majority’ of Romney’s top 100 donors would back Bush in a competitive nomination fight.”

Jeb’s biggest drawback would be the same as Hillary’s

How does he represent the future? Yet the Post also notes -- as we have in the past -- the potential drawbacks of a Jeb Bush candidacy. “Out of public office for seven years, he has struggled in some appearances and has had difficulty navigating the Republican Party’s fault lines on immigration and other issues. A Bush candidacy also would test whether the nation still has a hangover from the George W. Bush administration.” But there’s another drawback for Bush, especially if Hillary Clinton is the Democratic nominee: The GOP wouldn’t be able to capitalize on campaigning for the future. As we’ve written before, Hillary Clinton’s biggest Achilles Heel in 2016 is that she’s a blast from the past and doesn’t necessarily represent the future. But the same would be true of Jeb Bush, if he becomes the GOP nominee. It’s kind of interesting: Both Jeb and Hillary have the same positives, but also the same negatives -- and oddly, they both benefit from the other being in the race.

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