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Obamacare’s Annual Check-Up: Three Things You Need to Know

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Cliff Owen / AP

Here are three important -- and conflicting -- facts about the federal health-care law with its second open enrollment season now underway: One, a year removed from HealthCare.Gov’s debacle, the law is working better than many had ever thought it would. The uninsured rate, per Gallup, has dropped from 18.0% last year to 13.4% now. Many premiums for 2015 are lower than expected. Medicare’s finances have improved due in part to the health-care law. And as for the website, it’s working much better than it did a year ago. “[On Saturday], we had 100,000 folks submit applications,” HHS Secretary Sylvia Burwell said on “Meet the Press” yesterday. “And there were over 500,000 people who logged in effectively yesterday as well. So I think the vast majority of people coming to the site were able to get on and do what they were intending to do.” That said, there were still some hiccups associated with the federal site. “[P]eople returning to the site often had difficulty unlocking their accounts and resetting their passwords,” the New York Times writes.

Administration: What we have here is a failure to communicate

Two, despite the law working better, the politics surrounding it haven’t really changed. For starters, it’s still unpopular. Per our October NBC/WSJ poll, just 36% viewed the law a good idea, versus 48% who see it as a bad idea -- virtually unchanged over the past year. And Republicans are committed to thwarting the law, even if the party’s incoming Senate majority leader essentially admitted during his re-election that his state exchange is OK. So why hasn’t the Obama administration been able to use the past successes to make the law more popular? HHS Secretary Burwell acknowledged that it needs to do a better job when it comes to communicating. “I think what we need to do is make sure that we're communicating clearly and that we talk about what is the substance instead of something that is one-word descriptions but actually what this is,” she said. Then again, that communication isn’t helped when “Gruber-gate” -- the controversial comments by MIT economist Jonathan Gruber, who helped draft the law -- becomes a national story. “The fact that some adviser who never worked on our staff expressed an opinion that I completely disagree with in terms of the voters, is no reflection on the actual process that was run,” President Obama told reporters yesterday in Australia.

HHS Secretary: 'Fundamentally Disagree' With Gruber's Comments 1:53

Here comes the Supreme Court -- again

And three, despite the law’s progress, the law is more imperiled than it was a year ago -- due to the Supreme Court’s surprising decision to hear yet another challenge to the law. At issue: whether due to (at worst) a drafting error, subsidies can be awarded to residents of states that didn’t set up their own state-based exchanges. The New Republic’s Jonathan Cohn writes what could happen if the Supreme Court decides that these folks can’t receive subsidies under the health-care law. “More than 800,000 Floridians would see their monthly insurance premiums rise, from an average of around $70 to an average of around $350, or roughly a factor of five. More than 600,000 people in Texas, about 325,000 in North Carolina, and another 275,000 in Georgia would see insurance premiums soar by similar amounts. Nationwide, more than 4 million people living in 37 states would be in situations like these. Most would have no way to pay the higher bills, forcing them to drop insurance coverage altogether. Their sudden absence would destabilize insurance markets in those states, giving carriers reason to raise premiums by additional amounts or to flee the states altogether—which would, in turn, lead more people to give up insurance.” The court’s decision won’t take place until later next year.

The law can’t be fully successful until there’s more GOP buy in

Here is one final point to make about health care: The law can’t truly be successful until the politics improve for the Obama administration. For instance, the number of states that have decided to expand Medicaid has stalled, and it probably won’t get any better with all the GOP successes at the ballot box earlier this month (especially at the state level). “In Louisiana, if we were to expand Medicaid, it would cost my taxpayers $1.7 billion over ten years,” Gov. Bobby Jindal said on “Meet the Press” yesterday. “For every uninsured person we'd cover, oh, we'd have to kick more than one person out of private insurance.” Bottom line: Until there’s more GOP buy in, the law won’t be firing on all cylinders. And therein lies the rub.

Crunch time for that U.S.-Iran nuke deal

Speaking of the difficulty of getting buy in from the opposition, the New York Times has a great look at the nuclear deal the United States is trying to strike with Iran -- with the final round of talks taking place this week in Vienna. “Today, Mr. Obama needs a foreign policy accomplishment more than ever, and he sees time running out on his hope of changing the calculus in a Middle East where Americans are, against his instincts, back on the ground,” the paper says. “But the forces arrayed against a deal are formidable — not just Mr. Khamenei and the country’s hard-liners, but newly empowered Republicans, some of his fellow Democrats, and many of the United States’ closest allies.” More: “Yet even if a deal is struck it will be the beginning of an argument, rather than the end of one. For many of the president’s adversaries, the details of whatever deal he emerges with — how much warning the West would have if Iran raced for a bomb, for example — are almost beside the point.”

Keystone -- the most overhyped political issue out there?

After the House passed legislation on Friday to green-light the controversial Keystone XL Pipeline, the bill heads to the Senate, where Politico says it’s one vote short of the 60 need to clear a filibuster. Yet given all the attention Keystone gets, has it become the most overhyped political issue in America? As Republican oil billionaire said last week, the United States already has PLENTY of oil and natural gas. “If we have an … oil oversupply looking at us, do we need more Canadian oil here? Probably not.” And as for the job-creation claims, here’s Politifact: “According to the State Department, construction would require around 10,400 seasonal workers for stretches that would last either four or eight months. This works out to 3,900 "average annual" jobs over one year of construction, or 1,950 jobs each year if the project takes two years to finish. The State Department estimates that 26,100 indirect and induced jobs "would be supported by construction of the proposed project" during the construction phase… After construction, the pipeline would employ about 50 people, primarily for maintenance.”

Are Democrats doing enough to help Landrieu?

While Senate Democrats are using Keystone to help prop up Sen. Mary Landrieu (D-LA) in her runoff next month, the Democratic Senatorial Campaign Committee has pulled its advertising plug on the race. We know that the DSCC doesn’t have much cash left after the conclusion of the other midterms, and we also know that Landrieu is the underdog in this race. But you do have to wonder if Democrats could be DOING MORE to help Landrieu, especially since it’s much easier to win back the Senate majority if the GOP is at 53 seats next year -- instead of 54.

Landrieu Not Shy in Taking Credit for Keystone Pipeline Vote 1:02

Updating the undecided races

Parnell concedes in AK GOV: Incumbent Alaska Gov. Sean Parnell (R) conceded to independent challenger Bill Walker.

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