Last week, the Wall Street Journal editorial page compared Ted Cruz and his band of Obamacare defunders to kamikaze pilots. Today, as he neared the end of his long, weird diatribe against Obamacare, Ted Cruz thanked the staffers who “endured this Bataan Death March.” So now Cruz and his critics agree that the most apt comparison to Ted Cruz is the World War II–era Japanese military. The analogy does capture the defunders’ sheer obsessive determination to resist and utter inability to formulate a plausible strategy.
The Obama administration today released the final numbers on the premiums in the state health exchanges. This is the single most important piece of data we have to gauge the plausibility of the exchanges, which are the crucial mechanism of Obamacare. The premiums are not spin, they are the collective judgment of the marketplace. The conservative judgment of Obamacare has been a ceaseless litany of doom — rate shock, fumbling bureaucracy, unreasonable regulations. If that indictment were true, insurers would be charging higher rates than the administration initially forecast. Instead, the premiums are clearly lower than forecast — 94 percent of customers in the exchanges will have the chance to pay below-forecast premiums.
In 2010, conservatives were highly confident that the inherent awfulness of Obamacare was such that premiums would rise. James Capretta, writing at National Review, criticized the Congressional Budget Office for issuing “rosy premium scenarios.” Capretta argued “this CBO analysis is terribly optimistic … the premium estimates are based as much on judgment as analytics, and CBO’s judgment is clearly on the optimistic side.” Too optimistic! Clearly! Conn Carroll, then at Heritage, enthusiastically endorsed Capretta’s critique.
But now we know the CBO’s forecasts of the premiums were not too optimistic but too pessimistic. Surely this might budge their evaluation of Obamacare, even a teeny bit, right? Their response? Total silence.
One might think that Ted Cruz’s
filibuster really long speech overshadowed this major news. But the premium news has slowly leaked out over months, and has been a nonevent within the cocoon of conservative media. Not only is the news on the right entirely bad, but many conservatives appear genuinely unaware that anybody even thinks otherwise. Nick Gillespie likewise asserts there is “every reason to believe it will be a clusterfudge of epic proportions.” Note the “every reason,” which implies that the collective judgment of the industry with the most skin at the game does not count as a reason at all.
That is why Cruz can say, “Everyone in America knows Obamacare is destroying the economy,” and quite plausibly believe it. News to the contrary has never penetrated his mental bunker.
A telling iteration of the same delusion comes from Holman Jenkins’s column in The Wall Street Journal today. Jenkins writes about the second major goal of Obamacare, which was to slow cost inflation by transforming the medical system from paying for quantity to paying for quality. Jenkins is certain that this goal backfired as well. Obamacare, he writes, was “not reform—it was a piling on of subsidies that can only throw fuel on the fire of health-care inflation. Not even the usual mouthpieces pretend otherwise anymore.” Not only is Obamacare increasing medical inflation, but this fact is so obvious that not even “mouthpieces” for the law deny it!
In reality, the evidence on medical inflation to date has exceeded the most optimistic hopes of health reformers when the law passed. Medical inflation has slowed to the lowest rate in 50 years. The only argument is whether, or to what degree, Obamacare has helped drive this change (and, therefore, to what degree it will continue). The skeptics suggest the recession may have caused the slowdown — though, if that were true, it wouldn’t explain why Medicare, whose beneficiaries are insulated from the effects of the recession, would have lower utilization, Peter Orszag argues.
In any case, the usual mouthpieces are very much of the opinion that Obamacare’s numerous cost reforms are introducing more cost pressure into the system. They are joined by a growing list of disinterested experts, a few of whom I quoted in my print story on Obamacare:
“The ongoing slowdown in the health-care growth rate defies historical post-recession patterns and is likely to be sustained,” concluded PricewaterhouseCoopers in June. “It appears that the reforms will stick and health-care exchanges and other policies will bring competitive pressure to markets,” says Randall Ellis, a professor of health-care economics. “Although the proof for this point of view is not yet definitive,” reports the Health Affairs blog, “the depth and breadth of change suggest that significant transformation in the nation’s delivery system is under way.”
Again, the news to date is provisional. But it’s also, on balance, highly encouraging. In the face of it, I have yet to see a single conservative grapple with the positive developments. I grant that glitches and setbacks have occurred, mostly but not entirely because of fanatical Republican sabotage efforts, and that conservatives have an incentive to highlight those. But doesn’t it tell us something that, three years after Obamacare’s passage, the law has so far clearly overshot its targets both for premium affordability and overall cost savings? Does the conservative movement have any mechanism whatsoever that would allow it to process this news? Or will Cruz and his allies end up like the Japanese soldiers still fighting on from remote outposts in the Pacific, unaware that the war has ended?