NDN Blog

New Studies on ACA: Uninsured Rate Plummets by 30%, Healthcare Cost Increases Slow

Earlier this year, I wrote about new data which suggested that the Affordable Care Act (ACA) was positively impacting the American Healthcare System. In particular, reports at the time highlighted the fact that the law was completing its primary objectives: decreasing the number of uninsured, bending the healthcare cost curve, and slowing the growth of premiums.

This week multiple reports point to the continued successful policy implementation of the ACA. A report released by the Urban Institute on December 3rd, estimated that in the first year of the ACA, the number of uninsured decreased by 10.6 million—about 30% of the entire uninsured population. The Centers for Medicare and Medicaid Services reported that in 2013 National Healthcare Expenditures only grew by 3.6%. While still an increase, this rate was below the historical growth rate of healthcare costs. In fact, the last four years have had the slowest growth in healthcare spending since the Center began measuring this information in the 1960s.

Source: CMS

The Department of Health and Human Services also released new information that suggested another goal of the ACA, making the system as a whole work better, is moving forward. Sarah Kliff of Vox.com has a good take on the HHS data that found that ACA programs contributed in reducing hospital errors; this action resulted in saving about 50,000 lives over a four-year period. Infections acquired in hospitals decreased by over 17% since 2010.

The next phase of open enrollment for the market exchanges is also off to a great start. In the two weeks since open enrollment began on November 15th, over 760,000 people have signed up for plans. This is a large turnaround from the initial launch of Healthcare.gov where just a little over 100,000 people were able to sign up during the entire first month. Open enrollment will continue until the middle of February 2015.

Source: Urban Institute

Though the first year of the Affordable Care Act has not been without flaws, we are beginning to see the healthcare system change in a profound way. Whether it’s reducing costs at large, helping improve hospitals, or decreasing the uninsured, the ACA has started to impact the system in the way that its proponents had intended.

Event Recap: NDN Hosts DHS Secretary Jeh Johnson

Secretary of the Department of Homeland Security, Jeh Johnson, spoke on November 19th about the Obama Administration’s Border Enforcement and Immigration Record at an NDN event. The event took place in Washington at the National Press Club in the main ballroom.

NDN President Simon Rosenberg introduced the Secretary. Simon spoke about important strides that the Department of Homeland Security had made by using prosecutorial discretion and the “Morton Memos” to make the immigration system safer, stronger, and work more efficiently.

If you missed the event, you can watch it in full on CSPAN

Numerous media outlets covered the event, including the Washington Post, Huffington Post, NBC, and more. You can find a full list of press links below:

"Obama to Detail His Executive Action on Immigration, Setting Up Clash with GOP," Washington Post, 11/19/14.  

"Obama Executive Order on Immigration Coming Thursday," Amanda Sakuma, MSNBC, 11/19/14.

 “DHS sec’y: Obama Immigration Plan ‘Comprehensive’,” Alicia Caldwell, AP, 11/19/14.

Homeland Security Secretary Talks Immigration,” Matt McGovern, NBC, 11/19/14.

Obama to Boost Border Security, DHS Secretary Says,” Erin Kelly, USA Today, 11/19/14.

Jeh Johnson: Obama has ‘Fairly Wide Latitude’ to Act on Immigration,” Elise Foley, Huffington Post, 11/19/14.

DHS Secretary Says Country Could Face New Surge of illegals,” Stephen Dinan, Washington Times, 11/19/14.

DHS Chief: Obama’s Immigration Order will be ‘Comprehensive’,” Jesse Byrnes, The Hill, 11/19/14.

Homeland Security Secretary: Obama’s Immigration Relief Will Contain Border Security Components,” Esther Yu-Hsi Lee, Think Progress, 11/19/14.

"Obama to announce immigration measures on Friday, news outlets report," Fox News Latino, 11/19/14

Consumer Sentiment at 7-Year High

When it comes to understanding the U.S. Economy, there are many different ways that experts, pundits, and policy makers attempt to measure progress. Some look at the monthly jobs report as the key indicator; other suggest that median wage income ought to be the new guiding light. Consumer sentiment might also be a good way to measure how people at large feel about the economy.

The Consumer Sentiment Index, taken by Thomson-Reuters and the University of Michigan, is a five question survey that aims to capture the mood about current economic conditions. The survey asks the taker about the conditions of their family’s income, whether they are better or worse off, and if businesses and the economy at large will be better off next year.

This month, the survey found consumer sentiment at 89.6, which was the highest rating since July 2007. Despite positive feelings about lowering gas prices and the lower unemployment rate, many still felt like their income would not improve by much in the coming year. Still, this month’s report was on the whole good news. Consumer Sentiment took a major hit even before the financial crisis of 2008, when the initial recession began in late 2007. During the Debt Ceiling negotiations of 2011, Consumer Sentiment took another dive after the fear that the US might default on the national debt. Afterwards, it has slowly inched back up and made gains over the past year—finally returning to high levels after seven years.  

Event Recap - Nov 19: Simon joined panel on Innovation in Technology at Mobile Future Forum

On November 19th, Simon joined a conversation on the future of the Internet and Mobile Technology. The event took place at the Ronald Reagan Building (1300 Pennsylvannia Ave Entrance) in Washington, D.C. 

The event started with a conversation moderated by Jonathan Spalter (Chair of Mobile Future) and FCC Commissioner Ajit Pai. Afterwards, Simon joined a panel with Julie Diaz-Asper (Social Lens Research), Professor David J. Farber (Professor at Carnegie Mellon University/Former FCC Chief Techonlogist), and Professor Emeritus Gerald Faulhaber (Wharton School, University of Pennsylvania/Former FCC Chief Economist). 

You can find an archived video of the event at Mobile Future's site. In addition, be sure to check out Simon's piece written with Jonathan Spalter in the Hill, entitled: "Fighting to Keep the Internet Open and Free."

Hill Election Prediction Contest Results: Grover Norquist Wins

Last week, NDN’s President Simon Rosenberg once again took part in the Hill’s election prediction contest. As a winner in 2012 and 2008, Simon hoped to keep the momentum going and take the midterm election contest as well. Unfortunately, Simon’s crystal ball was a bit foggy this year—and so his predictions were a little off.

Congratulations to Grover Norquist, president of Americans for Tax Reform, on his 2014 Hill contest win.

Despite the loss, Simon looks forward to the opportunity to keep his presidential election winning streak going in 2016. Until then, we encourage you to read Simon’s post-election memo and keep an eye on day-to-day thoughts on Twitter (@SimonWDC).

Backgrounder: The President's Coming Executive Action and Prosecutorial Discretion

At the core of the coming debate over Executive Action will likely be a discussion of prosecutorial discretion and/or the “Morton Memos.” The use of this power is what created DACA; it is something the entire GOP House voted on to repeal twice in the current Congress; and will likely provide the legal basis of what the President does next. Much of our work this past year has been in documenting how much change the Morton Memos brought to the immigration and border enforcement system over the past several years.

We conclude that the way the Administration has already used P/D has helped make our border safer, kept the net flow of undocumented immigrants into the US at zero and improved public safety by prioritizing the removal of undocumented immigrants with criminal records from the interior of the country. It has also been humane, as the number of people deported without criminal records or caught entering the country illegally has fallen to very low levels. It has been smart and successful policy, providing the President with a strong foundation on which he can take additional action.   

For more on this see our assembled resources below. 

NDN Materials:

# of People DHS Is Removing/Returning From US Continues to Decline, October 2, 2014.

NDN/SR Statement on President Obama's Immigration Decision, Deportations, September 7, 2014.

Addressing the Central American Migrant Crisis” – Aspen Idea Blog, September 2, 2014.

NDN Report on Central American Migrants and Obama's Immigration/Enforcement Record, July 18, 2014.

"On Immigration, the House GOP has one answer: Deport the Kids", MSNBC, July 15, 2014. 

"GOP Attacks on Obama Enforcement Record are Ridiculous", April 25, 2014.

New Ice Data Finds Big Changes in Who is Getting Deported from the US, March 11, 2014.

On Trust and "Enforcing the Laws" in the Immigration Reform Debate - A Response to Speaker Boehner, Feburary 6, 2014.

 Additional, Executive Action related materials:

PowerPoint: Deportation and Discretion, Reviewing the Record and Options for Change, Marc Rosenblum, Migration Policy Institute, October 16, 2014. 

Deportation and Discretion: Reviewing the Record and Options for ChangeMigration Policy Institute, October 2014

Executive Action for Unauthorized Immigrants: Estimates of the Populations that Could Recieve ReliefMigration Policy Institute, September 2014. 

Lawyers Agree: Obama Has Broad Authority to Act on Deportations, Greg Sargent, Washington Post, September 3, 2014.

As Growth Stalls, Unauthorized Immigrant Population Becomes More SettledPew Hispanic, September 3, 2014.

Obama Well Within His Authority on Deportations, David Leopold, The Hill, August 12, 2014. 

The Current Record on Deportations: What Underlies the 'Eye of the beholder' Dynamic?,Migration Policy Institute, April 28, 2014.

Performance Measures Suggest the Border Strategy May Be WorkingBipartisan Policy Center,April 22, 2014.

Court Deportations Drop 43 Percent in Past Five YearsNew York Times, April 16, 2014.

In 2013, 59% of Deported Immigrants Convicted of a CrimePew Research Center, March 18, 2014.

 Political and Other Articles on the Hispanic Electorate

5 Takeaways About the 2014 Latino Vote, Pew Hispanic, November 10, 2014. 

Dramatic Improvement in Hispanic Dropout Rate,  Pew Research, October 2, 2014

Hispanic Uninsured rate drops 1/3 in 1st year of ACA  , September 26, 2014. 

Hispanic Only Group to See Its Poverty Rate Decline and Incomes Rise, Pew Research, September 19, 2014. 

Most Anti-Hispanic House of Representatives Ever? August 2, 2014

Best Job Growth of the 21st Century?

This morning in the Department of Labor’s monthly jobs report, BLS reported that the unemployment rate had slide down to 5.8% and 214,000 new jobs were created. October’s unemployment rate is the lowest since President Obama took office and since July 2008. Recent weeks have shown strong indicators, including 3.5% GDP growth in Q3 and the average 4-week unemployment benefit claims fell to a decade low. The U.S. Economy in 2014 has added 2.3 million new jobs; if this trend continues, it'll be the best year of job growth since 1999.  

Despite this, voters felt that the economy is in poor condition and the recovery is not reaching them.  Many experts have attributed that to stagnant wage growth, which in October only improved by 2% in the last year.  Fixing this issue may become more of a focus as the unemployment rate continues its decline over the next year.

One economic issue that also slipped through the cracks in the past month was the debt-to-GDP ratio. The budget deficit to GDP ratio has shrunk to the lowest levels since 2007, and now sits at a shortfall of $483.4 billion. In layman’s terms, this outcome comes that the Obama Administration has been successful in greatly reducing the budget deficit. It is now 1/3rd of what the budget deficit was during President Obama’s first year in office in 2009.


Post-Election Must Read Press Clips

Following the election results, we found these pieces to be insightful in explaining the midterm results and previewing the next presidential election:

"Hard Questions for Democrats As They Look to 2016," Dan Balz, Washington Post, 11/6/14.

Republicans Just Broke The Democrats Blue Wall,” Josh Kraushaar, National Journal, 11/5/14.

What Really Went Wrong For the Democrats,” Greg Sargent, Washington Post, 11/5/14

Did Republicans Conquer Obamaland?” Ryan Lizza, New Yorker, 11/5/14

Invite: Wed, Nov 12th - Simon Joins ASP for Discussion of US-EU Relations

On November 12th, Simon will join the American Security Project for a conversation entitled: "The U.S. - EU Strategic Partnership: Trade, Energy, and Security." Things kick off with lunch at noon, and the discussion follows shortly afterwards at 12:30.

The event will open with a keynote address by Julieta Valls Noyes, the Deputy Assistant Security in the Bureau of European and Eurasian Affairs. Afterwards, Simon joins a panel to discuss issues of international trade, energy security, and foreign conflicts. The panel discussion includes Simon, Paul Adamson, and additional unannounced guests. 

For more information, including participant biographies and the rsvp link, visit ASP's event page. The American Security Project is located at 1100 New York Ave, 7th Floor West Tower, Washington, DC, 2005. 

Does Our Government Still Have the Consent of the Governed?

Simon and I worked on this piece together. For the full report, including charts and graphs, download the full pdf version at the bottom.

As we enter the home stretch of the 2014 election and survey the races across the country, we keep returning to the same question - whether or not our much maligned American political system is still capable for providing the most foundational of all electoral outcomes in a democracy, the “consent of the governed.”

The basic issue is that for far too many Americans their vote for Federal office simply doesn't matter. In recent years, there has been a significant decline in the number of competitive states at the Presidential level, and in competitive Senate and House races. Using one measure, in 2012 only 17% of registered voters cast a meaningful vote for President, 1.7% for the Senate and 3.7% for the House (meaningful being a vote which could in theory alter the outcome of the election). Not only does this lack of competitive states and races contribute to lower voter turnout (see graph below), but it is becoming routine for 65-85% of the country to not really be part of any Federal election every two years – the ads, the voter contact, the ubiquitous candidates – giving them far less investment in the issues at hand, the democratic process, and we fear ultimately the outcomes of these elections themselves.

Consider that in 3 of our 4 largest states, CA, NY and TX, equaling about 22% of all voters in the country, there has not been a competitive race for President, Governor or Senate since the 1980s. This means young adults in their mid 20s who have grown up and still live in these states have never experienced a close statewide election contest with all that comes with it in their entire lifetimes. Below you will find a series of charts and graphs offering a bit more data on the trends we refer to here.

We will readily acknowledge that our concern here about consent is in an early beta form of analysis, but we wanted to put it out there for broader discussion. One recent poll taken earlier this year found that only 19% of the public believes that Washington has “the consent of the governed.” And it makes sense. If you are one of those whose Presidential vote has not mattered for decades, and perhaps only once every ten years or so for the Senate or House, even if you are voting regularly are you truly granting your consent in the way the Founding Fathers conceived it? Or is our current system in fact achieving the exact opposite – a reinforcement of distance and not proximity, of a system no longer connected to the concerns of everyday people as just far too many people are just sitting on the sidelines watching others far away experience real campaigns with real debates and where one’s vote really matters?

Given how large and diverse our democracy is, ensuring that our process provides true legitimacy and consent is particularly important. But our system now has developed an enormous bias against ease of voting; allows a candidate with fewer votes to become President; provides wealthy Americans a far greater voice in the electoral process; and gives power to political parties in Congress based on a very small fraction of the population’s vote preference. There is little wonder why average Americans would feel disconnected from politics and the outcomes of Federal elections in DC given all this.

How has this come about and what can we do about it? Both of those subjects will have to wait for a longer examination in another day. But the system is ripe for major reform, and ideas like same day registration, universal vote-by-mail, and eliminating the Electoral College should be given far more consideration. In light of all this, efforts to further restrict participation in a system without enough of it today seems particularly malevolent and pernicious.

We end our pre-election musings with this passage from the Declaration of Independence which makes clear just how important this perception of consent is to our democracy and way of life:

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.--That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed.”

The clear implication - it is only governments elected with the consent of the government that are capable of being just.

Send us your thoughts to srosenberg@ndn.org and ccantor@ndn.org. 

Graphs -- For Additional Charts and Data -- see Full Report

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