Saturday, February 1, 2014

Morning Notes to Myself

I just finished writing these down in Notes, then concluded that they are reasonably intelligible, so here they are:

What’s Going On?
  1. Economy is strengthening: removal (relative basis) of fiscal drag (4th qtr showed .98 % Governmentt drag - this will go to 0); good consumer spending; continued improvement in Net Exports, based partly on falling oil imports; fair investment levels (slowdown in housing), plus ACA. GDP growth in the 4th quarter was 3.2%; 2014 could average 4%. This will have the US as the fastest growing developed economy (China, an emerging market, will slow down to 5-6% range).
  2. Obamacare-Announcement from US’ largest insurer-Wellpoint: enrollment good, pool as expected, holding earnings forecast-takes most of the uncertainty out-ACA is on track.Ezra Klein’s point this am in Bloomberg: many signups from folks who had insurance; the big deal, not yet focused on, is that our total healthcare delivery system is moving from “quantity to quality, coordinated care vs. isolated procedures, and data driven, evidence-based medicine vs. intuition and individual experience only”. Part of the conversation may shift to this larger perspective. Just released Health Affairs/CUNY study of red state/no Medicaid expansion showing 7-17,000 increased deaths, hundreds of thousands of increased depression cases, missed diabetes treatment, missed pap smears/mammograms, missed cholesterol screenings, missed blood pressure tests. Plus ACA cuts uncompensated care payments to hospitals in these states; hospitals must cover uninsured in ER; lower uncompensated care reimbursement puts pressure on hospitals. This could be an election issue in red states.
  3. GOP P CARE: No Medicaid expansion, so poor (<100% FPL) adults w/o kids have no coverage. Subsidies to cover catastrophic events for 100-300% FPL offered to small business employees and people w/o employer coverage; presume this will change to all folks w/o employer coverage, but perhaps not. Auto enroll ensures big signup. No preexisting conditions if continuous coverage maintained. Uninsured will have one time open-enrollment period where they will get this benefit. ESI exclusion capped at 65% of cost of Cadillac plans: this will either be a tax increase on workers with big plans, or those plans will be cut way back. If a tax increase, this means middle class is funding the plan (not wealthy or business); if no tax increase results, no funding. No coverage for poor adults w/o kids. Near poor only get catastrophic coverage, w/o prevention services. Middle class is funding the uninsured through tax hikes. If not, plans reduced and no funding. Medicaid shifted to defined contribution/block grant program. Preexisting gets handled only through continuous coverage. If this is seriously pursued by GOP, will give Dems big ammo:”Which do you want, our plan or the GOP’s? You must make a choice.” Will GOP push this? Don’t know. Possible.
  4. Immigration-Everyone will describe GOP plan as just a slower path to citizenship (legalization). That’s why Dems might accept it. This could pass the House with a lot of Dem votes. If Boehner rules out going to Conference with the existing Senate Bill, then Senate could take up a version of the House Bill, presumably closer to their own, and Conference on that. I’ll go 60-40 that this happens before November. What election impact? Primaries will be more divisive. And this might cause primary losers to stay home.
  5. GOP will back down on debt ceiling. Compromise will be reached on UI. Dems will launch state-by-state effort on Minimum Wage.
  6. Election forecast: Same. Dems will hold the Senate; pick up 3-5 in the House.
  7. Iran - there will be a deal.
  8. Syria - discussions will continue sporadically. CW will eventually be removed. Some agreement by year end.
  9. Israel-Palestinians - 50-50 for a deal by year end
  10. Polls - Obama-back to 50% approval by election; Obamacare - 50% approval by election.

1 comment:

  1. This is great stuff, Jim. From your lips to the ears of the gods of policy and public opinion. My gut is telling me Conventional Wisdom will not apply this cycle when it comes to the House. Voters seem restless for movement there (see: Virginia) Pundits are usually slow to detect this. Holding the Senate is key. I remember last cycle the pundits were just sure the GOP would reclaim the Senate.