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COLUMNISTS
TODAY'S STORIES
03.12.2007
So, About That 15 Million Figure You've Been Hearing...

By now, almost everybody in Iowa and quite a few people beyond it have heard Hillary Clinton or John Edwards attack Barack Obama over his health care plan.Edwards and Clinton would both require every American to obtain insurance, a proposal known to policy wonks as an “individual mandate.” Obama would require all children to have insurance, but not all adults. Citing that difference, Edwards and Clinton have said that Obama's plan could leave as many as 15 million people without insurance.

Curious where they that number came from? Well, it seems to come from me. Sort of.

The day Obama unveiled his plan, back in May, I wrote an article about it. I praised the plan as an ambitious, meaningful proposal that would likely improve the lives of millions of Americans. I praised Obama himself for showing a genuine commitment to this issue. Then I criticized him for not including a mandate, which one of his rivals, Edwards, had already done. (Clinton hadn't yet unveiled her plan.) In other words, I said that Obama's plan was good but not greatthe same verdict that other close observers of health care policy, like Ezra Klein and Paul Krugman, reached.

In the course of making my case, I thought it important to convey some sense of scale. So, based on my reporting, I suggested somewhere around 15 million peopleor roughly a third of the people now without insurancemight still lack coverage, even if Obama's plan were implemented.

That magic 15 million figure has since worked its way into the campaign. Edwards was the first to invoke it, during a televised debate in early June. But it's Clinton who really put the estimate into play in mid-November, when she started using it as part of her attacks on Obama's health care planand distributing my article as proof of its validity. Most recently, Clinton cited the figure and my article on Friday, when calling upon Obama to retract an advertisement in which he promises his plan would cover everybody.

Mandates raise lots of interesting and complicated questions, about which I hope to say something more intelligent shortly. In the meantime, though, here's the explanation of how I got that figureand whether, six months later, it still seems sound to me.

***

It's pretty much conventional wisdom that, without a mandate, a substantial portion of Americans would remain uninsured. But to come up with a figure, I relied heavily on conversations I had with Jonathan Gruber, an economist at the Massachusetts Institute of Technology.

Gruber is a highly regarded economist who specializes in precisely these kinds of issues. Although he served in the Clinton Administration and is generally identified with Democrats, politicians of both parties have sought his advice. Back when Governor Mitt Romney was setting up his universal health care plan for Massachusetts, he brought Gruber into the process. Today, Gruber continues to serve on the board of the Connector, which is overseeing the Massachusetts plan. 

The reason so many people ask Gruber's advice is that he has developed a model, based on past data, for projecting how various policy changes will affect the number of people who obtain health insurance. It is similar to the model used by both the Congressional Budget Office and the Treasury Department. (You can read more about him in this Washington Post story.) Since all three of the leading Democratic contenders, including Obama, were known to be have sought his input this campaign cycle, I figured that made him a particularly reliable source of guidance.

Gruber told me that his projections showed that, without an individual mandate, a program of very generous subsidies and market reforms would bring in close to half the uninsured population. Adding a child mandate, he said, could bump it to two-thirds. Since Census figures showed around 45 million uninsured, I asked if that meant roughly 15 million would still lack insurance. He said that sounded about right. I put that figure in my story (although, in my quick translation of our conversation, I explained the step-by-step math incorrectlysaying that the starting baseline for coverage without a mandate was one-third, not one-half). I didn't attribute this to Gruber directly, though I'd cited his work elsewhere in the article, since that part of our discussion had been on background. He's since made these views public.

*** 

It was a crude, back-of-the-envelope calculation based on a projection. And all projections contain some uncertainty because they make assumptions, some of which might turn out to be wrong. In other words, the figure should not be treated as gospel.

On the other hand, figures like these also represent the best available information we have for evaluating policy proposals.  And a projection like Gruber's is no less reliable, certainly, than a lot of the other numbers campaigns routinely throw around. Take, for example, Obama's promise that his plan will require only $50 to $65 billion a year in new revenue once fully phased inbecause he anticipates generating huge savings from better management of disease and use of information technology. It's a number the campaign has provided. It's reasonable to put at least some stock in it because they likely reflect the influence of David Cutler, a Harvard economist who studies health care extensively and is also widely respected for his intellect and honesty. But if you're going to take that figure seriously, then, it seems to me, you certainly have to take Gruber's figures seriously, too.

And, more important, Gruber's views are hardly out of the mainstream. Over the last few days, I've had the chance to do something I couldn't with that first-day story: consult several other leading authorities. One of them is Len Nichols, an economist who worked on the 1993-94 Clinton health care effort and today heads up the health policy project at the New America Foundation. “Every reasonable model out there ... will show you that the kind of subsidies that we could do, 50 percent or so, are going to get you half," he said. "The way you go from half to 15 [million] is the kid mandate.”

These days, Nichols is probably the most visible promoter of individual mandate schemes in Washington. And, for those who want to see hidden agendas at work, Gruber's advocacy of individual mandates is also well-known. Then again, in both cases, they've reached that conclusion based on their respective research histories. If they have a bias, it's in favor of a policy as opposed to a candidatea policy that they happen to believe is right. 

Still, for the purists out there is always somebody like John Holohan, who directs the Urban Institute's Health Research Center and, as best as I can tell, has no direct connection to the presidential campaign. Holohan commands universal respect, too, having worked on these sorts of problems for two decades. And he's pretty much where Gruber and Nichols are on this question. Without a mandate, he told me, “Obama would still leave about 22 million, 23 million, but he has a mandate for children, about 9 million uninsured kids, so assuming you get most of them, you get pretty close to 15 million.”

Just to be sure this sentiment wasn't purely a project of Washington group-think, I contacted Altarum, a non-profit health care research institute based in Ann Arbor, Michigan. They hadn't modeled a plan like this specifically and warned that, without more details, they couldn't be precise. But with those caveats out of the way, analyst George Miller and economist Charles Roehrig sent me an e-mail explaining that "We've done some very crude hand calculations that suggest that the estimate of 15 million uninsured under an Obama-like plan (no individual mandate, coverage of all children, incentives) is in the right ball park."

By the way, while the Clinton campaign had been circulating my article as evidence to back their claim, an official later told me that they weren't relying on me exclusively. Before using the number publicly, they'd consulted experts independentlypresumably, some of the same ones I did.

***

For the record, the Obama campaign continues to dispute the 15 million figure, arguing the estimate is based too heavily on a generic reform package and not a plan with the specific provisions that Obama has. They are particularly enthusiastic about the potential for automatic insurance plan enrollment at the workplace to boost participation. One economist, Sara Collins of the Commonwealth Fund, has gone on the record as saying the 15 million figure sounds too high. (She told that to Factcheck.org, which ran a story on this right after the controversy started).  Holohan, too, told me that auto enrollment might help bump up the participation, though he couldn't say by how much. Jacob Hacker, a Yale University political scientist (and occasional TNR contributor) who has also been working with all three campaigns, concurred.

Gruber, Nichols, and Roehrig, on the other hand, were more dubious that the new enrollment practices would change much. Among other things, Gruber explained, his two-thirds estimate already made optimstic assumptions about Obama enrollment practices. In addition, most of the evidence on automatic enrollment comes from studies of 401K retirement accounts. (Research has shown that when you enroll people automatically but let them opt out, they are much more likely to sign up than if you simply give them the option to enroll. In other words, it's the default choice that matters.) And it's not necessarily true, as Roehrig noted, that people will treat health insurance the same way.

My own opinionand it is only an opinion, albeit one by somebody who's spent a lot of time trying to figure out health care policyis that Gruber, Nichols, and Roerhig are probably more right than wrong. Automatic enrollment could be a huge help, but it seems like the crude two-thirds estimate already takes that into account, at least partly. (Also, the paperwork for the Obama plan doesn't actually say anything about automatic enrollment, although Cutler referred to ita bit obliquelyin this article posted after Obama first unveiled the plan.)

So I guess I'm right back where I started: 15 million is a very, very rough estimate of how many people might still be uninsured if Obama's plan became law. But these are the figures we use in campaigns.  And at least a few well-respected authorities, none of them tied to one candidate, think it makes sense.

***

Of course, that's only half the storyas the Obama campaign will eagerly tell you. For the last few days, they have been concentrating on a different argument altogether: that the estimates of their rivals' plans are too optimistic. Austan Goolsbee, a top Obama advisor who is also an economist at the University of Chicago, has written a memo arguing that Obama's plan may actually cover more people than either of the rival plans wouldonce you take into account that the Clinton and Edwards plan would leave out millions, too.

Is he right? Is this really basically a wash?  My best guess on that very important question is coming shortly.

Note: The world of health policy is small, so I've gotten to know virtually every expert cited in this articleincluding Cutler, Gruber, Hacker, and Nicholswell enough to call them friends. I don't think that biases me, particularly since they occupy different sides in this dispute, but I thought I should make that clear.

--Jonathan Cohn

Posted: Monday, December 03, 2007 4:43 PM with 20 comment(s)

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blackton said:

an unenforceable mandate, wherein the government will try to force young, healthy people take a portion of their often meager starting salaries to buy into a program they are not very likely to use is somehow a political winner? How will enforcement work? Arrest young people who have accidents or become sick who are not insured? I give credit to Obama to realize coercion does not equal compliance, and much less equals popular acceptance.

I think it makes far more sense to offer health care vouchers to be redeemed at accredited agencies, ther through companies or individually. Not using them would be essentially to throw money away since the vouchers are being paid for by our own taxes. With these everyone can be offered basic insurance, and if people want to get better policies they can shell their own money out (or their company can).

I can easily accept mandates for car insurance, nobody wants to be hit by an uninsured driver, but the direct relationship just ain't there with health insurance. If you get sick and are uninsured, the costs to me will be spread out and very minor, so frankly I don't care all that much, at least enough to levy sanctions against you for not having insurance. How much less so if you never get sick, in which case you cost me nothing except very indirectly as a person not subsidizing everyone else.

Mandates: bad

Affordable options (in ways not taking it is foolish): good

December 3, 2007 2:52 PM

virginiacentrist said:

JC:

I trust you more than anyone else on this, so I'll take your word: Hillary's plan is better.

At any rate, don't miss what robert Reich had to say recently in favor of Obama's plan:

robertreich.blogspot.com/.../why-is-hrc-stooping-so-low.html

December 3, 2007 3:27 PM

aeromonas said:

Or instead of mandates, why not follow the lead of just about every other industrialized nation and scrap private insurance altogether?

This is all much ado about nothing.  The mandate issue is a side-show.  Until we talk seriously about de-linking health insurance from employment, we're giving the better part of the game away.  Fifteen million, mostly young, healthy uninsured out of a population of 300 million--really who gives a shit?  From a population, public health policy standpoint, these numbers are irrelevant.

Though it does sadden me to hear Obama talking nonsense about cost savings through disease management and information technology.  I'm going to say it probably for the twentieth time on this website: THERE CAN BE NO NET REDUCTION IN HEALTH CARE EXPENDITURES WITHOUT RATIONING WHERE 'RATIONING' = DENIAL OF TREATMENT OR DENIAL OF THE FULL RANGE OF CHOICES AMONG AVAILABLE TREATMENTS.  "Disease management" entails MORE costs, more doctors visits, more monitoring tests, more drugs etc.  And while the theory is that through effectively 'managing' the disease, type-II diabetes, say, you keep patients out of hospital where the costs truly mount up, the reality is that a hospitalization avoided is not a hospitalization prevented, but a hospitalization postponed.  We all gotta die sometime, and until we're ready to have a conversation about how old is too old and how sick is too sick to receive expensive treatments, our savings will be ZERO.

December 3, 2007 4:37 PM

ralphnelle said:

If the mandate isn't enforceable, won't Hillary's uninsured numbers be identical. If so, what the hell is the point, and how do you, Cohn, justify taking part in an underhanded, dishonest smear?

December 3, 2007 9:00 PM

The Stump said:

I'm sympathetic to the Jonathan Cohn critique of Obama's health care plan (i.e., that it would

December 3, 2007 9:31 PM

Jonathan Cohn said:

Ralphnelle:  Who said the mandate was unenforceable?  I sure didn't.  More soon...

December 3, 2007 9:33 PM

Jonathan Cohn said:

Blackton:  Ha, you know I'd love single-payer or a true voucher system better.  But this is what we have in front of us right now.  And, as I just wrote, I'm not so ready to dismiss a mandate as unenforceable.  Again, stay tuned.  

Virginiacentrist: I like Bob Reich.  And I think he's just plain wrong on this.

Again, I'll have more to say on this shortly.  Thanks for the comments!

December 3, 2007 9:35 PM

ralphnelle said:

Mr. Cohn,

Well, I look forward to hearing about the enforcement plan. That sounds like a political loser to me ("big government liberalism on steroids"), but maybe you can prove me wrong.

December 4, 2007 12:00 AM

jhildner said:

Jon:  You've done a good job backing up the 15 million figure, but the automatic enrollment issue seems like a huge one that is not sufficiently dealt with here.  The 15 million makes "optimistic" projections about enrollment, but that doesn't mean that it takes automatic enrollment into account.  I noted the weasel word "seems" when you said that they do.  As you note, the default rule probably matters *a lot*.  Think of it this way: an individual mandate with opt-out v. individual mandate without opt-out but questions about enforcement.  If the choice really is between these two, the plans get a lot closer.  Plus, preserving the ability to opt out I think would be attractive to voters in the general.  Being able to say, "You can always opt out" will probably give comfort to some voters who feel as though an individual mandate may be too intrusive.  You suggest that people might not approach health care as they do 401K contributions (where automatic enrollment makes a big difference), but why not?  We need more on that point.  My own gut instinct, based on how I behave with respect to my benefits at work, and how most people behave when it comes to opting in v. opting out generally, is that automatic enrollment at the workplace would make a very big difference.  If the official version of the plan doesn't play this issue up, the candidate should explain himself.  (Maybe he is, or was, leaving his options open with respect to automatic enrollment.  If he's now for it unreservedly, it should be in the literature.)  Either way, this wrinkle needs to be explored further.

December 4, 2007 11:22 AM

rr87 said:

Jon,

I loved your book, but I think that you're off the mark on the mandate issue.  (Full Disclosure: I'm an Obama supporter and a resident of MA, the only state with a mandate.)  A few points:

1. Mandates are fiscally regressive.  

Progressives can make a good case that we shouldn't support them for the same reason that we don't supprot regressive taxation.  For example MA caps its subsidies at 300% of the federal poverty line.  That means that a family earning about $62,000 would have to may at least $8000 a year for bare bones, high-deductible coverage (according to the MA health connector website) or a $4000 penalty.  That's unconscionable.  Alternatively, you can exempt people who can't pay.  MA has done precisely this, exempting some 20% of its uninsured population.  If you project that percentage nationally, that's about 9.4 million people.  The point is that there is an anguishing choice here -- and you can't just wish it away.  You also shouldn't give Hillary a free pass on her plan, which would almost certain leave people uninsured -- possibly 10 million, but we won't know until she tells us how she'll enforce the mandate and how many she'll exempt.

This is straight off the Obama campaign's talking points.  But let's take it a step further.  Let's say that low-income Americans who don't qualify for a subsidy have to purchase insurance and this drives them into an even more financialy precarious situation.  There's a lot of social science and public health data that suggests that socioeconomic status is a more powerful determinant of health outcomes than access to medical care.  I concede that this is debatable (and, as a doctor, I hate to admit it,) but you should at least consider this.  So a mandate could leave low income Americans far worse off.

To take this even further -- the real problem with any plan that lacks a mandate is that if you don't force everyone to play some healthy people will game the system.  This is what Krugman argues -- that some people will forgo insurance while they're healthy and then buy it when they need a bone marrow transplant.  Obama's plan deals with this by capping risk for insurers through federal reinsurance, a provision that the Clinton plan lacks (even though several of her advisors were strongly in favor of such a provision when they were working for Kerry in 2004.)  The Obama plan allows the federal government to shoulder the cost of paying for the sick until we can lower the price of insurance for everyone.  After lowering costs, he's open to mandate to cover whoever's left.

Bottom line: Obama's argument against mandates is neither calculating nor conservative -- it's progressive.  It shares nothing in common with the argument against mandates made by right-wing Republicans.  

2. Obama isn't opposed to a mandate in the long run.

Both the Clinton and Edwards plans are non-universal in that they leave out a few important details.  Clinton says that she'll negotiate the enforcement provision of her mandate with Congress after she's elected.  This really isn't any different from Obama saying, as he has, that he's willing to consider a mandate after his plan has lowered the cost of health insurance to reasonable level.  It's intellectually dishonest to call her plan universal and chastize Obama for introducing a non-universal plan, as Krugman does (I'm not quite sure where you come down on this.)

As a subpoint, I've always understood you to be in favor of a single payer system.  I certainly am.  Paul Krugman clearly is.  I don't understand how he (again, I'm not exactly clear where you come down on this, as you've been much more restrained in your criticism of the Obama plan,) can criticize the Obama plan as being inadequate, but then pull his punches when it comes to the Edwards or Clinton plans.  If we're going to measure all plans by the same ideal standard of single payer, and if we're going to be textualists, then we should acknowledge all of them as non-universal.  If we're going to look at intent, then all three candidates are committed to universal health care.  In fact, only Obama and Edwards are commited to doing it in their first term.  

3. You and Paul Krugman are giving Hillary a free ride.

Lastly, and most importantly, can Paul Krugman, Ezra Klein (and maybe you?) honestly claim that the Obama plan's lack of a mandate, despite his stated committment to achieving universal health care in his first term, will do more to set back the cause of universal health care than Hillary's turning the mandate into a litmus test issue for progressives?  

Every prior attempt to enact universal health care has failed because we haven't been able to hold the coalition together.  Individual mandates for insurance have never been a cornerstone of progressivism.  In fact, Krugman himself was lukewarm about Arnold Schwarzenegger's mandate-based plan when he wrote about it last January: select.nytimes.com/.../12krugman.html.  When did the individual mandate suddenly become the best idea in health policy?  

My point is that Hillary and Paul Krugman are turning on a fellow ally in the fight for universal healthcare -- and this is doing more to shred the progressive front on this issue than any specific aspect of Obama's plan.  Don't give Hillary a free pass on this.

I loved your book because you illuminated the moral case for universal health care.  That's what Democratic candidates should be doing now -- and that's what Obama is trying to do.  You and I could undoubtedly come up with 10 different ways of reach universal healthcare if someone were to lock us in a room for an hour.  It's not for lack of ideas or policy wonks that we don't have univeresal health insurance in this country.  Your book and this whole thread -- which rewards people for picking apart (some dishonestly, I think) the wonkish details of a candidate who is passionately committed to universal health care -- are at cross purposes.  

Give me a call or drop me a line if you want to chat about this some more!

John Rawls (not my real name)

December 5, 2007 4:23 AM

The Plank said:

Kit Seelye's piece in today's New York Times concludes fairly strongly ( too strongly , Paul

December 5, 2007 1:44 PM

The Plank said:

From time to time, we ask New York drama critic Jeremy McCarter to assess the theater of politics. Here's

December 30, 2007 6:05 PM

The Plank said:

Hillary Clinton and John Edwards haven't had much trouble convincing experts that their health care

January 21, 2008 10:53 PM

The Plank said:

Hillary Clinton and John Edwards haven't had much trouble convincing experts that their health care

January 21, 2008 11:16 PM

The Plank said:

For those missed the first few minutes of the debate, an early question from Jeanne Cummings went to

January 31, 2008 10:02 PM

The Plank said:

Following up on my previous item , here's one other note about Jim Cooper, the Democratic congressman

February 5, 2008 3:25 PM

The Plank said:

It wouldn't be a primary night if I didn't say something specifically about health care. And

February 19, 2008 10:38 PM

The Plank said:

It wouldn't be a primary night if I didn't say something specifically about health care. And

February 19, 2008 11:02 PM

The Plank said:

As you may have heard, Hillary Clinton recently blasted Barack Obama over a piece of campaign literature

February 26, 2008 3:20 AM

The Plank said:

It figures that one of the few times I can't watch the Democratic presidential debate live, Hillary

February 27, 2008 10:45 AM