Under the Constitution, only Congress has the power to “declare war.” The president, however, has ample authority to use military force without a “declaration of war” where the anticipated U.S. engagement in hostilities is limited in its expected nature, scope and duration. Presidential administrations of both political parties have recognized a long tradition that supports this use of force. And Congress has acknowledged its legitimacy as well.
The authority for the president to act without specific congressional authorization is set out in two opinions of the Office of Legal Counsel. The first, issued in 1994, defends the plan to send 20,000 troops into Haiti and the second, issued in 1995, provides the legal authority for the use of air power in Bosnia. (I should note that I was head of OLC at the time these opinions were issued).
As these opinions note, the structure of the War Powers Resolution enacted by Congress necessarily presupposes the existence of unilateral presidential authority to deploy armed forces “into hostilities or into situations where imminent involvement in hostilities is clearly indicated by the circumstances.” The resolution requires that, in the absence of a declaration of war, the president must report to Congress within 48 hours of introducing armed forces into such circumstances and must terminate the use of U.S. armed forces within 60 days unless Congress permits otherwise. This structure makes sense only if the president may introduce troops into hostilities or potential hostilities without prior authorization by the Congress: the resolution regulates such action by the president and seeks to set limits to it.
President Obama has fully complied with the reporting requirements set out by Congress in the War Powers Resolution. To be sure, the resolution declares that it should not be construed to grant any new authority to the president. But it obviously assumes that the president already had such authority, and sets out reporting (and subsequent withdrawal) requirements when he exercises that power.
It has been 15 years since these OLC opinions were issued and widely discussed. In that time, Congress has continued to provide for military forces to be deployed throughout the world without placing any restrictions that would preclude their use in circumstances such as those presented by Haiti, Bosnia and Libya. Under well-established precedents endorsed by both the executive and congressional branches of the national government, there is no doubt of the legitimacy of the president’s use of force in Libya.
By: Walter Dellinger, Visiting Professor of Law, Harvard University; Former Assistant Attorney General and Head, Office of Legal Council. Article published in The Arena, Politico, March 22, 2011
There’s been a lot of criticism of President Obama for being too slow to support the Mideast’s popular uprisings, especially in Libya.
“Feeble,” “incoherent” and “not showing leadership” are some of the complaints I get from readers from both sides of the political spectrum. At moments, I’ve felt the same: The White House’s Mideast team is weak, his “peace process” diplomacy has failed, his support of pro-democracy rebels is conflicted.
Yet, after reflecting on a recent visit to Egypt and conversations with experts in the region, I’ve concluded that no U.S. administration could have acted more decisively to aid Arab rebels. Any president would have been constricted by the same factors Obama faced.
Let’s start with Libya, where Obama hesitated for weeks to intervene, but has now agreed to a U.N.-backed no-fly zone that aims to stop Col. Moammar Gadhafi from slaughtering his own people.
In deciding how to act, Obama was haunted by the legacy of the Iraq war. That ill-conceived conflict and failed occupation turned the entire Middle East, including democrats, against U.S. interventions. Egyptian rebel leaders made that point to me over and over. Imposing democracy from above, a la Iraq, is out.
So unilateral U.S. intervention in Libya was out of the question. Moreover, the Pentagon strongly opposed intervention in another Muslim country. U.S. generals feared it would take ground forces to get rid of Gadhafi.
Only after the Arab League endorsed a no-fly zone March 12 (and called for United Nations support) could the White House press for a vote by the U.N. Security Council. The vote meant – in theory, at least – that Arab countries could provide cover for action by France and Britain, with the United States in a supporting role. Even so, had Gadhafi not been on the verge of committing large-scale atrocities against civilians in full view of the world, Obama might not have concurred.
However, the Libya story is but a tragic sideshow. The fate of the region will turn on the results of democratic experiments in Egypt and events in Yemen, Bahrain, and Saudi Arabia.
The Obama-ites were slow to support Egyptian rebels, but that may have been a godsend. Much of Egypt’s newfound pride lies with the fact that its rebels made their revolution on their own.
Now is the moment when U.S. officials should back democratic Egyptians (and Tunisians) in their push for fair elections and an open constitutional process. Secretary of State Hillary Rodham Clinton, who just visited both countries, seems to get it. But in their eagerness to avoid interference in Egypt’s politics, U.S. officials may be taking an approach that’s too hands-off.
The president’s ambivalence has also stemmed, however, from the fact that we have sharply conflicting interests in the region.
In theory, we back political reform in the Middle East, in the hope that Arab states can build democratic institutions in the long run. If they succeed, terrorists may find less fertile ground in the region.
Yet in the short run, the United States still faces crucial security threats from Iran and from Islamist terrorists. Our autocratic Arab allies helped us fight these threats. Their demise is likely to create instability in coming months or years that will enable those threats to increase.
This conflict underlay the slow support for change in Egypt. Hosni Mubarak’s intelligence service was aggressive in pursuit of Islamist terrorists, and he was a key Sunni ally in containing Shiite Tehran. In the new Egypt (and Tunisia, and Libya, if Gadhafi falls), intelligence services will be curbed. This is a good thing, as the secret police repressed their own people. But it will also make it easier for terrorist networks to regroup in the region.
At least in Egypt, the White House can still rely on a close relationship with the army, which will remain a power center for the foreseeable future. In the Arabian Peninsula and the gulf, however, the democracy-vs.-security conflict makes it almost impossible to shape a coherent policy.
Gulf rulers like Saudi Arabia’s King Abdullah want Obama to forget about democracy and focus on security. Such a choice seemed possible in the last decade: George W. Bush promoted Mideast democracy in his first term; then, when that backfired, he emphasized Mideast security in his second term. But that choice is not possible now.
The administration has tried, unsuccessfully, to encourage the president of Yemen to usher in peaceful democratic change. Neither ruler nor rebels seem able to make the necessary compromises, which means U.S. officials probably can’t save Ali Abdullah Saleh. Yet if he falls, this country, just below Saudi Arabia, may relapse into tribal warfare. This would make it easier for al-Qaida in the Arabian Peninsula to flourish.
In Bahrain, the revolt of a largely Shiite population against its Sunni rulers presents the greatest danger to U.S. interests. This island kingdom is connected by a causeway to Saudi Arabia, whose eastern oil region is dominated by its Shiite minority. The Saudis fear that if Bahrain’s rulers fall, Iran will have the perfect base from which to push Saudi Shiites to rebel.
Last week, over Obama’s objections, the Saudi monarch sent troops across the causeway to help crush Bahrain’s rebels. He won’t listen when U.S. officials urge him (and Bahrain’s ruler) to give more representation to their Shiites. Obama’s team says this will head off trouble; Abdullah believes it will create more.
The Saudis think Obama is too strong on democracy and weak on security. Obama’s critics slam him for being too weak on democracy – or on security. Few realize he is caught in a historical bind that requires him to be strong on both, even though the two contradict each other – at least in the short term. Bush couldn’t resolve that contradiction; Obama has no choice but to try.
By: Trudy Rubin, Columnist, The Philadelphia Inquirer, March 22, 2011
Now that a Wisconsin judge has temporarily blocked a state law that would strip public employee unions of most collective bargaining rights, it’s worth stepping back to place these events in larger historical context.
Republicans in Wisconsin are seeking to reverse civic traditions that for more than a century have been among the most celebrated achievements not just of their state, but of their own party as well.
Wisconsin was at the forefront of the progressive reform movement in the early 20th century, when the policies of Gov. Robert M. La Follette prompted a fellow Republican, Theodore Roosevelt, to call the state a “laboratory of democracy.” The state pioneered many social reforms: It was the first to introduce workers’ compensation, in 1911; unemployment insurance, in 1932; and public employee bargaining, in 1959.
University of Wisconsin professors helped design Social Security and were responsible for founding the union that eventually became the American Federation of State, County and Municipal Employees. Wisconsin reformers were equally active in promoting workplace safety, and often led the nation in natural resource conservation and environmental protection.
But while Americans are aware of this progressive tradition, they probably don’t know that many of the innovations on behalf of working people were at least as much the work of Republicans as of Democrats.
Although Wisconsin has a Democratic reputation these days — it backed the party’s presidential candidates in 2000, 2004 and 2008 — the state was dominated by Republicans for a full century after the Civil War. The Democratic Party was so ineffective that Wisconsin politics were largely conducted as debates between the progressive and conservative wings of the Republican Party.
When the Wisconsin Democratic Party finally revived itself in the 1950s, it did so in a context where members of both parties were unusually open to bipartisan policy approaches. Many of the new Democrats had in fact been progressive Republicans just a few years earlier, having left the party in revulsion against the reactionary politics of their own senator, Joseph R. McCarthy, and in sympathy with postwar liberalizing forces like the growing civil rights movement.
The demonizing of government at all levels that has become such a reflexive impulse for conservatives in the early 21st century would have mystified most elected officials in Wisconsin just a few decades ago.
When Gov. Gaylord A. Nelson, a Democrat, sought to extend collective bargaining rights to municipal workers in 1959, he did so in partnership with a Legislature in which one house was controlled by the Republicans. Both sides believed the normalization of labor-management relations would increase efficiency and avoid crippling strikes like those of the Milwaukee garbage collectors during the 1950s. Later, in 1967, when collective bargaining was extended to state workers for the same reasons, the reform was promoted by a Republican governor, Warren P. Knowles, with a Republican Legislature.
The policies that the current governor, Scott Walker, has sought to overturn, in other words, are legacies of his own party.
But Mr. Walker’s assault on collective bargaining rights breaks with Wisconsin history in two much deeper ways as well. Among the state’s proudest traditions is a passion for transparent government that often strikes outsiders as extreme. Its open meetings law, open records law and public comment procedures are among the strongest in the nation. Indeed, the basis for the restraining order blocking the collective bargaining law is that Republicans may have violated open meetings rules in passing it. The legislation they have enacted turns out to be radical not just in its content, but in its blunt ends-justify-the-means disregard for openness and transparency.
This in turn points to what is perhaps Mr. Walker’s greatest break from the political traditions of his state. Wisconsinites have long believed that common problems deserve common solutions, and that when something needs fixing, we should roll up our sleeves and work together — no matter what our politics — to achieve the common good.
Mr. Walker’s conduct has provoked a level of divisiveness and bitter partisan hostility the likes of which have not been seen in this state since at least the Vietnam War. Many citizens are furious at their governor and his party, not only because of profound policy differences, but because these particular Republicans have exercised power in abusively nontransparent ways that represent such a radical break from the state’s tradition of open government.
Perhaps that is why — as a centrist and a lifelong independent — I have found myself returning over the past few weeks to the question posed by the lawyer Joseph N. Welch during the hearings that finally helped bring down another Wisconsin Republican, Joe McCarthy, in 1954: “Have you no sense of decency, sir, at long last? Have you left no sense of decency?”
Scott Walker is not Joe McCarthy. Their political convictions and the two moments in history are quite different. But there is something about the style of the two men — their aggressiveness, their self-certainty, their seeming indifference to contrary views — that may help explain the extreme partisan reactions they triggered. McCarthy helped create the modern Democratic Party in Wisconsin by infuriating progressive Republicans, imagining that he could build a national platform by cultivating an image as a sternly uncompromising leader willing to attack anyone who stood in his way. Mr. Walker appears to be provoking some of the same ire from adversaries and from advocates of good government by acting with a similar contempt for those who disagree with him.
The turmoil in Wisconsin is not only about bargaining rights or the pension payments of public employees. It is about transparency and openness. It is about neighborliness, decency and mutual respect. Joe McCarthy forgot these lessons of good government, and so, I fear, has Mr. Walker. Wisconsin’s citizens have not.
By: William Cronon, Op-Ed Contributor, The New York Times, March 21, 2011
The Importance of Independence: Affordable Care Act’s Independent Payment Advisory Board Key to Quality Care at Lower Cost
A year ago this week, President Barack Obama signed into law our nation’s first comprehensive health reform law, the Affordable Care Act, which not only extends health insurance protection to tens of millions of Americans but also actually reduces the deficit—in large part because of measures the law takes to responsibly slow the growth in Medicare and overall health spending. Lowering the projected growth of health care costs is a key promise of the law because these ever-escalating costs drain businesses, government coffers, and individuals’ savings. Yet many who criticize the law as a budget buster are aiming to repeal some of its key cost-containment features.
The Independent Payment Advisory Board is a case in point. The Affordable Care Act establishes this board to serve as a guarantor that the law’s cost-containment goals will actually be achieved. If the government’s main health care program for the elderly and disabled Medicare exceeds its per capita cost-growth targets under the new law, then the Independent Payment Advisory Board is empowered to recommend ways to reduce program expenditures by changing the way Medicare pays health care providers.
The secretary of health and human services must implement these recommendations unless Congress passes an alternative proposal or discontinues the cost-containment review process by the Independent Payment Advisory Board. Some legislators propose to eliminate the board. This would be a mistake.
Understanding the purpose of the board—as part of the Affordable Care Act’s cost-containment strategy overall—makes it clear that keeping and strengthening the independent board makes sense. The new health law’s cost-containment strategy includes both reducing excessive payments to providers under Medicare’s current payment mechanisms and moving Medicare—and, by example, the private sector—away from a payment system that rewards volume of services, without regard to health benefits, to payment arrangements that reward effective care, efficiently provided.
The Independent Payment Advisory Board will reinforce this twin focus on quality care at lower cost.
The Affordable Care Act holds hospitals and other institutional health care providers to productivity gains—something every other sector of our economy has achieved over the past several decades. Between 1995 and 2008 average annual productivity growth across the vast majority of U.S. businesses was 2.4 percentage points—just more than 1 percentage point higher than the previous two decades. In contrast, the health care, education, and social services sectors combined have produced average annual productivity growth rates of negative 0.2 percentage points.
The Affordable Care Act’s push for providers to produce productivity gains on par with other sectors promotes the efficiencies needed to reduce health care costs. But to assure that growth rates actually slow, the Affordable Care Act sets a target for Medicare spending growth and requires the Independent Payment Advisory Board to develop and recommend payment changes to achieve it. Both the Congressional Budget Office and the executive branch’s Centers for Medicare and Medicaid Services predict that explicit payment changes will produce most but not all of the savings needed to realize the independent board’s spending-growth targets through 2019 under the new law.
Avoiding excessive increases in the rates Medicare pays historically slows spending growth across the entire health care industry and can do so in the future. But tightening fee-for-service does nothing to improve quality or efficiency in care delivery—a critical goal of health reform. That’s why the Affordable Care Act includes multiple strategies to promote payment and delivery reform.
First, the new law stops rewarding bad behavior. The law authorizes the secretary of health and human services, without seeking congressional action, to review and alter “misvalued” fees, such as paying more for services than they’re worth, and to reduce payments for clearly undesirable behavior, such as hospital-acquired infections or conditions, inappropriate hospital readmissions, and, even more egregious, outright fraud. These new steps will deliver market-based signals to Medicare health care providers—and by example to the entire industry—that the wrong kinds of services that drive up current costs will no longer be rewarded.
Alongside what might be considered these “sticks” to change behavior come a set of essential “carrots,” or rewards to deliver more effective and efficient care. At the most basic level, these rewards are extra payments to providers for doing “good” things—say, meeting a set of efficiency standards while maintaining quality care. But more importantly, these rewards reside in alternative payment mechanisms to replace today’s fee-for-service payment system.
Among the new payment systems the new health law encourages is “bundling” separate fees into a single payment for services associated with a specific condition, such as a hip fracture, which today would include separate fees for diagnosis, surgery, and postoperative care. Another provision of the law promotes the financial and health benefits of primary care and chronic care management through newly created “medical homes,” which coordinate health care for their patients. And yet another new approach to health care promoted by the new law are so-called “accountable care organizations,” which are collaboratives of inpatient and outpatient providers who are rewarded for delivering quality care to a defined set of patients at lower-than-projected costs.
The new law sets a clear timetable for implementing some of these measures and creates the Center for Medicare and Medicaid Payment Innovation to initiate, evaluate, and broadly extend the application of these methods as part of “rapid cycle change.”
The law also recognizes that these efficiencies and the savings they can deliver will not be realized if changes in payment systems are limited to the public sector, and therefore encourages public-private partnerships. Medicare is a large payer, accounting for 20 percent of our nation’s medical bill in 2009. Private payers have historically followed Medicare payment practices. But that outcome is neither automatic nor immediate.
What’s more, inconsistent payment mechanisms across payers discourage providers from changing behavior, impede efficiency improvements, and create opportunities for offsetting one payer’s spending reductions with increases for others. Indeed, a recent study by the Medicare Payment Advisory Commission, an independent congressional agency, finds that hospitals squeezed by both Medicare and private payers changed their operations to become more efficient, yet hospitals with generous private payments ignored Medicare constraints, took losses on Medicare patients, and continued business as usual. Better quality care at lower costs requires that the public and private sectors work in tandem.
The health reform law encourages common action in different ways. The law gives preference to innovations where providers engage with private payers alongside Medicare in adopting new payment incentives Other provisions in the law further support payment reform in the private sector by extending access to Medicare provider performance data to guide private payers’ payment-reform efforts, and requiring private health plans to regularly report on those efforts. These data will inform the Independent Payment Review Board when it uses its authority to make nonbinding recommendations for private-payer reforms alongside binding recommendations for public programs.
This is a key provision of the new law. From 1970 to 2000 the private sector was less effective than Medicare in promoting efficiency, with an average annual growth rate per enrollee of 11.1 percent compared to Medicare’s rate of 9.6 percent. An effort that addresses public-sector but not private-sector health care spending risks limited access for beneficiaries as well as missed opportunities to encourage health care providers to operate more effectively and efficiently. Therefore, the broader the new board’s authority is to influence not only public but also private spending, the more effective it will be.
A focus on policy tools alone, however, obscures the most important element of the Independent Payment Review Board’s potential impact. Payment improvements in the past were stymied by legislators responding to providers’ resistance to change. Provider payment is rarely a partisan issue but it is a political issue. The new law takes the politics out of the equation by giving the independent board the authority to make Medicare payment recommendations that become law unless explicitly overridden by legislative action. This gives a major boost to policy over politics in containing health care costs.
And it’s precisely this boost that special interest groups want to prevent. Opponents of the new board complain it undermines congressional authority and removes from their control an important budgetary lever at a time when the federal budget deficit is rising at an unsustainable rate. But the real concern of many of these critics, who often are the fiercest advocates of fiscal restraint, is that the board’s authority diminishes their influence and their ability to fashion a Medicare budget that benefits the pharmaceutical industry and other special interest groups that are in a position to lose the most from the board’s future recommendations.
Other critics of the Independent Payment Advisory Board fear the Affordable Care Act did not go far enough in granting it authority, leaving too many loopholes for special interest groups to avoid payment adjustments. In making adjustments the board is prohibited from addressing payments to hospitals, skilled nursing facilities, and other health care providers who are scheduled to receive “productivity adjustments” under the Affordable Care Act. Rather than repeal the board, the more sensible option would be to close these loopholes and extend accountability for unacceptable health care cost increases.
In fact, members of Congress and policymakers in the federal government should be thinking of ways to strengthen the Independent Payment Advisory Board given the fiscal reality facing the federal government today. The new board is one of the Affordable Care Act’s most important cost-containment tools. We can’t afford to lose it.
By: Judy Feder, Senior Fellow, Center For American Progress, March 21, 2011
Conservatives often push myths and misconceptions of the Affordable Care Act of 2010 as a way to increase opposition. During the debate in Congress in the run-up to passage of the new health reform law, conservatives pushed wild accusations that the law would be a “government takeover” and establish “death panels,” claims that were labeled “the lie of the year.” Now, a year after the Affordable Care Act was signed into law, inaccurate claims and mistruths against the law continue.
Conservatives continue to make false claims against the law as a way to repeal it, undermine consumer protections, and put insurance companies back in charge of our health system. The reason these false statements endure is clear: There are those who would rather take us back to the way our health system was before when insurance companies were in charge rather than move forward and protect our care.
This issue brief is a response to recent false attacks conservatives have made against the law. As we will demonstrate, the Affordable Care Act will create jobs, lower health care costs for families, help small businesses provide health insurance to their employees while maintaining the private sector’s key role in health insurance, and ensure we provide quality health care to all Americans at a lower cost to them and American taxpayers.
The Affordable Care Act will help create jobs
The Affordable Care Act helps our economic recovery by bringing health costs under control, freeing businesses to use that money to invest in job creation. The real threat to job creation is the conservative push to take us back to the old health system where costs were on an unsustainable path. Harvard University professor and Center for American Progress Senior Fellow David Cutler found that repealing the Affordable Care Act—and going back to the unsustainable costs—would cost up to 400,000 jobs annually over the next decade.
To push this “job destroying” argument, conservatives cite the nonpartisan Congressional Budget Office’s estimates that the law will reduce the labor supply (although conservatives dismiss CBO reports when they conclude the law will cut the deficit and reduce premiums). Yet conservatives fail to recognize that one reason for this reduction is that older workers, now forced to hold on to jobs to get health insurance, will now be able to retire—with insurance—when they choose.
The Affordable Care Act lowers premiums and costs for families
The Affordable Care Act takes steps to get our health costs under control and lowers costs for families. The real threat to costs is the conservative push to repeal the law. Cutler found that repealing the Affordable Care Act would increase total health spending by $125 billion and raise family premiums by nearly $2,000.
More small businesses are providing health coverage to their employees, thanks in part to the Affordable Care Act
Conservatives try to downplay the impact of the small business tax credits to provide health insurance to their employees. The truth is that last year, more than 4 million small businesses were eligible to receive a tax credit to make health coverage more affordable. According to the Los Angeles Times, “major insurers around the country are reporting that a growing number of small businesses are signing up to give their workers health benefits,” adding that an “important selling point” was the small business tax credits.
The Affordable Care Act keeps the employer-based health system intact
Conservatives claim the Affordable Care Act will undermine the employer-sponsored health coverage that millions of Americans enjoy when the state health insurance market exchanges become functional. This is not true. According to Mercer’s recent “National Survey of Employer-Sponsored Health Plans,” the vast majority of employers, particularly large employers, will continue to offer their employees health coverage. Indeed, the survey notes that if the Affordable Care Act follows the Massachusetts health law, “few employers of any size” will choose to drop coverage.
The Affordable Care Act ensures quality care and has flexibility for states
The Affordable Care Act provides states with considerable flexibility. Each state gets to decide how to set up their own marketplace of health options for consumers to choose which plan suits them best. States have flexibility in how they implement insurance reforms and consumer protections. The law encourages state innovation by allowing them to obtain waivers from some requirements provided the alternative proposal provides comparable coverage and affordability. President Obama recently endorsed legislation from Sens. Ron Wyden (D-OR) and Scott Brown (R-MA) that would move the start date for those waivers by three years.
At the same time, conservatives argue there is not enough flexibility in the Affordable Care Act. They criticize the Obama administration for granting too many waivers on so-called “mini med” plans that have a low annual limit. Since many of the consumer protections and mechanisms to increase patient choice—such as the state marketplaces—are not operational until 2014, the administration has in some instances granted waivers from the law’s early requirements, to avoid leaving people with nothing. CAP Senior Fellow Judy Feder told Congress that until the law is fully implemented, the goal should be to “make matters better, without making them worse.”
States can save money from the Medicaid reforms under the law
Medicaid is a federal-state health program that provides health coverage to predominantly lower-income families, elderly people, and people with disabilities. The federal government matches state funding on the program. For people made newly eligible for Medicaid by the Affordable Care Act, the federal government will pay 100 percent of costs in the early implementation of the Affordable Care Act. In the later years, states will have to pay only 10 percent.
Conservatives charge that the Affordable Care Act will increase state Medicaid spending by $118 billion. An Urban Institute study, however, found that states will save between $40.6 billion and $131.9 billion from 2014-2019 by replacing state and local spending for uncompensated care and mental health with federal Medicaid funds and by replacing federal Medicaid funding for adults with incomes over 133 percent of the federal poverty level with federal subsidies in the marketplaces.
There is no secret $105 billion hidden in the law
Conservatives such as Reps. Michele Bachmann (R-MN) and Steve King (R-IA) claim that $105 billion of mandatory funding was secretly put in the law unbeknownst to members of Congress. This is false. The Washington Post’s Fact Checker said this claim is “bordering on ridiculous” and “does not have credibility.” The truth is there was a considerable amount of transparency before the Congress approved the Affordable Care Act. In the House alone, there were: 79 bipartisan hearings, totaling 100 hours; 181 witnesses; and 239 amendments considered. The House bill was posted online 30 days before committee markup.
The law keeps Medicare solvent and cuts the deficit
Conservatives argue that the Obama administration “double counted” the Medicare savings for the law, arguing it went to save the Medicare Trust Fund and cut the deficit. The facts are these: The law cuts the deficit by $1 trillion over the next two decades and keeps Medicare solvent until 2029—12 years longer than before the law was passed. The Center on Budget and Policy Priorities explained how this works before the House Budget Committee:
There’s no double-counting involved in recognizing that Medicare savings improve the status of both the federal budget and the Medicare trust funds. In the same way, when a baseball player hits a homer, it both adds one run to his team’s score and also improves his batting average. Neither situation involves double-counting.
The conservative false attacks are meant to repeal the Affordable Care Act and bring our health system back to the time when insurance companies could discriminate because of a pre-existing condition. Despite these false attacks, the facts are clear: Millions of families, small business owners, and seniors are seeing the benefits of the Affordable Care Act. More than 4 million small businesses are eligible to receive tax credits to make health coverage more affordable. As many as 4 million seniors received help to make their prescription drugs more affordable. Already this year, more than 150,000 seniors with Medicare had a free wellness exam. And children with pre-existing conditions can no longer be excluded from insurance plans. We should move forward with this law and tell those who want to repeal it that we won’t go back.
By: Tony Carrk, Center For American Progress, March 21, 2011