“Managing Expectations”: How Conservatives Are Helping Obamacare
Yuval Levin, among other conservatives, has made an offer to liberals: Let’s delay the implementation of Obamacare for a year and make everybody better off:
Congressional Democrats surely want to avoid being blamed for a meltdown of American health care during a congressional election year, the people implementing this law at every level could certainly use the time, and Republicans believe that more time would not make Obamacare more popular but would allow them to further develop and articulate their alternatives (and allow another election to intervene earlier in the rollout process, making a replacement more plausible).
Liberals, wisely, are saying no. What’s funny about this conversation is that conservatives have been accidentally managing expectations for implementation: By harping constantly on what a disaster the rollout is going to be, they will make what actually happens look good by comparison.
Jonathan Cohn has a good piece in the New Republic arguing that implementation won’t be as bad as people are saying. This is his really important observation:
Notice that the worries about implementation chaos apply strictly to people who would otherwise be uninsured or at the mercy of the existing individual insurance market, in which plans are inconsistently priced, full of coverage holes, and of unpredictable reliability — and in which financial assistance for buying private coverage is not available at all. Even if it takes these people a while to get insurance, and even if finding that coverage is a maddening experience, they’re going to end up with something they don’t have now: Coverage that meets more of their needs and is available to them, with substantial financial assistance. Don’t forget: Today, people with pre-existing medical conditions frequently cannot get any coverage on the individual market.
This is something that has been lost in the discussion of Obamacare implementation difficulties:
Implementation won’t much affect the 78 percent of Americans currently covered through Medicaid, Medicare, or employer group health plans. It will make some people who currently buy individual coverage worse off. But only 5 percent of Americans get insurance through the individual market, which is already hugely dysfunctional. Three times as many Americans are currently uninsured, and they can only stand to gain from Obamacare implementation, even if it does not go smoothly.
For those 5 percent who buy individual coverage now, the new law will be a mixed bag. Some people will probably have frustrating bureaucratic experiences with the new exchanges that they didn’t have buying directly from insurers. And some people (particularly young and healthy people) will see their premiums go up. But others will see their premiums go down, either because they currently pay a lot because of age or health status, or because income-based premium subsidies will more than offset any premium increase.
There will also be people who lose group health coverage, when premium subsidies make it attractive for their employers to send them to shop in the exchanges. (Others will gain group coverage if employers decide it is better to offer it than to pay a penalty for uninsured workers.) But neither this effect nor any problems faced by people with existing individual insurance is likely to create a clamor for repeal that is any more effective than the din of the last three years.
That is because the most obvious way to fix the problem of those who have trouble in the health exchanges will be to fix the exchanges, not repeal them. Let’s say your employer dropped group coverage and you’re having trouble with the exchange. Will you want the whole law repealed in the hope that will lead your employer to reverse course and offer a group plan again? Or will you want the exchange fixed so you are guaranteed access to coverage?
Cohn looks back to Medicare Part D and the Children’s Health Insurance Program and argues that those programs got through their rocky implementations in large part because benefits obtained with bureaucratic difficulty are better than no benefits at all. He’s right, and this is why conservatives are “magnanimously” offering to delay implementation of Obamacare. They realize that once people have guaranteed access to health coverage, they won’t want to give it up, even if there are implementation problems.
The political landscape is already dire for those who still hope to repeal Obamacare, and they’re actually making their position worse by talking constantly about what a nightmare implementation is going to be. This fall, as the exchanges come on line, tens of millions of people are going to find they can get health coverage they never could before. They are likely to be quite happy about that, especially if they’ve been hearing for months in advance that it will be a mess.
By: Josh Barro, Bloomberg, April 29, 2013
“The Jan Brewer Cycle Of Death”: Turning The Gun-Buyback Model On Its Ear
I’m not an expert in gun buyback programs, but the basic idea seems pretty straightforward. In the hopes of getting more guns off the streets, there are organized events in which members of the public bring their firearms, and exchange them for cash. They’re usually publicly funded, though as Rachel noted on the show in March, some are privately financed.
But what matters is the point of the programs: removing guns from circulation. It’s possible Arizona Republicans find this confusing.
Arizona cities and counties that hold community gun buyback events will have to sell the surrendered weapons instead of destroying them under a bill Gov. Jan Brewer signed into law Monday.
The bill was championed by Republicans in the GOP-controlled Legislature who argued that municipalities were skirting a 2010 law that was tightened last year and requires police to sell seized weapons to federally licensed dealers. They argued that destroying property turned over to the government is a waste of taxpayer resources.
Hmm. Let’s say a local sheriff’s office in Arizona wants to reduce gun violence in its community by getting more guns off the streets. The sheriff decides to do this through a gun buyback program, encouraging local citizens to participate in exchange for money, helping to keep weapons out of the hands of children and criminals. The guns are then destroyed.
Under a new law championed by state Republicans, however, that sheriff’s office can’t destroy the guns — the firearms collected during the buyback will instead be brought to gun stores, where they then can be sold and put back on the streets.
The Arizona GOP wants to turn gun buyback programs into gun recycling programs — watch the assault rifle go from the street … to the police … to the gun dealers … back to the street.
Let’s all marvel at the cycle of life, or more accurately in this case, death.
By: Steve Benen, The Maddow Blog, April 30, 2013
“When Policy No Longer Has Value”: Pat Toomey’s Candor Sheds Light On The Post-Policy Republican Party
When Senate Republicans last week killed expanded background checks on firearms purchases, they were taking a political risk. After all, it was only four months after a massacre at an elementary school, and the bipartisan proposal enjoyed overwhelming support from the public. Some of the senators who supported the Republican filibuster are now paying a steep price.
So why did GOP senators put aside common sense and popular will? According to Sen. Pat Toomey (R-Pa.), who co-authored the bipartisan measure, it wasn’t just about the gun lobby — some of his Republican colleagues didn’t want to “be seen helping the president.”
“In the end it didn’t pass because we’re so politicized. There were some on my side who did not want to be seen helping the president do something he wanted to get done, just because the president wanted to do it,” Toomey admitted on Tuesday in an interview with Digital First Media editors in the offices of the Times Herald newspaper in Norristown, Pa.
Later, Toomey tried to walk that back a bit, saying he was referring not just to Senate Republicans, but also Republican voters, but I think in this case, Toomey’s original line was his honest assessment. Indeed, the clarification doesn’t even make sense — GOP voters “did not want to be seen helping the president”? C’mon.
I think the senator’s candor is important for a couple of key reasons. The first, of course, is that it puts the debate over gun reforms in a fresh light. You’ll recall that two weeks ago, much of the political commentary surrounding the Senate vote focused on holding President Obama responsible — he didn’t “twist arms” enough; he didn’t “lead” enough; he didn’t act like an Aaron Sorkin character enough. Blame the White House, we were told, for Republican intransigence.
According to Toomey — who presumably has a pretty good sense of the motivations of his own colleagues in his own party — the media’s blame game had it backwards. No amount of presidential arm-twisting can overcome the will of lawmakers who want to defeat the president’s agenda because it’s the president’s agenda.
The second angle to keep in mind is the post-policy thesis I’ve been harping on for weeks.
If you’re just joining us, Rachel used the phrase on the show two months ago, asking whether Republicans have become a “post-policy” party. This was the exchange between Rachel and Ezra Klein:
MADDOW: Does that mean that [Republican policymakers are] post-policy, that the policy actually — even some things that seem like constants don’t actually matter to them, that it’s pure politics, just positioning themselves vis-a-vis the president, and they’re not actually invested in any particular outcome for the country?
KLEIN: I would like to have an answer where that isn’t true. I really would.
In context, they were talking about budget issues, but note how well the thesis applies to just about every contemporary policy debate in Washington.
Indeed, according to Toomey, some Senate Republicans might have considered simple steps to prevent gun violence, but it was more important to them to play a partisan game — they were invested in pure politics, positioning themselves vis-a-vis the president, and the GOP was unconcerned with any particular outcome for the country.
This is unsustainable. The American system of government is dependent on a series of compromises — between the two parties, between the two chambers of Congress, between the executive and legislative branches — and governing breaks down when one party decides policy no longer has any value and there’s simply no need to consider concessions with those on the other side of the aisle.
By: Steve Benen, The Maddow Blog, May 1, 2013
“History Is A Cruel Judge Of Overconfidence”: Ten Years Ago, Bush Declared “Mission Accomplished” And The Media Swooned
Today marks the tenth anniversary of Mission Accomplished Day, or as it might better be known, Mission (Not) Accomplished Day. Sadly, it comes amid another upheaval in sectarian violence in Iraq—two days ago The New York Times warned of a new “civil war” there—and a week after the attempts at Bush revisionism upon the opening of his library. We’re also seeing aspects of the run-up to the Iraq invasion playing out in the fresh, perhaps overheated, claims of chemical weapons in Syria.
In my favorite antiwar song of this war, “Shock and Awe,” Neil Young moaned: “Back in the days of Mission Accomplished/ our chief was landing on the deck/ The sun was setting/ behind a golden photo op.” But as Neil added elsewhere in the tune: “History is a cruel judge of overconfidence.”
Nowhere can we see this more clearly than in the media coverage of the event.
On May 1, 2003, Richard Perle advised, in a USA Today op-ed, “Relax, Celebrate Victory.” The same day, President Bush, dressed in a flight suit, landed on the deck of the USS Abraham Lincoln and declared an end to major military operations in Iraq—with the now-infamous “Mission Accomplished” banner arrayed behind him.
Chris Matthews on MSNBC called Bush a “hero” and boomed, “He won the war. He was an effective commander. Everybody recognizes that, I believe, except a few critics.” He added: “Women like a guy who’s president. Check it out. The women like this war. I think we like having a hero as our president. It’s simple.”
PBS’ Gwen Ifill said Bush was “part Tom Cruise, part Ronald Reagan.” On NBC, Brian Williams gushed, “The pictures were beautiful. It was quite something to see the first-ever American president on a—on a carrier landing.”
Bob Schieffer on CBS said: “As far as I’m concerned, that was one of the great pictures of all time.” His guest, Joe Klein, responded: “Well, that was probably the coolest presidential image since Bill Pullman played the jet fighter pilot in the movie Independence Day. That was the first thing that came to mind for me.”
Everyone agreed the Democrats and antiwar critics were now on the run. The New York Times observed, “The Bush administration is planning to withdraw most United States combat forces from Iraq over the next several months and wants to shrink the American military presence to less than two divisions by the fall, senior allied officials said today.”
Maureen Dowd in her column did offer a bit of over-the-top mockery, declaring: “Out bounded the cocky, rule-breaking, daredevil flyboy, a man navigating the Highway to the Danger Zone, out along the edges where he was born to be, the further on the edge, the hotter the intensity.
“He flashed that famous all-American grin as he swaggered around the deck of the aircraft carrier in his olive flight suit, ejection harness between his legs, helmet tucked under his arm, awestruck crew crowding around. Maverick was back, cooler and hotter than ever, throttling to the max with joystick politics. Compared to Karl Rove’s ”revvin’ up your engine” myth-making cinematic style, Jerry Bruckheimer’s movies look like Lizzie McGuire.
“This time Maverick didn’t just nail a few bogeys and do a 4G inverted dive with a MiG-28 at a range of two meters. This time the Top Gun wasted a couple of nasty regimes, and promised this was just the beginning.”
When Bush’s jet landed on the aircraft carrier, American casualties stood at 139 killed and 542 wounded. That was over 4,300 American, and hundreds of thousands of Iraqi, fatalities ago.
By: Greg Mitchell, The Nation, May 1, 2013
“Ugly And Getting Worse”: A Republican House Divided Against Itself
It didn’t get much attention last week, but House Majority Leader Eric Cantor (R-Va.) suffered a significant defeat last week. The Virginia Republican, as part of a larger rebranding campaign, crafted something called the “Helping Sick Americans Now Act,” which intended to transfer money from the Affordable Care Act to high-risk pools for the uninsured.
Democrats saw through the scheme, but more importantly, House Republicans hated the idea, seeing it as a plan to “fix” Obamacare. Humiliated, Cantor was forced to pull his bill without a vote.
The overlooked fiasco was a problem House GOP leaders saw coming.
Less than two weeks ago, House Majority Whip Kevin McCarthy walked upstairs to Majority Leader Eric Cantor’s Capitol office to discuss a sensitive issue: Why did Cantor schedule a vote before McCarthy had the chance to survey Republican support?
The meeting — described as “tense” by several people familiar with it — ended with McCarthy abruptly standing up and storming out of the room. Aides downplayed the exchange. But a week later, it turned out that McCarthy’s pique was merited: The health care-related bill was suddenly pulled from the floor in what was the most recent stumble for House Republicans.
If this was a rare misstep, and the Republican-led House ran like a well-oiled governing machine, it’d be easy to overlook. But the trouble with Cantor’s bill appears to be evidence of a much larger and deeper problem.
We talked a month ago about House Speaker John Boehner’s (R-Ohio) “Make the Senate go first” rule that effectively takes the House out of the governing process altogether, but Jake Sherman’s report makes it seem as if Boehner doesn’t have much of a choice — this is a House “in chaos.” Republican leader are “talking past each other”; the House conference “is split by warring factions”; and influential outside groups are fighting their ostensible allies.
It’s ugly, and it’s getting worse.
There appear to be a series of factions, which clearly don’t see eye to eye. Right-wing lawmakers want to invest their time and energy into combating Democrats and voting on health care repeal; Cantor and his allies are focused on rebranding and conservative-friendly solutions; and Boehner has some big-ticket items in mind as he weighs the future of the so-called “Hastert Rule.”
In the meantime, four months into the new Congress, the House has no policy agenda, and according to the Politico report, GOP leaders even consider immigration reform a “long shot” in the lower chamber.
I’m not entirely convinced that the House is so far gone that governing is literally impossible, especially if the Speaker’s office is willing to forgo the “majority of the majority” and start passing bills with Democratic votes. Boehner has already done this four times this year, and if he’s willing to do it some more, this Congress may not be a complete disaster.
But clearly House Republicans are divided against themselves. There’s no meaningful leadership; no interest in cooperation or compromise; and post-policy nihilism rules the day. The demise of Cantor’s health care bill was a reminder that House Republicans will reject their own party’s policy ideas with nearly the same speed as they’ll reject Democratic ideas.
For many Beltway pundits, the inability of House Republicans to act like a governing caucus is mainly President Obama’s fault — if only he’d schmooze with them, form personal relationships, and act like a character in an Aaron Sorkin movie, maybe these radicalized nihilists would be more likely to get something done.
But all available evidence suggests the collapse of the House GOP is out of Obama’s hands. The House Republican conference is simply broken.
By: Steve Benen, The Maddow Blog, May 1, 2013
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