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“Old Time Crackpot Patriarchy”: Behind The Right’s Crazy Crusade To Make Women Pay More For Health Insurance

In a sane world, when Rep. Renee Ellmers asked rhetorically last week “Has a man ever delivered a baby?” she would have been arguing not against, but for the Affordable Care Act’s requirement that men and women pay the same insurance premiums. After all, the special physical burdens borne solely by women to ensure the life and health of the next generation obviously benefit both genders, right? Healthy men today can thank their mothers for eating well and getting good prenatal care; likewise fathers are grateful to the mothers of their children for the same. (Michael Hiltzik runs down the case for sharing those costs publicly here.)

But no, Ellmers asked that question of Health and Human Services Secretary Kathleen Sebelius in order to rail against the ACA’s equal premium requirement. She thought it was a clever “gotcha” moment, designed to show the craziness of requiring all insurance policies to cover maternity care and contraception without a co-pay. (The doofuses at Breitbart agreed, declaring “Ellmers brings her A game.”) Amazingly, Ellmers chairs the House GOP’s “women’s policy committee” – so how could she be so tone-deaf in attacking the way the ACA helps that increasingly elusive GOP constituency, female voters?

Because the right-wing base of the modern Republican Party is dedicated to restoring men as the head of the household, and the nuclear, husband-headed family as the principle social unit. From Rick Santorum railing against contraception and preaching the nuclear family as the answer to poverty in last year’s GOP presidential primary, to Rafael Cruz Sr. telling an audience that “God commands us men to teach your wife, to teach your children—to be the spiritual leader of your family,” today’s right-wing Republicans are increasingly comfortable with open displays of old-time crackpot patriarchy. This week Sen. Ted Cruz Jr. courts the right-wing preachers of the South Carolina Renewal Project, which is thought to be a key stop on his way to the GOP nomination in that early-primary state.

Let’s face it: The only way charging women more for health insurance and healthcare makes sense is if they have a partner who either shares that burden or shoulders it entirely. As in … a husband. Then it’s clear that the male of the species is doing his part to keep the species healthy and reproducing itself. A woman who doesn’t have a husband to play that role? Well, there shouldn’t be women like that – and certainly if there are, they shouldn’t be having children anyway, or even having sex, so they don’t need maternity care or contraception.

That’s the only way I can explain the GOP’s willingness to openly endorse an enormous transfer of wealth from women back to men by not only advocating the repeal of the ACA but specifically railing against its equal-premium provisions. But don’t worry, gals: You’ll get that wealth back once you get yourself a man!

I got a glimpse of this mind-set from an otherwise open-minded Republican, former RNC chair Michael Steele, last year, when he argued against the ACA’s contraception without a co-pay provision on “Hardball.” As Steele told me:

The problem is that you have effectively absolved the male of any responsibility in the relationship with this woman, whether it’s a sexual nature or beyond that. It’s not just about giving women access to contraception. It’s about the responsible behavior that goes with that access. It’s nice for Barack Obama to tell women, ‘I got your back. Here, have a pill.’ Men have a responsibility here … It’s this other piece that doesn’t get talked about in terms of the responsibility of fathers, or potential fathers, in this relationship.

I tried to reassure Steele that men could continue to be responsible to the women in their lives, even if they got contraception without a co-pay, but he wasn’t having it. I saw the uneasiness with female autonomy that’s at the heart of modern Republicanism, even if Steele himself handles that anxiety better than folks on the far right.

The father of the man who led the crusade to shut down the government over Obamacare, Rafael Cruz Sr., is quite clear about his belief that women must be subservient to men. As David Corn revealed in Mother Jones, Cruz told an Irving, Texas, mega-church last year:

As God commands us men to teach your wife, to teach your children—to be the spiritual leader of your family—you’re acting as a priest. Now, unfortunately, unfortunately, in too many Christian homes, the role of the priest is assumed by the wife. Why? Because the man had abdicated his responsibility as priest to his family…So the wife has taken up that banner, but that’s not her responsibility. And if I’m stepping on toes, just say, ‘Ouch.’

Ouch. I’m waiting for mainstream reporters to ask Cruz whether he shares his father’s beliefs – including his claim that President Obama should “go back to Kenya.” Rafael Cruz is a leading surrogate for his son, and has played a core role in his political rise. I don’t think it’s unfair to ask how much their views overlap, especially as Cruz courts the extremists in the South Carolina Renewal Project.

Right now those extremists matter more to key GOP leaders than ordinary women do. But if Ken Cuccinelli loses the Virginia governor’s race to Democrat Terry McAuliffe, as polls indicate is likely, he’ll do so because of the women’s vote. Republicans can’t win women because they’re still fighting a culture war to restore men to their “rightful” place as the head of the family and society. They’re profoundly uncomfortable with women’s autonomy – and that makes women voters increasingly uncomfortable voting Republican. Making Renee Ellmers the face of the backlash won’t help.

But I don’t expect a Cuccinelli loss to sober up the GOP either. Already right-wingers are telling reporters that McAuliffe is winning because the stridently antiabortion lieutenant governor didn’t campaign hard enough on culture-war issues. Antiabortion activist Marjorie Dannenfelser, who leads the Susan B. Anthony List, told Politico that Cuccinelli bowed to a GOP establishment-mandated “jobs, economy, that’s all that matters script.” Dannenfelser says “that script didn’t work in the presidential with [Mitt] Romney, who is not viewed as conservative as Ken is, and it has been problematic in this gubernatorial race. Sometimes, when it gets to social policy, everyone gets in the fetal position on the Republican side.”

Democrats have to hope the GOP listens to Dannenfelser heading into the 2014 midterms.


By: Joan Walsh, Editor at Large, Salon, November 5, 2013

November 6, 2013 Posted by | GOP, War On Women, Women's Health | , , , , , , | 1 Comment

“The Texas Abortion Emergency”: This Isn’t Complicated, Women Are Paying An Unconstitutional Price

Outside the chambers of federal appellate judges Priscilla Owen, Jennifer Elrod, and Catharina Haynes, virtually everyone understands that H.B. 2, the new Texas law that places various restrictions on a woman’s ability to obtain an abortion, is not about protecting women’s health — it’s about stopping abortion.

And yet on Friday, those three judges, who sit on the U.S. Court of Appeals for the Fifth Circuit in New Orleans, ruled that the law could go into effect, since it was “not designed to strike at the right itself,” and wasn’t invalid simply because it “has the incidental effect of making it more difficult or more expensive to procure an abortion.”

That ruling led to the immediate closure of one-third of clinics in Texas where abortions are performed — several in rural areas that serve women without the means to travel hundreds of miles to another clinic.

On Monday morning, Supreme Court Justice Antonin Scalia allowed the charade to continue for at least another week when he declined to grant an emergency request by the law’s challengers to stay the appeals court’s ruling, and ordered the state to file a response by Nov. 12. (Justice Scalia hears all emergency-stay applications out of the Fifth Circuit.)

The law requires, among other things, a doctor to have admitting privileges at a hospital no more than 30 miles from where he or she performs abortions. On Oct. 28, U.S. District judge Lee Yeakel ruled that this provision was “without a rational basis and places a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus.”

The state appealed immediately, and on Friday, the Fifth Circuit panel issued its stay of Judge Yeakel’s ruling.

But no matter what the panel says, the law is intended precisely to “strike at the right itself” — only dishonest politicians pretend otherwise. Making it harder for women to get an abortion is not an “incidental effect” of the law; it is its primary goal.

Consider the words of Texas solicitor general Jonathan Mitchell, who claimed during the trial before Judge Yeakel that the state has a vested interest in “protecting the life of the unborn child,” and thus may impose “inconveniences on women seeking abortion in hopes that it may lead women considering abortion to consider childbirth instead.”

Like similar laws popping up all over the country, H.B. 2 is cloaked in the guise of protecting women’s health only because anti-abortion activists know it’s their best shot of surviving judicial scrutiny.

This shouldn’t be complicated. On one side is a law of dubious constitutionality passed by legislators who openly admit their desire to end all abortions. On the other side are real women whose constitutional right to have an abortion is being effectively blocked.

The arguments of all sides have been on the table for months, which is why Texas was able to file its appeal within hours of the district court’s ruling. Now the state has at least another week, while Texas women pay the price.


By: Jess Wegman, The Opinion Pages, The New York Times November 4, 2013

November 6, 2013 Posted by | War On Women, Womens Rights | , , , , , , , | Leave a comment

“The Coming Electoral Consequences”: Speaker Boehner Keeps Motivating The Wrong Base

The widely held assumption is that a variety of popular measures can pass the Senate and earn President Obama’s signature, but won’t become law because of the Republican-led House. And in plenty of instances, that’s true.

But on a variety of important proposals, the problem isn’t the House majority party, but rather, the willingness of the House GOP leadership to let the chamber vote up or down on the bills in question. The obstacle, in other words, isn’t 218 “no” votes; it’s House Speaker John Boehner’s disinclination to let the House exercise its will.

I can appreciate why the Speaker would rather kill popular bills than pass them – he promised his right-wing members he’d honor the manufactured “Hastert Rule,” and Boehner’s afraid of being deposed – but as Brian Beutler noted yesterday, the posture may well carry electoral consequences.

Big Senate bills in and of themselves won’t shake House Republicans out of their paralysis. It’s unrealistic to expect the House will address all of these issues and it’s possible they won’t address any of them. But the constituent groups to whom these issues matter – Latinos, the LGBT community, women and African Americans – won’t be confused about who killed them.

The flip side of the GOP becoming a whites-only party and crossing its fingers that fails is that Boehner is doing his damnedest to help Democrats receive their 2008 and 2012 coalitions in the coming midterm.

Remember, one of the key Democratic hopes going into the 2014 midterms – now 364 days away – is that congressional Republicans will motivate the Democratic base to show up for a change in a midterm cycle. How’s that going so far?

Swimmingly. Democratic candidates and campaign committees now intend to go to Latino communities and say, “Like immigration reform? Then help vote out the Republicans who killed the bipartisan reform package.” Dems intend to go to LGBT communities and say, “Like ENDA? Then help vote out the Republicans who killed the bipartisan bill.” Dems intend to go to African-American communities and say, “Like voting rights? Then help vote out the Republicans who made it impossible to reform the Voting Rights Act.”

And Dems intend to go to everyone and say, “Like the government shutdown and series of self-imposed crises? If not, then help vote out the Republicans who cooked up these schemes.”

The Democratic coalition is stable, but not unbreakable. By refusing to govern, Boehner and House Republicans are strengthening that coalition, boosting Democratic fundraising, helping Democratic recruiting efforts, and motivating the Democratic base.


By: Steve Benen, The Maddow Blog, November 5, 2013

November 6, 2013 Posted by | GOP | , , , , , , , , | Leave a comment

“Obstructing Obamacare Navigators”: The Republican Suppression Syndrome Continues

On August 15th, Jodi Ray, a project director at Florida Covering Kids and Families, a University of South Florida program that works to get uninsured children access to health care, won a federal grant to hire ninety people as health-care “navigators”: workers who will help applicants apply for insurance through the exchanges set up as part of the Affordable Care Act. In states that declined to set up their own exchanges, like Florida, the Department of Health and Human Services awarded funding worth sixty-seven million dollars for outreach efforts to help the uninsured enroll through the federal marketplace. Nearly four million people in Florida are uninsured—the third highest figure in the country—and Ray had six weeks to recruit staff from community-service groups in sixty-four counties across the state, and guide new hires through twenty hours of online federal training attached to her grant.

“But our navigators don’t only have to comply with federal requirements for the training,” Ray said. “We have state requirements that we have to comply with, too.” Last spring, the Florida legislature, apparently concerned that swindlers would land jobs as health-care experts with access to Social Security numbers and tax information, decided that the navigators should undergo fingerprinting and criminal background checks, and barred them from visiting state-run health clinics. Ray preferred not to comment on what the advocacy group Healthcare For America Now calls “navigator-suppression measures.” She only said, “I’m keeping my head down, the noise out, and focusing on what we are supposed to be doing.”

After the government shutdown ended, attention shifted to the blips and seizures bedevilling the federal marketplace’s Web site, Thirty-four states, all but seven of them Republican-controlled, chose not to set up their own exchanges, leaving hundreds of millions of dollars in outreach funding on the table, and forcing their residents onto the federally-operated Web site at the center of the current uproar. Twenty-one of those states are also expected to refuse nearly three hundred billion dollars in federal funding to expand Medicaid coverage over the next decade, which would have extended care to more than six million people; a majority of those excluded will likely be African-Americans and single mothers. To compound the effects of their recalcitrance, conservative governors, state legislators, and members of Congress have also passed navigator-suppression measures in thirteen states—Arkansas, Florida, Georgia, Iowa, Illinois, Indiana, Maine, Missouri, Montana, Ohio, Tennessee, Texas, and Wisconsin—home to seventeen million people without insurance who are eligible for coverage under the A.C.A.

Two weeks after Ray received her grant, she was notified by the House Energy and Commerce Committee that she would have to participate in a phone interview with the committee’s staff in September; she was also asked to give written answers to half a dozen questions from the committee and provide “all documentation and communication related to your Navigator grant.” Similar notifications were sent to navigator offices in eleven of the most underinsured states in which residents will need to use the federal health-care exhange—including Texas, Florida, and Georgia, home to about a quarter of the nation’s uninsured. Representative Henry Waxman, a Democrat from California, protested, in an open letter to the committee’s chairman, Michigan Republican Fred Upton, that the requests appeared “to have been sent solely to divert the resources of small, local community groups, just as they are needed to help with the new health care law.”

On September 18th, Darrell Issa, the Republican chairman of the House Committee on Oversight and Government Reform, released a report that singled out Florida as the site of “numerous reports of scam artists posing as navigators and Assisters to take advantage of people’s confusion about ObamaCare.” On October 2nd, Fox News aired footage of volunteers for Get Covered America, a non-profit advocacy campaign, going door-to-door in a Miami suburb to distribute flyers about the new insurance marketplace—but wrongly identified them as federally-funded navigators, giving the impression that these “navigators” were hawking plans like pushy insurance salesmen. Upton linked to the report on his Web site. Ray, who still spends much of her time getting new navigators licensed while the federal government fixes the Web site’s glitches, was reticent about discussing the maelstrom of controversy. “It’s been busy,” she said.

As these tactics jam up early efforts in many states, they also amplify the contrast with successful rollouts in states that have wholeheartedly embraced the new law, like Colorado, Connecticut, New York, Kentucky, and Washington.

Elisabeth Benjamin, who leads New York’s largest team of navigators at the Community Service Society, spent much her early career improving health-care capacity in developing countries like India, Tunisia, and postwar Iraq—where, she said, people often told her, “I don’t understand why you’re in our country. You have a lot of problems with health care and poor people in your country.” Back home, she started a health-law unit at the Legal Aid Society to assist low-income New Yorkers with unforgiving medical bills. In 2008, she unveiled an insurance ombudsman program at C.S.S. to help people at every income level understand their options for medical coverage. “If you need a loaf of bread, it’s a buck,” she said, explaining health care’s central distinction from other forms of assistance. “If you need a transplant, it’s five hundred thousand dollars.”

Around the same time Benjamin was starting her program, Eliot Spitzer, then the governor of New York, proposed statewide health-care reform similar to the law Massachusetts had passed four years earlier. Vermont’s legislature had expanded coverage, and Arnold Schwarzenegger had made national news by calling for a similar program in California. Benjamin joined an affordable-health-care advocacy campaign, Healthcare for All New York, and testified before the New York State Legislature. “We just assumed there would be a state-by-state movement to extend coverage,” Benjamin said. But two years later, the Obama Administration, with the help of a Democrat-controlled House and Senate, passed the Affordable Care Act. New York’s governor, Andrew Cuomo, along with the state legislature in Albany, accepted the expansion of Medicaid, and the state established its own online exchange. After the Supreme Court upheld the constitutionality of Obamacare, in June, 2012, Cuomo released a statement that said, “We look forward to continuing to work together with the Obama administration to ensure accessible, quality care for all New Yorkers.”

That spirit of coöperation has been integral to New York’s early success. Elisabeth Benjamin, in New York, and Jodi Ray, in Florida, offer exactly the same services to people who were previously unable to obtain medical coverage: they help determine voucher amounts, parse available options, and submit applications online, over the phone, or through the mail. But because New York set up its own exchange, the state received twenty-seven million dollars to fund its navigators, while Florida has just eight million dollars for outreach. Benjamin, who is herself a trained navigator, conceded that there were glitches on New York’s Web site the first week, but said that most of them have been resolved. In the second week, she helped enroll a woman who had worked as a home-health-care aid for twenty years, earning around twenty-four thousand dollars annually. Home health care “has to be the hardest job in America—so physically taxing and emotionally draining,” Benjamin said. “And we don’t give them health coverage. Are you kidding me? They’re part of the health-care system.” Benjamin helped find a plan for the woman that costs seventy-two dollars a month. “I was crying,” Benjamin said. “That’s what it’s all about.”

For the A.C.A. to succeed in its goal of providing coverage for all citizens at an overall reduction in cost, a critical mass of people—old and young, sick and healthy—will need to participate in the insurance exchanges. As of October 23rd, New York had enrolled thirty-seven thousand people, more than twice the goal set by H.H.S. for the entire month of October. Florida won’t know how many people have enrolled until H.H.S. releases its figures sometime in November. The Congressional Budget Office has estimated that a total of seven million people nationwide could enroll in the first year. But Dr. Kavita Patel, a health-care-reform expert at the Brookings Institution, and a former policy advisor in the Obama Administration, told me, “If by the end of 2014 there are three million people enrolled, that would be a success.” The politicians who are currently bemoaning the looming failure of Obamacare might consider doing more to help navigators like Jodi Ray make it work.


By: Rob Fischer, The New Yorker, November 1, 2013

November 6, 2013 Posted by | Affordable Care Act, GOP, Republicans | , , , , , , | Leave a comment

“Intentionally Obscuring The Obvious”: Five Things Every American Needs To Know About Health Care Reform

“Discover the obvious,” Jonathan Cohn said on Monday.

Cohn is one of the nation’s foremost health care journalists and the keynote speaker of the journalism portion of “Hearsay or Fact: A Symposium on the Communication of the Affordable Care Act,” hosted by the Center for Healthcare Research and Transformation.

A senior editor at The New Republic and author of Sick: The Untold Story of America’s Health Care Crisis—and the People Who Pay the Price, Cohn decided to use his time to give five rules about reporting on the Affordable Care Act (ACA). His first rule was an admission that people who follow the everyday tribulations related to Obamacare — like wonks in every field — often assume they don’t need to report on “the obvious” and thus fail to report on the issues that matter most to the public.

He pointed to the success of fellow panelist Stephen Brill’s Time magazine cover story “Bitter Pill: Why Medical Bills Are Killing Us” that illuminated the outrageous variation in medical prices and profits from one hospital and one patient to the next, a well-known fact to experts that came as a shock to many Americans.

What’s obvious to everyone about the debate over Obamacare is that the public is confused. Nearly two-thirds of Americans didn’t know in late September that the health care exchanges were opening on October 1 and 67 percent of the uninsured said “they don’t have enough information about the law to know how it will impact their families,” according to the Kaiser Health Tracking Poll. The uninsured, of course, make up this law’s key demographic. They are the people this law is designed to help most, and their participation in the health care marketplaces will determine if the law is a success.

Why are people so confused? Much of what should be “obvious” has become obscured — intentionally.

Democrats passed the ACA with only Democratic votes — and Joe Lieberman. Republicans have responded with an unprecedented effort to scare voters, starve implementation and sabotage the law, an effort that helped doom the launch of, which the White House has to own as a greater act of self-sabotage than anything Republicans could have pulled off themselves.

The political battle over the law has overwhelmed any pertinent policy discussion. So it’s no wonder that people can’t even agree on the basic premises that made health reform necessary and an improvement over the current system, with 56 percent of Americans saying they’ve heard more about the politics and the controversies of the law than any discussion of its practical impact.

Here are five “obvious” premises that every American needs to understand so we can begin to have a rational debate on health care reform.

Before The ACA, America’s Health Care System Was Already ‘Socialized’

You should know by now that the United States spends more than any country on health care, even though approximately 50 million citizens have no insurance whatsoever. This is how we ended up with the 46th most efficient health care system in the world.

The Affordable Care Act attempts to fix this in a number of ways, including health care exchanges, subsidies, Medicaid expansion and regulation.

Since 2011, the government has set how much insurance companies have to spend on actual care – 80-85 percent depending on their size — and the minimum standard for the policies they can offer, among several other regulations. So even though private insurers remain in business and the government hasn’t taken control of the medical industry as it has in the United Kingdom, Republicans argue that it’s “a government takeover” of the health care system. Based on this standard, health care has been “taken over” by the government and even “socialized” for decades.

Since 1965, Americans over 65 and under the poverty level were guaranteed basic care, though it took until 1982 before the last state, Arizona, accepted Medicaid. This left America with a single-payer system, with a giant hole mostly made up of Americans under 65 with jobs, and their families.

In 1986, President Ronald Reagan signed a bill that tried to plug that hole — the Emergency Medical Treatment and Active Labor Act. This law states that any hospital that accepts any federal funds — which basically every hospital in America does — cannot turn away any patient, regardless of his or her ability to pay. As this bill provides no reimbursement for this care, the costs of those who can’t pay get passed on to those who can.

In 1996, Congress passed and President Clinton signed the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which mandated guaranteed renewability for all health insurance plans, requiring that an insurer has to offer you renewals of your policy without charging you any more based on any new information it has about your health.

These are three of the key “government takeovers” that helped lead to the broken health care system that we are now attempting to fix, while maintaining a private insurance industry.

The ACA clearly isn’t a one-size-fits-all solution, health economist Thomas Buchmueller pointed out at Monday’s symposium.

That would be a two-page bill that said, more or less, “Everyone is now on Medicare.”

Rich People Get Their Health Care Subsidized By Taxpayers

Single payer is a simple, proven system that would insure all Americans, save lives and cut costs. And it will likely never happen in America as long as the filibuster exists in the Senate. Still, liberals will not stop offering this ideal solution whenever Republicans complain about costs or cancellations.

The right has its own fantasy solution that is about as improbable as single payer: getting rid of the tax exclusion of premiums for employer-sponsored insurance.

As a result of an accident of history, employers and employees do not have to pay taxes on costs of health insurance policies.

Conservatives hate this. “We call the tax exclusion for ESI a tax ‘break,’ but when you think about it, it operates more like a tax hike,” writes the Cato Institute’s director of health policy Michael F. Cannon, another symposium participant. “It coerces workers into handing control over $11,000 of their earnings to their employers, who then choose the workers’ health plans for them.”

John McCain campaigned for president on ending this “tax break,” which costs taxpayers more than the costs of all the subsidies and Medicaid expansion in the ACA, according to symposium participant Dr. John Z. Ayanian. This will never happen because it would be far more disruptive than Medicare for All and — unlike effective single-payer systems around the globe — it has never been proven to work, anywhere.

As a result, taxpayers will continue to help subsidize takers like Ted Cruz, whose family’s $40,000-a-year insurance policy from Goldman Sachs entitles them to a subsidy large enough to put a family of four on Medicaid, though the Cruzes are clearly able to afford their own health insurance.

Republican Arguments Against Obamacare Are Opportunistic And Contradictory

Republicans fought the passage of the ACA by conjuring images of “death panels” pulling the plug on grandma and a “government takeover” that would destroy America.

The problem with these warnings was that approximately 80 percent of Americans get their health insurance through their employers. Most of these people haven’t and likely won’t notice much of a change in their coverage whatsoever, unless they’ve gone in for preventive or reproductive health care and discovered that they didn’t have to pay a co-pay for it.

That’s why Mitt Romney’s continual assertion that President Obama was embracing “European” solutions never made sense to most Americans.

Republicans didn’t seize on the president’s now-disproven promise “If you like your insurance, you can keep it” until late 2013, though it was clear that it never jibed with his other promise to make sure insurance policies met minimum standards.

Now their fixation on cancellation notices boxes them in, in two ways. First, it ignores that their plot to repeal Obamacare would result in as many as 137 million cancellation notices. Second, right-wing policy proposals would force cancellations that target far more than the estimated 5 percent of Americans who are having their plans changed by the ACA.

“Even if free-market health care reformers were able to pass the plan of their dreams — which would involve tweaking the tax code to end the bias in favor of employer-sponsored insurance — it would likely mean a lot of people would get dropped from their current plans,” the Washington Examiner’s Philip A. Klein notes.

The Republicans’ advantage is that they’re so stuck on the “repeal” part of “repeal and replace” that they’ve never actually passed an ACA replacement. Their rhetoric, and the fact that the only real conservative alternative to single payer requires an individual mandate, means any plan they pass would likely end up generating the same criticisms they’re lobbing at the ACA.

We Can’t Go Back To The Pre-Obamacare Health System

Dr. Ayanian pointed out that though the ACA may not be embraced by a majority of the American public, three key policies have: young people staying on their parents’ plans until age 26, closing the Medicare Part D prescription-drug donut hole, and the ending of concerns about pre-existing conditions.

The Republican Study Committee Obamacare replacement plan, which the House has not voted on, provided pre-existing conditions protections, but only for those who are already insured.

The Washington Post’s Jonathan Bernstein puts it simply — repeal “is dead”:

No one is ever going to kick young adults off their parents’ insurance (or change the law so that insurance companies are allowed to do it). No one is going to bring back the various limitations in pre-ACA insurance policies. Some trimming of the new Medicaid rolls might be possible. But no one — no politician who has to face reelection, at least – is going to just toss all those people off their insurance with nothing to replace it.

Beyond all this is simply the Humpty Dumpty-ness of the situation: The old system has been slowly pushed off the wall for three years now, and by this point it’s really beyond repair, whatever the merits or politics of the situation. Garance Franke-Ruta captured some of this in making the point that delaying things would be impractical at this point, but it really goes beyond that. Too many people have already done too many things to make a full reversal even remotely plausible.

Before the ACA became law, millions of Americans lost their insurance, rates were rising faster than the rate of inflation and the federal government was absorbing more and more health care costs. Repealing it would be a nightmare in that it would reveal a broken health care system badly in need of some type of fix.

Republicans Are Hurting Themselves, Their States And The Working Poor To ‘Punish’ Obama

Because the Supreme Court gave them the chance to do it, about two dozen — all Republican — states have completely rejected the Medicaid expansion in the ACA, even though the government will cover 100 percent of the costs of the expansion for the first three years. States could then opt out of the coverage or continue it with the feds’ contribution decreasing to 90 percent by 2020.

Medicaid expansion should be a huge transfer of wealth from rich blue states to poorer red states, as most of America’s public assistance programs are. Instead Texas, with the largest uninsured population in the nation, has rejected expansion, but will still contribute to helping to insure Californians.

By rejecting Medicaid expansion, just four states – Florida, Texas, Georgia, and North Carolina —  will leave 5 million poor people with jobs uninsured. This will result in more emergency room visits that the uninsured cannot afford, and higher rates for the insured in those states.


By: Jason Sattler, The National Memo, November 5, 2013

November 6, 2013 Posted by | Affordable Care Act, Health Reform | , , , , , , , | Leave a comment

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