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“They’ll Never Rally Behind A Single Plan”: The GOP’s Push To Replace ObamaCare Is Cynical And Doomed

On Friday, House Majority Leader Eric Cantor (R-Va.) is gathering key members of his caucus to work toward coming up with a single, official Republican alternative to the Democrats’ Affordable Care Act (ACA), or ObamaCare. Republican lawmakers have several competing bills to work with, and putting the party’s weight behind one plan or piece of legislation would be great for the country: Finally, America could have a real discussion about the best way to reform America’s health care insurance system.

But an official Republican health care plan would also be great for Democrats — which is reason No. 1 Republicans aren’t going to actually rally behind a single plan.

They will, of course, make a public effort. “GOP leaders have been clear that ahead of the 2014 elections, the conference wants to show what it is for, not simply what it is against,” says Daniel Newhauser at Roll Call. “Similarly, they want to show that they are not in favor of simply returning to the old health care system, which is viewed unfavorably by the electorate.” But any viable plan needs 218 votes from the fractured GOP caucus.

Cantor and his fellow House Republicans have at least three separate House bills to consider — from Reps. Tom Price (R-Ga.), Paul Broun (R-Ga.), and Phil Roe (R-Tenn.) — and a plan from Sens. Tom Coburn (R-Okla.), Richard Burr (R-N.C.), and Orrin Hatch (R-Utah) that was unveiled to much fanfare in January. There’s also a bill, from Rep. Todd Young (R-Ind.), that would raise ObamaCare’s definition of full-time employment to 40 hours a week, from 30. And a George W. Bush administration economist named Edward Lazear is pushing what he calls BushCare.

As they sort through these plans, what criteria will they use? If they can agree on one proposal, says Roll Call‘s Newhauser, it’s “likely to include poll-tested measures that have broad agreement in the GOP conference, including allowing the purchase of health insurance across state lines, allowing insurance portability between jobs, expanding access to health savings accounts, and limiting medical malpractice lawsuits.”

Another way of putting that: Republicans are looking for popular talking points that sound different enough from ObamaCare to win support from the more conservative factions of the GOP caucus. The problem, as The Washington Post notes, is that “there are only so many ways to preserve the patient protections that the ACA offers, which Republicans say they want to keep, while maintaining a private insurance market and assisting those who can’t afford coverage.”

Once Republicans hold up a specific plan, the Congressional Budget Office gets to issue its verdict and the public gets to weigh the proposals not just against ObamaCare but also the GOP’s attacks against ObamaCare.

The CBO analysis for Rep. Young’s bill to raise full-time employment to 40 hours, for example, found that the bill would raise the federal deficit by $74 billion while reducing the number of people getting employer-sponsored health insurance by about a million; about half of those people would go on Medicaid or other public programs, the other half would be uninsured.

It’s not clear the other Republican proposals would be popular in practice, either. Some of them, as the Washington Post editors note, would be better than ObamaCare at holding down health care costs and incentivizing people to buy private health insurance. But they are more disruptive to the status quo — especially post-ObamaCare — and almost all of them would be ripe for articles about sick people losing coverage or watching their health insurance costs skyrocket.

All of the GOP alternative plans, in other words, have their own drawbacks. Some people will lose, and some people will win. They would reduce the role of the federal government in most cases, but increase the power of insurance companies. Many of the policies are really interesting. Here are some examples of the big ideas from the GOP plans:

Cap or end employer tax breaks for providing health insurance: The idea here is that the insurance market is distorted by the tax incentives for employers to offering their workers insurance. It’s a fair point. But capping the tax breaks, as Coburn-Burr-Hatch does, or eliminating them would almost certainly cause employers to drop their plans. Almost 60 percent of Americans get their health insurance through work.

Provide tax breaks for individuals to buy their own insurance: With no employer-offered health plans, individuals and families would buy their own insurance on the open market. The Coburn-Burr-Hatch plan, for example, offers age-adjusted tax credits to people at up to 300 percent of the federal poverty line: Individuals 18 to 34 would get $1,560 a year, while those 50 to 64 would get $3,720 a year (families would get more than double those figures). Lazear’s BushCare would give all Americans with any type of health insurance $7,500 a year in tax breaks, or $15,000 for families; if people opted to buy low-cost, low-coverage insurance, they’d pocket the difference.

Allow insurance to be sold across state lines: This is a perennial GOP proposal to lower health insurance costs. The idea is that if insurers could sell the same policies to any state, regardless of that state’s own insurance regulations, it would increase market competition and drive down prices. A 2005 CBO report estimated those savings to consumers at about 5 percent overall, with the savings skewed toward the young and healthy; the old and sick would pay more. Enacting this option would require scrapping the minimum standards required for all plans under ObamaCare — a selling point for conservatives who argue we use too much health care, anyway.

“The fact that Republicans are coalescing around healthcare reform plans of their own could be very bad news for ObamaCare,” says Sally C. Pipes at Forbes. “Once voters see that the Republican alternative adds up to sensible and affordable health care, ObamaCare’s days will be numbered.”

But the opposite is almost certainly true. And House Republicans know that.

The GOP has gotten a lot of mileage out of its push to repeal ObamaCare — with a big assist, since October, from the Obama administration — but now the law is signing up real people (four million and counting) for real insurance policies. Republicans have to do better than provide plausible-sounding alternatives. They have to come up with a plan that Americans will think is much better than ObamaCare, and worth the disruption of overhauling the health care system again.

Here’s the bottom line: If reforming America’s health care system to provide near-universal affordable coverage were easy, it would have been done 60 years ago — or at any point since. Several Democratic presidents had tried and failed before President Obama. If Republicans had wanted to take their own bite at the apple, they had plenty of chances, too.

This isn’t spitballing. If Republicans want to be relevant voices in the health care debate, they have to come up with something. They should come up with a plan they can try to sell to America.

“One of the unseemly aspects of the last four-plus months is watching some on the right root for ObamaCare to fail,” says Forbes‘ Avik Roy, one of ObamaCare’s wonkiest critics. Among some conservatives, “there has been a kind of intellectual laziness, a belief that there’s no need for critics to come up with better reforms, because Obamacare will ‘collapse under its own weight,’ relieving them of that responsibility.” But it’s clear now that’s not going to happen, he adds. “And that makes the development of a credible, market-oriented health-reform agenda more urgent than ever.”

Well, don’t hold your breath.

The Affordable Care Act was written and enacted by Democrats — with a few exceptions — and that’s one of its main weaknesses: If Republicans had helped shape and pass the law, they probably wouldn’t have spent the last four years attacking and undermining it. They now have at least 10 months left to criticize the law without having to take any serious action to replace it. Don’t expect them to squander the opportunity.

 

By: Peter Weber, The Week, February 26, 2014

February 27, 2014 Posted by | Affordable Care Act, GOP, Health Reform | , , , , , | Leave a comment

“In Shocker, GOP Proposes Cutting Taxes For The Wealthy”: Don’t Believe The Baloney About Tax Simplification

For some time, I’ve been saying, perhaps naively, that we ought to have a real debate about tax reform, and maybe actually accompish something. Sure, Democrats and Republicans have different goals when it comes to this issue—Democrats would like to see the elimination of loopholes and greater revenue, while Republicans want to reduce taxes on the wealthy—but there may be a few things they could agree on somewhere in there. You never know.

So today, Representative Dave Camp, the chair of the House Ways and Means Committee, is releasing the latest incarnation of Republican tax reform. And it’s…exactly what you’d expect. Unfortunately.

In fact, though we’re waiting for details, it looks almost exactly like the plan Republicans released two years ago. The centerpiece is an elimination of most tax brackets, leaving only two, at 10 percent and 25 percent. In a total shocker, that means a huge tax break for the wealthy! I know—I too am amazed that Republicans would propose such a thing.

But they’ll make up the revenue, they protest. How? Well as always, Republicans say they’ll eliminate loopholes, but won’t say which ones. The reason for that is simple: everyone hates loopholes that other people benefit from, but everyone wants to keep their own loopholes. As long as you never say which loopholes you’d eliminate, nobody has reason to fight against your plan, since they don’t know whether the ox being gored is theirs or someone else’s. Furthermore, the really big loopholes are ones that lots of people love, like the mortgage interest deduction, a largely middle- and upper-class entitlement that cost the Treasury $82 billion in 2012, or the deduction for employer-provided health insurance, the largest tax expenditure at a whopping $184 billion. Think anyone’s going to eliminate those? Not on your life. But that’s where the real money is.

There is one new thing in this Republican proposal, a surtax on certain incomes over $400,000 a year, which would assumedly recover some of the money we’re losing by cutting those people’s taxes. But there are some devilish details. First, some kinds of high earners, like those in manufacturing, are excluded. And most importantly, it would only apply to wages over $400,000, and not investment income. In other words, as is usually the case with Republican proposals, they reflect a particular value: that work should be taxed at a higher rate than investments. And of course, the higher you go up the income scale, the greater the proportion of their income the wealthy get from their investments.

One final note on this. The part of the plan that will get the most attention is reducing the number of tax brackets to two. This is always offered in the name of “tax simplification,” but the truth is that the number of brackets is just about the least complicated thing about the tax code. Kevin Drum has it right:

I’m not encouraged by the fact that reducing the number of tax brackets is apparently a key feature of this “simplification” plan. That doesn’t simplify things by even an iota. The hard part of calculating your taxes, after all, is figuring out your taxable income. That takes about 99.9 percent of your time. Once that’s all done, the final step is to look up your tax rate and then multiply the rate by your taxable income. That part takes about 30 seconds.

In fact, we ought to have more tax brackets, not fewer, particularly at the high end. There’s no reason that someone making $400,000 a year should pay the same marginal rate as someone making $400 million a year.

Anyhow, the most consequential feature of this Republican tax plan, like those that came before it, is its attempt to relieve the nation’s wealthy of their burden of taxes, so terribly weighed down as they are. Maybe I’m forgetting something, but I can’t recall there ever being a Republican tax plan that didn’t propose precisely that. Ever. And they wonder why Democrats have so much success characterizing them as the party of the rich.

 

By: Paul Waldman, Contributing Editor, The American Prospect, February 26, 2014

February 27, 2014 Posted by | GOP, Tax Reform | , , , , , , , | Leave a comment

“Conservatism Is Too Big For Its Own Good”: The Right No Longer Understands The Difference Between The Movement And The Party

There’s a moment every year at the Conservative Political Action Conference when some eminence from the 1970s talks about the good old days at CPAC, hearkening back to the time when Ronald Reagan would show up and speak to a a small room of only about 500 activists. Things have changed. Now there are about 500 journalists who get registered to report on CPAC, which has bloated to some 10,000 participants in the fat years.

Maybe conservatism is just too big for its own good.

The conservative movement has grown large because it aspired to be something greater than a part of the Republican coalition. It wanted to become the entirety of the GOP. Instead of splitting into different interest groups, the conservative movement devises ad-hoc philosophies to integrate single-issue advocates into a larger coalition. You’re not just for low taxes or against abortion, you’re a conservative!

In this sense, the conservative movement has become a kind of parallel institution that drains resources, attention, talent, and energy from the GOP’s own electoral and governing efforts. Conservative Inc. is an enterprise with enough resources and power to be an attractive alternative to America’s official institutions of electoral power.

If you are a Republican politician and don’t have the wherewithal to become president of the United States, perhaps you have enough talent to become president of Conservatism. It’s an unofficial position, but has plenty of benefits. You won’t have the psychic pleasures of representing the electoral will of the American public, but you also won’t be burdened by any real responsibilities either.

Naturally, the idea of being a player without responsibility provides more attractions for charlatans, rabble-rousers, and opportunists.

Shades of this phenomena began in the 1990s presidential primaries. Whereas Pat Buchanan picked a principled fight with his party over issues like trade and foreign policy, candidates like Alan Keyes ran less for president than for publicity: mailing lists filled out, speaking fees increased, and radio shows picked up on more networks.

By the 2012 Republican primaries, it was obvious that there were in fact two competitions happening on the same debate stages. Herman Cain, Michele Bachmann, and even Newt Gingrich were not running for president in the same way that Mitt Romney and Rick Perry were.

This seems not to happen in the Democratic primaries. Sure, 2004 saw Howard Dean emerge as the leader of “the Democratic wing of the Democratic Party.” But there is no parallel universe called Liberalism where he and Mike Gravel could become well-paid industries unto themselves as think leaders, book hawkers, and distinguished dinner guests. Dean became chairman of the Democratic National Committee, a political job with actual responsibilities and geared toward winning elections, not just flame wars.

The composition of the Democratic coalition seems stronger precisely because it is more splintered and more issue driven. No one is afraid that Planned Parenthood or the teachers’ unions are going to impose a broad-ranging ideological revolution on the nation. The public assumes that they will simply lobby for their particular, limited interests and that the party to which they belong will have a moderating effect on them.

But the conservative movement really is large enough to exert a destabilizing gravitational force on the entire political culture. Its opponents fear that its size and strength make the GOP immoderate. And they may be right.

In any GOP presidential primary, the candidates who are running to be unofficial head of the conservative movement can do a great deal of damage to the GOP’s eventual nominee. They can pressure the eventual candidate to over-commit to the right in the primary race, essentially handing them more baggage to carry in the general election. Or they can cripple the eventual primary winner by highlighting the nominee’s deviations from the movement, dispiriting the GOP’s base of voters.

When the attendees of CPAC gather in Washington early next month and conduct their presidential straw poll with the self importance of a warning shot, it might profit them to consider whether they intend to elect a new president of their ideological ghetto or one for their nation.

 

By: Michael Brendan Dougherty, The Week, February 26, 2014

February 27, 2014 Posted by | Conservatives, GOP | , , , , , , , | Leave a comment

“Ohio’s War On Voting Intensifies”: The Kind Of Moves Official’s Make When They Want Fewer Voters

In advance of the 2012 elections, Ohio Secretary of State Jon Husted (R) launched an aggressive campaign against early voting, most notably targeting Sunday voting, for reasons he struggled to explain. The efforts ultimately failed, however, when federal appeals courts intervened to protect Ohioans voting rights against Husted’s policy.

Zachary Roth has been keeping a close eye on developments in the Buckeye State, where Husted is apparently picking up where he left off two years ago.

Ohio Secretary of State Jon Husted announced Tuesday he is cutting early voting on Sundays and weekday evenings, dealing another blow to the voting rights effort in the nation’s most pivotal swing state.

Husted’s change would spell doom for a voting method that’s popular among African-Americans in Ohio and elsewhere. Many churches and community groups lead “Souls to the Polls” drives after church on the Sunday before the election.

There’s little doubt that cuts to early voting target blacks disproportionately. In 2008, black voters were 56% of all weekend voters in Cuyahoga County, Ohio’s largest, even though they made up just 28% of the county’s population.

Mike Brickner, a spokesperson for the Ohio American Civil Liberties Union, told msnbc, “By completely eliminating Sundays from the early voting schedule, Secretary Husted has effectively quashed successful Souls to the Polls programs that brought voters directly from church to early voting sites.”

In the larger context, it’s worth keeping two angles in mind. First, there’s simply no reason to impose these new voting restrictions on Ohio. Second, this is only part of an even broader campaign against voting rights launched by Republican officials in the state.

On the former, those who support voting restrictions usually argue the measures are necessary to prevent “voter fraud.” The argument is a rather transparent fig leaf – the fraud scourge is generally limited to the imaginations of conservative activists – but that’s their story and they’re sticking to it.

But going after early voting is something else entirely because it has nothing to do with the fear of fraud. If an Ohioan can legally cast a ballot, it shouldn’t matter whether he or she votes on Election Day Tuesday or the Sunday before. The only reason to close the early-voting window is to discourage participation – it’s the kind of move an official makes if he or she wants fewer voters.

As for the larger “war on voting,” Ohio Republicans have kept their foot on the gas. Just last week, GOP policymakers in the state ended the so-called “Golden Week,” when Ohioans can register and vote on the same day, while at the same time, making it harder for voters to receive absentee ballots.

As we discussed last week, Ohio’s recent voting history matters. A decade ago, during the 2004 elections, the state struggled badly with long voting lines, so state policymakers decided to make things better. And in 2008, Ohio’s voting system worked quite well and voters enjoyed a much smoother process.

So smooth, in fact, that Ohio Republicans have worked in recent years to reverse the progress.

A month ago, President Obama’s non-partisan commission on voting issued a detailed report, urging state and local election officials to make it easier for Americans to access their own democracy.

Perhaps Ohio Republicans missed the message?

 

By: Steve Benen, the Maddow Blog, February 26, 2014

February 27, 2014 Posted by | Voting Rights | , , , , , , , | 1 Comment

“Like A Drunk In A Bar Fight”: Why Republicans Will Never Stop Lying About Obamacare

Politically speaking, here’s the thing about those melodramatic ads attacking the Affordable Care Act currently running on TV: In terms of actual policy, they’re as futile as the 40-odd votes to repeal the law that House Republicans have already cast.

GOP hardliners are like a drunk in a bar fight threatening to whip somebody twice his size if only his friends would let go of his arms.

It’s all over but the shouting.

Even if Republicans make big gains in the 2014 congressional elections, they can’t possibly win enough votes to overcome a presidential veto. What’s more, chances of capturing the White House in 2016 on a platform of canceling millions of Americans’ health insurance benefits appear so remote as to be downright delusional. Like it or not, the ACA is here to stay.

Indeed, governors and legislatures in previously recalcitrant states including New Hampshire, Tennessee, Pennsylvania, Utah and Virginia are considering Medicaid expansion they’d previously shunned. Despite early signup problems with the federal HealthCare.gov exchange, signups for individual private policies have increased to where it now appears the ACA will come close to meeting its projected goal of 7 million enrollees by the March 31 deadline.

Moreover, for all the predictions of actuarial doom heard on Fox News and elsewhere—supposedly caused by an imbalance of old, sick enrollees versus younger, healthier ones—the Washington Post reported last month that “the Kaiser Family Foundation estimates that if the market’s age distribution freezes at its current level—an extremely unlikely scenario—‘overall costs in individual market plans would be about 2.4 percent higher than premium revenues.’”

That’s a minor problem, but nothing like a “death spiral.”

In terms of affecting health care policy, then, the TV ads are largely symbolic — scripted melodramas calculated to arouse the partisan passions of the GOP “base” in states where control of the U.S. Senate could be determined this fall. Financed by Americans for Prosperity, the Scrooge McDuck-style front group controlled by the Koch brothers and fellow anti-government tycoons, they’re aimed less at killing the Affordable Care Act than convincing voters that Democrats are their enemies.

Maybe that’s why the ad campaign has proven so singularly unpersuasive to skeptics. In Lousiana, where Democratic Sen. Mary Landrieu is up for re-election this fall, AFP has run a commercial featuring a group of actors pretending to be ordinary Louisiana citizens whose health insurance was canceled due to “Obamacare.” But it’s make-believe; a scripted TV drama as fictive as a Viagra advertisment.

In Arkansas, virtually every news program features a pretty, AFP-sponsored actress plaintively begging viewers to remind Democratic Sen. Mark Pryor that health care is about “people,” and that “the law just doesn’t work.” More in sorrow than anger, it seems, because Pryor remains personally popular.

Pryor’s opponent, Koch-financed Rep. Tom Cotton, tells a touching tale about one “Elizabeth, from Pulaski County” whose premiums have allegedly risen 85 percent under the new law “simply because Washington politicians and bureaucrats think they know what’s best for her and her family.”

I found myself wondering what kind of insurance plan the otherwise unidentified Elizabeth used to have, or if she’s like one of those imaginary digitally enhanced hotties that Internet ads assure me are just a mouse-click away.

Supposedly factual AFP ads have proven even less persuasive to skeptical journalists. In Michigan, 49-year-old leukemia patient Julie Boonstra earnestly explained to viewers that her existing health care policy had been canceled due to the Affordable Care Act, implying that she’d also lost her doctor and been broadsided by ruinous costs.

Fact checks by the Washington Post and Detroit News, however, determined that Boonstra hadn’t lost her doctor at all. What’s more, her monthly premiums under the Affordable Care Act cost roughly half what she’d been paying ($571, from $1,100). Her out-of-pocket expenses almost precisely matched those savings — overall, a wash.

A determined opponent of the law, apart from her understandable anxiety about changing insurance carriers while fighting cancer, Boonstra turned out to have suffered no real losses. Not to mention that she now has a policy that can’t be rescinded due to a “previously existing condition.”

And so it goes. Los Angeles Times economics columnist Michael Hiltzik has made a minor specialty out of fact checking these successive tales of woe. It’s left him wondering if there are really any “Obamacare” victims at all.

“What a lot of these stories have in common,” he writes “are, first of all, a subject largely unaware of his or her options under the ACA or unwilling to determine them; and, second, shockingly uninformed and incurious news reporters, including some big names in the business, who don’t bother to look into the facts of the cases they’re offering for public consumption.”

Politically, however, printed facts rarely prevail against televised fictions. Anyway, repealing the Affordable Care Act isn’t the point. It’s inflaming the GOP base and defeating Democrats.

 

By: Gene Lyons, The National Memo, February 26, 2014

February 27, 2014 Posted by | Affordable Care Act, Obamacare, Republicans | , , , , , , | Leave a comment

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