“LePage Vetoes Medicaid Expansion For All The Wrong Reasons”: Maine’s Paul LePage Is One Uninformed And Paranoid Governor
Maine’s Democratic state House Speaker, Mark Eves, noted the circumstances this week surrounding Medicaid expansion. “We have a bipartisan plan for life-saving health care for tens of thousands of Mainers,” he said. “It creates jobs, it save lives, it saves money.”
All of this happens to be true. Every state north of Virginia has either embraced Medicaid expansion or is working towards doing so – except Maine, where Gov. Paul LePage (R) refuses to cooperate. More than 60,000 low-income Mainers would benefit from the policy, on top of the economic and fiscal benefits, but the Republican governor nevertheless vetoed Medicaid expansion yesterday.
The measure also would have established a managed care system for all 320,000 beneficiaries, an effort to control costs in the $2.5 billion program, which is Maine’s version of the Medicaid health insurance program.
Under the Affordable Care Act, also known as Obamacare, the federal government offered to reimburse states for 100 percent of the cost of expansion for at least three years, then gradually reduce reimbursements rates to about 90 percent.
But in his veto message to the Legislature, LePage wrote that Maine could neither afford expansion nor trust the federal government to deliver on its promises.
The rejection didn’t come as a surprise, and Democratic state lawmakers will try to override LePage’s veto. By all accounts, however, they face an uphill climb – some GOP state lawmakers are on board with the policy, but probably not enough to generate a two-thirds majority.
But what was somewhat surprising was just how awful LePage’s defense was. The governor, struggling in his re-election bid this year, had plenty of time to come up with a credible rationale for blocking Medicaid expansion, but he didn’t come up with much.
“It is shortsighted to think federal funds will always be available, especially after watching the federal deficit climb and witnessing continual delays and changes from Washington,” he said in a statement.
I realize that Paul LePage sometimes struggles with policy details, but there are some rudimentary facts he should probably understand before telling 60,000 people they can’t have health insurance.
For example, if LePage is “watching the federal deficit climb,” he’s not watching closely enough. The federal deficit isn’t climbing; it’s shrinking. In fact, in recent years, we’ve seen the fastest deficit reduction than at any point since World War II. Does LePage not know that? Maybe he should have looked it up before issuing his statement?
What’s more, LePage is convinced federal funds may not “always be available” to finance Medicaid expansion. In other words, he’ll refuse the funds now because maybe, someday, far off in the future, Washington won’t offer the funds they’re promising to provide.
Sorry, 60,000 struggling Mainers. You can’t have access to affordable medical care because your governor is paranoid about a fiscal situation that may or may not materialize at some point.
These are the best arguments the governor’s office could come up with after having months to prepare?
By: Steve Benen, The Maddow Blog, April 10, 2014
“Health Care Nightmares”: There’s An Extraordinary Ugliness Of Spirit Abroad In Today’s GOP America
When it comes to health reform, Republicans suffer from delusions of disaster. They know, just know, that the Affordable Care Act is doomed to utter failure, so failure is what they see, never mind the facts on the ground.
Thus, on Tuesday, Mitch McConnell, the Senate minority leader, dismissed the push for pay equity as an attempt to “change the subject from the nightmare of Obamacare”; on the same day, the nonpartisan RAND Corporation released a study estimating “a net gain of 9.3 million in the number of American adults with health insurance coverage from September 2013 to mid-March 2014.” Some nightmare. And the overall gain, including children and those who signed up during the late-March enrollment surge, must be considerably larger.
But while Obamacare is looking like anything but a nightmare, there are indeed some nightmarish things happening on the health care front. For it turns out that there’s a startling ugliness of spirit abroad in modern America — and health reform has brought that ugliness out into the open.
Let’s start with the good news about reform, which keeps coming in. First, there was the amazing come-from-behind surge in enrollments. Then there were a series of surveys — from Gallup, the Urban Institute, and RAND — all suggesting large gains in coverage. Taken individually, any one of these indicators might be dismissed as an outlier, but taken together they paint an unmistakable picture of major progress.
But wait: What about all the people who lost their policies thanks to Obamacare? The answer is that this looks more than ever like a relatively small issue hyped by right-wing propaganda. RAND finds that fewer than a million people who previously had individual insurance became uninsured — and many of those transitions, one guesses, had nothing to do with Obamacare. It’s worth noting that, so far, not one of the supposed horror stories touted in Koch-backed anti-reform advertisements has stood up to scrutiny, suggesting that real horror stories are rare.
It will be months before we have a full picture, but it’s clear that the number of uninsured Americans has already dropped significantly — not least in Mr. McConnell’s home state. It appears that around 40 percent of Kentucky’s uninsured population has already gained coverage, and we can expect a lot more people to sign up next year.
Republicans clearly have no idea how to respond to these developments. They can’t offer any real alternative to Obamacare, because you can’t achieve the good stuff in the Affordable Care Act, like coverage for people with pre-existing medical conditions, without also including the stuff they hate, the requirement that everyone buy insurance and the subsidies that make that requirement possible. Their political strategy has been to talk vaguely about replacing reform while waiting for its inevitable collapse. And what if reform doesn’t collapse? They have no idea what to do.
At the state level, however, Republican governors and legislators are still in a position to block the act’s expansion of Medicaid, denying health care to millions of vulnerable Americans. And they have seized that opportunity with gusto: Most Republican-controlled states, totaling half the nation, have rejected Medicaid expansion. And it shows. The number of uninsured Americans is dropping much faster in states accepting Medicaid expansion than in states rejecting it.
What’s amazing about this wave of rejection is that it appears to be motivated by pure spite. The federal government is prepared to pay for Medicaid expansion, so it would cost the states nothing, and would, in fact, provide an inflow of dollars. The health economist Jonathan Gruber, one of the principal architects of health reform — and normally a very mild-mannered guy — recently summed it up: The Medicaid-rejection states “are willing to sacrifice billions of dollars of injections into their economy in order to punish poor people. It really is just almost awesome in its evilness.” Indeed.
And while supposed Obamacare horror stories keep on turning out to be false, it’s already quite easy to find examples of people who died because their states refused to expand Medicaid. According to one recent study, the death toll from Medicaid rejection is likely to run between 7,000 and 17,000 Americans each year.
But nobody expects to see a lot of prominent Republicans declaring that rejecting Medicaid expansion is wrong, that caring for Americans in need is more important than scoring political points against the Obama administration. As I said, there’s an extraordinary ugliness of spirit abroad in today’s America, which health reform has brought out into the open.
And that revelation, not reform itself — which is going pretty well — is the real Obamacare nightmare.
By: Paul Krugman, Op-Ed Columnist, The New York Times, April, 11, 2014
“Bringing The Shutdown Logic Home”: The Government Shutdown Crowd Has A New Target, John Boehner
The long knives are out for John Boehner on the right – again. National Journal’s Tim Alberta has a must-read today on a conservative plot to oust the House speaker next year … or put the squeeze on House Majority Leader Eric Cantor … or something.
According to Alberta, the frustrated right numbers in the “several dozen,” with the ringleaders all hailing from the House Liberty Caucus, from which came the core of the dozen GOP’ers who voted against Boehner for speaker last year. Alberta writes:
The conservatives’ exasperation with leadership is well known. And now, in discreet dinners at the Capitol Hill Club and in winding, hypothetical-laced email chains, they’re trying to figure out what to do about it. Some say it’s enough to coalesce behind — and start whipping votes for — a single conservative leadership candidate. Others want to cut a deal with Majority Leader Eric Cantor: We’ll back you for speaker if you promise to bring aboard a conservative lieutenant.
But there’s a more audacious option on the table, according to conservatives involved in the deliberations. They say between 40 and 50 members have already committed verbally to electing a new speaker. If those numbers hold, organizers say, they could force Boehner to step aside as speaker in late November, when the incoming GOP conference meets for the first time, by showing him that he won’t have the votes to be reelected in January.
They’re not gunning for Boehner alone. They’re pissed at Eric Cantor because he moved the Medicare “doc fix” through on a voice vote a few weeks back, a move which had the pragmatic virtue of passing needed legislation without forcing members to go on the record casting a vote which could have proved potentially troublesome in a primary. In short, Alberta writes, “conservatives find fault with the entire leadership team.”
So what’s the plan? They haven’t found someone to run against Boehner yet (conservatives like Texas Rep. Jeb Hensarling and Ohio Rep. Steve Scalise aren’t interested, Alberta reports) and while “privately they define success as vaulting one of their own into any of the top three leadership spots,” they also tell Alberta that scenarios like Republican Study Committee Chairman Steve Scalise running for whip – which is, you know, one of the top three leadership spots – “would hardly qualify as the splash conservatives are determined to make.”
In short conservatives are all riled up and determined to make a splash; they’re eyeing a nuclear option – blocking Boehner from another term as speaker – but don’t have a clear end-game beyond that. But they’re pretty sure one will materialize when their opponents inevitably fold in the face of their show of will. They’re definitely going to make a splash because they’re really, really determined.
Does any of this sound familiar? It should – it’s the government shutdown logic transferred to the Republican civil war. The right wound itself up about Obamacare and then shuttered the government without a clear plan other than that Obama was going to inevitably fold in the face of their Keyzer Soze-like superior show of will. However it turned out, they were going to get something big out of the whole affair because they’d tried really, really hard. (“I don’t think our conference will be amenable for settling for a colletion of things after we’ve fought so hard,” New Jersey GOP Rep. Scott Garrett said at the time.) How’d all that turn out?
The tea party right’s problem here is that they echo chamber themselves into badly overestimating their leverage and end up with little more than egg on their collective faces. See the paltry dozen votes they managed against Boehner last time, for example, or the outcome of the government shutdown.
We’ll see. Maybe the wingers really will be able to produce 50 anti-Boehner votes and shut down the House. Or maybe they’re basting too long in their own tough and angry talk. Again.
By: Robert Schlesinger, U. S. News and World Report, April 10, 2014
“Stuck Between Obamacare And A Hard Place”: As A Massachusetts State Senator, Scott Brown Voted For Romneycare
Former Massachusetts Sen. Scott Brown will officially kick off his campaign to unseat New Hampshire Democratic Sen. Jeanne Shaheen tonight, as he attempts to return to the world’s greatest deliberative body (or something) after being ousted from his Bay State Senate seat by Democrat Elizabeth Warren two years ago. According to leaked excerpts of the speech he plans to deliver tonight, Brown will be campaigning against Obamacare, just as he did in 2010 when he won an upset in the race to succeed the late Sen. Edward Kennedy.
“Along with our money and our health plans, for a lot of us, it feels like we’re losing our liberty, too. Obamacare forces us to make a choice, live free or log on — and here in New Hampshire, we choose freedom,” Brown plans to say. (Get it? Because New Hampshire’s state motto is “live free or die.” But wait, if Obamacare is the major assault on freedom Republicans claim it is, do you have the choice to live free under it? Or is it just that “log on or die” didn’t send the right message? But I digress.)
There’s definitely a danger for Brown in taking this approach. Yes, the health care law has, according to a recent WMUR Granite State poll, a less than stellar approval rating in New Hampshire, with only 34 percent saying they approve of it while 53 percent say they oppose it. (Let’s add the caveat that the poll doesn’t say what portion of the opposition thinks the law goes too far and what portion thinks it doesn’t go far enough.) But Brown will have a hard time getting around the various problems other Republicans are running into when it comes to making Obamacare a focal point of a campaign.
For starters, the law may be unpopular in theory, but in practice, signups under Obamacare’s New Hampshire exchange have exceeded expectations. Does Brown have a plan for providing for those folks? Or how about the estimated 50,000 people who are going to receive health insurance under New Hampshire’s recently approved Medicaid expansion, which was made possible by Obamacare and on which Brown has thus far been mum? Those are real people who are experiencing real benefits from the law.
And therein lies the problem for Republicans, which Brown is eventually going to run into as well: Providing the benefits of Obamacare requires something that looks like Obamacare. Just look at this quote a Republican aide gave to Talking Points Memo’s Sahil Kapur (emphasis added):
As far as repeal and replace goes, the problem with replace is that if you really want people to have these new benefits, it looks a hell of a lot like the Affordable Care Act. … To make something like that work, you have to move in the direction of the ACA. You have to have a participating mechanism, you have to have a mechanism to fund it, you have to have a mechanism to fix parts of the market.
And Brown knew this once upon a time. As my former colleague Igor Volsky noted, as a state senator Brown voted for the Massachusetts health reform law that looks a whole lot like Obamacare.
This is exactly why the long awaited Republican health care alternative never actually comes to fruition. (Sure, some individual lawmakers have proposed plans, but the party hasn’t coalesced around one bill.) To actually craft an alternative, the GOP would either have to admit that Obamacare is a pretty darn conservative measure or admit, like House Budget Committee Chairman Paul Ryan did the other day, that the popular provisions and benefits of Obamacare have to go away as well in order to enact a more Republican-y plan.
Will that latter approach work in still quite blue New Hampshire? Or will Brown try to get away with hand waving about an Obamacare alternative that will never materialize? Either way, spouting “live free or log on” will be no slam dunk.
By: Pat Garofalo, U. S. News and World Report, April 10, 2014
“IRS Hearings Are Another Republican Circus”: A Folly Wrapped In A Charade And Shrouded By Farce
Dave Camp had a secret.
The House Ways and Means Committee chairman was ready to send the panel’s files on former IRS official Lois Lerner to the Justice Department for a possible prosecution — a handover that could have been accomplished with a simple phone call to the attorney general. Instead, Camp put on a show.
The Michigan Republican invited the press and the public to the committee’s storied hearing room Wednesday, only to call an immediate vote to kick them out. This way, the panel could meet in a closed session to debate Lerner’s fate — a dramatic but meaningless gesture because the sole purpose of the secret meeting was to authorize releasing the committee’s files on Lerner to the public.
Republicans said the closed session was required to make the information public, but the panel’s ranking Democrat, Sandy Levin (Mich.), said the debate should be held in the open.
“Mr. Chairman?” he inquired after the plan to go into secret session was announced.
Camp ignored Levin. “The clerk will call the roll,” he said.
“Mr. Chairman?”
“The clerk will call the roll.”
“Mr. Chairman?”
“The clerk will call the roll.”
Levin pressed on, patiently raising a point of order.
“Just chill out,” the 60-year-old Camp finally snapped at his 82-year-old colleague.
“I’m very chilled out,” Levin replied.
This was true. Levin hadn’t raised his voice at all. Camp, on the other hand, was agitated — for good reason.
The lawmaker, who is retiring at the end of this term, has built a solid reputation over the years, and he recently won plaudits for releasing a thoughtful proposal to overhaul the tax code. Camp was on course to retire with dignity — at least until he allowed his committee room to be turned into a circus tent Wednesday. It was a folly wrapped in a charade and shrouded by farce.
Folly: There was no need to have a formal hearing to convey the information to the Justice Department, which is already investigating the IRS’s targeting of conservative groups.
Charade: The committee made a big show of having its secret hearing, even though it was a foregone conclusion that the members would vote along party lines to release its “secret” information — including the transcript of the secret hearing — to the public.
Farce: Camp said Lerner could be prosecuted for releasing private taxpayer information. Yet in making public its Lerner files, the committee used its authority to do legally the same thing it accused her of doing illegally: releasing confidential taxpayer information. That hadn’t been done in at least 40 years.
Of course, the taxpayers whose information was released — mostly related to Karl Rove’s Crossroads GPS group — may not mind, because they have an interest in seeing somebody pay for the IRS’s targeting of a disproportionate number of tea party groups for extra scrutiny.
The IRS scandal didn’t come close to the “culture of corruption” Camp promised or the “targeting of the president’s political enemies” and coverup alleged by Darrell Issa (R-Calif.), whose committee is holding the contempt vote. Instead, the investigations didn’t go beyond Lerner, a civil servant who led the agency’s tax-exempt division. “This was a career employee in the IRS potentially who did all these things,” Camp said after Wednesday’s secret session. “So we have to make sure that the signal goes out that this doesn’t happen again.”
That’s a reasonable sentiment, and one shared by Levin, who on Wednesday said Lerner had been guilty of “clear mismanagement.” Democrats objected not to Camp turning over the committee’s information on Lerner, but to the cloak-and-dagger hearing followed by the wholesale release of tax records.
The AP’s Stephen Ohlemacher asked Camp why he didn’t just “pick up the phone” rather than make private taxpayer files public.
Camp agreed that such a release was unprecedented but said, “This is so important that I think the public has a right to know.” He repeatedly called the matter “important” and “a very serious thing.”
But the chairman’s claims of importance were undermined by his committee’s antics, including its showy secrecy. Reporters, waiting out the two-hour closed session in the hallway, were treated to Krispy Kreme doughnuts by the committee’s staff. But inside the room, other staffers were unplugging the journalists’ cables, just to be sure nobody pierced the veil.
When Camp reconvened the hearing after the secret session, cameramen called out for him to wait as they reassembled their equipment. Rep. Paul Ryan (R-Wis.) complained. “Are you guys ready?” he moaned.
But Camp waited, which was wise. What good is a farce if it isn’t on film?
By: Dana Milbank, Opinion Writer, The Washington Post, April 9, 2014
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