“Grappling With Their Shortsighted Rejection”: The Tough Politics Of Medicaid For Republicans
In the world of Republican politics, there is no surer bet than opposing ObamaCare. But conservative obstruction to the health care overhaul may finally be catching up with a handful of Republican governors running for re-election. Their rejection of ObamaCare’s expansion of Medicaid — the federal health assistance program for the poor and disabled — has been them losing both the argument and voters.
Princeton political scientist Sam Wang recently published an analysis of polling data from this year’s gubernatorial races. It found that Republican incumbents who resisted ObamaCare’s Medicaid expansion — including Wisconsin’s Scott Walker, Pennsylvania’s Tom Corbett, and Kansas’ Sam Brownback — are in much tighter races than those who accepted it. “Republican governors who bucked their party’s stance and accepted the policy are faring better with voters — in these races, an average of 8.5 percentage points better,” Wang discovered.
This shouldn’t be surprising. Setting aside the incendiary politics surrounding ObamaCare and its alleged freedom-killing agenda, the simple truth is that Republican governors have blocked health insurance for nearly six million citizens. And they’ve done so despite the fact that under ObamaCare, the federal government covers all the cost of expanding Medicaid for the next six years, and at least 90 percent of the cost in 2020 and beyond.
Why have Republican governors spurned this incredibly good deal? Their ostensible justification has been disbelief that the federal government would hold up its end of the bargain, leaving states to pick up the tab.
But researchers at the Urban Institute threw cold water on this argument in a study last month. They found that the federal government has almost never reduced funding to the states for Medicaid. In fact, it has not done so since 1981, when President Reagan and Congress imposed a temporary funding cut.
Indeed, Congress has been far more likely to increase funding for state Medicaid programs. It has done so twice in recent memory — in 1997 and in 2005 — boosting state funding even while making other cuts to the program.
The sanctity of the federal commitment to Medicaid has only grown in recent years. As evidence of federal faint-heartedness, conservatives point to an administration proposal floated during 2011 budget negotiations that would have reduced federal Medicaid funding to the states.
But this bad idea was dropped after the states got newfound bargaining power from the Supreme Court’s 2012 decision making the Medicaid expansion entirely voluntary. With the expansion now optional, the administration can ill afford to weaken the financial carrot for red states to buy in. This has also made the administration agreeable to some conservative twists on traditional Medicaid, like using public dollars to enroll people in private health plans in Arkansas and Iowa.
The Urban Institute also quantified how much intransigent red states are losing by resisting ObamaCare. They’re turning down $400 billion in free federal money over 10 years. They will have missed out on over 172,000 new jobs in 2015 alone. And they’ve cost their hospitals $168 million, enough to completely offset ObamaCare’s reimbursement cuts to hospitals for Medicare and Medicaid.
And, of course, these states have also frozen themselves at pre-ObamaCare rates of high uninsurance. “While the number of uninsured in other states fell by 38 percent since September 2013,” the researchers explain, “non-expanding states experienced a decline of just 9 percent.”
As the midterm elections approach, Republican candidates are discovering that the politics around health care reform are becoming unexpectedly complicated. Trailing badly in the polls, Gov. Corbett announced last month that Pennsylvania will expand its Medicaid program. In states that have already expanded their programs, pro-repeal conservative candidates are stumbling to explain how they would handle new Medicaid enrollees.
But this is what happens when you engage with the actual policy implications of health care reform. Conservatives can whip up fear and hostility over an abstract big-government monolith called ObamaCare. But the actual programs contained therein (like expanding public health insurance for the poor) tend to be pretty appealing to voters.
As their arguments are rendered hollow, obstructionist Republicans are paying the electoral price for thwarting these types of programs. When they picked a fight against expanding Medicaid, conservatives chose the wrong bulwark for massive resistance against national health care reform.
By: Joel Dodge, The Week, September 9, 2014
“More Promising Tools Than Brute Force”: Obama Keeps His Options Open On Dealing With Islamic State
President Obama’s strategy against the Islamic State may be hard to pin down — maddeningly so, some complain — but it is likely to work far better than anything his bellicose critics advocate.
Perhaps the president will eliminate any confusion when he addresses the nation Wednesday, but I doubt it. Based on what he told NBC’s Chuck Todd on Sunday’s “Meet the Press,” there may be no way to reduce Obama’s fluid and perhaps deliberately ambiguous thinking to a black-or-white, all-or-nothing dichotomy.
“This is not going to be an announcement about U.S. ground troops. This is not the equivalent of the Iraq war,” Obama said. Later in the interview, he added that “we’re not looking at sending in 100,000 American troops” and that “our goal should not be to think that we can occupy every country where there’s a terrorist organization.”
Clear? Kind of.
We understand that the president will not announce the deployment of U.S. troops in large numbers and that he does not intend for the United States to re-invade and re-occupy Iraq. But we know that U.S. military advisers and Special Operations teams have already been active in both Iraq and Syria. And since Obama described the fight against the Islamic State as “similar to the kinds of counterterrorism campaigns that we’ve been engaging in consistently over the last five, six, seven years,” we can assume there will be some U.S. military presence on the ground, however covert and limited.
A strong believer in multilateralism, the president asserted that “we have, I believe, a broad-based coalition internationally and regionally to be able to deal with the problem.”
True? Again, kind of.
The 10-nation coalition assembled last week to fight the Islamic State — the United States plus Australia and NATO members Britain, France, Germany, Canada, Turkey, Italy, Poland and Denmark — is much less than meets the eye, operationally speaking. Britain, France, Australia and Canada have the will and capacity to project military power overseas. The others, not so much.
As far as regional cooperation is concerned, perhaps Turkey can be counted on to help tear down the Islamic State. But assistance from two key powers in the Middle East that also find themselves threatened by the jihadist group — Iran and Saudi Arabia — promises to be tenuous and situational at best.
To further complicate a situation that already seems hopelessly complicated, every blow against the Islamic State is a blow in favor of Syria’s Bashar al-Assad and his murderous regime. But Obama implied on “Meet the Press” that Assad is a secondary concern and said that, “when it comes to our policy and the coalition that we’re putting together, our focus specifically is on ISIL,” another name for the Islamic State.
In internal administration discussions, Obama has reportedly been skeptic-in-chief about the capabilities of the ostensibly “moderate” Syrian rebels. On Sunday, the president was less than fulsome in his praise of groups such as the Free Syrian Army, which he noted “have been on the defensive.” He said, “We’re going to have to develop a moderate Sunni opposition that can control territory,” indicating that no such opposition now exists.
It all sounds kind of circular and vague, implying there is much that may be planned, or already taking place, that we know nothing about. Obama seems to give himself the option of confronting the Islamic State directly when he chooses, ignoring it when he feels it can be ignored, using airstrikes when he believes they are needed, cooperating with adversarial or unreliable governments only when he believes it is in the U.S. interest to do so.
I don’t know if it will work. But I’m confident that the hawkish alternative — more bombs, more boots, more bluster — would be a tragic failure.
Massive airstrikes in both Iraq and Syria probably would not be enough to destroy the Islamic State without ground support. In Iraq, such support has been inconsistent. In Syria, it could come only from Assad’s brutal army. If U.S. troops are not an option, should we encourage Saudi Arabia and even Iran to deploy their forces? To me, that sounds like fighting a fire with gasoline.
To the hawks, Obama’s cautious, patient, this-could-take-years approach to dealing with the Islamic State will be emotionally unsatisfying. But, given the complexity of the situation, subtlety and indirection are more promising tools than brute force. Locking the United States into the kind of rigid strategy that critics demand would likely ensure only that this crisis sows the seeds of the next one.
By: Eugene Robinson, Opinion Writer, The Washington Post, September 8, 2014
“Pay Close Attention!”: Don’t Be Fooled By New GOP Enthusiasm For Over-The-Counter Birth Control
The hot new trend among Republican candidates is a surprising one, to say the least. As of now there are four GOP Senate contenders who have endorsed making birth control pills available over the counter.
All four — Cory Gardner in Colorado, Thom Tillis in North Carolina, Ed Gillespie in Virginia, and Mike McFadden in Minnesota — oppose abortion rights, and all four oppose the Affordable Care Act’s mandate that insurance policies pay for preventative care, including birth control, with no deductibles or co-pays. Yet these conservative Republicans are touting their deep commitment to easily available birth control. It’s likely that more Republicans will now be asked their position on OTC birth control, and some will embrace it to counter Dem criticism that they’re soldiers in a “war on women.”
The one who has advocated OTC birth control pills most aggressively is Gardner, in large part because he has been the target of relentless criticism from Democrats over his prior support of “personhood” measures granting full legal status to fertilized eggs, which would outlaw not only abortion but some forms of birth control as well. Here’s an ad in which Gardner practically pretends to be Gloria Steinem while a group of women nod and smile their approval.
Democrats telegraphed way back in April that they would make these attacks central in multiple Senate races. The fact that Republicans have come up with this new push-back suggests the Dem attacks may have been working.
The new-found embrace of OTC birth control pills might seem odd, even bizarre. But it makes more sense if you think about it as a fundamentally elitist position. The truth is that conservatives have long been much more concerned with restricting the reproductive choices available to poor and middle class women, while leaving wealthy women free to do pretty much as they please. And allowing birth control pills to be sold over the counter is perfectly in line with that history.
Let’s be clear that making birth control pills available over the counter would be a good thing — but only if insurance continued to pay for it. The cost of the pill can be as much as $600 a year, which is out of reach for many women. And we know that insurance companies seldom reimburse customers for OTC medications. The price of the medication might come down over time if it were sold over the counter, but in the meantime millions of women are dependent on their insurance plans to be able to afford it. By opposing the ACA, all these GOP candidates are putting themselves on record in opposition to requiring insurance companies to pay for any birth control in policies women themselves have bought. And that’s not to mention other forms of contraception, like IUDs, that require a doctor’s care and come with a significant up-front cost.
If you’re well-off, you can afford whatever kind of contraception you like whether your insurance company reimburses for it or not. And abortion restrictions don’t impose much of a burden on you either. The federal government bans Medicaid from paying for abortions, but that only affects poor women. A law mandating a 48-hour waiting period before getting an abortion may be an inconvenience for a wealthy woman, but it can make it all but impossible for a woman without means. In some states, it means taking (unpaid) time off work to travel to one of the state’s few abortion clinics, driving hundreds of miles, and paying for a hotel room.
While they’re going to use a lot of buzzwords like “access” and “choice,” the net effect of the policies these candidates are advocating would be to make birth control less available to women. And I think that’s why we haven’t seen any public blowback from the Christian right on this issue. The articles written about the new Republican enthusiasm for OTC birth control sometimes include a disapproving quote from a representative of the Catholic Church. But none of the bevy of organizations with the word “Family” in their name, which are so vehemently opposed to any kind of reproductive freedom for women, are loudly condemning these candidates. Nor are any of their Republican colleagues. So what does that tell you?
By: Paul Waldman, Contributing Editor, The American Prospect, September 8, 2014
“So Very 2002”: A National Amnesia About Our Experience In Iraq
Anyone who for some reason checked out of U.S. politics a month ago and then checked back in this week might well be startled to realize that the “problem” of the Islamic State in Syria and Iraq had become a crisis, and for some an existential threat to the United States. What changed in that span of time? Did IS conquer some major new territory? Did Nouri al-Maliki hang on to power and thwart U.S./Iranian efforts to build a stronger Iraqi state? Is there evidence of IS possessing weapons of mass destruction?
I just threw in that last one as a reminder of how these things can get out of hand.
What actually seems to have happened is that IS cruelly executed two American journalists after trying to extort vast sums of money or perhaps even a change of U.S. policies. They’re threatening to execute more westerners in captivity, presumably with the same grim and barbaric ritual of videotaped beheadings. The images and the savagery behind them has momentarily produced national amnesia about our experience in Iraq over the last quarter century or so, and a decided bipartisan burst of war fever.
The President, Vice President and Secretary of State have issued various “this will not stand” declarations. According to an excellent report from HuffPost’s Sam Stein, there’s an instant consensus in Washington for more airstrikes and special ops attacks on IS; an effort to round up international support and commitments of assistance; and a reconsideration of U.S. wariness to engage more directly in Syria, where, of course, we have been supporting an anti-Assad coalition while avoiding the inconvenient fact that its most powerful component is IS.
You get the distinct sense the Obama administration is trying to preempt the lust for war emanating from a suddenly bellicose Republican Party, where even Rand Paul is strapping on the gunbelt and swaggering around making loose commitments of other people’s lives. Check out this report on the mood of the GOP from WaPo’s Sebastian Payne and Robert Costa:
A roiling national debate over how to deal with the radical Islamic State and other global hot spots has prompted a sudden shift in Republican politics, putting a halt to the anti-interventionist mood that had been gaining credence in the party.
The change is evident on the campaign trail ahead of the November midterm elections and in recent appearances by the GOP’s prospective 2016 presidential candidates, with a near-universal embrace of stronger military actions against the group that has beheaded two American journalists.
A hawkish tone has become integral to several key Republican Senate campaigns, with a group of candidates running in battleground states calling attention to their ties to veterans and their support for the U.S. military at every turn.
In contests in Iowa, Arkansas and Alaska — where Republicans are running for seats held by Democrats — the GOP candidates are military veterans and focusing much of their time extolling their expertise.
A thirst among many conservative activists for a more muscular U.S. foreign policy was clear over the weekend at a meeting of Americans for Prosperity, the tea-party-affiliated group backed by the billionaire Koch brothers. The loudest applause came when Sen. Ted Cruz (R-Tex.), a potential presidential candidate, called for bombing the Islamic State “back to the Stone Age.”
It’s feeling very, very 2002. The difference, of course, is that an opponent of the Iraq War is president at the moment, while Dick Cheney raves and snarls from the sidelines instead of deploying troops and crafting official lies. Like Digby, I hope Obama’s reluctance to articulate a “strategy” for “destroying” IS reflects an understanding that this task could indeed involve unacceptable costs and could definitively produce unintended consequences in an unstable region with multiple threats to U.S. security interests. But she’s right this hope could be naive:
Hysteria is building. The hawks sense that there’s action afoot. The Republicans are aroused at the prospect that this could change the dynamic in 2016. The Democrats are freaking out that someone might call them wimps.
The warship is sailing out of the harbor and once again we’re all just standing here on the shore screaming into the wind.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, September 4, 2014
“When Moderates Fight Back”: Middle-Of-The-Road Republicans Are Now Attacking The GOP From The Outside
The missing component in the machinery of American politics has been moderate-to-liberal Republicanism, and the gears of government are grinding very loudly. You wonder if Kansas and Alaska have come up with a solution to this problem.
In Kansas, Democrat Chad Taylor shook up the Senate race by dropping out last week, giving an independent candidate, Greg Orman, a clean shot at the incumbent, Pat Roberts.
At least one poll showed Orman with a 10-point lead over the 78-year-old Roberts in a two-way race. Republicans are so afraid of Orman that Kansas’s Republican (and unabashedly ideological) secretary of state, Kris Kobach, used a technicality to keep Taylor’s name on the November ballot anyway. Taylor is challenging the decision.
In Alaska, Democrat Byron Mallott ended his candidacy for governor and chose instead to run for lieutenant governor on a ticket led by an independent candidate, Bill Walker. By combining forces, Walker and Mallott hope to oust Republican Gov. Sean Parnell.
Because of the revolution in Republican politics spearheaded by the tea party, these should not be treated as isolated episodes. They are both signs that moderates, particularly moderate Republicans, are fighting back.
The safe journalistic trope is that both of our major parties have become more “extreme.” This is simply not true. It’s the Republican Party that’s veered far off center. To deny the fact is to disrespect the hard work of conservatives in taking over the GOP.
By contrast, there are still plenty of moderates in the Democratic Party. They include Sens. Mark Pryor in Arkansas, Mark Begich in Alaska, Mary Landrieu in Louisiana and Kay Hagan in North Carolina. All of them are threatened in this fall’s elections by conservative or right-wing Republicans. Sen. Mark Warner of Virginia is another moderate on the ballot this year, but so far, he seems safe.
On the other hand, outright liberals have been losing primaries in the Republican Party since the late 1960s, particularly in Senate races. In the House, the few remaining liberal Republicans (one thinks of Maryland’s Connie Morella and Iowa’s Jim Leach) were defeated because Democrats in their districts finally decided that electing even Republicans they liked only empowered the party’s increasingly conservative congressional leadership.
As for the Republican establishment, it may have overcome many tea party challenges this year, but it is increasingly captive to the right wing.
This summer, conservative writers Rich Lowry and Ramesh Ponnuru offered an insightful analysis of the tea party-establishment dynamic in an article in National Review appropriately titled “Establishment Tea.” Lowry and Ponnuru argued that the establishment candidates who triumphed did so largely on the tea party’s terms, though the authors put the matter somewhat more politely. “Candidates who make the case that they will fight for conservative ideas, and not just serve time,” they wrote, “can win tea-party support.”
What’s happening in Kansas is particularly revealing of the backlash against the right from moderate Republicans. Although Roberts is not a tea party candidate — indeed, he defeated a tea party challenger in last month’s primary — the Senate race could be influenced by the state’s contest for governor, one of the most important in the country.
Incumbent Republican Sam Brownback has championed an unapologetic tea party, tax-cutting agenda and has sought to purge moderate Republicans who opposed him from the state legislature. Many GOP moderates have responded by endorsing Brownback’s opponent, Democrat Paul Davis. A Brownback defeat would be a major blow to the right.
“The moderates have said, ‘I’m mad as hell and I’m not going to take it anymore,’ ” said Dan Glickman, a moderate Democrat who represented the area around Wichita in Congress for 18 years. In an interview, Glickman argued that the rightward tilt is antithetical to the GOP’s history in Kansas, a state that sent both Bob Dole and Nancy Landon Kassebaum, in her day a leading GOP moderate, to the Senate.
“The Republican Party in Kansas was always a heartland, common-sense, moderate or moderately conservative party,” Glickman said, adding that at times, it has had a strongly progressive contingent as well.
Orman has been almost maddeningly disciplined in not revealing which party he would caucus with if he defeated Roberts. With national Republican operatives pouring into the state to save the three-term incumbent’s floundering campaign, the battle will get a lot tougher.
But already, Republicans are learning that the cost of driving moderates away could get very high. What middle-of-the-roaders could not accomplish inside the party, they may achieve by attacking from outside the gates.
BY: E. J. Dionne, Jr., Opinion Writer, The Washington Post, September 7, 2014
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