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“37 Pages Of Talking Points”: The Republican Healthcare Plan Isn’t Actually A Healthcare Plan

Rep. Billy Long (R-Mo.) boasted on Twitter yesterday, “You’ve asked for it and tomorrow, House Republicans will release our plan to replace Obamacare.” Whether or not this actually constitutes a “plan,” however, is open to some debate.

After six years of vague talk about a conservative alternative to the Affordable Care Act, House Republicans on Tuesday finally laid out the replacement for a repealed health law – a package of proposals that they said would slow the growth of health spending and relax federal rules for health insurance. […]

In finally presenting one, Speaker Paul D. Ryan of Wisconsin and his Republican team did not provide a cost estimate or legislative language. But they did issue a 20,000-word plan that provides the most extensive description of their health care alternative to date.

Perhaps, but let’s not grade on a curve. It was seven years ago this month that House Republican leaders began promising to unveil a GOP health-care-reform plan, and for seven years, the party has done nothing except offer vague soundbites and vote several dozen times to repeal the Affordable Care Act, replacing it with nothing.

Or put another way, we’ve seen seven years of posturing on health care policy, but no actual governing.

The New York Times is correct that we now have an “extensive description” of the House Republican vision on the issue, but an “extensive description” does not a plan make. There’s still no legislation; there are still no numbers; there’s still no substance to score and scrutinize.

The Huffington Post summarized the problem nicely: “Speaker Paul Ryan wants to replace 20 million people’s health insurance with 37 pages of talking points.”

The plan, which isn’t legislation and is more like a mission statement, lacks the level of detail that would enable a full analysis, but one thing is clear: If put in place, it would almost surely mean fewer people with health insurance, fewer people getting financial assistance for their premiums or out-of-pocket costs, and fewer consumer protections than the ACA provides.

It’s difficult to be certain, because the proposal, which House Speaker Paul Ryan (R-Wis.) will talk up at the American Enterprise Institute in Washington on Wednesday, lacks crucial information, like estimates of its costs and effects on how many people will have health coverage.

The document weighs in at 37 pages, which includes the cover, three full pages about how terrible Obamacare is, and two blank sheets.

As for the outline itself, the “plan” includes exactly what we’d expect it to include: tax credits, health savings accounts, high-risk pools that Republicans don’t want to finance, transitioning Medicare into a voucher/coupon system, and the ability to buy insurance across state lines without necessary consumer safeguards and protections.

After seven years of study, GOP lawmakers are stuck with the same collection of ineffective ideas they’ve been pushing to no avail all along.

When House Speaker Paul Ryan (R-Wis.) announced plans to unveil a six-part “Better Way” governing agenda, he vowed, “We’re not talking about principles here. This is substance.” That may have been the goal, but as of this morning, we’re still left with “a starting point” and “a broad outline” on health care that will ostensibly help Republicans to work out the details later.

There’s no great mystery here. Republicans haven’t been able to come up with a credible reform package for some pretty obvious reasons: (1) they’re a post-policy party with no real interest in governing; (2) health care reform has never really been a priority for the party, which would prefer to leave this in the hands of the private sector and free-market forces; and (3) trying to improve the system requires a lot of government spending and regulations, which contemporary GOP policymakers find ideologically abhorrent.

On this last point, New York’s Jon Chait explained a while back, “The reason the dog keeps eating the Republicans’ health-care homework is very simple: It is impossible to design a health-care plan that is both consistent with conservative ideology and acceptable to the broader public. People who can’t afford health insurance are either unusually sick (meaning their health-care costs are high), unusually poor (their incomes are low), or both. Covering them means finding the money to pay for the cost of their medical treatment. You can cover poor people by giving them money. And you can cover sick people by requiring insurers to sell plans to people regardless of age or preexisting conditions. Obamacare uses both of these methods. But Republicans oppose spending more money on the poor, and they oppose regulation, which means they don’t want to do either of them.”

A Republican Hill staffer famously put it this way in 2014: “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.”

Which, of course, Republicans can’t bring themselves to do. The result is a shell of a plan, like the one Paul Ryan is rolling out today.

 

By: Steve Benen, The Maddow Blog, June 22, 2016

June 26, 2016 Posted by | Affordable Care Act, Health Reform, House Republicans, Paul Ryan | , , , , , , , | 1 Comment

“We’ll Never Stop Arguing About It”: Obamacare Is Helping A Lot Of People. Not Everyone Thinks That’s Good News

April 21, 2016 Posted by | Affordable Care Act, Conservatives, Obamacare, Republicans | , , , , , , , , | 1 Comment

“Seven Years And Counting”: House Republican On Health Care Plan: ‘Give Us A Little Time’

One of the best running jokes in American politics is the one about Republicans releasing their own alternative to the Affordable Care Act. Any day now, GOP leaders have been saying for many years, they’re going to have a plan that rivals “Obamacare,” and it’s going to be awesome.

Yesterday, The Hill reported on the latest installment in this ongoing fiasco.

A group of senior House Republicans is promising to deliver proof that the party is making headway in its six-year struggle to replace ObamaCare.

“Give us a little time, another month or so,” House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) told reporters this week. “I think we’ll be pretty close to a Republican alternative.”

Upton is not just some random figure in the broader effort: The Michigan Republican is a key committee chairman and a member of House Speaker Paul Ryan’s “task force,” responsible for coming up with the GOP’s reform alternative.

Upton said the Republican group is currently in “listening mode” – which it’s apparently been in since its creation 14 months ago.

And yet, we’re apparently supposed to believe that in “another month or so,” House Republican lawmakers will be “pretty close” to having their own reform plan.

Who knows, maybe the GOP is making enormous strides towards its goal. Maybe “listening mode” is going so well that the Republican alternative to the Affordable Care Act is nearly complete. Maybe, with “a little time,” they’re ready to deliver.

It’s certainly possible, but the odds are heavily against it.

As we discussed when the Republican “task force” was created early last year, the political world may not fully appreciate just how overdue this GOP health care plan really is. It was on June 17, 2009 that then-Rep. Roy Blunt (R-Mo.) made a bold promise. The Missouri Republican, a member of the House Republican leadership at the time, had taken the lead in crafting a GOP alternative to the Affordable Care Act, and he was proud to publicly declare, ”I guarantee you we will provide you with a bill.”

The same week, then-Minority Whip Eric Cantor (R-Va.) told reporters that the official Republican version of “Obamacare” was just “weeks away.” We’d all see the striking proof that far-right lawmakers could deliver real solutions better than those rascally Democrats.

This was nearly seven years ago. The Huffington Post’s Jeffrey Young has gotten quite a bit of mileage out of a joke, documenting all of the many, many times in recent years GOP officials have said they’re finally ready to unveil their big health care solution, only to quietly fail every time.

In early April 2014, then-House Majority Whip Kevin McCarthy (R-Calif.) said his party’s health plan was nearly done, but it was being delayed “at least a month.” That was 24 months ago. In 2015, assurances that the Republican plan was on the way were also wrong.

In 2016, however, a GOP leader has been reduced to arguing, “Give us a little time,” seemingly unaware of how hilarious this is.

As we talked about last week, the problem probably isn’t dishonesty. In all likelihood, Republicans would love to have a health care plan of their own – no one likes to appear ridiculous while breaking promises – but haven’t because they don’t know how to craft one.

As New York’s Jon Chait explained, “The reason the dog keeps eating the Republicans’ health-care homework is very simple: It is impossible to design a health-care plan that is both consistent with conservative ideology and acceptable to the broader public. People who can’t afford health insurance are either unusually sick (meaning their health-care costs are high), unusually poor (their incomes are low), or both. Covering them means finding the money to pay for the cost of their medical treatment. You can cover poor people by giving them money. And you can cover sick people by requiring insurers to sell plans to people regardless of age or preexisting conditions. Obamacare uses both of these methods. But Republicans oppose spending more money on the poor, and they oppose regulation, which means they don’t want to do either of them.”

Or as a Republican Hill staffer famously put it in 2014, “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.”

Which, of course, Republicans can’t bring themselves to do.

But hope springs eternal, and I can’t wait to hear more about the GOP’s progress in “another month or so.”

 

By: Steve Benen, The Maddow Blog, April 19, 2016

April 19, 2016 Posted by | Affordable Care Act, Fred Upton, Health Care, House Republicans | , , , , , , , | 1 Comment

“Who Hates Obamacare?”: Progressives Should Not Be Trash-Talking Progress And Impugning Motives Of People On Their Side

Ted Cruz had a teachable moment in Iowa, although he himself will learn nothing from it. A voter told Mr. Cruz the story of his brother-in-law, a barber who had never been able to afford health insurance. He finally got insurance thanks to Obamacare — and discovered that it was too late. He had terminal cancer, and nothing could be done.

The voter asked how the candidate would replace the law that might have saved his brother-in-law if it had been in effect earlier. Needless to say, all he got was boilerplate about government regulations and the usual false claims that Obamacare has destroyed “millions of jobs” and caused premiums to “skyrocket.”

For the record, job growth since the Affordable Care Act went fully into effect has been the best since the 1990s, and health costs have risen much more slowly than before.

So Mr. Cruz has a truth problem. But what else can we learn from this encounter? That the Affordable Care Act is already doing enormous good. It came too late to save one man’s life, but it will surely save many others. Why, then, do we hear not just conservatives but also many progressives trashing President Obama’s biggest policy achievement?

Part of the answer is that Bernie Sanders has chosen to make re-litigating reform, and trying for single-payer, a centerpiece of his presidential campaign. So some Sanders supporters have taken to attacking Obamacare as a failed system.

We saw something similar back in 2008, when some Obama supporters temporarily became bitter opponents of the individual mandate — the requirement that everyone buy insurance — which Hillary Clinton supported but Mr. Obama opposed. (Once in office, he in effect conceded that she had been right, and included the mandate in his initiative.)

But the truth is, Mr. Sanders is just amplifying left-wing critiques of health reform that were already out there. And some of these critiques have merit. Others don’t.

Let’s start with the good critiques, which involve coverage and cost.

The number of uninsured Americans has dropped sharply, especially in states that have tried to make the law work. But millions are still uncovered, and in some cases high deductibles make coverage less useful than it should be.

This isn’t inherent in a non-single-payer system: Other countries with Obamacare-type systems, like the Netherlands and Switzerland, do have near-universal coverage even though they rely on private insurers. But Obamacare as currently constituted doesn’t seem likely to get there, perhaps because it’s somewhat underfunded.

Meanwhile, although cost control is looking better than even reform advocates expected, America’s health care remains much more expensive than anyone else’s.

So yes, there are real issues with Obamacare. The question is how to address those issues in a politically feasible way.

But a lot of what I hear from the left is not so much a complaint about how the reform falls short as outrage that private insurers get to play any role. The idea seems to be that any role for the profit motive taints the whole effort.

That is, however, a really bad critique. Yes, Obamacare did preserve private insurance — mainly to avoid big, politically risky changes for Americans who already had good insurance, but also to buy support or at least quiescence from the insurance industry. But the fact that some insurers are making money from reform (and their profits are not, by the way, all that large) isn’t a reason to oppose that reform. The point is to help the uninsured, not to punish or demonize insurance companies.

And speaking of demonization: One unpleasant, ugly side of this debate has been the tendency of some Sanders supporters, and sometimes the campaign itself, to suggest that anyone raising questions about the senator’s proposals must be a corrupt tool of vested interests.

Recently Kenneth Thorpe, a respected health policy expert and a longtime supporter of reform, tried to put numbers on the Sanders plan, and concluded that it would cost substantially more than the campaign says. He may or may not be right, although most of the health wonks I know have reached similar conclusions.

But the campaign’s policy director immediately attacked Mr. Thorpe’s integrity: “It’s coming from a gentleman that worked for Blue Cross Blue Shield. It’s exactly what you would expect somebody who worked for B.C.B.S. to come up with.” Oh, boy.

And let’s be clear: This kind of thing can do real harm. The truth is that whomever the Democrats nominate, the general election is mainly going to be a referendum on whether we preserve the real if incomplete progress we’ve made on health, financial reform and the environment. The last thing progressives should be doing is trash-talking that progress and impugning the motives of people who are fundamentally on their side.

 

By: Paul Krugman, Op-Ed Columnist, The New York Times, February 5, 2016

February 6, 2016 Posted by | Affordable Care Act, Bernie Sanders, Obamacare, Progressives | , , , , , , , | 1 Comment

“Living Exact Same Day Over And Over Again”: On Groundhog Day, Republicans Vote To Repeal Obamacare

President Obama hasn’t spent a lot of time with House Speaker Paul Ryan (R-Wis.), but the two leaders, joined by Senate Majority Leader Mitch McConnell (R-Ky.), met at the White House this morning. The point, according to everyone involved, was to look for ways the policymakers can find some common ground and try to get things done in 2016.

To help set the tone, the Wisconsin congressman told reporters yesterday he was excited about the Iowa caucuses because “what it tells me is the days of Barack Obama’s presidency are numbered.”

He’s a real charmer, this one. You can just feel his enthusiasm for bipartisan policymaking in an era of divided government.

After the meeting in which the president tries to find areas of possible agreement with GOP leaders, Ryan will hold another vote on repealing the Affordable Care Act. The Washington Post reported:

The House is scheduled to vote Tuesday on overturning President Obama’s veto of legislation to repeal Obamacare and defund Planned Parenthood. The vote, appropriately scheduled for Groundhog Day, is expected to fail, leaving conservatives to gear up for a final year of budget fights with the president.

Asked about today’s events, White House Press Secretary Josh Earnest told reporters, “Republicans are poised to host another vote in the United States Congress today for the 60th time to repeal Obamacare. It’s almost like it’s Groundhog Day, except today it is actually Groundhog Day and they’re doing it again.”

Earnest added, “So I’m not really sure that qualifies as the contours of a proactive legislative agenda but it does put some pressure on Speaker Ryan and Leader McConnell, and other Republicans in Congress, to lay out what it is exactly they support and try to find some common ground with the administration.”

For the record, estimates vary on exactly how many times Republicans have tried to repeal all or part of the ACA, but the last time I checked, they were up to 62. In other words, Earnest might have been understating the case a bit.

Incidentally, shortly before the last repeal vote, Ryan was asked why he was moving forward with a bill to eliminate the Affordable Care Act before the Republican alternative is ready. The Republican leader told reporters with a smile, “Just wait.”

We later learned that this wait will continue past this year – because GOP lawmakers have already effectively given up on their plans to unveil a reform alternative in 2016.

As for today’s veto-override vote, there’s no chance of the bill succeeding. Paul Ryan and his team know that, of course, but they’re holding the vote anyway, just to go through the motions.

Postscript: In case anyone doesn’t get the reference, I should probably mention “Groundhog Day” was a classic movie from 1993 in which Bill Murray is stuck in a time loop, forced to live the exact same day over and over again. For those who haven’t seen the movie, I can assure you it’s far more entertaining than watching Republicans vote 63 times to take health care benefits away from millions of families for no particular reason.

Update: Reader F.B. emails, “In the movie, the character played by Bill Murray learns from each repetition how to live that day better. Unfortunately the Republicans show no similar improvement.”

 

By: Steve Benen, The Maddow Blog, February 2, 2016

February 3, 2016 Posted by | Affordable Care Act, Mitch Mc Connell, Obamacare, Paul Ryan | , , , , , , | 1 Comment

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