“Boehner Struggles With His Failed ACA Predictions”: He Should At Least Try To Discuss The Substance Of The Issue Honestly
House Speaker John Boehner sat down with NBC’s Chuck Todd on “Meet the Press” yesterday, and the host asked a good question about the Republican leader’s failed predictions about the Affordable Care Act. Regrettably, the Speaker couldn’t respond with an equally good answer.
TODD: You made some dire predictions about health care. 2014 you said fewer people would have health insurance. According to plenty of surveys, more people have health insurance today than they did before it went down from – the uninsured rate went down 17 percent to just under 12 percent. You said it would destroy jobs. The first year it was implemented, the country added 3 million jobs. Why…
BOEHNER: Obamacare made it harder for employers to hire people. The economy expands and as a result, you are going to have more employees because businesses have to. But if you can ask any employer in America, and ask them whether Obamacare has made it harder for them to hire employees, they’ll tell you yes. Because it’s a fact.
When you look at – you know why there are more people insured? Because a lot more people are on Medicaid. And giving – you know, we expanded Medicaid in a big way. And giving people Medicaid insurance is almost like giving them nothing. Because there aren’t – you can’t find a doctor that will see Medicaid patients.
The Speaker soon added that, as far as he’s concerned, the Affordable Care Act is “not working.”
Boehner might have a credible argument, if we abandoned the agreed upon meaning of “working.”
Look, I realize that health care policy has never been the Ohio Republican’s strong suit, and the Speaker isn’t a wonk deeply engaged in policy details. I can also appreciate why he’s a little embarrassed about making all kinds of ACA predictions, each of which turned out to be wrong. It’s just not realistic to think Boehner will fess up on national television to getting the entire fight over health care backwards.
There’s just no avoiding the fact, however, that Boehner’s comments on “Meet the Press” were woefully incorrect.
According to the Speaker, “it’s a fact” that the Affordable Care Act has “made it harder for employers to hire people.” There’s simply no evidence to support this. None. The U.S. economy saw a jobs boom coincide with the implementation of the ACA. Indeed, the reform law has actually created plenty of jobs within the health care industry by spurring “unprecedented” levels of “entrepreneurial activity.”
At the same time, Boehner believes the drop in the uninsured rate is the result of Medicaid expansion, but that’s wrong, too – millions of consumers have gained private coverage by way of exchange marketplaces. This is even true of the Speaker’s home state of Ohio, which is prepared to create its own exchange if the Supreme Court makes it necessary.
As for the benefits of Medicaid, coverage through the program is not the practical equivalent of “nothing.” Many Americans who’ve gained health security through Medicaid have benefited greatly from affordable care.
Boehner’s conclusion – that “Obamacare” is “not working” – is only true if one closes their eyes, sticks their fingers in their ears, and refuses to consider the evidence. The law is pushing the uninsured rate to new lows; it’s succeeding in satisfying consumers; the law’s price tag is lower than expected; it’s producing impressive results on premiums and enrollment totals; we’re seeing the lowest increase in health care spending in 50 years; the number of insurers who want to participate in exchange marketplaces keeps growing; there’s reduced financial stress on families, the efficacy of Medicaid expansion is obvious, as is the efficacy of the medical-loss ratio and efforts to reduce medical errors system-wide.
The maligned law is even becoming more popular.
Boehner doesn’t have to like the law. He doesn’t even have to admit he was wrong. But he should at least try to discuss the substance of the issue honestly.
By: Steve Benen, The Maddow Blog, May 4, 2015
“A Big Split In The Republican Party”: Here Comes The Big Intra-GOP Fight Over Obamacare Subsidies
It’s been obvious for a while that congressional Republicans will be placed in a difficult position if SCOTUS strikes down subsidies for health insurance purchases under the Affordable Care Act in states that did not create their own exchanges. On the one hand, they’ll be blamed for failure to do something about the consequent loss of insurance and/or increases in premiums (at least in states that do nothing about it, either), when a one-sentence law confirming the original understanding virtually everyone had about the universal availability of subsidies would suffice. On the other hand, any reaction to such a SCOTUS decision that does not at least begin with an all-night kegger-and-prayer-vigil in celebration of this blow against tyranny will rile up The Base into a hate frenzy. Theoretically, GOPers could be ready with a full-fledged Obamacare Replacement bill that could be presented to the president on a take-it-or-leave-it basis, but despite having five years to come up with such a creature, that ain’t happening.
So as TPM’s Sahil Kapur explains today, Sen. Ron Johnson has introduced a bill, which the Senate GOP leadership has quietly gotten behind, that would extend the Obamacare subsidies until the end of 2017, in exchange for some key concessions to conservatives that fall vastly short of an alternative structure for health care reform.
The Senate’s top five Republican leaders have cosponsored legislation to extend until 2017 the Obamacare insurance subsidies that may be struck down by the Supreme Court this summer
The legislation, offered by Sen. Ron Johnson (R-WI), one of the most politically vulnerable Senate incumbents in 2016, would maintain the federal HealthCare.gov tax credits at stake in King v. Burwell through the end of August 2017.
The bill was unveiled this week with 29 other cosponsors, including Senate Majority Leader Mitch McConnell (R-KY) and his four top deputies, Sen. John Cornyn (R-TX), John Thune (R-SD), John Barrasso (R-WY) and Roy Blunt (R-MO). Another cosponsor is Sen. Roger Wicker (R-MS), the chairman of the conference’s electoral arm.
Such a move would seek to protect the GOP from political peril in the 2016 elections when Democrats would try to blame the party for stripping subsidies — and maybe insurance coverage — from millions of Americans in three dozen states. A defeat for the Obama administration in a King ruling would likely create havoc across insurance markets and pose a huge problem for Republicans, many of whom have been pushing the Supreme Court to nix the subsidies.
Given the certainty that this proposal will split Republicans, what are the odds Democrats would go along with this semi-“fix.”?
Democrats would probably demand a fix to make the subsidies permanently available if they go down. But they would be hard-pressed to vote down a bill to temporarily extend them if Republicans were to bring it up.
That may depend, however, on what happens to provisions Kapur calls “sweeteners” for conservatives, including elimination of Obamacare’s individual and employer mandates, and perhaps even more crucially, of the ACA’s minimum benefit requirements. Kapur seems to anticipate, and some conservative critics agree, that Republicans would cave on most of these “sweeterners” in exchange for Democrats agreeing to a temporary instead of a permanent extension of subsidies.
But you will note that the cosponsors of Johnson’s bill do not include Ted Cruz, Rand Paul or Marco Rubio, who will likely be focused on the Iowa Straw Poll at the time the decision comes down. There’s also a competing Senate bill from Ben Sasse that would instead of extending the subsidies replace them with simple tax credits for insurance purchasing that would fade away over time. And there are, according to The Hill‘s Sullivan and Ferris, several plans percolating in the House that would replace the subsidies with our without some “bridge” offering temporary relief. You can judge how much consensus there is from this remark by Republican Study Committee co-chair Bill Flores of Texas, who is one of the people working on one of the many plans:
“I’m not saying there should absolutely not be a bridge, I’m not saying there should absolutely be a bridge,” Flores said. “If we start building toward a shore, but we don’t know what that shore is, then the bridge might not work very well.”
I think we can all agree on that. And that is why despite everything you will hear from them before and after SCOTUS rules, there’s probably no group of people more avidly if silently cheering for Obama to win this case than are congressional Republicans.
By: Ed Kilgore, Contributing Writer, Political Animal Blog, The Washington Monthly, April 24, 2015
“Asking For A Bail Out Of His Self-Made Crisis”: Cut Taxes Or Expand Medicaid?; Florida Governor Rick Scott Is In Quite A Pickle
The Florida state government has been a hotbed of opposition to Obamacare, and has succeeded in resisting the law’s Medicaid expansion, in large part because of the state’s Low Income Pool: a multi-billion dollar, 10-year-old pilot program through which, right now, the federal government subsidizes health care providers who treat the poor.
Also right now, in Florida, Governor Rick Scott wants to enact hundreds of millions of dollars in annual tax cuts.
The budget room for those tax cuts, in other words, exists because the federal government is spending money—money that comes with no guarantee—in a way that bolsters Florida’s resistance to Obamacare.
Not keen on financing opposition to itself, the Obama administration is leaning toward ending this sweet arrangement, and phasing out the Low Income Pool, which has in any case grown obsolete in a world where Florida can adopt the Medicaid expansion and provide insurance to nearly a million of its poor citizens.
All of which is to say that if Scott and Florida Republicans want their tax cuts, they will have to use expanded Medicaid to fill the budget hole where the Low Income Pool used to be. But rather than push against that open door, Scott announced Thursday that he will sue the federal government. Specifically, he’s arguing that by rescinding the Low Income Pool, the Obama administration is coercing Florida into participating in Obamacare, so the Low Income Pool must continue. Put another way, he’s asking the courts to force the feds to bail out his tax cut.
This is all playing out against the backdrop of King v. Burwell, in which conservatives have asked the Supreme Court to rescind billions of dollars in Affordable Care Act subsidies in their own states—money they claim is contingent upon them establishing their own exchanges. Like most Republican governors, Rick Scott didn’t establish an exchange, but for some reason he isn’t sounding the coercion alarm over King.
Scott’s argument is transparently frivolous, but it underscores the extent to which the GOP’s deranged resistance to Obamacare is boomeranging on itself. As Greg Sargent notes at the Washington Post, “Scott’s lawsuit is designed to get the administration to fork over federal money for health care—but only if it isn’t part of Obamacare.” Without that money, Scott probably won’t get his tax cuts. Which means that in Florida, the GOP’s commitment to tax cuts is running up against its Massive Resistance to Obamacare. And the tax cuts might lose.
This adamant opposition to the Medicaid expansion is a relatively recent development. Scott claims his opposition stems from the administration’s coolness to the Low Income Pool. If the federal government can just end that program, how can Floridians trust them to commit to their end of the Medicaid expansion? But that doesn’t wash. The Low Income Pool was scheduled to expire, whereas the federal government is obligated by law to fund 90 percent of the Medicaid expansion in perpetuity.
Florida’s Senate president—a Republican—thinks Scott is being ridiculous. He released a statement that refutes Scott’s objection to the Medicaid expansion and undermines the lawsuit:
The federal government has no obligation to provide LIP funding, or to work within our timeframe. While we respect Governor Scott’s authority to protect the state’s interests in the way he sees fit, we have a constitutional responsibility to pass a balanced budget by a specific deadline. From where I sit, it is difficult to understand how suing [the federal government] on day 45 of a 60 day session regarding an issue the state has been aware of for the last 12 months will yield a timely resolution to the critical health care challenges facing our state. The Senate budget anticipated the potential reduction or elimination of LIP funding and included solutions to provide Floridians access to health care services and coverage. We remain hopeful CMS will approve the Senate proposal.
A likelier explanation for Scott’s change of heart is a combination of anti-Medicaid spending by the Koch-backed advocacy group Americans for Prosperity, and entrenched Obamacare opposition in the Florida House. Sensing that the Medicaid expansion might be in danger, Scott flipped, rather than be caught on the losing side of it.
But Scott could have solved this problem a long time ago if he’d ever fought for Medicaid expansion earnestly, and could solve it now by teaming up with the Senate to stare down the House.
Instead Scott is suing the federal government to bail him out of a self-made crisis. This isn’t an anomaly, but a pattern. Across the country, Republican governors are coping with the consequences of their own Obamacare intransigence—staring into a future where their insurance markets get destroyed by virtue of their refusal to help implement Obamacare and their unwillingness to take on the right as it pursued litigation.
It was inevitable that as Obamacare became more entrenched, Republicans would see their opposition to the law come into tension with their other core interests. This is exactly what’s happened, and to some extent it has exposed weaknesses in the resistance strategy. But that resistance—to the idea of providing health insurance to the poor—remains very strong. Stronger, perhaps, than the allure of tax cuts.
By: Brian Beutler, The New Republic, April 17, 2017
“This Did Not Go According To Plan”: McMorris Rogers Gets An Earful On ACA
For much of 2013 and 2014, Republicans were on a quest to discover “Obamacare victims.” GOP officials were convinced the Affordable Care Act was wreaking havoc on families’ lives, and Republicans everywhere were hunting for horror stories.
In nearly every instance, those stories fell apart in the face of routine scrutiny, and most of the “victims” were actually far better off with the ACA than without it. One of the more notable examples arose early last year when Rep. Cathy McMorris Rodgers (R-Wash.), the House Republican Conference chair, used her party’s official response to the State of the Union to introduce America to “Bette in Spokane.”
Predictably, the story unraveled and McMorris Rodgers was pressed for an apology after pushing a misleading story. A year later, the Republican congresswoman hasn’t given up.
Cathy McMorris Rodgers, chair of the House GOP conference, took to Facebook to commemorate the fifth anniversary of the Affordable Care Act by asking to hear real-life horror stories from real people.
This did not go according to plan. McMorris Rodgers generated plenty of responses, most of which were from people who see the ACA as a lifesaver for their families.
I’m not altogether sure what the point of the endeavor was supposed to be. What exactly did the Republican congresswoman hope to accomplish?
But even putting that aside, this little incident should be a reminder to GOP lawmakers that their assumptions about “Obamacare” may not be in line with Americans’ reactions in the real world. In fact, if Republicans on the Supreme Court gut the law, consumers will be looking to folks like McMorris Rodgers to prevent systemic chaos.
Postscript: Wonkette joked, “[O]bviously, the takeaway here is that Obamacare is such a huge failure that the government is paying people to troll Facebook and lie about how much they like the ACA, because liberals are congenital liars, and poor Cathy McMorris Rodgers is a victim of cyberbullying, the end.”
Wonkette was kidding, but I wouldn’t be too surprised if this line took root in conservative media fairly soon, if it hasn’t already.
By: Steven Benen, The Maddow Blog, March 27, 2015
“Obamacare Opponents Still Await The Apocalypse”: Opponents Are As Wrong About Obamacare As Reagan Was About Medicare
A while back, progressive activists and politicians pushed for legislation to provide health insurance for a cohort of Americans who could not easily pay for their doctors’ visits and medications. Predictably, that effort was met with fierce resistance from conservatives, who didn’t seem concerned about those less-fortunate citizens who couldn’t afford medical care.
Conservatives denounced the plan as “socialized medicine” or a “communist takeover” of the American health care system. One notable conservative was especially alarmist, declaring that if the proposal passed Congress, “… you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free.”
No, that hysterical tirade didn’t come in response to the Affordable Care Act. Those words were spoken in 1961 by Ronald Reagan, who was crisscrossing the country to campaign against the adoption of Medicare. Yes, Medicare, which Congress passed in 1965 and is widely considered a resounding success.
Fast-forward a few decades. The same alarms were sounded more recently, as progressive activists and politicians pushed for legislation to provide inexpensive health insurance for those who couldn’t afford it. Actually, the denunciations of the Patient Protection and Affordable Care Act, usually called “Obamacare,” may have been even more hysterical.
As the law neared passage, I watched angry crowds gather near the White House — many holding vicious, racially charged signs lambasting the president — to chant about “socialism” and “communism.” Strangely, the most vehement criticisms came from Americans 65 and older, the very cohort that benefits from Medicare.
President Obama signed the Affordable Care Act in March 2010, so it has been the law of the land for five years. Given that, it’s possible to make a reasoned assessment of its strengths and weaknesses.
First off, let’s note that there has been no “socialist takeover” of American medicine. Obamacare uses private health insurance providers; the law merely sets requirements for health insurance plans and issues subsidies to patients who cannot afford to purchase policies.
As you might expect, the number of Americans with health insurance — and, therefore, with access to preventive medical care — has increased in the last five years. Before the law went into effect, there were 48 million uninsured Americans. Now, with 16 million people having signed up for Obamacare, that number has been cut by a third.
Furthermore, health insurance companies are no longer allowed to deny coverage to patients who are already sick or to set a “lifetime cap” on the amount of money a company will pay for medical care. Adult children, who might be in college or working at low-paying jobs without benefits, can stay on their parents’ policies until they are 26.
The Affordable Care Act may also have decreased the rate at which health care costs were escalating. Five years ago, medical care costs were skyrocketing, well beyond the rate of general inflation. Now, those costs are still going up — but at the lowest rate in 50 years. While economists aren’t certain that Obamacare’s cost-containment measures are responsible, many of them give the law credit.
To be sure, the Affordable Care Act has been no panacea. There are still 32 million Americans without health insurance. And, despite the president’s early pledge that people already insured could retain their policies, a tiny but vocal group lost their insurance because Obamacare deemed those policies inadequate. Many in that group ended up paying more for insurance, hardly a happy outcome.
But the worst failings of the Affordable Care Act are beyond its supporters’ control. Because of persistent, irrational Republican opposition, more than 20 states have refused to expand Medicaid — even though the feds would pay the lion’s share of costs. That means that millions of working-class Americans are not getting the health care they need. Furthermore, Obamacare’s unrelenting antagonists have mounted yet another challenge to the law before the U.S. Supreme Court.
It’s hard to fathom. The Affordable Care Act has failed to produce the apocalypse (remember “death panels”?) its fiercest critics predicted; instead, it has given millions of people access to decent health care. Its opponents are as wrong about Obamacare as Ronald Reagan was about Medicare.
By: Cynthia Tucker, Pulitzer Prize for Commentary in 2007; The National Memo, March 28, 2015
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