“Not So Fast Bucko’s”: Anti-Obamacare Desperation Lawsuit Just Got More Desperate
The D.C. Circuit just agreed to hear the Halbig lawsuit. The short explanation of what this means is that it has closed off the easiest path to crippling Obamacare. Here’s the long explanation:
1. The Halbig lawsuit is the right’s most recent desperate effort to retroactively nullify the Affordable Care Act. The lawsuit is a wildly tendentious argument that, based on an extremely narrow reading of one ambiguous passage in the health-care law, people in states with federal-run insurance exchanges should be ineligible. Since the tax credits make insurance affordable for most consumers, the lawsuit would wreck the exchanges for some 6.5 million people, which is its entire point.
2. The Halbig suit has previously been laughed out of court, but in July, two out of three judges from the D.C. Circuit agreed with it. This ruling reflected the luck of the draw — the two judges were Republican appointees on a court consisting mostly of Democratic appointees.
3. This created a split, with some courts dismissing Halbig and another one embracing it. The split created an obvious window for the Supreme Court to take up the case — contrasting opinions between Federal Courts is a common reason for the Supreme Court to take up a case.
4. The split would close if the entire D.C. Circuit took up the case. In important cases with split decisions, the entire court usually weighs in. Conservatives desperately wanted to avoid this, for the reason stated above. They undertook a furious public campaign (see, for instance, here and here) to persuade the Court not to hear Halbig as a whole. Their rationale is that the Halbig lawsuit is not legally important enough to merit a full hearing. That argument is as ridiculous and transparently partisan as it sounds. Nicholas Bagley explains why here.
5. What happens next is that the entire D.C. Circuit will hear the case. Since the logic of the lawsuit is so ludicrous only a wildly partisan Republican jurist would ever accept it, it stands zero chance of success.
6. After that, Federal Courts will be unanimous in opposition to the Halbig lawsuit. The Supreme Court could still take up the case then, but it could just as easily decide not to hear it.
By: Jonathan Chait, Daily Intelligencer, New York Magazine, September 4, 2014
“The Medicare Miracle”: Everything The Usual Suspects Have Been Saying About Fiscal Responsibility Is Wrong
So, what do you think about those Medicare numbers? What, you haven’t heard about them? Well, they haven’t been front-page news. But something remarkable has been happening on the health-spending front, and it should (but probably won’t) transform a lot of our political debate.
The story so far: We’ve all seen projections of giant federal deficits over the next few decades, and there’s a whole industry devoted to issuing dire warnings about the budget and demanding cuts in Socialsecuritymedicareandmedicaid. Policy wonks have long known, however, that there’s no such program, and that health care, rather than retirement, was driving those scary projections. Why? Because, historically, health spending has grown much faster than G.D.P., and it was assumed that this trend would continue.
But a funny thing has happened: Health spending has slowed sharply, and it’s already well below projections made just a few years ago. The falloff has been especially pronounced in Medicare, which is spending $1,000 less per beneficiary than the Congressional Budget Office projected just four years ago.
This is a really big deal, in at least three ways.
First, our supposed fiscal crisis has been postponed, perhaps indefinitely. The federal government is still running deficits, but they’re way down. True, the red ink is still likely to swell again in a few years, if only because more baby boomers will retire and start collecting benefits; but, these days, projections of federal debt as a percentage of G.D.P. show it creeping up rather than soaring. We’ll probably have to raise more revenue eventually, but the long-term fiscal gap now looks much more manageable than the deficit scolds would have you believe.
Second, the slowdown in Medicare helps refute one common explanation of the health-cost slowdown: that it’s mainly the product of a depressed economy, and that spending will surge again once the economy recovers. That could explain low private spending, but Medicare is a government program, and shouldn’t be affected by the recession. In other words, the good news on health costs is for real.
But what accounts for this good news? The third big implication of the Medicare cost miracle is that everything the usual suspects have been saying about fiscal responsibility is wrong.
For years, pundits have accused President Obama of failing to take on entitlement spending. These accusations always involved magical thinking on the politics, assuming that Mr. Obama could somehow get Republicans to negotiate in good faith if only he really wanted to. But they also implicitly dismissed as worthless all the cost-control measures included in the Affordable Care Act. Inside the Beltway, cost control apparently isn’t considered real unless it involves slashing benefits. One pundit went so far as to say, after the Obama administration rejected proposals to raise the eligibility age for Medicare, “America gets the shaft.”
It turns out, however, that raising the Medicare age would hardly save any money. Meanwhile, Medicare is spending much less than expected, and those Obamacare cost-saving measures are at least part of the story. The conventional wisdom on what is and isn’t serious is completely wrong.
While we’re on the subject of health costs, there are two other stories you should know about.
One involves the supposed savings from running Medicare through for-profit insurance companies. That’s the way the drug benefit works, and conservatives love to point out that this benefit has ended up costing much less than projected, which they claim proves that privatization is the way to go. But the budget office has a new report on this issue, and it finds that privatization had nothing to do with it. Instead, Medicare Part D is costing less than expected partly because enrollment has been low and partly because an absence of new blockbuster drugs has led to an overall slowdown in pharmaceutical spending.
The other involves the “sticker shock” that opponents of health reform have been predicting for years. Bulletin: It’s still not happening. Over all, health insurance premiums seem likely to rise only modestly next year, and they are on track to be flat or even falling in several states, including Connecticut and Arkansas.
What’s the moral here? For years, pundits and politicians have insisted that guaranteed health care is an impossible dream, even though every other advanced country has it. Covering the uninsured was supposed to be unaffordable; Medicare as we know it was supposed to be unsustainable. But it turns out that incremental steps to improve incentives and reduce costs can achieve a lot, and covering the uninsured isn’t hard at all.
When it comes to ensuring that Americans have access to health care, the message of the data is simple: Yes, we can.
By: Paul Krugman, Op-Ed Columnist, The New York Times, August 31, 2014
“Another Republican Gives Up Obamacare Fight”: Unfortunately For Corbett, It’s Probably Too Late To Save His Re-Election Campaign
Governor Tom Corbett of Pennsylvania is the latest Republican to retreat from the Obamacare wars.
On Thursday, the federal government approved Governor Corbett’s plan to expand Medicaid in the Keystone State, making it the 27th state in the nation to adopt the controversial provision of the Affordable Care Act. Corbett had initially opposed expanding Medicaid at all, but earlier this year he bowed to mounting political pressure by offering a plan that would expand Medicaid with a number of Republican-friendly conditions, such as a work requirement and the authority to charge premiums for recipients living below the poverty line. Those did not make it into the final deal.
The agreement should be a boon to Pennsylvania’s working poor; at least 500,000 Medicaid-eligible Pennsylvanians will now be able to sign up for coverage starting on January 1. It will also save the state $4.5 billion over the next eight years, according to Corbett (independent studies have pegged the savings to be even higher)
Corbett clearly hopes that the news will provide a political boost as well. The governor’s announcement of the agreement, which calls it “historic,” “innovative,” and “truly a Pennsylvania solution,” is just about the nicest thing that any elected Republican has ever said about the Affordable Care Act. Meanwhile, Medicaid expansion is wildly popular in Pennsylvania. And as of last week, the Republican governors on the ballot in 2014 who have adopted Medicaid expansion were polling an average of 8.5 percent better than those who hadn’t. It’s not hard to understand what prompted Corbett’s change of heart.
Unfortunately for Corbett, it’s probably too late to save his re-election campaign; the terminally gaffe-prone governor trails his Democratic challenger Tom Wolf by 16.6 percent according to the RealClearPolitics polling average. But plenty of other Republicans have also realized that it makes sense to buck the party line on Medicaid expansion. As The Washington Post’s Greg Sargent has documented, GOP senate candidates such as Scott Brown in New Hampshire, Tom Cotton in Arkansas, Joni Ernst in Iowa, Terri Lynn Land in Michigan, and Thom Tillis in North Carolina have tied themselves in knots trying to explain how they would repeal the Affordable Care Act without getting rid of any of the popular parts.
It’s almost as if voters would rather expand health care coverage than burn billions of dollars to thumb their noses at the White House.
Of course, this wasn’t supposed to happen. For over a year, Republicans have been promising that Obamacare would be the anchor that sinks every Democrat on the ballot and sparks a GOP wave in November. Instead, many Republicans are now either embracing sections of the law, or just ignoring it altogether. It appears that we can add this blown prediction to long list of Obamacare disasters that stubbornly refused to materialize.
By: Henry Decker, The National Memo, August 29, 2014
“Obamacare, Beyond The Label”: The Politics Of Obamacare Are Upside-Down
The Affordable Care Act was supposed to be a slam-dunk issue for the Republicans in this fall’s elections. Karl Rove told us so in April, writing that “Obamacare is and will remain a political problem for Democrats.”
So how’s that Obamacare thing working out for the GOP?
The most significant bit of election news over the last week was the decision of Senator Mark Pryor, the embattled Arkansas Democrat, to run an ad touting his vote for the health care law as a positive for the people of his increasingly Republican state.
Pryor’s ad is so soft and personal that it’s almost apolitical. After his dad, the popular former senator David Pryor, tells of his son’s bout with cancer, he notes that “Mark’s insurance company didn’t want to pay for the treatment that ultimately saved his life.” The picture has widened to show Mark Pryor sitting next to his father. “No one should be fighting an insurance company while you’re fighting for your life,” he says. “That’s why I helped pass a law that prevents insurance companies from canceling your policy if you get sick, or deny coverage for pre-existing conditions.”
Who knew a law that critics claim is so dreadful could provide such powerful reassurance to Americans who are ill?
Democrats have never fully recovered from the Obama administration’s lousy sales job for (and botched rollout of) what is, legitimately, its proudest domestic achievement. That’s one reason Pryor doesn’t use the word “Obamacare” in describing what he voted for. Another is that in many of the states with contested Senate races this year, most definitely including Arkansas, President Obama himself is so unpopular that if you attached his name to Social Security, one of the most popular programs in American history would probably drop 20 points in the polls.
So, as the liberal bloggers Greg Sargent, Brian Beutler and Steve Benen have all noted, Republicans would much prefer to run against the law’s name and brand than the law itself. They also really want to avoid being pressed for specifics as to what “repealing Obamacare” would mean in practice.
As one Democratic pollster told me, his focus groups showed that when voters outside the Republican base are given details about what the law does and how it works, “people come around and say, ‘That’s not so bad, what’s everybody excited about?’”
This consultant says of Democrats who voted for the law: “You’re going to be stuck with all the bad about this but not benefit from any of the good unless you advertise” what the Affordable Care Act does. This is what Pryor has decided to do.
In fact, according to Gallup, Arkansas is the No. 1 state in the country when it comes to reducing the proportion of its uninsured since the main provisions of the ACA took effect. The drop was from 22.5 percent in 2013 to 12.4 percent in 2014. The No. 2 state is Kentucky, where the uninsured rate fell from 20.4 percent to 11.9 percent. What they have in common are Democratic governors, Mike Beebe in Arkansas and Steve Beshear in Kentucky, committed to using Obamacare — especially, albeit in different ways, its Medicaid expansion — to help their citizens who lack coverage. Beshear has been passionate in selling his state’s version of Obamacare, which is called kynect.
Kentucky also happens to be the site of another of this year’s key Senate races. Democrat Alison Lundergan Grimes is giving Republican leader Mitch McConnell what looks to be the toughest re-election challenge of his 30-year Senate career.
The Bluegrass State is particularly instructive on the importance of labeling and branding. A Public Policy Polling survey earlier this month found that the Affordable Care Act had a net negative approval rating, 34 percent to 51 percent. But kynect was rated positively, 34 percent to 27 percent. Grimes and the Democrats need to confront McConnell forcefully on the issue he has tried to fudge: A flat repeal of Obamacare would mean taking insurance away from the more than 521,000 Kentuckians who, as of last Friday, had secured coverage through kynect. How would that sit with the state’s voters?
Election results, like scripture, can be interpreted in a variety of ways. You can bet that foes of expanding health insurance coverage will try to interpret every Republican victory as a defeat for Obamacare. But as Mark Pryor knows, the president’s unpopularity in certain parts of the country doesn’t mean that voters want to throw his greatest accomplishment overboard — even if they’d be happy to rename it.
By: E. J. Dionne, Jr., Opinion Writer, The Washington Post; The National Memo, August 25, 2014
“Taking Cover Behind What’s Left Unsaid”: The GOP’s Midterm Strategy Is As Hollow As Their Ideas Are
The most interesting thing about Senator Mark Pryor’s decision to tout his support for the Affordable Care Act in a well-financed, statewide television ad isn’t that he stands apart from other embattled Democrats this election cycle. It’s that Republicans scrambled to spin the story, insisting to reporters that Pryor couldn’t possibly be running on Obamacare if he won’t refer to the law by name.
This was poorly disguised Calvinball, a standard that Republicans invented for the special case of the ACA. Literally no other members of Congress are expected to refer to the laws they’ve helped pass by name or nickname. Republicans in the aughts weren’t expected to refer to the “Economic Growth and Tax Relief Reconciliation Act,” or “EGTRRA,” or “the Bush tax cuts,” or “the Bush tax cuts for the rich,” no matter how unpopular the moniker became. They ran on having cut taxes, and wanting to renew those tax cuts. And sure enough when President Obama set about trying to let “the Bush tax cuts” expire, he conveniently omitted the popular ones. Which is to say, the vast majority of them. He made those permanent.
Nevertheless, several reporters fell into line. And good for the ref workers. Score one for them.
But if Obamacare is a huge liability for Democrats, why are conservatives and GOP operatives desperate to control the narrative surrounding Pryor’s decision to run on the law? If your opponent’s stepping on rakes, why not just stand back and let him?
The answer is that with respect to both Obamacare and other issues Republicans must rely on diversions from policy and outcomes when expressing their substantive and strategic views. We’ve reached a point in the fight over Obamacare where the best thing Republicans have on their side is the law’s unpopular brand. Particularly in states like Arkansas, where President Obama is widely loathed but his signature law has cut the uninsurance rate nearly in half. It’s deeply silly to argue that Pryor isn’t running on Obamacare unless he refers to it using one of two unpopular slogans. But that’s the argument.
Instead, Pryor says, “I helped pass a law that prevents insurance companies from canceling your policy if you get sick or deny [sic] coverage based on pre-existing conditions.” Maybe he shouldn’t have said anything about “a law” at all, but that’s a niggling, semantic critique. That Republicans working to defeat Pryor are asking reporters to squeeze the word “Obamacare” into this sentence is an admission that they’ve lost the policy fight. They criticize Pryor for eschewing the label, because the label’s just about the only thing they’re comfortable assailing. In this way, they resemble Democrats six and eight years ago, running against the Bush tax cuts (for the rich), knowing that they had no intention of letting anything but the most regressive of those tax cuts expire.
In that sense, the GOP’s obsession with the moniker, and only the moniker, is excellent news for Obamacare’s political durability. But only if the people who cover politics are clear about the implications of the GOP’s rhetoric. Unlike Democrats, who were generally clear about the fact that they planned to make most of the Bush tax cuts permanent, Pryor’s opponent, Representative Tom Cotton, acknowledges that the pre-Obamacare status quo, in which insurers denied coverage to people with pre-existing health conditions, was “broken,” but nevertheless maintains that his goal is to repeal the law that makes that practice illegal.
Cotton repeated that mantra just this week, on the trail with Mitt Romney, who, in an amusing twist, tried to save Cotton from himself. “Tom Cotton is going to make sure that we change Obamacare, making sure that people can keep insurance and those that have pre-existing conditions can have coverage,” Romney said, “but he doesn’t want to see the federal government telling people in Arkansas what kind of insurance they have to have or making it more expensive.” Those are remarkably accommodating priorities. They’re just not ones Cotton is prepared to espouse just yet.
In this way, the politics of Obamacare in Arkansas mirror the politics of legislative brinksmanship in Kentucky. Just two days ago, Mitch McConnell, the embattled Senate minority leader who hopes to become majority leader next year, vowed to lard up appropriations bills with partisan policy riders and allow the president to choose between a veto, precipitating a government shutdown, and a bitter pill. A classic take it or leave it proposition.
McConnell said it would be up to the president to decide whether to veto spending bills that would keep the government open.
Obama “needs to be challenged, and the best way to do that is through the funding process,” McConnell said. “He would have to make a decision on a given bill, whether there’s more in it that he likes than dislikes.”
It wouldn’t be much of a challenge to Obama if McConnell plans to cave the moment the president whips out his veto pen. So the threat is pretty clear. Nevertheless, McConnell’s campaign wasn’t pleased by the ensuing deluge of stories about how a GOP majority would embrace high-stakes confrontations and potentially shut down the government again. And in a very narrow sense they have a point—McConnell never said he’d shut down the government. Political scientist Jonathan Bernstein, no McConnell partisan, was among those who defended McConnell on this score.
But much like Cotton can’t credibly claim to support protections for people with pre-existing medical conditions when his plan is to repeal Obamacare, McConnell can’t sidestep the implications of his publicly declared strategy. He can’t say “when we’re in power, we’re going to put two and two together,” and then get angry when the headlines say, “McConnell promises four.”
That won’t stop him from trying to, though. And to an unappreciated extent, the broader Republican strategy heading into November is to speak in abstractions, and take cover behind what’s left unsaid.
By: Brian Beutler, The New Republic, August 22, 2014
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