“Last Gasps Of A Dying Movement”: Obamacare Obstructionists’ Self-Created Trap
Kevin McCarthy doesn’t have the best timing. The House majority whip released what he hoped would be the foundational document of Obamacare truthers, “Debunking Obamacare’s 7 million enrollees ‘success’ story,” the same day the White House announced that, in fact, 8.03 million Americans had enrolled in the insurance exchanges. Republicans will no doubt try to debunk the higher figure the same way, but the more we learn about who’s been covered under the Affordable Care Act, the harder it will be. It is, overwhelmingly, a success story.
I said the same thing back when the number was 7 million: Imagine how many more people might have been covered if shrill Republicans hadn’t made repealing and obstructing the ACA their top priority. The news that 35 percent of enrollees are under 35 is particularly heartening: it means many young people ignored the campaign to tell them not to sign up – remember that creepy Uncle Sam “doctor” and reports of cool campus keg parties? Yes, the president had Zach Galifianakis and Bradley Cooper – damn you, Bradley Cooper! Greg Gutfeld is still so angry at you – but imagine where we’d be without an organized national campaign to scare people out of signing up.
The campaign to discredit the act will continue. McCarthy’s dumb document lists five new metrics for measuring success, including how many enrollees have actually paid, and how many didn’t have insurance before. Those are old talking points, but they’ve added a new one – how many received subsidies — which is ugly in several ways. Republicans will use a high rate of subsidies, if that’s the case, to negate the act’s success, when in fact the subsidies were always key to it: You can’t have an individual mandate to purchase private insurance without making some provision to help those who can’t afford it. Affordability is why most didn’t have it in the first place.
But McCarthy also tacks on an ugly parenthetical, asking “how many received a subsidy (raising concerns about fraud).” Brian Beutler at the New Republic calls this an effort to “welfarize Obamacare,” to stigmatize it and also make it subject to the same hysteria about “fraud” that conservatives use to smear other social programs. Remember that Sen. Ted Cruz called the subsidies “sugar,” telling Sean Hannity that when Americans got a taste of it, they’d be “addicted to the sugar, addicted to the subsidies. And once that happens, in all likelihood, it never gets …”
“It’s over,” Hannity declared. “It never gets repealed.”
Exactly.
Still, a high rate of subsidies will let the GOP continue to demonize the “takers” vs. the “makers.” But some of them are going to have a big problem: A lot of the takers will turn out to be their voters. Poor Mitch McConnell: His own state of Kentucky, under the leadership of Democratic Gov. Steve Brashear, set up its own insurance exchange, expanded Medicaid and conducted a bold public health campaign to get folks into “Kynect.” Now Kentucky has reduced the number of uninsured by 40 percent – and many of those newly insured are McConnell’s aging white constituents.
McConnell seems appropriately alarmed. The man who has repeatedly pledged to “repeal” the law just this week told healthcare workers in Kentucky that repealing the law can’t happen while Obama is president, so “we’re going to figure out a way to get this fixed.” That softer tone isn’t sitting well with his Tea Party challenger Matt Bevin, who’s already accusing McConnell of being an Obamacare appeaser, but the Senate minority leader seems to be looking past Bevin to his November battle with Alison Lundergan Grimes.
The only thing that might get Republicans out of a mess of their own making is Democratic cowardice, and you can never underestimate the capacity of centrist and red state Democrats to sabotage themselves and their own party. We’ll see how hard Grimes hits McConnell over his role in obstructing the ACA; so far, it hasn’t been very hard at all. She needs to make him the man who’s trying to charge women more than men for insurance again; the man who’s trying to take healthcare away from 370,000 Kentuckians who have it thanks to Democrats.
Democrats have similar opportunities in Virginia and Arkansas. Republicans have been itching to make the midterms a referendum on Obamacare. Thursday’s news means that might not work the way they had planned.
By: Joan Walsh, Editor at Large, Salon, April 18, 2014
“Conservative Crybabies Lose Again”: The Right’s Laughable New Obamacare Conspiracies, Officially Debunked
If you click through a few conservative news websites, you’ll learn all about the latest and most nefarious bit of lawless chicanery from the Obama administration as it tries to paper over the Affordable Care Act’s obvious failures. Jumping off from a New York Times report that the Census Bureau “is changing its annual [healthcare] survey so thoroughly that it will be difficult to measure the effects of President Obama’s health care law in the next report,” conservatives have put two and two together and come up with CONSPIRACY.
Megan McArdle asks, “Is Obama cooking the Census books for Obamacare?” Townhall’s Guy Benson suspects this change was implemented to boost Democratic fortunes for the midterms: “The brand new survey questions will unquestionably ‘reveal’ a dramatic decrease in the uninsured population, bureau experts say, which will deliver Democrats a super handy talking point. And oh-by-the-way, the artificially improved numbers will be released … this fall.” Mediaite’s Noah Rothman writes that the conservatives who argle-bargled in 2009 about the White House politicizing the census now look prescient. “The fears of some that the Census Bureau could be corrupted by the imperatives of the political operatives in the White House was today proven accurate.”
Nonsense. The timing of the switch is obviously not ideal, though, as Vox’s Sarah Kliff notes, the new methods will be used to collect data for 2013, before the state marketplaces went up and the Medicaid expansion took effect. The suggestion of political interference from the White House, however, is a bombshell accusation that, despite Rothman’s insistence, is nowhere near being “proven.” Evan McMorris-Santoro of BuzzFeed talked to a census official who said that the White House had precisely zero involvement in the changes implemented, and that the bureau had been discussing the shift “way before the ACA was an idea.”
“She Surely Paid Her Dues”: Will Kathleen Sebelius Win In The End? Legacy Tied To Obamacare’s Outcome
Yes, there was utter failure, but there was also one hell of a recovery. As time goes on, she’ll get less blame for the former and more credit for the latter.
It was always going to be a tough job, Health and Human Services secretary under this president. Even so, I’d bet Kathleen Sebelius was plenty shocked at the whole business.
True, she was only a second-string nominee, after Tom Daschle had to bow out because of those tax problems. But Sebelius still should have had little to fear. After all, she’d been the Democratic governor of a ruby-red state, Kansas. In a state where Republicans outnumbered Democrats roughly two-to-one, she won reelection in 2006 with 57 percent of the vote. She got one of the state’s prominent Republicans to switch parties and run with her for lieutenant governor.
So yes, it must have shocked when only eight Republicans voted to confirm her, while 31 voted against. Four-to-one against?! What had she done that was so bad? The answer was: nothing. Oh, Republicans invoked her “ties” to a Wichita doctor who performed abortions. But really, it was what she was going to do. She was going to be a point person on health-care reform, and they needed to ding her.
Today, and in the near future, she will have to endure being associated with the massive fiasco that was the launch of healthcare.gov. And that’s deserved. It’s hard to imagine what she was doing last summer instead of spending every waking minute ensuring that the initiative for which this administration will be remembered, the one thing that will color and even determine its historical legacy, was going to launch well. But it happened.
I don’t know how many times she got dragged up to the Hill and asked the same questions by all those Republican solons, striving to win the “let’s use this guy!” competition for the cable nets and NPR and the nightly newscasts, but it seemed like she was up there almost every day for a spell. On the surface, it all looked disastrous.
But I will say this. Behind the scenes, they did get to work. I could tell just from the way people talked, the things they said were happening there, that it really was getting better. They were (and I guess still are) sitting on this battery of IT stats about response times and how long a person had to wait to be logged in and so on and so forth, and those were being cut quickly. So Sebelius and the rescue team really did do their jobs once they were up against the wall.
Think of it this way. Did you think, last fall, that they’d actually hit the 7 million? Did you think they’d even come close? In a year-end column I wrote with my 2014 predictions, I said they’d make 5.8 million. And I thought that would be respectable. The latest report is that they’re approaching 7.5 million. So yes, there was utter failure. But there was one hell of a nice recovery. As time goes on, I think Sebelius will start getting less blame for the former, and more credit for the latter.
But her fate will be forever tied to Obamacare. If it succeeds, she’ll share the credit as the secretary who helped bring it to life. If it fails, she’ll share the blame. It’s about that simple. And I think it’ll probably succeed.
Meanwhile, there’s the question of getting a new HHS secretary installed. Obama’s nominee is Sylvia Mathews Burwell, who heads the Office of Management and Budget. Chief of staff Denis McDonough told The New York Times that “the president wants to make sure we have a proven manager and relentless implementer in the job over there,” which is both praise of Burwell and a little slap at Sebelius.
But will the Republicans let her through? Actually, forget the Republicans: Six Democratic senators are seeking reelection in red states. Are they going to vote for a new Obamacare point person during an election season? It never ends. Except it is now for Sebelius, who’s surely paid her dues.
By: Michael Tomasky, The Daily Beast, April 10, 2014
“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
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