“Stop Me Before I Kill Government Again”: Republicans Tying Themselves Into Knots Yet Again
Happy as I am that a bipartisan convergence on sentencing reform just possibly could be in the works, it can’t obscure the more immediate spectacle of Republicans simultaneously trying to identify with and tamp down the “base’s” desire for a government shutdown (or debt default) over “defunding Obamacare.” Greg Sargent nicely diagnoses the malady after watching Reince Priebus tie himself into knots on a Sunday show:
After CNN’s Candy Crowley pointed out some Republicans are challenging the conservative demand for a government shutdown confrontation to force the defunding of Obamacare, Priebus actually responded:
“I think all Republicans are unified on one thing and that is defunding, delaying, getting rid of, eliminating Obamacare. So we have total unanimity on that issue and the question is what are the tactics? And you know, even if you take the position of a Ted Cruz or Mike Lee, basically what they’re saying is we actually are funding 100 percent of the government except for that small percentage of nondiscretionary — excuse me, discretionary funding the Obamacare.
“So Mr. President, if you want to shut the government down because you want to continue to fund this monstrosity that you’ve already admit is half broken, then go ahead. I mean the fact that it’s on the Republican Party I just think is spin from the Democratic Party that you ought not be adopting. I don’t know why you’re adopting that spin….”
[I]t’s not surprising that Republican officials have effortlessly internalized the framing of the coming Obamacare/government shutdown Priebus adopts above. Thanks partly to the GOP leadership’s willingness to lavish years of care and feeding on the base’s preoccupation with Obamacare repeal, large swaths of the party’s base appear to remain convinced that the law is entirely illegitimate and that they need not accept that the law is here to stay. It’s easy to get from here to the conclusion that Obama will be to blame for any catastrophic consequences that flow from the continued showdown over Obamacare; after all, this whole situation was created by Obama’s initial exercise of tyranny (Dems rammed the law through!!!) and is now being perpetuated by his continued tyrannical resistance to undoing it in the face of the popular will.
I’m guessing the next act for “adult Republicans” like Priebus will be to oppose a government shutdown confrontation on grounds that they are saving the country from Obama’s reckless behavior. The truth is that they would be acting to save their own party from the same kind of political disaster the GOP incurred with the same behavior in 1995.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, August 12, 2013
“Muddied Waters And Smokescreens”: These Six States Want To Allow Health Insurers To Deny Coverage To Sick People
Officials in Texas and five other GOP-led states are refusing to oversee even Obamacare’s most basic — and popular — consumer protections and insurance market reforms. That includes the law’s ban on denying coverage or charging more because of a pre-existing condition and discriminating against women on the basis of gender. The decision could present major hurdles to Americans who buy health insurance through federally-run marketplaces in the Lone Star State, Arizona, Alabama, Missouri, Oklahoma, and Wyoming.
A majority of states haven’t set up their own insurance marketplaces, opting to let the federal government set one up for them. But every one of those states (other than the six in question) have at least said they will police the insurers that sell plans on their federally-run marketplaces to make sure that they aren’t giving consumers short shrift. The Centers for Medicare and Medicaid Services (CMS) will instead be responsible for enforcing Obamacare’s insurance industry reforms and reviewing consumer complaints in the states refusing to do so on their own.
That could be confusing for Americans who are buying insurance for the first time through the marketplaces. For example, imagine you’re a relatively poor person with diabetes. Your income isn’t low enough to get you on Medicaid — but your employer doesn’t offer health benefits, and you’ve never qualified for insurance on the individual market because of your medical condition. On October 1st, you can go buy insurance with government subsidies for the first time on an Obamacare marketplace. But the plan you choose charges you a suspiciously high premium relative to your income. You suspect it’s because of your medical problem, which is clearly illegal under the reform law. But who do you complain to?
Usually the answer is your state’s insurance department. But the answer is CMS if you live in one of the six states that won’t enforce the consumer protections. Unfortunately, if you don’t know that, you could spend months oscillating between the state and federal government, trying to figure out if you’re getting hoodwinked by your insurance company. And in the meantime, the bills are piling up.
Those kinds of scenarios are the reason that health policy experts say insurance complaints are best handled by state agencies. Officials with the Texas Department of Insurance argue that they legally can’t enforce the regulations because they’ve ceded authority over the marketplace to the federal government, and Texas doesn’t have corresponding state laws holding insurers to the same standards as Obamacare. But Stacy Pogue of the Center for Public Policy Priorities tells the Texas Tribune that’s likely a smokescreen, since Texas has enforced plenty of other federal laws on a statewide level in the past.
Officials in the Lone Star State certainly haven’t been shy about their opposition to the health law. Gov. Rick Perry (R) dug in his heels against reform in 2012, saying he wouldn’t “be a part of expanding [the] socializing of our medicine.” More recently, Perry denied basic health benefits to 1.5 million of his state’s poorest residents by forgoing Obamacare’s Medicaid expansion. Evidently, that wasn’t going far enough.
National Republicans have also been stepping up their efforts to to undermine Obamacare. Reps. Tim Huelskamp (R-KS) and Jason Chaffetz (R-UT) are refusing to help their own constituents if they have questions about the health law, and the Tea Party-affiliated advocacy group FreedomWorks has been telling young Americans to forgo signing up for health coverage under Obamacare entirely.
By: Sy Mukhergee, Think Progress, August , 2013
“Purposeful Republican Misrepresentation”: Read This Before You Believe The Obamacare Premium Spike Hysteria
While some states are reporting lower than expected health care premiums in the exchanges established by the Affordable Care Act, a growing number of Republican-controlled states — like South Carolina, Ohio, Indiana, Florida and Georgia — are garnering screaming headlines about huge premium spikes under the law.
Calculating premium rates is a complicated and tedious task that will vary greatly among states and is open to interpretation and manipulation by both supporters and opponents of President Obama’s health care law. Generalities are particularly hard to draw, as the law will impact Americans differently: the new regulations will lead some younger people to may pay more than they’re contributing now, but will save older and sicker people hundreds, if not thousands of dollars a month.
Still, since Republicans are politically motivated to portray the proposed premium increases in a negative light and the media is far more interested in sensational claims about Obamacare failing, coverage of the new rates often leads readers with the mistaken perception that the law is coming off the tracks. Below is a short guide that will help you identify if someone is misrepresenting how much premiums will increase under Obamacare:
1. Do the premiums account for subsidies?
Most articles about premiums for health insurance in the exchanges relegate information about the Affordable Care Act’s tax credit subsidies to the lower two thirds of the piece, thus presenting the top rates as the actual amount families and individuals will be required to pay.
In reality, the number of applicants who are eligible for sliding-scale tax credits will vary — the credits are available to people making less than four times the poverty line — but the Congressional Budget Office (CBO) estimates that out of the 7 million Americans expected to enroll in coverage in 2014, 6 million will be eligible for subsidies. Those with incomes up to 400 percent of the Federal Poverty Line (FPL) will also see reduced the out-of-pocket limits.
Maryland officials, for instance, project that three-fourths of enrollees will receive assistance. In 2014, the average subsidy will be $5,510 and will increase in the years ahead.
2. What is the state comparing the new premiums to and does it break down the increases by the available levels of coverage?
While states like New York or California have already enacted strict regulations that mirror many of the new rules in the Affordable Care Act, others (like Indiana or South Carolina) allow insurers to sell skimpy bare-bones high deductible plans that provide little actual coverage.
Comparing the comprehensive plans that will be available in the exchanges (and the individual market) to the existing coverage is like likening a Lexus to a bicycle — yes, the car is more expensive, but it is in a whole different category of transportation. Under the law, all new insurance plans have to offer essential health benefits like prescription drug and mental health services.
3. Are cheaper coverage options mentioned?
Last month, state officials in Indiana announced that premiums for individual policies would be 72 percent higher than the premiums people currently play. But a closer look at the data revealed that the state wasn’t issuing actual premiums, but calculations for “allowed cost” or “the cost of insurance before calculating how much individuals would pay out-of-pocket, because of co-payments and deductibles.” The actual premiums turned out to be much lower.
What’s more, the numbers were averages of all plans in the exchange — from bronze plans that cover 60 percent of health care costs to platinum plans, which pay for 90 percent — and were not representations of the prices actual families will pay. Past experience in Massachusetts shows that consumers are very price conscious and will gravitate towards the cheaper bronze or silver plans. (In Massachusetts, 84 percent enrolled in bronze or silver policies.)
A catastrophic plan will also be available to those up to age 30 in the individual market. In Nevada, this coverage will be available for less than $100.
4. Has the state done all it could to reduce premiums?
Approximately two dozen states allow the state insurance department or commission “the legal power of prior approval, or disapproval, of certain types of rate changes” and under the Affordable Care Act, the federal government has offered grant funding “to help with rate review activities.” States like Maryland — which has some of the strongest rate-setting laws in the country — claims to have used its authority to deny rate increases to reduce the proposed premiums by “more than 50 percent.” Oregon regulators also slashed carriers’ rate requests by as much as 35 percent.
By: Igor Volsky, Think Progress, August 5, 2013
“Kill The Law, Kill The Patient”: The Most Insane Conservative Anti-Obamacare Gambit Ever
In a last-ditch effort to stop Obamacare, Tea Party groups are trying to sabotage the healthcare law in a way that could leave young people without coverage and increase insurance premiums for everyone else. It assumes that the end of “repealing Obamacare” justifies the means of potentially years of worse health.
The gambit, as explained by Sarah Kliff of the Washington Post, is to convince young people to eschew the Affordable Care Act’s health insurance exchanges and the subsidies they offer in order to destabilize the insurance risk pools. And now the leader of the effort is talking to Salon about the idea.
First, some background. The “plan,” such as it is, works like this: Young people tend to be healthier and thus cheaper to insure, so they essentially subsidize the cost of older and sick people. If enough young people don’t sign up, and the pool is mostly older and sick people, costs will skyrocket. A price “death spiral” is health policy experts’ biggest fear with the law, but it’s exactly what the conservative groups want to artificially induce, thus dooming the law.
To that end, conservatives are trying to rally young people to skip the healthcare exchange and pay the fine for violating the individual mandate to have health insurance. They’re making their case with GIFs, Op-Eds and a campaign to burn Obamacare draft cards (which don’t actually exist, but can be downloaded from FreedomWorks’ website for later incineration). Americans for Prosperity is even considering setting up kiosks at Universal Fighting Championship matches and college football games to tell people not to enroll.
But, if this gambit is successful, wouldn’t that lead to millions of young people living without health insurance, and older and sick people paying higher health insurance premiums? And since Obama will never repeal his signature law, we’re talking about at least three years of intentionally inflicted misery, all for a shot at repealing Obamacare sometime in the future and replacing it with something that doesn’t even exist yet. What about the human toll?
We asked Dean Clancy, the vice president of FreedomWorks who is spearheading the effort. “Yes, we would like to hasten the collapse of the exchanges, but the purpose is not to drive up anybody’s insurance. The purpose is to get this law defunded or delayed so we can get to a patient-centered system,” Clancy said in a telephone conversation Thursday evening. “Without young people, Obamacare can’t work.”
Regardless of intention, wouldn’t it have the effect of driving up premiums? “I would not say it will drive up premiums for older Americans, I would say it will allow premiums to rise,” he said. “It would allow premiums to rise faster than they otherwise would if everybody bought the overpriced coverage, including the younger, healthier people.”
And what about young people who currently lack insurance – 90 percent of whom will qualify for subsidies in the Obamacare exchanges — what should they do? “You can get coverage outside the exchanges,” Clancy said, pointing to catastrophic care plans, healthcare savings accounts, or even Medicaid.
Even without the subsidies, which are only available through the exchanges, Clancy said, it would still be cheaper for young people to pay the fine and go their own way. “We encourage people to go for a health savings account with a high deductible policy, and to pay cash for repeat medical expenses. It’s a great way to save money and helps the system be more efficient,” he said. Plus, there’s always free-riding: “And they have to take you when you get sick, that’ll be in the law now.”
What if you get in a car accident or something and don’t have time to sign up for insurance? A pause as he consulted with the communications director, who was also on the call. “In that case, you may incur some costs,” Clancy acknowledged. “You may have to deal with, as people do today who don’t have funds available, paying it back in installments, or uncompensated care, or you can sign up for Medicaid.” In other words, you’re on your own. Most uninsured people can’t afford medical bills.
“Just to be clear, we’re telling people: ‘Do what you think is best for you,’” he added. “But understand that if Obamacare continues, you’re going to have to pay more and more to get less and less.”
For Judy Feder, a prominent health policy expert at Georgetown who supports the health reform law, this approach is “crazy.” “It’s not even killing the patient to save the patient — it would stick with killing the patient. They just want to kill the law, which doesn’t save anybody,” she said.
It’s hard to overstate how nihilistic this plan is. If the scheme succeeds — which it will not, since more than enough young people are saying they’ll purchase insurance through the exchange — not only would some people lack good health coverage they’d otherwise be entitled to, but costs would be higher on everyone else. “It is as outrageous as you say it is,” Feder confirmed.
This is basically the “Cloward–Piven strategy” Glenn Beck always rants about, but 1) applied to healthcare instead of the economy, and 2) real.
By: Alex Seitz-Wald, Salon, August 2, 2013
“The Character Of The Caucus”: Thanks To Republican Intrasigence, It’s All About 2016 Now
It wasn’t the House Republicans’ refusal to take up the president’s jobs plan before the last election. Or their reckless games with the debt ceiling when Paul Ryan’s budget called for trillions in fresh debt itself. Or House intransigence when it comes to the Senate’s bipartisan immigration fix. Or even its recent call to nix high, common school standards.
Not that these steps weren’t awful. But somehow they could be put down to “normal” petty politics. The “out” party never wants the jobs picture to improve before an election. The debt ceiling is one of a handful of “forcing devices” that pols of all stripes seize on in a town where nothing really has to happen. One can argue that immigration reform isn’t as urgent as, say, jobs. And stoking phony fears of a federal school takeover is the oldest slander in the book (never mind that these “common core” standards were adopted by states voluntarily, and that the world’s top-performing school systems all have something like them).
No, what finally made me lose it was House Republicans’ warped obsession with Obamacare. This fixation showcases so many noxious traits simultaneously that it reveals the ultimate character of the caucus.
At bottom, Obamacare is a moral assertion that it is wrong when a wealthy nation has 50 million people without health insurance, when medical bills are a leading cause of bankruptcy for families and when millions of luckless souls are unable to get coverage because they have preexisting conditions. The House GOP today says these are not real problems.
Obamacare addressed these problems with precisely the mechanism that conservative thinkers and Republican policymakers favored (subsidies to buy insurance from competing private carriers with a requirement that everyone be in the insurance pool). Yet the House GOP effectively has said: Even if you adopt the approach our party favors for a problem we used to say was real — a problem that our presidential nominee addressed successfully in his state — we still can’t be with you. We have to damn you as un-American. We have to deceive the public about your aims and methods. We have to do everything in our power to stop you from using our preferred approach to bring a measure of security to the middle class.
It’s the most perverse, irredeemable bait-and-switch since Lucy pulled the football away from Charlie Brown. Even Lucy didn’t do it 39 times.
I’ve long been a critic of the House GOP. But something in their poisonous Obamacare stance has made me snap. It’s one thing to think you can’t do business with these people. It’s another to realize these people aren’t operating in the same moral and economic universe.
So here we are. The only question for those seeking American renewal is what will break this gridlock. The only certain answer is that the president’s speech Wednesday will not. Obama is calling for an economy built from the “middle out” (hats off to progressive activists Nick Hanauer and Eric Liu, who pushed this smart messaging so relentlessly for two years that it’s become the official Democratic creed).
By: Matt Miller, Opinion Writer, The Washington Post, July 24, 2013
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