“An Act Of Human Decency”: The Real Winners Of The Affordable Care Act Are Ordinary Americans
So the Supreme Court — defying many expectations — upheld the Affordable Care Act, a k a Obamacare. There will, no doubt, be many headlines declaring this a big victory for President Obama, which it is. But the real winners are ordinary Americans — people like you.
How many people are we talking about? You might say 30 million, the number of additional people the Congressional Budget Office says will have health insurance thanks to Obamacare. But that vastly understates the true number of winners because millions of other Americans — including many who oppose the act — would have been at risk of being one of those 30 million.
So add in every American who currently works for a company that offers good health insurance but is at risk of losing that job (and who isn’t in this world of outsourcing and private equity buyouts?); every American who would have found health insurance unaffordable but will now receive crucial financial help; every American with a pre-existing condition who would have been flatly denied coverage in many states.
In short, unless you belong to that tiny class of wealthy Americans who are insulated and isolated from the realities of most people’s lives, the winners from that Supreme Court decision are your friends, your relatives, the people you work with — and, very likely, you. For almost all of us stand to benefit from making America a kinder and more decent society.
But what about the cost? Put it this way: the budget office’s estimate of the cost over the next decade of Obamacare’s “coverage provisions” — basically, the subsidies needed to make insurance affordable for all — is about only a third of the cost of the tax cuts, overwhelmingly favoring the wealthy, that Mitt Romney is proposing over the same period. True, Mr. Romney says that he would offset that cost, but he has failed to provide any plausible explanation of how he’d do that. The Affordable Care Act, by contrast, is fully paid for, with an explicit combination of tax increases and spending cuts elsewhere.
So the law that the Supreme Court upheld is an act of human decency that is also fiscally responsible. It’s not perfect, by a long shot — it is, after all, originally a Republican plan, devised long ago as a way to forestall the obvious alternative of extending Medicare to cover everyone. As a result, it’s an awkward hybrid of public and private insurance that isn’t the way anyone would have designed a system from scratch. And there will be a long struggle to make it better, just as there was for Social Security. (Bring back the public option!) But it’s still a big step toward a better — and by that I mean morally better — society.
Which brings us to the nature of the people who tried to kill health reform — and who will, of course, continue their efforts despite this unexpected defeat.
At one level, the most striking thing about the campaign against reform was its dishonesty. Remember “death panels”? Remember how reform’s opponents would, in the same breath, accuse Mr. Obama of promoting big government and denounce him for cutting Medicare? Politics ain’t beanbag, but, even in these partisan times, the unscrupulous nature of the campaign against reform was exceptional. And, rest assured, all the old lies and probably a bunch of new ones will be rolled out again in the wake of the Supreme Court’s decision. Let’s hope the Democrats are ready.
But what was and is really striking about the anti-reformers is their cruelty. It would be one thing if, at any point, they had offered any hint of an alternative proposal to help Americans with pre-existing conditions, Americans who simply can’t afford expensive individual insurance, Americans who lose coverage along with their jobs. But it has long been obvious that the opposition’s goal is simply to kill reform, never mind the human consequences. We should all be thankful that, for the moment at least, that effort has failed.
Let me add a final word on the Supreme Court.
Before the arguments began, the overwhelming consensus among legal experts who aren’t hard-core conservatives — and even among some who are — was that Obamacare was clearly constitutional. And, in the end, thanks to Chief Justice John Roberts Jr., the court upheld that view. But four justices dissented, and did so in extreme terms, proclaiming not just the much-disputed individual mandate but the whole act unconstitutional. Given prevailing legal opinion, it’s hard to see that position as anything but naked partisanship.
The point is that this isn’t over — not on health care, not on the broader shape of American society. The cruelty and ruthlessness that made this court decision such a nail-biter aren’t going away.
But, for now, let’s celebrate. This was a big day, a victory for due process, decency and the American people.
By: Paul Krugman, Op-Ed Columnist, The New York Times, June 28, 2012
“Attack And Distract Strategy”: Mitt Romney’s Empty ObamaCare-Repeal Rhetoric
Mitt Romney strode out to respond to the Supreme Court ruling behind a podium that read “Repeal and Replace.” His response focused on the first verb and ignored the second.
Right off the top, Romney delivered one of the tightest lines of his campaign: “What the court did not do on its last day in session, I will do on my first day if elected president of the United States. And that is, I will act to repeal Obamacare.”
It went downhill from there. Careful to repeat the word “Obamacare” some 18 times throughout his brief remarks, Romney was careless with the facts in his rebuttal.
Maybe it is the inherent awkwardness of the fact that Romney’s major governmental accomplishment is an individual mandate-driven health-care plan, but his response was fear- rather than fact-based. This is consistent with the “attack and distract” strategy he has deployed when it comes to policy during his general-election campaign.
At least three claims Romney made in his speech deserve particular scrutiny:
First, Medi-scare: “Obamacare cuts Medicare—cuts Medicare by approximately $500 billion.” Medi-scare is a classic fear-mongering technique usually deployed by Democrats against Republicans, most vividly by the television ad depicting Paul Ryan pushing grandma off a cliff. The Affordable Care Act does try to rein in Medicare costs by slowing the rate of growth and ending the Medicare Advantage program, but that should be consistent with Republican values of increasing efficiency and reducing waste, fraud, and abuse. Moreover, the Ryan plan, which Romney endorses, would cut at least that amount but redirect the savings to reducing the deficit. Playing the Medi-scare card is low and discredited, but hearing it from a Republican nominee is more than a bit surreal.
Second, the deficit-bomb card: “Obamacare adds trillions to our deficits and to our national debt.” Deficit and debt make up one of the Obama administration’s greatest weaknesses among independents. It is ultimately a form of generational theft. But the nonpartisan Congressional Budget Office scored the ACA and determined that it actually would reduce the deficit by more than $100 billion in the next 10 years. I agree that government estimates almost always lowball the eventual costs, especially in the realm of entitlements, but the CBO scoring can’t just be ignored in favor of a partisan narrative. And of course, one of the arguments for health-care reform in general is that it will reduce costs in the long run with our aging population and improve American industry competitiveness.
Third, “Obamacare puts the federal government between you and your doctor.” This is always the emotional kicker, directly connected to the oft-repeated talking point that the ACA is a “government takeover of health care.” That would be scary indeed, but keep in mind the liberal critique of the Obama health-care reform is that it is too insurance-industry-friendly. After all, there was never even a public option, let alone the single-payer fantasy. The current system is far from perfect and far from free market. I happen to believe that third-party-payer problem is a big part of what drives up costs. But the Big Brother dystopian fantasy captured by this instant classic in the paranoid style typed by Ben Shapiro—“This is the greatest destruction of individual liberty since Dred Scott. This is the end of America as we know it. No exaggeration.”—is just that. A paranoid exaggeration.
Other specters offered up by Romney include the estimate that an unspecified 20 million Americans will lose health insurance under the ACA and that the law represents a $500 million tax increase. (Keep in mind that the penalty/tax would only be paid by people who refuse to buy health insurance and therefore continue to freeload off the rest of us when they go to the emergency room for urgent care.)
Of course, this law will not solve all the problems in American medicine, and it almost certainly will create some new ones. But aspects of the bill—like coverage of children up to age 26 and stopping insurance companies from denying people insurance due to preexisting conditions—are justly popular and improvements over the status quo.
Republicans beyond Romney were also quick to hoist the “repeal” banner—calling a vote in the House on July 9. They believe this ruling could be a political benefit in terms of getting out the vote in November. The Romney campaign claimed that they raised more than a million dollars online in the hours after the decision. This could be the boost the Romney camp needs for the Tea Party to overlook the ironic inconsistency of the GOP nominee on this core issue. Republicans may very well get a base boost from this decision, reflected in both dollars and votes.
But if you’re actually interested in governing as well as in winning, the impulse to scream “repeal” has to be followed by a plan to “replace.” There are plenty of good Republican policy proposals on how to reduce costs and increase individual choice in health care, but Mitt Romney still needs to decide which specific policy plan he would enact. Unclaimed ideas range from medical-malpractice reform to expanding health savings accounts to allowing insurance purchases across state lines to generic-drug importation. There might even be some degree of bipartisan support for a few these reforms. Then again, the individual mandate once had bipartisan support as well.
Bottom line: simply making up stats for the sake of soundbites is beneath a serious nominee. There is an obligation to propose as well as oppose if you are running for president.
By: John Avlon, The Daily Beast, June 29, 2012
“An Implausible Argument”: Mitt Romney’s Other Health-Care Contradiction
In vowing this morning to do what the Supreme Court didn’t—repeal Obamacare—Mitt Romney trotted out all his arguments against the newly constitutionally sanctioned health care law. Among them were these two points: First, that Obamacare would cause 20 million Americans to lose their health insurance, and second, that it would be a job-killer to boot.
Problem is, these two arguments directly contradict each other.
The 20 million Americans who presumably would lose their health insurance would do so because their employers would decide to cease offering it, letting their employees fend for themselves on the health-insurance exchanges. Why would these employers opt to do that? The only conceivable reason is that it would be cheaper for them to do that. And if it was cheaper for them to do that, they’d then have more money to hire more employees, creating rather than killing jobs.
You can argue, with serial implausibility, that Obamacare will cause millions to lose their health insurance or that it’s a job-killer. You can’t argue both.
With today’s ruling, the fate of Obama’s health-care reform will be up to the voters in November’s election. For voters who hate Obama and all he stands for, that’s one more reason to go to the polls—but those voters are probably going to the polls in any event. If Romney decides to ride this issue, it’s not clear he’ll gain any more votes than he already has locked up. He may motivate some Republicans who don’t particularly care for him but will vote out of their hatred of Obama to care for him somewhat more. (Polling shows that a higher percentage of pro-Obama voters support the president because they like him than pro-Romney voters like Romney.) But I doubt that raising his positives among voters who are already determined to vote for him anyway matters.
Republicans will doubtless exploit the court’s upholding the mandate under the Congress’s power to tax rather than under the Constitution’s commerce clause. There’s that t-word again! It’s unlikely that more than a couple percent of the American people, those with incomes adequate enough to decline to buy insurance, will ever be subject to that tax, but you can count on Republicans to depict it as a mass confiscation worthy of Lenin. Obama and the Democrats need to be able to counter this with real numbers—in Massachusetts, the one state that has already adopted a similar law, just 1 percent of taxpayers are subject to the penalty—even as they focus on the benefits most Americans will derive from the law, which was the tack the president took in his statement this morning.
By: Harold Meyerson, The American Prospect, June 28, 2012
“Mitt Romney Will Be Relieved”: Republicans Will Soon Stop Talking About Health Care
The Supreme Court’s decision on the Affordable Care Act (ACA), particularly Justice John Roberts siding with the liberals, took most everyone by surprise this morning. But if you tune in to Fox News or surf around the conservative blogs, they seem to be taking it somewhat philosophically. They’re not happy, but there’s little rending of garments and gnashing of teeth. Mostly they’re saying, well, we’ll just have to win this in November (see here for a representative sample). There’s also a good deal of discussion of the fact that the Court declared that the requirement to carry health insurance is permissible under the government’s taxing power. After all, if there’s one thing Republicans know how to do, it’s complain about taxes. Mitch McConnell quickly took to the floor of the Senate to condemn the decision, and no doubt Mitt Romney will soon say something so vague that no one can determine what he actually thinks.
But here’s my guess: Republicans are going to drop health care very quickly. They took their shot with the only avenue they had to kill the ACA, and they came up short. The legal battle is over, and they know that once they start talking about repealing the whole thing, it makes it easier to talk about the benefits of the ACA that will be repealed, particularly since they have given up on even bothering to come up with a “replace” part of “repeal and replace.” Oh, they’ll still condemn the ACA when they’re on Fox, or when they’re talking to partisan audiences—just enough to reassure base conservatives that they’re still angry. But in short order, they’re going to move on to other topics now that the legal question has been settled.
That suits Mitt Romney just fine. You may remember that when the primary campaign started, many people said it would be impossible for him to become the Republican nominee, given that he had passed a health-care plan so closely resembling the ACA in Massachusetts, complete with an individual mandate. He managed to wriggle and writhe away from questions about it for the last two years. Those questions are no more comfortable than they ever were. As the leader of the GOP, he’ll set the agenda for the party. And there are few things he’d rather talk about less. We’ll pore over this decision for the next week, then the news media will move on, and Romney will breathe a sigh of relief.
By: Paul Waldman, Contributing Editor, The American Prospect, June 28, 2012
“Legally Challenged”: Judge Allows Florida Voter Purge To Move Forward Despite Federal Law Forbidding It
Federal Judge Robert Hinkle rejected the Justice Department’s request for a temporary order suspending Florida Gov. Rick Scott’s (R) effort to purge tens of thousands of names from his state’s voter roles. According to the AP, Judge Hinkle relied on highly questionable reasoningin order to do so:
The U.S. Department of Justice filed a lawsuit earlier this month to halt the purge, saying it was going on too close to a federal election. U.S. officials also said the list used by Florida had “critical imperfections, which lead to errors that harm and confuse voters.”
Hinkle in ruling from the bench said federal laws are designed to block states from removing eligible voters close to an election. He said they are not designed to block voters who should have never been allowed to cast ballots in the first place.
If this AP report is accurate, then Judge Hinkle is simply wrong. Here is the text of the federal law at issue in this case:
A State shall complete, not later than 90 days prior to the date of a primary or general election for Federal office, any program the purpose of which is to systematically remove the names of ineligible voters from the official lists of eligible voters.
Although the law does include exceptions for voters who ask to be removed, felons, the mentally incapacitated and dead voters, none of those exceptions apply to this case. The law says that no state may engage in a Florida-style voter purge seeking to remove ineligible voters within 90 days of an election. Period.
Judge Hinkle’s apparent decision is not simply wrong as a matter of statutory text, it also defies common sense. No state should ever purge eligible voters from its voter rolls for reasons that should be obvious. The purpose of the federal law preventing purges of ineligible voters within 90 days of an election is to avoid a situation where a state wrongly flags an eligible voter as someone who cannot lawfully vote without providing that voter enough time to demonstrate that the state made a mistake. Hinkle’s apparently misreads this law to suggest that Florida is perfectly free to kick legal voters off its voter rolls so long as it does so more than three months before an election.
By: Ian Millhiser, Think Progress, June 27, 2012
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