How The Affordable Care Act Incorporates Many Of Gingrich’s Health Care Proposals
Despite growing evidence — and video footage— that he has previously supported a national health insurance mandate, Newt Gingrich continues to characterize the Affordable Care Act as a government takeover of the health care system that he would repeal on his first day in office. But a closer look at Gingrich’s past health care proposals, his work at the Center for Health Transformation, and numerous books about health care reform, suggest that the law he seeks to repeal includes many aspects of his own health care philosophies and proposals.
As the table below demonstrates, the provisions included in President Obama’s health reform law are more progressive than Gingrich would have allowed, but they aim to expand coverage and lower health care costs in very similar ways:
| Newt Gingrich | Affordable Care Act | |
| Individual Mandate | “You ought to either have health insurance, or you ought to post a bond.” [Healthcare Cease Fire, 2005] | Section 1501: U.S. citizens and legal residents who don’t obtain coverage by 2014, pay a tax penalty. |
| Group Purchasing | “Large risk pools…should be established so low income people can buy insurance as inexpensively as large corporations.” [Winning The Future, 2005] | Section 1321: States establish health insurance exchanges to allow individuals, families, and small businesses to harness the purchasing power of large employers. |
| Subsidies | “Some aspect of the working poor has to involve transfer of finances. To ask people in the lowest paying jobs to bear the full burden of their health insurance is just irrational.” [Healthcare Cease Fire, 2005] | Section 1401: Families with incomes between 133-400% of the federal poverty line will receive premium credits to purchase insurance through the Exchanges. |
| Comparative Effectiveness Research | “A health care system that is driven by robust comparative clinical evidence will save lives and money.” [NYT, 2008] | Section 6302: Establishes a non-profit Patient-Centered Outcomes Research Institute to identify research priorities and conduct research that compares the clinical effectiveness of medical treatments. |
| Improving Quality | “Don Berwick at the Institute for Healthcare Improvement has worked for years to spread the word that the same systematic approach to quality control that has worked so well in manufacturing could create a dramatically safer, less expensive and more effective system of health and health care.” [Washington Post, 2000] | TITLE X: Improves health care quality through numerous provisions, including the innovation of payment reform models and rewarding providers who deliver quality care. |
| Prevention | “The 21st Century System of Health and Healthcare will partner with you first to prevent illness and then to care for you as a patient if you become ill.” [Saving Lives & Saving Money, 2006] | TITLE IV: Prevention services will be available without additional cost-sharing and the law establishes a Prevention and Public Health Fund. |
| Health Information Technology (HIT) | “Going to a paperless all-electronic system is going to save lives, it’s going to save money, it’s going to lead to better outcomes, it’s going to give us new opportunities.” [Paper Kills, 2007] | The stimulus act invested in HIT and the ACA requires the government to develop standards “that facilitate electronic enrollment of individuals in Federal and State health and human services programs.” |
| Fraud | “First, we must dramatically reduce healthcare fraud within our current healthcare system.” [Stop Paying The Crooks, 2009] | The federal government has “more than tripled the amount of money it has recovered” in the past six years form fraud and the ACA includes numerous anti-fraud provisions from increasing the federal sentencing guidelines for health care fraud to appropriating an additional $350 million over 10 years to ramp up anti-fraud efforts. |
Does GOP Really Want To Increase Taxes On The Middle Class?
As the Senate considers an extension of the payroll tax holiday, the big question is: why in the world would Republicans in Congress consider raising middle class taxes by $1,000 to $1,500 per household in the midst of an economic downturn and an election year?
This is a particularly vexing question when you recall the ardor with which the GOP has campaigned against raising the taxes paid by millionaires and billionaires by even one dime.
At the beginning of the week it appeared that virtually every Republican in the Senate was prepared to vote no on a Democratic proposal to extend and broaden the current payroll tax holiday.
Now some are beginning to get cold feet. Senate Republican Leader Mitch McConnell has now reportedly “opened the door” to considering the possibility of a payroll tax cut extension.
But the real question is why Republicans would contemplate voting against extension of the payroll tax holiday in the first place?
Voting no would be like leaping off a political cliff — taking an iconic vote that would no doubt become emblematic of the fact that they are willing to sacrifice the interests of the 99% to protect the fortunes of the wealthiest people in America. John Paulsen — the Wall Street hedge fund manager who made $5 billion last year (that’s $2,400,000 per hour!) — might consider this a courageous stand. But the everyday worker — who will take 48 years to make as much as Paulsen makes in one hour — might not be so charitable.
Perhaps, you might say, it’s because Republicans are taking a strong principled stand against raising the deficit. But that would not be the case, since the Democratic proposal is entirely paid for by a small increase in the taxes of millionaires.
What on earth could drive Senate Republicans to consider taking such a stupid vote? Four possibilities jump to mind.
1). Possible Reason Number 1: They claim the extension of the payroll tax holiday will undermine Social Security and Medicare.
Republican Senator Jon Kyl made this argument on the weekend talk shows. We can dismiss this talk as a complete smoke screen.
First, Senator Kyl and the Republicans have never given a rat’s rear about Social Security and Medicare in the first place.
Second, the payroll tax holiday that was passed last year does not remove one dime from the Social Security or Medicare trust funds. In fact, the lost payroll tax is replaced dollar for dollar from the Federal general revenue fund.
The payroll tax holiday itself is simply a means of putting money directly into the pockets of working people that is then replaced with money from the much more progressive overall Federal tax structure.
2). Possible Reason Number 2: Some Republicans really don’t believe that taking $1,500 out of the paychecks of everyday consumers will hurt the economy.
There are apparently some Republican lawmakers who have drunk the “Keynesian Economics Doesn’t Work” Kool-Aide. They actually believe that the only way to stimulate economic growth is to shovel more and more income into the hands of the top 1% — the “job creators” — and watch that money “trickle down” on the rest of us.
The problem is that there is absolutely no evidence that “trickle down” economics works — or ever worked.
We had an actual experiment with “trickle down” economics during the Bush Administration. The Republicans cut tax rates for the wealthy. The rich got a lot richer, and the median income of everyday families actually dropped. In fact it was the first decade in modern history that the economy did not create one net private sector job.
But — the Republicans say — two and a half years ago Congress passed a huge stimulus bill, and we still don’t have enough jobs.
Of course, they forget to mention that at the time, the economy was shedding hundreds of thousands of jobs because the financial system had collapsed as a result of the very same policies they are now advocating once again. And there is the inconvenient fact that since the stimulus worked its way through the economy, we have had 20 straight months of private sector job growth — whereas during the last twelve months of the Bush Administration we lost massive numbers of private sector jobs.
Of course a good deal of that private sector growth has been offset by the Republican refusal to continue the stimulus bill’s aid to state and local governments. That resulted in layoffs of teachers, firefighters, police officers — and other public service workers who they must presume do not hold “real jobs.”
The problem with the stimulus bill was not that it didn’t work. The problem was that it wasn’t big enough. Republicans remind you of a guy who uses a hose to put out half of a house fire, turns off the water and then contends that water doesn’t put out fires because the entire fire hasn’t been extinguished. The obvious answer is to get more water. Not only do the Republicans want to stop pouring on the water of stimulus — they want to pour on the gasoline of austerity — just the opposite of what is needed to put out the bad economic flames.
When an economy is in recession the problem — by definition — is too little demand to absorb the goods and services that the economy can produce. The way to solve the problem is to generate more demand to jump-start the economy. This is not just a matter of opinion — it’s a matter of mathematics.
Republicans who run around claiming that economic stimulus — money in consumer pockets — isn’t what’s needed to stimulate economic growth are like people in the middle ages who refused to believe that the earth circles the sun. If the evidence doesn’t support their ideological frame, they throw out the evidence — not the ideological frame. They ignore the facts. It makes no more sense for them to vilify “Keynesians” than it did for an earlier generation to vilify “Copernicans.”
There is complete economic consensus that eliminating the payroll tax holiday today will be a disaster for the economy. In fact, economists like Mark Zandi — who advised John McCain’s campaign — argue that if the payroll tax holiday is not extended, it will shave 1.7% off the gross domestic product and throw the economy into a double dip recession.
3). Possible Reason Number 3: The Republicans oppose extending the payroll tax holiday, because President Obama is for it.
That’s certainly their knee-jerk response. They believe that anything that makes Obama look effective hurts Republican chances in 2012.
But they have some big problems here. First, many Republicans supported a payroll tax holiday in the past — and many voted for the original holiday last year. If they form a solid wall of opposition, they will look like hypocrites who changed their position simply to hurt their political opponents.
And, second, the entire issue puts them in political box canyon — with no escape. If they oppose extension they look like they are obstructing something that is good for the economy — and very palpable to everyday voters. If they support an extension, they give the President a victory.
4). Possible Reason Number 4: Republicans actually understand that ending the payroll tax holiday will hurt the economy — and that’s exactly what they want to do.
There are clearly some Republicans in Congress who actually believe that ending the payroll tax holiday won’t hurt the economy. But there are a lot of Republicans who know exactly what will happen and would be perfectly happy to hurt the economy.
In fact, the Republican leadership has laid a bet that if the economy continues to stagnate they are that much more likely to defeat Democrats next fall. They know that no President in a hundred years has been re-elected when the economy was not materially improving. And they are certainly right that a major issue in next year’s election will be who is responsible for the lousy economy.
Their problem is that by supporting an increase in the payroll tax that takes $1,500 out of the pockets of every middle class family, they create an iconic example of why the real problem is the “do-nothing Republican Congress.”
Sixty-seven percent of Americans believe that Congress is completely controlled by Republicans. And even though the Senate leadership is Democratic, the Republican willingness to stop action using the filibuster means that they are, in fact, entirely responsible for preventing action to create jobs.
That’s good news for Democrats, since in some polls only 9% of Americans have a positive view of Congress and overwhelming numbers believe the country is on the wrong track.
That means that Democrats in Congress can run as outsiders who want to break the log jam in Congress and take action on jobs — take action to defend the middle class. It means that the President can lay the blame for the lousy economy directly at the doorstep of the Republican Party – and its nominee.
The battle over the extension of the payroll tax holiday plays right into that narrative. It is a huge problem for the Republicans in Congress. Bad enough that the “do-nothing Republican Congress” is doing everything it can to oppose President Obama’s agenda to create jobs. Taking $1,500 out of the pockets of everyday Americans gets downright personal.
That’s why, when the chips are down, the odds are good that the Republican leadership will fold its hand and support extension of the payroll tax holiday.
By: Robert Creamer, The Huffington Post, November 30, 2011