“The Wingnut Line”: Rick Scott Announces Florida Won’t Take Medicaid Money
It’s not shocking that Rick Scott becomes the first governor to announce officially that his state (Florida) won’t accept the new Medicaid money under the health-care law. In case you’re not up on the deets, it’s the subsidies for poor and working-class people, up to 133 percent above the poverty line, to buy insurance.
Funny. I seem to remember a time when Scott was quite eager to take Medi-CARE money! That wasn’t his. You remember what I’m talking about.
So this is what social programs mean to Scott. As a private-sector businessman, something to steal from. As a public “servant,” something to play political games with. Floridians will die so that he can be first in the wingnut line.
I don’t know the precise number, but in a state that size, surely a couple million people/families who’ll be eligible for care under the new law in 2014–families of four up to $88,000 are eligible for the subsidies–will be denied the chance to buy coverage at subsidized rates because Scott has refused this money. From a policy perspective, this is the next battleground, the pressure point of resistance for the hard-shell ideologues. How many states will really sacrifice billions in federal dollars for the sake of ideology, and how many will do it before the election so they get a gold star from Rove?
Those interested in what we used to call facts may want to read through this nice primer from the Center on Budget and Policy Priorities, which describes the Medicaid transfer from the feds to the states and explains how the federal government will actually be picking up 93 percent of the costs over the next nine years.
As to biggest health-care news of the weekend, the John Roberts switch reported by CBS yesterday, I will have much more to say about that story tomorrow. But watch these Republican governors. If not for the poor people in their states, I say fine, let them refuse it. Saves me money since I live in Maryland and they’re mostly moocher states anyway. It’s just a few more of my tax spare change not going to Mississippi. All right by me.
By: Michael Tomasky, The Daily Beast, July 2, 2012
“‘That Is Not The Issue”: Mitch McConnell On How GOP Will Insure Americans After Repealing ObamaCare
Since the Supreme Court last week upheld the Affordable Care Act, Republicans have been scrambling for a response. Without much to say now that the law has been ruled constitutional, the GOP has fallen back on its pledge to repeal ObamaCare. However, the new health care law provides 30 million Americans with access to health insurance. So how do Republicans plan to replace this key feature if they repeal?
Fox News’s Chris Wallace asked Senate Minority Leader Mitch McConnell (R-KY) this important question on Fox News Sunday today and the senior senator from Kentucky had no answer. After McConnell meandered through the typical GOP talking points that they plan to allow the sale of health insurance across state lines and that they will institute medical malpractice reform, he finally settled on an answer: Insuring Americans “is not the issue”:
WALLACE: One of the keys to ObamaCare is that it will extend insurance access to 30 million people who are now uninsured. In your replacement, how would you provide universal coverage?
MCCONNELL: Well first let me say the first single thing we can do for the American system is get rid of ObamaCare. … The single biggest direction we can take in terms of improving health care is to get rid of this monstrosity. […]
WALLACE: But you’re talking about repealing and replace, how would you provide universal coverage?MCCONNELL: I’ll get to it in a minute. […]WALLACE: I just want to ask, what specifically are you going to do to provide universal coverage to the 30 million people who are uninsured?
MCCONNELL: That is not the issue. The question is, how can you go step by step to improve the American health care system. … We’re not going to turn the American health care system into a Western European system.
If Republicans are successful in repealing ObamaCare, they’ll also have to answer how they’ll provide coverage for those with pre-existing conditions, lower-income Americans, and even the millions of young Americans who can now stay on their parents’ health care plans until age 26.
By: Ben Armbruster, Think Progress, July 1, 2012
“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
“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
“Bush v Gore”: The Only Precedent That Seems To Matter To “Judicial Counter Revolutionaries”
Nobody would much describe Monthly alumnus and long-time Atlantic writer James Fallows as a firebrand. But he does have a sense of historical perspective. Over the weekend, mulling a probable Supreme Court action to invalidate some or all of the Affordable Care Act, Fallows put together a stunningly brief summary of how we came to this point:
Pick a country and describe a sequence in which:
* First, the presidential election is decided by five people, who don’t even try to explain their choice in normal legal terms.
* Then the beneficiary of that decision appoints the next two members of the court, who present themselves for consideration as restrained, humble figures who care only about law rather than ideology.
* Once on the bench, for life, those two actively second-guess and re-do existing law, to advance the interests of the party that appointed them.
* Meanwhile their party’s representatives in the Senate abuse procedural rules to an extent never previously seen to block legislation — and appointments, especially to the courts.
* And, when a major piece of legislation gets through, the party’s majority on the Supreme Court prepares to negate it — even though the details of the plan were originally Republican proposals and even though the party’s presidential nominee endorsed these concepts only a few years ago.
How would you describe a democracy where power was being shifted that way?
Fallows answers his own question by using a term—“long-term coup”—that he later downgrades to “radical change.” That’s appropriate, since “coup” implies tanks in the street rather than black-robed ideological cheerleaders. But it’s becoming more obvious each day that the judicial counter-revolutionaries of the Supreme Court don’t need the crisis atmosphere that they used to justify Bush v. Gore to continue its legacy. Indeed, it seems to have become the only precedent the majority reliably respects. Maybe they will surprise us all on Thursday and step back from the brink. But without question, if another seat on the Court falls their way, the constitutional substructure of every 20th century social accomplishment from the New Deal to the Civil Rights Act to the Clean Air Act to the right to an abortion is in immediate danger. And anyone who remembers that strange night in 2000 when the Court’s Republican appointees decided to seize the opportunity to choose a president should not be surprised.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, June 25, 2012
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