“Memo To GOP”: The War Over Big Government Health Care Is Over, And You Lost
The federal government has released new data on Medicaid enrollment showing that with the implementation of the Affordable Care Act, six million Americans were added to the program’s rolls. That’s six million low-income people who now have health coverage, who can see a doctor when they need to and who don’t have to worry about whether an accident or an illness will send them spiraling into utter financial ruin.
The numbers reveal something else, too, something that should horrify conservatives: we’re well on our way to health-care socialism.
Okay, that’s an exaggeration. But only a slight one. And at a time when the press is realizing that Republicans are losing their taste for anti-Obamacare bloviating (more on that in a moment), it shows that Bill Kristol’s nightmare has nearly come true.
Back in 1993, Kristol wrote Republicans an enormously influential memo advising that the best approach to Bill Clinton’s health reform plan was not to do everything they could to kill it outright. If any plan managed to pass, he warned, “it will re-legitimize middle-class dependence for ‘security’ on government spending and regulation. It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government.”
Now let’s look at where we are today. Prior to ACA implementation, there were just under 59 million people enrolled in Medicaid and CHIP, the program that covers poor children. States that accepted the ACA’s expansion of Medicaid signed up a total of 5.2 million new people. The states that rejected the expansion signed up an additional 800,000; these are “woodwork” enrollees, people who were already eligible under their state’s (often absurdly restrictive) rules, but came out of the woodwork to sign up because of all the attention to health care. Add them in, and there are now 64 million Americans on Medicaid and CHIP.
On top of that, there are now over 52 million seniors on Medicare. There are another 9 million veterans enrolled in the Veterans Health Service.
That’s a total of 125 million Americans getting their insurance from the federal government (or, in the case of Medicaid, a federal-state program). The current U.S. population is 318 million. That means that 39 percent of us, or just under two out of every five Americans, are recipients of government health insurance.
As a liberal, of course, I believe that’s a good thing, though just how good varies from program to program (I’ve spent enough time fighting with private insurance companies to wish I could be insured by the government). Conservatives, on the other hand, view this as a disaster. What they’ve only partly come to terms with is the fact that it’s going to be almost impossible for them to do anything about it.
It’s true that Republicans appear to have realized that while the ACA remains unpopular, the idea of repealing it is even less popular. Which is why, as the November election approaches, they’ve almost stopped trying to elevate the issue. As Sam Baker points out, Republicans passed on the opportunity to use the confirmation of Sylvia Burwell to be HHS secretary as a forum to relitigate the law, and the bills circulating around the Hill on health care are now more likely to be small-bore fixes. Notes Baker: “Anyone who’s been around Capitol Hill and health care for the past four years can see it — the anti-Obamacare fire just isn’t burning as hot as it used to.”
Beyond that, as this blog has documented, multiple Republican Senate candidates are now mouthing support for Obamacare’s general goals and have essentially been reduced to gibberish when trying to explain their “repeal and replace” stance.
But the story is bigger than all of this. Republicans may have to accept that while we may not have the single-payer system liberals want, government still dominates American health care, and that isn’t going to change.
It isn’t just that Republicans could stage another fifty ACA repeal votes in the House and accomplish just as little as the last 50 repeal votes did. Rather, it’s that even if Republicans took back the White House and both houses of Congress, moving people off their government insurance would be next to impossible.
One of the most important lessons of the last 20 years of health reform is this: people fear change. That’s what the Clinton administration found out when their attempt at reform crashed and burned, in large part because the Clinton plan would have meant a change in coverage for most Americans. The Obama administration took that lesson to heart in creating its plan, which was designed to give coverage to people who lacked it but offer only new protections to those who already had insurance. That was also the reason for the false but endlessly repeated “if you like your insurance, you can keep it” assurances — they knew that if most Americans, particularly those with somewhat-secure employer plans, thought they’d have to endure some kind of change, then they’d once again be gripped by fear.
Any Republican plan to unwind the ACA is going to run headlong into people’s fear of change and be stopped in its tracks. Are you going to push 64 million Medicaid and CHIP recipients off their current insurance and onto private plans? Are you going to move away from employer-provided coverage? Are you going to privatize Medicare?
Perhaps, given the right circumstances, Republicans could overcome that fear. But I wouldn’t bet on them finding a way to do it.
By: Paul Waldman, The Plum Line; The Washington Post, June 5, 2014
“Tantrums Don’t Change The Facts”: McCain Rejects Evidence, Accuses Critics Of ‘Lying’
Republican reversals on securing the release of Sgt. Bowe Bergdahl have been jaw-dropping for much of the week. As we discussed yesterday, Republicans were happy about an American POW coming home; then they changed their minds. Republicans endorsed the prisoner swap itself; then they changed their minds. Republicans extended their thoughts and prayers to Bergdahl and his family; then they changed their minds. Republicans demanded that the Obama administration had a responsibility to do everything humanly possible to free this POW from his captors; then they changed their minds.
But perhaps no one has been quite as brazen in the flip-flop department as Sen. John McCain (R-Ariz.), who’s still treated as a credible figure on matters related to foreign policy and the military, despite his poor track record. The Arizona Republican expressed public support for the prisoner-swap, then did a 180-degree turn after President Obama pursued the course McCain endorsed.
Apparently, the senator is angry that his shameless flip-flop has been noticed.
“The details are unacceptable and for anyone to accuse me, therefore, of saying that I’d support any prisoner swap under any circumstances is lying,” he told CNN’s Jake Tapper.
“And the details are outrageous. They went to Qatar, where the Taliban has an office, and in a year they are going to be out and the deal is, like any other agreement, as I said, in the details,” McCain said on CNN, explaining his opposition to the swap. “I mean, it’s just totally unacceptable. These people would be back in the fight.”
It’s hard to know if McCain actually believes what he’s saying. Indeed, the senator has never been detail-oriented, so perhaps he doesn’t fully understand the nature of the recent criticism.
But in reality, as the New York Times’ editorial board noted today, McCain “switched positions for maximum political advantage” – as he’s done “so often in the past.”
The lawmaker can throw around words like “lying” if he chooses, but a closer look at the facts lead to only one conclusion.
As far back as 2011, the Obama administration was in talks with the Taliban about securing Bergdahl’s release, in exchange for five specific detainees at the Guantanamo Bay prison, who would then be transferred to Qatar. Members of Congress, including McCain, were aware of these talks and knew exactly which five Taliban prisoners would be included in the prisoner-swap.
In 2012, McCain was asked about this during a national television interview. Though he said he’d need all of the details, the senator said he “would support” the exchange.
And then the Obama administration made the exchange, at which point McCain condemned the exact same policy he’d already endorsed.
Indeed, perhaps unaware his own position, McCain has been quite unconstrained in denouncing the swap he used to support, calling it “outrageous” and “unacceptable.” At a classified briefing yesterday, the senator reportedly “walked out shortly after shouting at an official.”
Tantrums don’t change the facts.
What surprises me is McCain’s willingness to keep digging. His audacious reversal was uncovered on Tuesday, at which point the senator could have laid low so as to not draw attention to his shameless, knee-jerk opposition to an idea he supported. Indeed, I had no intention of returning to the subject, since it was so obvious that the Arizona Republican had contradicted himself.
But McCain can’t seem to help himself. Caught in a shameless reversal, he feels the need to lash out, making matters worse for no reason.
By: Steve Benen, The Maddow Blog, June 6, 2014
“Joni Ernst Fights For Dirty Water In Iowa”: Shows How Far Republican Candidates Have Drifted From The Party’s Old Moorings
Joni Ernst, the winner of the Iowa Senate Republican primary on Tuesday, has a briefcase full of the usual shopworn, hard-right policies: no same-sex marriage, no reform of immigration, no federal minimum wage, no Education Department, no progressive tax code. She still clings to the idea of private accounts for Social Security.
But one of her positions, expressed at a recent debate, demonstrates a particularly pernicious and little-known crusade of the modern Republican Party: she opposes the Clean Water Act. She called it one of the most damaging laws for business.
That a Senate nominee could take this position, even more than the others, shows how far Republican candidates have drifted from the party’s old moorings. In 1972, the Clean Water Act passed with full bipartisan support, and is widely regarded as one of the most successful environmental acts ever passed. It doubled the number of rivers, streams and lakes suitable for fishing and swimming. It drastically reduced the amount of chemicals in drinking water, and substantially increased the size of protected wetlands. Rivers no longer catch fire.
The law’s value is so obvious that it shouldn’t even be necessary to defend it. But in Iowa, it remains a divisive issue, and Ms. Ernst’s offhand remark was a clear signal to the state’s big agricultural interests of which side she is on.
Iowa’s waterways are notoriously dirty, the result of runoffs from vast livestock operations and crop fertilizer. The problem has become worse in recent years with a sharp increase in the global demand for pork, leading to enormous hog farms that pack tens of thousands of pigs into small spaces. Last year, the Des Moines water utility had to turn on, for the first time, the world’s largest nitrate-removal plant to get the chemical — the result of manure and fertilizer pollution — out of people’s taps. (Excessive nitrates can cause cancer and miscarriages, and are linked to “blue baby syndrome,” in which infants suffocate.)
“The issue is the quality of the water in the Raccoon and the Des Moines” rivers, Bill Stowe, the waterworks manager, told the Des Moines Register last year. “This trend is absolutely off the scale. It’s like having serial tornadoes. You can deal with one, you can deal with two, but you can’t deal with them every day.”
For years, the state’s Department of Natural Resources, which is in the pocket of big agriculture, didn’t deal with the runoff problems. And two years ago, the Environmental Protection Agency told the state that it was violating the Clean Water Act and must immediately do a better job. State farm operations and politicians have bridled at the moderate increase in regulation that resulted, and last year House Republicans passed a bill that would undermine enforcement of the Clean Water Act, giving the states much more power to set their own rules. (Fortunately the bill was never taken up in the Senate.)
Ms. Ernst wants to take the seat of Senator Tom Harkin, who is retiring after compiling a strong liberal and pro-environmental record. For Iowans who worry about what’s coming out of their faucets, she has a great deal of explaining to do.
By: David Firestone, Editors Blog, The New York Times, June 4, 2014
“Shrill Partisan Hackery”: The Right’s Unhinged Bergdahl Hypocrisy; The Ultimate Way To Savage Obama
Of course Republicans are going to compare the prisoner swap that won the release of Army Sgt. Bowe Bergdahl to Benghazi. They both start with B. It leads to their favorite words that start with I: investigation, and possibly impeachment.
The ridiculous Andrew McCarthy, flacking his new book making the case for Obama’s impeachment, of course finds more fodder in the prisoner transfer. Tuesday morning he was joined by Fox News “legal analyst” Andrew Napolitano and a man who couldn’t even hold on to a congressional seat for a second term, Allen West. The shift to Bergdahl reflects growing concern that the right’s Benghazi dishonesty isn’t working with voters. Even conservative analysts have chided colleagues for Benghazi overreach. Sure, Trey Gowdy will continue with his election year partisan witch hunt, but the right is wagering the Bergdahl story might hurt Obama more.
The anti-Bergdahl hysteria plays into six years of scurrilous insinuation that Obama is a secret Muslim who either supports or sympathizes with our enemies. Even “moderate” Mitt Romney, you’ll recall, claimed the president’s “first response” to the 2012 Benghazi attack “was not to condemn attacks on our diplomatic missions, but to sympathize with those who waged the attacks.” This is just the latest chapter.
The partisan opportunism over the Bergdahl deal shouldn’t be surprising, but it is, a little bit. This wasn’t some wild radical idea of the Obama administration; it was driven by the Defense Department and signed on to by intelligence agencies. Although Congress is claiming it wasn’t given the requisite 30 days’ notice of a prisoner transfer (more on that later), this deal or something very much like it has been in the works for at least two years, with plenty of congressional consultation.
And plenty of partisan demagoguery: In 2012 the late Michael Hastings reported that the White House was warned by congressional Republicans that a possible deal for the five Taliban fighters would be political suicide in an election year – a “Willie Horton moment,” in the words of an official responsible for working with Congress on the deal. In the end, though, Hastings reported that even Sen. John McCain ultimately approved the deal; it fell apart when the Taliban balked.
“Impeachment To Save Gitmo”: Republicans Getting Dangerously Close To Treating Liberalism As An Impeachable Offense
So today Sen. Lindsey Graham warned the White House that any additional releases of Gitmo prisoners without express congressional authorization could lead to the introduction of Articles of Impeachment.
Now one way to look at this threat is that Republicans are getting awfully free and easy with the I-word these days. If they aren’t thinking about impeaching Obama over Benghazi!, they’re thinking about impeaching him over the IRS “scandal,” or maybe his determination to implement the Affordable Care Act, or perhaps his promulgation of Clean Air Act regs. GOPers may think they’re being careful and clever by dropping the I-word without taking action, but the problem is their activist base is going to get irrepressibly excited by such talk, and then it’s 1998-99 all over again.
Another way to look at it is that Republicans are getting dangerously close to treating liberalism as an impeachable offense. Since they cannot quite make that case, they will latch onto any passing “scandal,” even if it’s not scandalous to anyone other than their own selves and such media figures as can be seduced into complicity with fantasies of becoming the Hero Journalists of Watergate.
In this particular case, though, Graham is indulging in some unacknowledged irony by threatening impeachment in order to protect the despicable symbol of a former president’s (and vice president’s) excesses. Even talking about removing a duly elected and re-elected president in order to save Gitmo is the kind of behavior that could expose the presumed bipartisan gang-leader from South Carolina for the ideological bully he truly is.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, June 4, 2014
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