“They’ll Never Rally Behind A Single Plan”: The GOP’s Push To Replace ObamaCare Is Cynical And Doomed
On Friday, House Majority Leader Eric Cantor (R-Va.) is gathering key members of his caucus to work toward coming up with a single, official Republican alternative to the Democrats’ Affordable Care Act (ACA), or ObamaCare. Republican lawmakers have several competing bills to work with, and putting the party’s weight behind one plan or piece of legislation would be great for the country: Finally, America could have a real discussion about the best way to reform America’s health care insurance system.
But an official Republican health care plan would also be great for Democrats — which is reason No. 1 Republicans aren’t going to actually rally behind a single plan.
They will, of course, make a public effort. “GOP leaders have been clear that ahead of the 2014 elections, the conference wants to show what it is for, not simply what it is against,” says Daniel Newhauser at Roll Call. “Similarly, they want to show that they are not in favor of simply returning to the old health care system, which is viewed unfavorably by the electorate.” But any viable plan needs 218 votes from the fractured GOP caucus.
Cantor and his fellow House Republicans have at least three separate House bills to consider — from Reps. Tom Price (R-Ga.), Paul Broun (R-Ga.), and Phil Roe (R-Tenn.) — and a plan from Sens. Tom Coburn (R-Okla.), Richard Burr (R-N.C.), and Orrin Hatch (R-Utah) that was unveiled to much fanfare in January. There’s also a bill, from Rep. Todd Young (R-Ind.), that would raise ObamaCare’s definition of full-time employment to 40 hours a week, from 30. And a George W. Bush administration economist named Edward Lazear is pushing what he calls BushCare.
As they sort through these plans, what criteria will they use? If they can agree on one proposal, says Roll Call‘s Newhauser, it’s “likely to include poll-tested measures that have broad agreement in the GOP conference, including allowing the purchase of health insurance across state lines, allowing insurance portability between jobs, expanding access to health savings accounts, and limiting medical malpractice lawsuits.”
Another way of putting that: Republicans are looking for popular talking points that sound different enough from ObamaCare to win support from the more conservative factions of the GOP caucus. The problem, as The Washington Post notes, is that “there are only so many ways to preserve the patient protections that the ACA offers, which Republicans say they want to keep, while maintaining a private insurance market and assisting those who can’t afford coverage.”
Once Republicans hold up a specific plan, the Congressional Budget Office gets to issue its verdict and the public gets to weigh the proposals not just against ObamaCare but also the GOP’s attacks against ObamaCare.
The CBO analysis for Rep. Young’s bill to raise full-time employment to 40 hours, for example, found that the bill would raise the federal deficit by $74 billion while reducing the number of people getting employer-sponsored health insurance by about a million; about half of those people would go on Medicaid or other public programs, the other half would be uninsured.
It’s not clear the other Republican proposals would be popular in practice, either. Some of them, as the Washington Post editors note, would be better than ObamaCare at holding down health care costs and incentivizing people to buy private health insurance. But they are more disruptive to the status quo — especially post-ObamaCare — and almost all of them would be ripe for articles about sick people losing coverage or watching their health insurance costs skyrocket.
All of the GOP alternative plans, in other words, have their own drawbacks. Some people will lose, and some people will win. They would reduce the role of the federal government in most cases, but increase the power of insurance companies. Many of the policies are really interesting. Here are some examples of the big ideas from the GOP plans:
Cap or end employer tax breaks for providing health insurance: The idea here is that the insurance market is distorted by the tax incentives for employers to offering their workers insurance. It’s a fair point. But capping the tax breaks, as Coburn-Burr-Hatch does, or eliminating them would almost certainly cause employers to drop their plans. Almost 60 percent of Americans get their health insurance through work.
Provide tax breaks for individuals to buy their own insurance: With no employer-offered health plans, individuals and families would buy their own insurance on the open market. The Coburn-Burr-Hatch plan, for example, offers age-adjusted tax credits to people at up to 300 percent of the federal poverty line: Individuals 18 to 34 would get $1,560 a year, while those 50 to 64 would get $3,720 a year (families would get more than double those figures). Lazear’s BushCare would give all Americans with any type of health insurance $7,500 a year in tax breaks, or $15,000 for families; if people opted to buy low-cost, low-coverage insurance, they’d pocket the difference.
Allow insurance to be sold across state lines: This is a perennial GOP proposal to lower health insurance costs. The idea is that if insurers could sell the same policies to any state, regardless of that state’s own insurance regulations, it would increase market competition and drive down prices. A 2005 CBO report estimated those savings to consumers at about 5 percent overall, with the savings skewed toward the young and healthy; the old and sick would pay more. Enacting this option would require scrapping the minimum standards required for all plans under ObamaCare — a selling point for conservatives who argue we use too much health care, anyway.
“The fact that Republicans are coalescing around healthcare reform plans of their own could be very bad news for ObamaCare,” says Sally C. Pipes at Forbes. “Once voters see that the Republican alternative adds up to sensible and affordable health care, ObamaCare’s days will be numbered.”
But the opposite is almost certainly true. And House Republicans know that.
The GOP has gotten a lot of mileage out of its push to repeal ObamaCare — with a big assist, since October, from the Obama administration — but now the law is signing up real people (four million and counting) for real insurance policies. Republicans have to do better than provide plausible-sounding alternatives. They have to come up with a plan that Americans will think is much better than ObamaCare, and worth the disruption of overhauling the health care system again.
Here’s the bottom line: If reforming America’s health care system to provide near-universal affordable coverage were easy, it would have been done 60 years ago — or at any point since. Several Democratic presidents had tried and failed before President Obama. If Republicans had wanted to take their own bite at the apple, they had plenty of chances, too.
This isn’t spitballing. If Republicans want to be relevant voices in the health care debate, they have to come up with something. They should come up with a plan they can try to sell to America.
“One of the unseemly aspects of the last four-plus months is watching some on the right root for ObamaCare to fail,” says Forbes‘ Avik Roy, one of ObamaCare’s wonkiest critics. Among some conservatives, “there has been a kind of intellectual laziness, a belief that there’s no need for critics to come up with better reforms, because Obamacare will ‘collapse under its own weight,’ relieving them of that responsibility.” But it’s clear now that’s not going to happen, he adds. “And that makes the development of a credible, market-oriented health-reform agenda more urgent than ever.”
Well, don’t hold your breath.
The Affordable Care Act was written and enacted by Democrats — with a few exceptions — and that’s one of its main weaknesses: If Republicans had helped shape and pass the law, they probably wouldn’t have spent the last four years attacking and undermining it. They now have at least 10 months left to criticize the law without having to take any serious action to replace it. Don’t expect them to squander the opportunity.
By: Peter Weber, The Week, February 26, 2014
“Ohio’s War On Voting Intensifies”: The Kind Of Moves Official’s Make When They Want Fewer Voters
In advance of the 2012 elections, Ohio Secretary of State Jon Husted (R) launched an aggressive campaign against early voting, most notably targeting Sunday voting, for reasons he struggled to explain. The efforts ultimately failed, however, when federal appeals courts intervened to protect Ohioans voting rights against Husted’s policy.
Zachary Roth has been keeping a close eye on developments in the Buckeye State, where Husted is apparently picking up where he left off two years ago.
Ohio Secretary of State Jon Husted announced Tuesday he is cutting early voting on Sundays and weekday evenings, dealing another blow to the voting rights effort in the nation’s most pivotal swing state.
Husted’s change would spell doom for a voting method that’s popular among African-Americans in Ohio and elsewhere. Many churches and community groups lead “Souls to the Polls” drives after church on the Sunday before the election.
There’s little doubt that cuts to early voting target blacks disproportionately. In 2008, black voters were 56% of all weekend voters in Cuyahoga County, Ohio’s largest, even though they made up just 28% of the county’s population.
Mike Brickner, a spokesperson for the Ohio American Civil Liberties Union, told msnbc, “By completely eliminating Sundays from the early voting schedule, Secretary Husted has effectively quashed successful Souls to the Polls programs that brought voters directly from church to early voting sites.”
In the larger context, it’s worth keeping two angles in mind. First, there’s simply no reason to impose these new voting restrictions on Ohio. Second, this is only part of an even broader campaign against voting rights launched by Republican officials in the state.
On the former, those who support voting restrictions usually argue the measures are necessary to prevent “voter fraud.” The argument is a rather transparent fig leaf – the fraud scourge is generally limited to the imaginations of conservative activists – but that’s their story and they’re sticking to it.
But going after early voting is something else entirely because it has nothing to do with the fear of fraud. If an Ohioan can legally cast a ballot, it shouldn’t matter whether he or she votes on Election Day Tuesday or the Sunday before. The only reason to close the early-voting window is to discourage participation – it’s the kind of move an official makes if he or she wants fewer voters.
As for the larger “war on voting,” Ohio Republicans have kept their foot on the gas. Just last week, GOP policymakers in the state ended the so-called “Golden Week,” when Ohioans can register and vote on the same day, while at the same time, making it harder for voters to receive absentee ballots.
As we discussed last week, Ohio’s recent voting history matters. A decade ago, during the 2004 elections, the state struggled badly with long voting lines, so state policymakers decided to make things better. And in 2008, Ohio’s voting system worked quite well and voters enjoyed a much smoother process.
So smooth, in fact, that Ohio Republicans have worked in recent years to reverse the progress.
A month ago, President Obama’s non-partisan commission on voting issued a detailed report, urging state and local election officials to make it easier for Americans to access their own democracy.
Perhaps Ohio Republicans missed the message?
By: Steve Benen, the Maddow Blog, February 26, 2014
“It’s Easier Than Honesty”: Winning A Debate By Quashing Scrutiny
In her party’s official response to the State of the Union a few weeks ago, Rep. Cathy McMorris Rodgers (R-Wash.), the House Republican Conference chair, shared an anecdote about “Bette in Spokane,” the latest in a series of “Obamacare victims.” As is usually the case, within a day or two, the story was debunked.
Once McMorris Rodgers realized her story was wrong, the congresswoman, instead of apologizing, tried to go on the offensive. “It’s sad partisan politicians are attacking Bette,” she argued.
In reality, no one had “attacked” the woman in the story. Rather, McMorris Rodgers’ anecdote was fact checked and proven to be wrong. To suggest that scrutinizing suspect claims is somehow improper is absurd, but that was nevertheless the congresswoman’s reaction.
It was apparently a sign of things to come.
Last week, the Koch-financed Americans for Prosperity launched a new attack ad targeting Rep. Gary Peters, a Democratic U.S. Senate candidate in Michigan. The spot features Julie Boonstra, a Michigan woman who’s paying less money for better insurance without having to change doctors, but who was nevertheless presented in the ad as yet another ACA victim.
Peters, not surprisingly, believes AFP should provide more information to bolster the claims in its ad. The right, no longer willing to defend the deceptive commercial, has decided to attack Peters.
U.S. Rep. Gary Peters, D-Mich., wants to be a United States senator, but he has a problem. He’s engaged in a “war on women” – make that a single woman – whom he’s trying to silence because he doesn’t like the story she has to tell. […]
Julie Boonstra deserves a medal for what she is doing. Peters should hang his head in shame.
It’s a fascinating rhetorical gambit, worth appreciating for its rare combination of audacity and mendacity. What’s more, it’s increasingly becoming the standard response to one of the right’s more glaring problems in the health care debate: all of the conservatives’ evidence keeps falling apart.
Let’s say you have a movement of sorts and your goal is to deliberately tear down the nation’s health care system, no matter the consequences. Let’s also say you have the bright idea of using anecdotal evidence to highlight “victims” in order to prove how awful the system is, only to have pesky reporters discover that all of your evidence is bogus and the victims haven’t really been victimized at all.
At this point, you have a few choices. You could, for example, find a new hobby and stop trying to prevent Americans from having access to affordable health care. Or you could cast a new line, hoping to find some elusive, legitimate horror stories that won’t be debunked a day or so later.
But these are strategies based on conventional thinking. What you really need is a very different kind of plan: one in which you keep presenting bogus anecdotes, but discourage those who know what they’re talking about from pointing out your errors. What you want is to promote misleading propaganda with impunity – more mendacity, less scrutiny.
And how do you do that? By lashing out angrily against those noting the facts. Those who recognize the AFP’s Boonstra ad as misleading are obviously attacking a woman with cancer and should be ashamed of themselves – or so the story goes.
I suppose it’s clever, in an Alice in Wonderland sort of way, but it’s no way to have a credible policy debate. Indeed, it seems some of these conservatives are effectively giving up on the very idea of a serious discourse – they not only want to present misleading anecdotes, they also want to intimidate those who might dare to note reality by accusing them of being heartless bullies.
As Greg Sargent put it the other day, many on the right have essentially declared “that the emotional content of these victims’ stories should shield such ads from scrutiny.” Fact-checking suspect claims “will be met with charges of insensitivity to the victims.”
I guess it’s easier than honesty.
Postscript: The Wall Street Journal ran a piece yesterday arguing that the Affordable Care Act cost a woman her cancer medication. The piece was quickly embraced by the right, but it was debunked by Michael Hiltzik a few hours later.
If recent history is any guide, this means Hiltzik should expect to be accused of not caring about people with cancer. Sorry, Mike.
By: Steve Benen, The Maddow Blog, February 25, 2014
“A GOP Sociopathetic Scam”: Why Actual ACA ‘Victims’ Are So Elusive
It’s practically a running joke at this point. The Affordable Care Act’s conservative detractors have spent the last several months in a desperate search for “Obamacare victims” to be used in various partisan attacks, and quite a few regular folks have received quite a bit of attention.
The problem, of course, is that all of these examples, once they’re subjected to even minor scrutiny, have fallen apart – the “horror stories” really aren’t so horrible. Michael Hiltzik speculated last week that there may not be any genuine anecdotes to bolster the right’s claims.
What’s going on here? Paul Krugman offers one possible explanation.
Even supporters of health reform are somewhat surprised by the right’s apparent inability to come up with real cases of hardship. Surely there must be some people somewhere actually being hurt by a reform that affects millions of Americans. Why can’t the right find these people and exploit them?
The most likely answer is that the true losers from Obamacare generally aren’t very sympathetic. For the most part, they’re either very affluent people affected by the special taxes that help finance reform, or at least moderately well-off young men in very good health who can no longer buy cheap, minimalist plans. Neither group would play well in tear-jerker ads.
That’s as good an explanation as any. What the right needs are sympathetic figures – real, relatable Americans who are struggling, and whose plight was made worse by the Affordable Care Act. The most notable recent example came last week with a Michigan woman, Julie Boonstra, featured in an Americans for Prosperity attack ad and in RNC events, who’s paying less for better insurance without having to change doctors.
In other words, as far as health care policy is concerned, it’s not much of a horror story, though it’s presumably the best the right can come up with.
But taking this one step further, let’s also acknowledge the extent to which the right is using ACA beneficiaries as a cudgel to undermine their own interests.
Brian Beutler did a nice job this morning explaining that the practice of using Americans to harm their own health security is a “sociopathic new scam.”
[W]e’re really just talking about Julie Boonstra here.
If she and AFP get their way, she’ll be just as much a victim of Obamacare repeal as all the people who face health circumstances similar to hers. And the saddest part of that tragic irony is that Boonstra doesn’t even seem to understand what her circumstances are, or why it doesn’t make sense to devote her energies to repealing the law. Boonstra told the Dexter Leader, “People are asking me for the numbers and I don’t know those answers — that’s the heartbreak of all of this. It’s the uncertainty of not having those numbers that I have an issue with, because I always knew what I was paying and now I don’t, and I haven’t gone through the tests or seen my specialist yet.”
But that’s just not so. Anyone who’s studied the law knows it’s not so. Anyone who’s paid unexpected health bills in installments knows it’s not so. And well-heeled Affordable Care Act foes like Americans for Prosperity certainly know it’s not so. And in that sense AFP, and everyone else on the right “supporting” Julie Boonstra, are using her as a weapon in a war against herself.
To a very real degree, it’s tragic to watch the developments unfold in real time. For much of 2013, especially in the months leading up to the open-enrollment period, assorted far-right groups launched an organized campaign to encourage the uninsured to stay that way – on purpose – in order to help conservative organizations advance their ideological agenda. It was a truly offensive display in which wealthy activists on the right urged struggling Americans to deliberately put their wellbeing in jeopardy.
Months later, we’re at a similarly painful moment in the debate, in which many of the same groups and activists are now exploiting people to create misleading attack ads, all in the hopes of keeping people from having access to affordable health care.
By: Steve Benen, The Maddow Blog, February 24, 2014
“Clearly Freakazoid Behavior”: Where Does The Tea Party Find These People?
I was on Hardball last night talking about the escapades of this Milton Wolf character, the tea party guy who’s challenging GOP incumbent Senator Pat Roberts this year. Wolf became freshly newsworthy this past weekend when the Topeka Capital-Journal revealed that in 2010, Wolf, a radiologist, posted photos of disfigured corpses on Facebook (of people who’d been shot, etc.) and joined other commenters in poking fun at the them.
One image he posted showed a human skull all but blasted apart, about which Wolf wrote: “One of my all-time favorites,” Wolf posted to the Facebook picture. “From my residency days there was a pretty active ‘knife and gun club’ at Truman Medical Center. What kind of gun blows somebody’s head completely off? I’ve got to get one of those.”
The Kansas City Star headlines an AP story by asserting that Wolf has “apologized,” but I read the piece and I’ll be jiggered if I see any apology in there. What Wolf does is try to explain his actions, although not really, and then accuse Roberts of leaking the material (which, if he did, so what; any opposing campaign would). A release by Wolf’s campaign even called the alleged leak (and it’s only alleged) “the most desperate move of any campaign in recent history,” another clueless and self-pitying statement.
So, this is clearly freakazoid behavior, and is obviously a grotesquely inappropriate thing for a medical professional to do. And it raises the broader question: Where does the tea party find these people?
I think this is an interesting question, because the answer describes one of the movement’s major impacts on our politics, which is the elevation of ideology above every other human consideration—of things like experience and temperament and character—in selecting people for high office; indeed, the creation of a posture in which those other considerations are scorned.
Here’s what I mean. Pre-tea party, if you wanted to be involved in Republican politics, you started the way nearly everybody starts in politics, in both parties. You run for city council, or county commissioner; then state legislature; then maybe, if you’ve demonstrated some skill or charisma or something, you’ll get to Congress or maybe become governor.
Each of these campaigns vets you, so that the crazy things you did and said when you were young are placed before the voters, who decide whether those things matter or not. And each of these experiences, as a county commissioner or state legislature, leavens you a bit, teaches you what the process of government is like, gives you a little sobriety. You might still be very conservative (or very liberal on the other side), but experience has, at least in theory and I think in most cases, made you a little more mature and better equipped to hold higher office.
But then comes the tea party in 2010, and boom, none of this matters anymore. So people who would normally have had to run for lower office first are suddenly running for United States Senate! Christine O’Donnell, no apparent relevant experience in anything except being on TV. Sharron Angle, who did admittedly serve in the Nevada state assembly for eight years but who was there to throw bombs; she voted no in the 42-member body so often that statehouse reporters joked about votes being “41 to Angle.” And lots of people with histories of out-there statements.
None of that earns any demerits in tea party “vetting.” For the tea party, all you need to do is pass ideological muster: hate Obama; hate government; embrace their idea of “freedom.” You sure don’t need to have shown a sober temperament. In fact, quite the opposite. Being known as 41 to Angle is a great calling card for tea party voters, because it shows them that you’re not a sell-out and the system hasn’t ruined you.
So it’ll be especially interesting to see if this harms Wolf. The reaction will tell us whether tea party people and Republicans generally in Kansas regard what he did as just another sort of manly joke that offends prissy liberal sensibilities (and thus requires that they rise to his defense)—that is, whether they have a knee-jerk ideological reaction—or as something that’s really just kind of beyond the pale for a human being, let alone a doctor, to do—that is, whether they have a more human reaction. Because I think 99 percent of normal human beings would react to what Wolf did with varying degrees of disgust. But once it becomes a political act, and he gets taken apart on MSNBC, a certain percentage will defend him. How high that percentage ends up being will be a fascinating thing to see.
As I was leaving the set, a producer said into Chris Matthews’s earpiece, and he announced, that a recent poll had it Roberts 49, Wolf 23. So Wolf is behind, but he’s not out of it. The primary isn’t until August. He has plenty of time to make a run. There’s also plenty of time to learn more weird stuff about him. That comes with the tea-party territory, and it’s creating a class of pols who should be back-bench state legislators but have the chance of becoming U.S. senators. It’s just a good thing most of them don’t win.
By: Michael Tomasky, The Daily Beast, February 25, 2014
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