“Defiant Obamacare Defense”: A New World Where Insurers Have To Cover Categories Of Treatments They Never Had To Before
President Obama’s speech at Faneuil Hall was probably his most passionate and unapologetic defense of the health-care law in ages, maybe since its passage. At times like this in the past, Old Mr. Reasonable has hemmed and hawed, ceding that his opponents had a point, but insisting—reasonably, of course—that he had a better one if you just stopped and thought about it. But Wednesday afternoon in Boston gave us a different Obama. He took a page out of the Bush playbook or, dare I say it, even the Cheney one. If things are going a little rocky at the moment, it doesn’t matter; cede nothing. Stick to plan. No matter the merits or facts, it’s the only approach that our political culture respects.
The money moment of the speech, of course, came when he answered the questions raised by the NBC report Tuesday. According to NBC, people who had bought insurance on the private market who don’t have either employer or government coverage were getting hammered by Obamacare. They were getting letters telling them their coverage had expired and then finding that the new coverage available to them was going to cost more. It flew in the face, said NBC’s Lisa Myers, of Obama’s promise that if you had coverage now and liked it, nothing would happen to you.
She was right. He shouldn’t have said it. And in Boston he didn’t exactly say, “I shouldn’t have said it.” But he did turn it around and say for that small percentage of people, the coverage they’re going to end up with is better! It also just might be cheaper, he said, and they are going to have peace of mind: “They can’t use allergies or pregnancy or sports injury or the fact that you’re a woman to charge you more. They can’t do that anymore!”
It’s an interesting, by which I mean preposterous, meme that’s developing on the Republican side. On Wednesday morning, Rep. Marsha Blackburn (R-TN) pressed Health and Human Services Secretary Kathleen Sebelius on the issue. Some people, Blackburn said, “would rather drive a Ford than a Ferrari.” No denying that; in my younger and single and childless days, I certainly would have opted for a Ford plan instead of a Ferrari plan, so up to a point, Blackburn is making sense.
But Obamacare creates a world where insurers have to cover several categories of treatments that they never had to cover before, and since people with those conditions are now going to sign up and use those services, it’s going to cost more in some cases. And it’s understandable if people are upset about that. But Blackburn’s analogy, of course, breaks down because any citizen, at some unknowable future point, may be hit with one of those conditions. A person might develop mental illness. Or their child might. No imaginable circumstance could make a reasonable Ford-owner think, “Damn, I should have bought that Ferrari.” But numerous circumstances could make the self-employed citizen or parent think, “Damn, I’m glad I bought that Ferrari plan.”
What’s most fascinating to me about the whole thing is that the experience is training, or is going to train, Americans to rethink the really fundamental questions about how life and society are organized in a way politics rarely does. One of the major differences between liberals and conservatives is that conservatives believe in the primacy of the individual, while liberals want people to think about the community. Another difference, related, has to do with the two creeds’ opposing conceptions of individualism. Conservatives go for the whole rugged individualism thing, whereas the liberal view of the individual is closer to “there but for the grace of God go I.”
Well, the nature of health-care coverage is it has the power to bring consideration of these questions to the fore. A country where people have to sit down and choose how best to protect themselves and their loved ones against pain and death, and where they have to think about the trade-offs between paying more and having better coverage, is a country where people are being forced, in a way, to think about the most profound questions of community and the individual—of how much responsibility we ought to be forced to shoulder for each other.
I used to think, “This is just like auto insurance; you’re a safe driver, but you insure yourself against the unsafe drivers, and everybody understands that, so why should this be different?” But it is, somehow. It’s so much more personal. It’s about our frailty as human beings, and contemplation of our frailty makes us both obstinate and individualistic (“I can take of myself, Jack!”) and, in our more honest moments, vulnerable and communitarian (“What will I do if I really get sick?”). Forcing people to think about their coverage forces them to think about all that.
How will it turn out? Who knows. It has the positive potential of making people, a majority of people, see that this all makes a kind of sense, that they are not, whether they like it or not, autonomous actors. That, come to think of it, is what terrifies conservatives. Since 1980, they have trained people to think chiefly about themselves, unburdened of the context of society. Obamacare will force them to think of society. And most people, not being selfish asses (and most people aren’t), will, once the kinks are worked out, accept it. Polls are already indicating that. No wonder Ted Cruz is losing it.
By: Michael Tomasky, The Daily Beast, October 30, 2013
“Solely An Oppositional Movement”: Why Winning Elections Is The Last Thing The Tea Party Wants
Keith Humphreys asks a provocative question: Does the Tea Party even want to win elections? This comes up in response to a long article in the National Review by Ramesh Ponnuru and Rich Lowry telling the Tea Party to get its head out of the clouds and start doing things that will help Republicans win. While it’s tricky to ascribe specific desires and intentions to a large, complicated collection of people like the Tea Party, to the extent we can, I think the answer to whether they want to win is pretty clearly no. And there’s a certain logic to it.
The reason is that the Tea Party is an oppositional movement, and oppositional movements only thrive when they’re in the opposition. They can talk all they like about both Republicans and Democrats being part of the problem, and being opposed just to “Washington,” but we all know that at its heart it’s about Barack Obama and everything he represents. If Hillary Clinton or another Democrat becomes president in 2016, most of the anger and resentment that gives the movement life will get transferred to that person, and it will continue. But as I’ve held for a few years now, as a movement the Tea Party has a firm expiration date, which is the inauguration of the next Republican president.
The movement also holds a contempt for compromise of any sort as one of its fundamental pillars, which is fairly easy to stick with when your side is out of power. It’s not like you’re going to be getting much of what you want anyway, so you can scoff at the half-loaves your more reasonable colleagues are offering up. But when there’s a Republican administration the gifts to conservatism will be showering down from every cloud, and they’ll be much tougher to say no to. How about we give you an appointment at the EPA, where you can destroy the agency from the inside instead of railing at it from the street? What say we do the same to the Labor Department? Now that our bills won’t get vetoed, let’s start slashing away at food stamps and CHIP and all those other programs the “takers” suckle on. It’s time to party! In that atmosphere, there’s so much to say yes to that saying no to everything isn’t so attractive anymore.
And when it can’t shout “No!”, the Tea Party will have no more reason for being. Obviously, even if it’s dead as a movement, many of the people who championed it will still be in Congress. But saying no won’t be as attractive for them either. It’s one thing to imagine yourself a brave warrior standing up against Barack Obama and his plan to turn America into a nightmare of socialist misery. It’s another to, say, fight against cuts to Medicaid because you want even bigger cuts to Medicaid. That’s far less romantic.
So no, as a whole the Tea Party doesn’t have much of an interest in winning elections, because if it helped Republicans have a resounding win, it would literally be the last thing the movement ever did.
By: Paul Waldman, Contributing Editor, The American Prospect, October 31, 2013
“A War On The Poor”: This Is Now The Central And Defining Issue Of American Politics
John Kasich, the Republican governor of Ohio, has done some surprising things lately. First, he did an end run around his state’s Legislature — controlled by his own party — to proceed with the federally funded expansion of Medicaid that is an important piece of Obamacare. Then, defending his action, he let loose on his political allies, declaring, “I’m concerned about the fact there seems to be a war on the poor. That, if you’re poor, somehow you’re shiftless and lazy.”
Obviously Mr. Kasich isn’t the first to make this observation. But the fact that it’s coming from a Republican in good standing (although maybe not anymore), indeed someone who used to be known as a conservative firebrand, is telling. Republican hostility toward the poor and unfortunate has now reached such a fever pitch that the party doesn’t really stand for anything else — and only willfully blind observers can fail to see that reality.
The big question is why. But, first, let’s talk a bit more about what’s eating the right.
I still sometimes see pundits claiming that the Tea Party movement is basically driven by concerns about budget deficits. That’s delusional. Read the founding rant by Rick Santelli of CNBC: There’s nary a mention of deficits. Instead, it’s a tirade against the possibility that the government might help “losers” avoid foreclosure. Or read transcripts from Rush Limbaugh or other right-wing talk radio hosts. There’s not much about fiscal responsibility, but there’s a lot about how the government is rewarding the lazy and undeserving.
Republicans in leadership positions try to modulate their language a bit, but it’s a matter more of tone than substance. They’re still clearly passionate about making sure that the poor and unlucky get as little help as possible, that — as Representative Paul Ryan, the chairman of the House Budget Committee, put it — the safety net is becoming “a hammock that lulls able-bodied people to lives of dependency and complacency.” And Mr. Ryan’s budget proposals involve savage cuts in safety-net programs such as food stamps and Medicaid.
All of this hostility to the poor has culminated in the truly astonishing refusal of many states to participate in the Medicaid expansion. Bear in mind that the federal government would pay for this expansion, and that the money thus spent would benefit hospitals and the local economy as well as the direct recipients. But a majority of Republican-controlled state governments are, it turns out, willing to pay a large economic and fiscal price in order to ensure that aid doesn’t reach the poor.
The thing is, it wasn’t always this way. Go back for a moment to 1936, when Alf Landon received the Republican nomination for president. In many ways, Landon’s acceptance speech previewed themes taken up by modern conservatives. He lamented the incompleteness of economic recovery and the persistence of high unemployment, and he attributed the economy’s lingering weakness to excessive government intervention and the uncertainty he claimed it created.
But he also said this: “Out of this Depression has come, not only the problem of recovery but also the equally grave problem of caring for the unemployed until recovery is attained. Their relief at all times is a matter of plain duty. We of our Party pledge that this obligation will never be neglected.”
Can you imagine a modern Republican nominee saying such a thing? Not in a party committed to the view that unemployed workers have it too easy, that they’re so coddled by unemployment insurance and food stamps that they have no incentive to go out there and get a job.
So what’s this all about? One reason, the sociologist Daniel Little suggested in a recent essay, is market ideology: If the market is always right, then people who end up poor must deserve to be poor. I’d add that some leading Republicans are, in their minds, acting out adolescent libertarian fantasies. “It’s as if we’re living in an Ayn Rand novel right now,” declared Paul Ryan in 2009.
But there’s also, as Mr. Little says, the stain that won’t go away: race.
In a much-cited recent memo, Democracy Corps, a Democratic-leaning public opinion research organization, reported on the results of focus groups held with members of various Republican factions. They found the Republican base “very conscious of being white in a country that is increasingly minority” — and seeing the social safety net both as something that helps Those People, not people like themselves, and binds the rising nonwhite population to the Democratic Party. And, yes, the Medicaid expansion many states are rejecting would disproportionately have helped poor blacks.
So there is indeed a war on the poor, coinciding with and deepening the pain from a troubled economy. And that war is now the central, defining issue of American politics.
By: Paul Krugman, Op-Ed Columnist, The New York Times, October 31, 2013
“When Discredited Nonsense Gets Recycled”: Be On The Lookout For Republicans Touting Heritage Foundation Talking Points Again
In the spring, when it was clear that comprehensive immigration reform would be the year’s biggest legislative fight in Congress, the Heritage Foundation wanted to give far-right lawmakers the ammunition they’d need to kill the bill. The group published a report conservative Republicans could ostensibly use to justify their reflexive opposition to the bipartisan proposal.
The result was a fiasco. First, the report itself was exposed as ridiculous, even by conservatives who often agree with Heritage, relying on lazy and incomplete scholarship. Second, one of the report’s co-authors was a guy by the name of Jason Richwine, who’s spent quite a bit of time arguing that white people are inherently more intelligent than people of color.
Soon after, Richwine resigned from Heritage and fair-minded people dismissed the group’s discredited report as nonsense. And yet, as my MSNBC colleague Benjy Sarlin reported yesterday, Heritage hasn’t given up on its document just yet.
Heritage may have distanced itself from its former scholar’s views on race, but not the study he did for their think tank. In a memo to Congressional staff obtained by msnbc, Heritage legislative strategist Tripp Baird said that while some supporters of reform on the Hill this week are “well meaning” in their concern for immigrants, “they’re being used to advance an amnesty policy that is far from conservative, and will cost trillions to American taxpayers.” Another talking point suggests that evangelical Christians supporting immigration reform “probably aren’t aware of the severe fiscal consequences of amnesty for American taxpayers.”
The “cost trillions” line echoes a report co-authored for Heritage by Robert Rector and Jason Richwine.
Yes, in May, Heritage’s report said immigration reform would cost over $6 trillion – a figure even many on the right found laughable. Soon after, independent analyses, including a report from the non-partisan Congressional Budget Office, found that the reform package would actually save hundreds of billions of dollars.
Stepping back, it appears the Heritage Foundation simply hopes lawmakers have forgotten what transpired six months ago. The group published its report, saw it quickly discredited, and largely stopped talking about it. That is, until now, when Heritage decided enough time has passed that it can start repeating the identical bogus claims all over again.
It’s difficult to imagine even the most craven lawmakers taking this seriously, but you never know. Be on the lookout for members touting Heritage talking points anyway.
By: Steve Benen, The Maddow Blog, October 30, 2013
“Obamacare Witch Hunt”: Republican Halloween Witch Trials About Obamacare Avoid The Facts
Watch out for the hobgoblins! The knives are out. The hearings are on. The charges are flying. Obamacare is on the hot seat … again!
The sad result is that as we get these unconfirmed anecdotes, these stories about problems with insurance companies, these people who face hardship supposedly because of Obamacare, few Republicans think back to pre-2010. Then the costs of health care were skyrocketing – from $1,000 per person in 1980 to about $3,000 in 1990 to $4,000 in 2000 to nearly $8,000 before the Affordable Care Act was passed. The next highest nation for cost: Norway at $5,352.
According to the Commonwealth Fund, 49.9 million Americans were without health insurance in 2009, up 13 million from 2000. Houston, we have a problem.
And remember the stories of pre-existing conditions? Getting kicked off your health insurance or unable to get coverage? How about caps on your care? Or huge deductibles, especially for women? Horror story after horror story.
The facts are clear: 17 million Americans had pre-existing conditions; 34 percent lacked coverage for mental health; 62 percent lacked maternity coverage.
How soon we forget the problems that the ACA was written to solve. Right now, only 5 percent of Americans are covered by individual plans – if you had your plan prior to 2010, you are grandfathered in and can keep it. If the insurance companies want to kick you off they have to alter your plan, but they can no longer kick you off because of a pre-existing condition or because you cost them too much.
Most of these individual plans are renewed yearly and, according to current figures, 48 percent of those with individual plans would get a tax credit under the Affordable Care Act. The average “rebate” would be $5,500, not exactly chump change. Nearly half of those who believe they are suffering sticker shock from their insurance companies would get better coverage for less money.
So, before more and more people are dragged up before Republican-led congressional committees and berated, maybe it is time to get the facts. Maybe it is also time to work to fix what problems may exist and to offer solutions and not engage in more Salem-like witch trials just before Halloween.
By: Peter Fenn, U. S. News and World Report, October 30, 2013
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