mykeystrokes.com

"Do or Do not. There is no try."

“At The GOP Debate, America Was The Loser”: Republicans Aren’t Remotely Serious About Governing

Last night’s debate in Houston was not only the first time Marco Rubio and Ted Cruz really attacked Trump. It was also the first time anyone went after Trump for the appalling superficiality of his statements and ideas about policy, and it did reveal that Trump is someone who neither knows nor particularly cares how government works or about what you need to do to address complex problems.

That’s good. But the debate revealed something else, too: That Trump is right at home in the GOP, because even the supposedly more serious candidates on that stage had barely anything more to say about policy than he did.

Let’s look, for instance, at an exchange Rubio and Trump had on health care. When Trump started to talk about it, it became obvious he doesn’t understand the first thing about health care policy. “We’re going to have something much better, but pre-existing conditions, when I’m referring to that, and I was referring to that very strongly on the show with Anderson Cooper, I want to keep pre- existing conditions,” he said. What he means there is that he wants to keep the ban on insurance companies denying people coverage because of pre-existing conditions, which is one of the central (and most popular) components of the ACA.

But soon after, they had this enlightening exchange:

RUBIO: Here’s what you didn’t hear in that answer, and this is important guys, this is an important thing. What is your plan? I understand the lines around the state, whatever that means. This is not a game where you draw maps…

TRUMP: … And, you don’t know what it means…

RUBIO: … What is your plan, Mr. Trump?

(APPLAUSE)

RUBIO: What is your plan on healthcare?

TRUMP: You don’t know.

BASH: (inaudible)

TRUMP: … The biggest problem…

(CROSSTALK)

RUBIO: … What’s your plan…

TRUMP: … The biggest problem, I’ll have you know…

RUBIO: … What’s your plan…

TRUMP: … You know, I watched him meltdown two weeks ago with Chris Christie. I got to tell you, the biggest problem he’s got is he really doesn’t know about the lines. The biggest thing we’ve got, and the reason we’ve got no competition, is because we have lines around the state, and you have essentially….

RUBIO: … We already mentioned that (inaudible) plan, I know what that is, but what else is part of your plan…

TRUMP: … You don’t know much…

RUBIO: … So, you’re only thing is to get rid of the lines around the states. What else is part of your healthcare plan…

TRUMP: … The lines around the states…

RUBIO: … That’s your only plan…

TRUMP: … and, it was almost done — not now…

RUBIO: … Alright, (inaudible)…

TRUMP: … Excuse me. Excuse me.

RUBIO: … His plan. That was the plan…

TRUMP: … You get rid of the lines, it brings in competition. So, instead of having one insurance company taking care of New York, or Texas, you’ll have many. They’ll compete, and it’ll be a beautiful thing.

It keeps going for quite a while like that. “Lines around the states” refers to the question of allowing insurance companies to sell policies across state lines, instead of only within one state. This is one of a very small number of ideas that Republicans have settled on so that they have something to say when asked what they’d do about health care.

And Marco Rubio supports that, too. The lengthiest explication Rubio has offered on his plans for health care came in this op-ed from August, which basically presents that Republican grab-bag: let insurance companies sell policies across state lines, give people tax credits instead of subsidies, block-grant (i.e. cut) Medicaid, turn Medicare into a voucher program, expand health savings accounts. And oh, you’re one of the tens of millions of people with pre-existing conditions? Um…well, you can go in a high-risk pool, which is just about the worst and most expensive way to cover those people. Throw in some meaningless drivel about “patient-centered reforms” and “empowerment” and you’ve got your standard-issue Republican health care “plan.”

What’s the difference between that and when Trump says he’ll repeal the ACA and replace it with “something terrific”? Almost nothing. If there’s anything the last seven years have taught us, it’s that health care policy is extraordinarily complex, and any reform you make has to grapple with that complexity. Republicans can’t seem to bring themselves to grapple with it: they talk about repealing the ACA as if that would be no big deal, when in truth repealing the law would represent a massive disruption to the American health care system in history, much more so than the passage of the law itself.

And it isn’t just health care. We see it over and over again in other areas: Trump offers some ridiculously simplistic notion about what he’d do in a critical policy area, and anyone with a brain says, “My god, he has no clue what he’s talking about,” but then when you look at the other candidates, you see that their ideas are barely more coherent or realistic. Trump says he’ll kick the crap out of the Islamic State. That’s no plan. But what do the other candidates say? Call it “radical Islamic terrorism,” and, uh, form a coalition! And also some crap-kicking!

Trump says he’ll go to China and tell them to give us back our jobs, then we’ll have a spectacular economy. And the other candidates? They say that if we cut taxes and curtail regulations, then we’ll have a spectacular economy. Their plan is to bring back George W. Bush’s economic policies, which will somehow produce Bill Clinton’s economic growth. Such a clever strategy.

Trump says he can eliminate the deficit by finding “waste, fraud, and abuse,” a line from the 1980’s that he doesn’t seem to realize is now considered a joke. “We are going to cut many of the agencies, we will balance our budget, and we will be dynamic again,” he says. It’s obviously inane. And the other candidates? They want to hugely increase the deficit with their tax cuts and increases to military spending. But they’ll do things like “prevent massive, irresponsible spending bills” (that’s from Rubio’s deficit reduction “plan”) or eliminate the IRS and “evaluate areas of waste and fraud” (that’s Cruz). And people wonder why the deficit always goes up under Republican presidents.

So yes, Trump is an ignoramus. He has no idea what is actually involved in running the government. But what’s really depressing is that even the other guys, who have been in government and do have at least some grasp of how it works, haven’t bothered to present anything that’s more than a notch or two more sophisticated to the voters. Either they don’t care enough to be remotely serious about governing, or they think the public won’t care that they aren’t remotely serious about governing. Or maybe both.

 

By: Paul Waldman, Senior Writer, The American Prospect; Contributor, The Plum Line Blog, The Washington Post, February 26, 2016

February 27, 2016 Posted by | Donald Trump, GOP Primary Debates, Governing | , , , , , , , , | 4 Comments

“Willfully Disobeying The Law”: Republican Leaders Refuse To Make Appointments To Key Obamacare Panel

The top two Republicans in Congress informed President Obama on Thursday that they will refuse to fulfill their duty under the Affordable Care Act to recommend members of a new board with the power to contain Medicare spending.

It’s a dramatic power-play driven by the explosive partisan politics of Obamacare and with potentially important implications for federal health care policy.

In a letter to President Obama, House Speaker John Boehner (R-OH) and Senate Minority Leader Mitch McConnell (R-KY) noted their original opposition to Obamacare, reiterated their intent to repeal it entirely, and declared that they would not make any appointments to the Independent Payment Advisory Board.

The IPAB is a 15-member panel whose members must be confirmed by the Senate. The President selects three members himself and is required by law to seek three recommendations each from the top Democrat and Republican in each chamber. With Thursday’s letter, Boehner and McConnell refused to make any recommendations.

The IPAB will be stood up in 2014 by Obamacare and tasked with making cuts to Medicare provider payments (it may not touch benefits) if costs exceed economic growth plus an additional percentage point in any given year. Congress can override it by passing equally large cuts with a simple majority or waiving the cuts entirely with a three-fifths majority.

“Because the law will give IPAB’s 15 unelected, unaccountable individuals the ability to deny seniors access to innovative care, we respectfully decline to recommend appointments,” Boehner and McConnell wrote in the letter.

But there is a catch: if IPAB fails to do its work for any reason, the Health and Human Services secretary must order the cuts herself. So in a way, Boehner and McConnell are surrendering some of their power in order to appear as though they’re thwarting Obamacare — when in reality they’re merely turning over more control to the executive branch.

“Under the ACA, if the IPAB fails to make a recommendation as required under the IPAB provision, the Secretary may make a recommendation in its place,” said Tim Jost, a professor of health law at Washington and Lee University. “So if no IPAB is created, it is not fatal.”

IPAB is, however, capable of functioning without all of its members confirmed. But the letter reflects a continuation of broader GOP obstruction of Obamacare implementation. Senate Republicans have suggested that they may filibuster any IPAB nominee, period.

This approach makes it easier for a future Republican president to neuter IPAB by executive fiat. In the short term, it puts the Obama administration more directly in the political line of fire for any cuts that it does approve.

The other political incentive for Republicans to oppose IPAB is that spending Medicare dollars more wisely makes it easier to sustain the single-payer structure of the program, and makes it harder to argue that it needs to be privatized, as the Paul Ryan budget does.

There is some irony as well in Boehner and McConnell refusing to play ball on IPAB — a key cost containment mechanism in Obamacare — while their party is complaining about potential cost increases under the law, and government spending more generally. Limiting Medicare spending and cutting the deficit, part of the rationale for IPAB, are routinely touted as central GOP goals.

“We believe Congress should repeal IPAB, just as we believe we ought to repeal the entire health care law,” Boehner and McConnell wrote. “In its place, we should work in a bipartisan manner to develop the long-term structural changes that are needed to strengthen and protect Medicare for today’s seniors, their children, and their grandchildren. We hope establishing this board never becomes a reality, which is why full repeal of the Affordable Care Act remains our goal.”

 

By: Sahil Kapur, Talking Points Memo, May 9, 2013

May 13, 2013 Posted by | Affordable Care Act, Politics | , , , , , , , | 1 Comment

   

%d bloggers like this: