“From GOP ‘Con Man’ To Newly Elected Governor”: Health Coverage For Kentuckians Was On The Line, And They Appear To Have Lost
Under two-term Gov. Steve Beshear (D), Kentucky has been one of the best-run states in the nation. Not only is the Bluegrass State’s unemployment rate at a 14-year low, but Kentucky has been so successful in implementing health care reform, it’s cut its uninsured by over 40%.
Perhaps the state’s voters grew tired of success and decided to go in a different direction.
Voters in Kentucky elected Republican Matt Bevin as governor Tuesday.
Bevin beat Democratic Attorney General Jack Conway. Unofficial results from the Kentucky State Board of Elections had Bevin beating Conway 52.52% to 43.82% with all 120 counties reporting Tuesday night.
Independent Drew Curtis was also on the ballot, and garnered 3.6% support – not enough to affect the overall outcome. Statewide turnout was only about 30%, meaning that over two-thirds of the state’s voters didn’t bother to show up at all.
Bevin’s road to the governor’s office was, for lack of a better word, improbable. A year ago, the right-wing candidate, who’s never served a day in public office, launched a primary fight against incumbent Sen. Mitch McConnell (R-Ky.). Republicans quickly labeled Bevin a “con man” who lies “pathologically.” The first-time candidate was exposed a man who lied about his educational background, and who even struggled in the private sector – his business needed a taxpayer bailout.
At one point, he even delivered a speech at a cockfighting gathering and then lied about that, too.
Bevin lost that primary. A year later, he’s a governor-elect.
The smart money bet against him. Indeed, even as this year’s race unfolded, the Tea Partier seemed on track to lose. In September, the Republican Governors Association scaled back its investments in the Kentucky race, and as recently as mid-October, Bevin’s own internal polling showed him trailing.
Complicating matters, the GOP candidate “created a nightmare for Kentucky’s political reporters” by lying – about a wide variety of issues – on an almost habitual basis, and then creating an “enemies list” of journalists who challenged the accuracy of his falsehoods.
And yet, voters in Kentucky yesterday overlooked all of this and handed Bevin a relatively easy victory.
What happens now is likely to have a major impact on many of his constituents’ lives. One of the central tenets of Bevin’s odd platform has been scrapping Medicaid expansion, which would have the effect of taking away health care benefits from many low-income families statewide. And because outgoing Gov. Steve Beshear (D) used executive orders to create much of the state’s health network, the new right-wing governor-elect will have the power to undermine the health security of a significant chunk of Kentucky’s population rather quickly.
The question is simple: will he? This sets the stage for the the first real test of whether far-right officials are prepared to hurt their own constituents, on purpose, to advance a partisan goal. It’s one thing for Republican state policymakers to block Medicaid expansion from taking effect, but in Kentucky, the Affordable Care Act has already been fully implemented – and it’s working beautifully.
Bevin’s stated goal is to roll back the clock, consequences be damned. Coverage for over 400,000 struggling Kentuckians was on the line in yesterday’s election, and as of last night, they appear to have lost.
By: Steve Benen, The Maddow Blog, November 4, 2015
“Romney Wants Credit For Obamacare”: Mitt, ‘Without Romneycare, I Don’t Think We Would Have Obamacare’
Given the Affordable Care Act’s striking successes, it’s not surprising that its champions would look for some credit for bringing health security to millions of families. President Obama, Nancy Pelosi, Harry Reid, and plenty of other Democrats have reason to be proud of one of this generation’s greatest policy breakthroughs.
It is a little jarring, though, seeing a Republican look for credit, too. MSNBC’s Benjy Sarlin reported this afternoon:
In a surprising move, Mitt Romney seemingly took credit on Friday for inspiring the Affordable Care Act – after famously running as the 2012 Republican nominee on a platform of repealing the law.
Romney championed and signed a comprehensive health care law in Massachusetts when he was governor. Known as “Romneycare,” it had strong similarities with Obamacare, including a mandate to purchase insurance, but he had long resisted comparisons between the two. In a Boston Globe obituary of Staples founder and longtime Romney backer Thomas Stemberg, however, the former Republican nominee finally embraced the connection.
“Without Tom pushing it, I don’t think we would have had Romneycare,” Romney told the Boston Globe. “Without Romneycare, I don’t think we would have Obamacare. So, without Tom a lot of people wouldn’t have health insurance.”
And as a factual matter, there’s certainly some truth to that. Romney approved a state-based law that served as an effective blueprint for President Obama’s federal model. The two-time failed Republican presidential candidate has a point when he says “Romneycare” helped pave the way for “Obamacare.”
But that doesn’t make his new boast any less jarring. Romney wants credit for one of the president’s signature accomplishments – which Romney was committed to tearing down just a few years ago?
Those who followed the last two presidential elections closely may recall that Romney’s position on health care got a little convoluted at times. The former one-term governor initially said he believed his state-based plan could serve as a model for the nation. Then he said the opposite.
By 2012, Romney was promising voters that he would – on his first day in the White House – issue an executive order to undo the federal health care law without congressional input, regardless of the consequences.
Or to use Romney’s phrase, he vowed to scrap health insurance for “a lot of people.”
Three years later, however, Romney is apparently shifting gears once again, taking partial credit for the system he embraced, then rejected, then vowed to destroy, and is now re-embracing again.
And to think this guy struggled as a candidate for national office.
Update: MSNBC’s report added, “After an uproar on social media, Romney clarified in a Facebook post that he still opposed Obamacare, but did not backtrack on his apparent praise of the law’s expansion of insurance coverage and its ties to his own legislation.”
Romney wrote that “getting people health insurance is a good thing,” which he followed with some dubious criticisms of the ACA. To my mind, his online clarification changes very little about the substance of the story.
By: Steve Benen, The Maddow Blog, October 23, 2015
Justice Antonin Scalia did not simply lose today’s key ruling on the federal health insurance subsidies for the Affordable Care Act — he had his own previous arguments turned against him.
The majority opinion issued today, written principally by Chief Justice John Roberts — whose crucial vote previously upheld Obamacare back in 2012 — illustrated the idea of the insurance subsidies being an integral part of health care reform itself.
And the absurdity of just striking out subsidies for people living in states with federally run exchanges — as Scalia and his fellow dissenters insisted had to be done under the law — was illustrated by citing… Antonin Scalia, from his earlier efforts to stamp out health care reform.
It is implausible that Congress meant the Act to operate in this manner. See National Federation of Independent Business v. Sebelius, 567 […] (SCALIA, KENNEDY, THOMAS, and ALITO, JJ., dissenting) […] (“Without the federal subsidies . . . the exchanges would not operate as Congress intended and may not operate at all.”).
That is, Roberts and company cited the dissent in the first major Obamacare case, from 2012, when the dissenters — Scalia being one of them — tried to say that pretty much each every single facet of the Affordable Care Act was not only wrong but unconstitutional, and that they interlocked so completely that by striking down even one of them, the entire Act would have to fall.
As a political staffer friend, who is a trained lawyer (though not currently practicing), tells me: “The problem with results-oriented jurisprudence is it makes hypocrisy easy to spot.”
The full paragraph in that original dissent is as follows:
In the absence of federal subsidies to purchasers, insurance companies will have little incentive to sell insurance on the exchanges. Under the ACA’s scheme, few, if any, individuals would want to buy individual insurance policies outside of an exchange, because federal subsidies would be unavailable outside of an exchange. Difficulty in attracting individuals outside of the exchange would in turn motivate insurers to enter exchanges, despite the exchanges’ onerous regulations. […] That system of incentives collapses if the federal subsidies are invalidated. Without the federal subsidies, individuals would lose the main incentive to purchase insurance inside the exchanges, and some insurers may be unwilling to offer insurance inside of exchanges. With fewer buyers and even fewer sellers, the exchanges would not operate as Congress intended and may not operate at all.
By: Eric Kleefeld, The National Memo, June 25, 2015
Was I on the edge of my seat, waiting for the Supreme Court decision on Obamacare subsidies? No — I was pacing the room, too nervous to sit, worried that the court would use one sloppily worded sentence to deprive millions of health insurance, condemn tens of thousands to financial ruin, and send thousands to premature death.
It didn’t. And that means that the big distractions — the teething problems of the website, the objectively ludicrous but nonetheless menacing attempts at legal sabotage — are behind us, and we can focus on the reality of health reform. The Affordable Care Act is now in its second year of full operation; how’s it doing?
The answer is, better than even many supporters realize.
Start with the act’s most basic purpose, to cover the previously uninsured. Opponents of the law insisted that it would actually reduce coverage; in reality, around 15 million Americans have gained insurance.
But isn’t that a very partial success, with millions still uncovered? Well, many of those still uninsured are in that position because their state governments have refused to let the federal government enroll them in Medicaid.
Beyond that, you need to realize that the law was never intended or expected to cover everyone. Undocumented immigrants aren’t eligible, and any system that doesn’t enroll people automatically will see some of the population fall through the cracks. Massachusetts has had guaranteed health coverage for almost a decade, but 5 percent of its nonelderly adult population remains uninsured.
Suppose we use 5 percent uninsured as a benchmark. How much progress have we made toward getting there? In states that have implemented the act in full and expanded Medicaid, data from the Urban Institute show the uninsured falling from more than 16 percent to just 7.5 percent — that is, in year two we’re already around 80 percent of the way there. Most of the way with the A.C.A.!
But how good is that coverage? Cheaper plans under the law do have relatively large deductibles and impose significant out-of-pocket costs. Still, the plans are vastly better than no coverage at all, or the bare-bones plans that the act made illegal. The newly insured have seen a sharp drop in health-related financial distress, and report a high degree of satisfaction with their coverage.
What about costs? In 2013 there were dire warnings about a looming “rate shock”; instead, premiums came in well below expectations. In 2014 the usual suspects declared that huge premium increases were looming for 2015; the actual rise was just 2 percent. There was another flurry of scare stories about rate hikes earlier this year, but as more information comes in it looks as if premium increases for 2016 will be bigger than for this year but still modest by historical standards — which means that premiums remain much lower than expected.
And there has also been a sharp slowdown in the growth of overall health spending, which is probably due in part to the cost-control measures, largely aimed at Medicare, that were also an important part of health reform.
What about economic side effects? One of the many, many Republican votes against Obamacare involved passing something called the Repealing the Job-Killing Health Care Law Act, and opponents have consistently warned that helping Americans afford health care would lead to economic doom. But there’s no job-killing in the data: The U.S. economy has added more than 240,000 jobs a month on average since Obamacare went into effect, its biggest gains since the 1990s.
Finally, what about claims that health reform would cause the budget deficit to explode? In reality, the deficit has continued to decline, and the Congressional Budget Office recently reaffirmed its conclusion that repealing Obamacare would increase, not reduce, the deficit.
Put all these things together, and what you have is a portrait of policy triumph — a law that, despite everything its opponents have done to undermine it, is achieving its goals, costing less than expected, and making the lives of millions of Americans better and more secure.
Now, you might wonder why a law that works so well and does so much good is the object of so much political venom — venom that is, by the way, on full display in Justice Antonin Scalia’s dissenting opinion, with its rants against “interpretive jiggery-pokery.” But what conservatives have always feared about health reform is the possibility that it might succeed, and in so doing remind voters that sometimes government action can improve ordinary Americans’ lives.
That’s why the right went all out to destroy the Clinton health plan in 1993, and tried to do the same to the Affordable Care Act. But Obamacare has survived, it’s here, and it’s working. The great conservative nightmare has come true. And it’s a beautiful thing.
By: Paul Krugman, Op-Ed Columnist, The New York Times, June 25, 2015
“GOP Bad Faith Legal Mischief”: Democrats Have Every Reason To Save Republicans From An Obamacare “Bloodletting”
Sometime this month, possibly as early as Monday morning, the Supreme Court will issue its ruling in King v. Burwell. If the Court ignores both the text and purpose of the Affordable Care Act, and rules for the challengers, millions of the law’s beneficiaries in 34 states will quickly lose their insurance subsidies and be forced off their health plans. The ensuing chaos would be the consequence not just of the ruling itself, but also of the Republican Party’s expected unwillingness to pass a one-sentence bill clarifying that Obamacare subsidies are available in every state, whether or not each state established its own health insurance exchange.
When King, and similar cases, were first conceived, they quickly became vessels of hope for conservatives, who recognized how difficult and punishing it would be to hobble or eliminate Obamacare through the legislative process. What many of them have come to recognize in the subsequent years is that farming out the job to the judiciary can’t spare them from the subsequent political cost: As decision day approaches, more and more of these conservatives are acknowledging candidly—and typically anonymously—that they will suffer badly if the Supreme Court does the very thing they’ve asked the Supreme Court to do.
“The most likely option is that Congress is unable to pass a fix,” an anonymous Republican Hill staffer told Joel Gehrke of the conservative National Review—a magazine that has beseeched the Court to void the subsidies. “Either Republicans won’t be able to settle on a fix or the president will veto whatever we do come up with. At that point, it will be up to the governors to pass their own laws deeming the national exchange a state exchange. That is the path of least resistance.”
Gehrke looks at the cross-pressures Republicans would face after a ruling for King and wonders whether they “could be in for a bloodletting.” Though they can’t admit it publicly, the promise of a bloodletting—compounded by the fact that every vulnerable Republican senator in cycle next year represents an affected state—is precisely why so many Republicans privately hope the Court will uphold the subsidies.
If the conventional wisdom which took shape after oral arguments—and to which I subscribe—is correct, the government will win, and this painful exercise in bad faith legal mischief will come to nothing. But if the challengers win, and a bloodletting ensues, Democrats won’t be able to stand back while Republicans absorb the political damage. Bloodletting or no, Obamacare will be crippled in most states. It could easily remain crippled indefinitely. Its fate will turn on the question of whether the political consequences for Republicans resemble the consequences of a government shutdown or collision with the debt limit. But either way Democrats will have to play an active role in bringing about a resolution.
The best-case scenario for Democrats is a public outcry so severe and sustained that Republicans cave, and agree to restore the subsidies with a clean fix.
Republicans have tacitly acknowledged that they won’t be able to sit on their hands while state insurance markets collapse. They have introduced legislation in both the House and Senate that would restore subsidies, but only for existing beneficiaries, and only on conditions Democrats could never accept, like the repeal of the ACA’s individual mandate.
You can interpret these offers in two ways. The first, as Greg Sargent of The Washington Post has noted, is that these bills are designed to be vetoed, allowing Republicans to blame an uncompromising Obama for perpetuating the crisis. But they could also serve as bases for a compromise, or surrender. If the public responds to a ruling for King the way they’ve responded to other GOP-instigated crises, Republicans would have to scale back their demands and eventually agree to reinstate the subsidies, perhaps for a modest price.
Two different forces will push in that direction. Even if sprinkled liberally with poison pills, and even if its proximate purpose is to invite a veto, Republican-sponsored legislation to partially reinstate ACA subsidies probably can’t pass. Democrats aren’t going to vote for an ersatz fix and neither will many rank-and-file conservative members of Congress. “As soon as the messaging is out there saying, ‘Look, a half-a-sentence fix saves millions of people from either losing their coverage or having massive spikes,’ we as a party won’t be able to sustain that pressure very long — certainly not through the August recess,” another Republican aide tells Gehrke.
But that doesn’t mean Democrats will win a standoff outright. Though their case for a clean fix will be compelling, they will also be highly motivated to reinstate the subsidies immediately, even if it means Republicans get to pocket unreciprocated concessions. Those can’t include structural damage to the core of the law, but could include eliminating things like the medical device tax and the employer mandate.
Real danger arises if, per Gehrke’s other source, an adverse King ruling registers somewhere below a government shutdown on the political Richter scale, inflicting damage on the GOP but not enough to make them seek a solution in earnest. Against the backdrop of a paralyzed Congress, Obamacare would begin to unravel in dozens of states, and would continue to do so until at least 2017. A ruling for the challengers would boomerang violently on Republicans, but Democrats have every reason in the world to want them spared from it.
By: Brian Beutler, Senior Editor, The New Republic, June 8, 2015