What Paul Ryan’s Constituents Think And Why It Matters
Rep. Paul Ryan’s (R) Wisconsin district isn’t competitive. Over the last decade, his most competitive race was the one he won by “only” 26 points. Last year, the margin was 38 points.
But when the Associated Press checked in with some of the far-right congressman’s constituents, they were aware of their representative’s plan to eliminate Medicare, and they weren’t exactly on board with the plan.
Brian Krutsch has been long one of many automatic votes here for Rep. Paul Ryan…. But this week, admiration has been tinged with apprehension as one of Ryan’s signature ideas — ending Medicare’s status as a full, guaranteed benefit for senior citizens — suddenly took a step toward reality.
“I think that’s one of the things they should probably leave alone — you know — unless it’s absolutely necessary,” Krutsch said as he took a break from reviewing job openings at the Rock County Job Center. “Old people need help with medical bills. There’s too many people under-insured right now — especially people like myself right now who don’t have insurance.”
Howard Gage, a 74-year-old Medicare recipient who owns a three-person video-production company, said he has voted for Ryan in all seven races, still supports the congressman and likes him as a person. But, he added, it’s hard to accept that fixing the budget should mean that his family wouldn’t receive the same Medicare benefits that he relies on.
“It bothers me that my kids or grandchildren might be affected by whatever has to be done” to curb spending, he said.
At face value, it’s interesting that those who elected Ryan aren’t at all sold on Ryan’s vision. If they’re not on board, it stands to reason more vulnerable Republican lawmakers from more competitive districts have reason to be concerned, and may very well balk at embracing such a radical move that won’t pass anyway.
But there’s more to it than that. As Greg Sargent explained, “These folks are worried about doing away with Medicare as we know it, but they are grappling with whether or not this will be necessary to put the nation on firmer fiscal footing.”
Right. Reading the piece, it seems these folks want to do the right thing. They’re uncomfortable with an extreme overhaul of Medicare, but they’re willing to listen to what’s “absolutely necessary.”
But the point is, the privatization of Medicare isn’t “necessary” at all. It won’t even lower health care costs. Paul Ryan’s plan is ostensibly about debt reduction, but even that’s a charade — he’s going after entitlements and other domestic priorities while slashing tax rates for the rich.
Or as Greg added, these voters “are proceeding from the premise that Ryan’s Medicare proposal is about fixing our fiscal situation in a way that would spread the pain around evenly — and not aware that it would shift the burden for fixing our fiscal situation downward, in keeping with conservative tax-cutting ideology.”
Guess what message Democrats should be pushing right now? Or put another way, what do you suppose those folks in Southeastern Wisconsin would say if they knew going after Medicare wouldn’t be at all necessary if Ryan weren’t so desperate to give millionaires another massive tax break?
By: Steve Benen, Washington Monthly-Political Animal, April 11, 2011
Government Shutdown: It’s Not Really About Spending
If the federal government shuts down at midnight on Friday — which seems likely unless negotiations take a sudden turn toward rationality — it will not be because of disagreements over spending. It will be because Republicans are refusing to budge on these ideological demands:
• No federal financing for Planned Parenthood because it performs abortions. Instead, state administration of federal family planning funds, which means that Republican governors and legislatures will not spend them.
• No local financing for abortion services in the District of Columbia.
• No foreign aid to countries that might use the money for abortion or family planning. And no aid to the United Nations Population Fund, which supports family-planning services.
• No regulation of greenhouse gases by the Environmental Protection Agency.
• No funds for health care reform or the new consumer protection bureau established in the wake of the financial collapse.
Abortion. Environmental protection. Health care. Nothing to do with jobs or the economy; instead, all the hoary greatest hits of the Republican Party, only this time it has the power to wreak national havoc: furloughing 800,000 federal workers, suspending paychecks for soldiers and punishing millions of Americans who will have to wait for tax refunds, Social Security applications, small-business loans, and even most city services in Washington. The damage to a brittle economy will be substantial.
Democrats have already gone much too far in giving in to the House demands for spending cuts. The $33 billion that they have agreed to cut will pull an enormous amount of money from the economy at exactly the wrong time, and will damage dozens of vital programs.
But it turns out that all those excessive cuts they volunteered were worth far less to the Republicans than the policy riders that are the real holdup to a deal. After President Obama appeared on television late Wednesday night to urge the two sides to keep talking, negotiators say, the issue of the spending cuts barely even came up. All the talk was about the abortion demands and the other issues.
Democrats in the White House and the Senate say they will not give in to this policy extortion, and we hope they do not weaken. These issues have no place in a stopgap spending bill a few minutes from midnight.
A measure to prohibit the Environmental Protection Agency from regulating greenhouse gas emissions came up for a Senate vote on Wednesday and failed. If Republicans want to have yet another legislative debate about abortion and family planning, let them try to pass a separate bill containing their restrictions. But that bill would fail, too, and they know it, so they have chosen extortion.
The lack of seriousness in the House is reflected in the taunting bill it passed on Thursday to keep the government open for another week at an absurdly high cost of $12 billion in cuts and the ban on District of Columbia abortion financing. The Senate and the White House said it was a nonstarter. Many of the same House members who earlier had said they would refuse to approve another short-term spending bill voted for this one, clearly hoping they could use its inevitable failure in the Senate to blame the Democrats for the shutdown. What could be more cynical?
The public is not going to be fooled once it sees what the Republicans, pushed by Tea Party members, were really holding out for. There are a few hours left to stop this dangerous game, and for the Republicans to start doing their job, which, if they’ve forgotten, is to serve the American people.
By: Editorial, The New York Times, April 8, 2011
The High Price Of Rigidity: The GOP Wants A Government Shutdown
House Republicans have already won so much in this year’s federal budget standoff that they could easily declare victory and put an end to the maddening and dysfunctional cycle. Previous Congresses would have noticed that millions of people are still struggling in an economic downturn and tried to help, but Republicans have succeeded in shutting off that conversation.
They have won the philosophical war, compelling Democrats to agree to tens of billions in spending cuts. Yet that does not seem to be enough for the Republicans who now control the federal steering wheel.
With a hard deadline looming, talks to prevent a government shutdown have been stymied for a week because Tea Party members of the House have demanded everything: not just some of their cuts but almost all of them, and not just a reduction in spending but a reduction only in the programs they don’t like. Many are insisting Democrats also agree to nonbudgetary riders, like ending the financing of Planned Parenthood or health care reform.
They simply will not accede to anything that looks like a compromise with President Obama. Caught in this position, Speaker John Boehner knows the public is likely to blame Republicans for the pain of a shutdown, once it sees that the Democrats offered difficult compromises that his caucus rejected. That is the price he pays for riding to power on the backs of people who don’t understand that government cannot be built out of ideological rigidity.
If Mr. Boehner cannot persuade his members that the public does not want a government shutdown and will blame them, then much of the government will close its doors on April 8, when the current stopgap funding measure runs out. So far, the Republicans have wrung $10 billion in cuts from earlier deadlines, but their bill to butcher the current year’s budget with $61 billion in radical cuts was voted down in the Senate.
Democrats have put together a package of $20 billion in cuts, on top of the $10 billion already agreed to. They have not released the details, but officials say they could include some current spending and some mandatory programs, like agriculture subsidies. This package is likely to be far more painful than the last one and will almost certainly pull back the reins much further than is prudent when the economic recovery is still sputtering. But in the split-the-difference culture of Washington, it will get them halfway toward the Republican goal line, further than imaginable just a few weeks ago.
Does that mean the House will end the week-by-week bloodletting that is already hampering many federal agencies? So far the signs do not look promising. Republicans have told Democratic negotiators that the cuts can only come from their original, rejected bill. Many are still clinging to the ideological riders that will certainly draw a presidential veto. One way or the other, Tea Party lawmakers are about to learn a lesson in how government operates; the only question is whether the public must suffer for their education.
By: Editorial, The New York Times, March 29, 2011
Health Reform Act Already Saving Lives Of Many Americans
Is the health care reform law a good deal for Americans, or is it so badly flawed that Congress should repeal it? Now that the measure is one year old — President Obama signed the Patient Protection and Affordable Care Act to law on March 23, 2010 — I humbly suggest we attempt an unbiased assessment of what the law really means to us, and where we need to go from here.
To do that in a meaningful way, we must remind ourselves why reform was necessary in the first place. I believe the heated rhetoric we’ve been exposed to since the reform debate began has obscured the harsh realities of a health care system that failed to meet the needs of an ever-growing number of Americans.
Among them: seven-year-old Thomas Wilkes of Littleton, Colorado, who was born with severe hemophilia. You would never know it to meet Thomas because he looks and acts like any other little boy his age, but to stay alive, he needs expensive treatments that over time will cost hundreds of thousands of dollars. Thomas’s parents were terrified before the law was passed because the family’s health insurance policy had a $1 million lifetime cap. Thanks to a provision in the law that makes lifetime caps a thing of the past, they can sleep easier at night.
Another person who faced the real possibility of not being able to pay for needed medical care is Robin Beaton of Waxahachie, Texas. Her insurance company notified her the day before a scheduled mastectomy two years ago that it was canceling her coverage. Why? Because Robin had forgotten to note when she applied for insurance that she had previously been treated for acne.
So Beaton – who told her story to a congressional committee — was a victim not only of breast cancer but of “rescission,” a once-prevalent practice in the insurance industry. The congressional panel — the House Energy and Commerce Committee — discovered that just three insurers had rescinded the policies of 20,000 people over the course of a five-year period, confirming for lawmakers that the practice was widespread and growing. By rescinding those 20,000 policies, the three companies avoided paying for more than $300 million worth of medical care, much of it for critically ill people. Thanks to the Affordable Care Act, Beaton and the rest of us will no longer have to worry that our insurance policies will be canceled when we need them most because of innocent omissions on applications.
Reform Will End Common Insurance Company Abuses
That same congressional committee discovered during another investigation that the four largest U.S. insurance companies had refused to sell coverage to more than 600,000 people with pre-existing conditions over a three-year period. Thanks to the Affordable Care Act, insurers can no longer deny coverage to children with pre-existing conditions. The law will apply to all of us by 2014.
In addition, young people who have not been able to find jobs that offer health care benefits can now stay on their parents’ policies until they are 26. Young adults, many of whom haven’t been able to find jobs, or who work for firms that don’t provide coverage, comprise the largest portion of the nearly 51 million Americans who are uninsured.
The new law also eliminates copayments for preventive services and requires insurers to establish appeals procedures for denied coverage or claims. And the law has additionally begun to close the infamous “doughnut hole” in the Medicare prescription drug program. Medicare beneficiaries are also now getting better coverage for preventive care. And small-business owners who provide benefits to their employees are being helped by tax credits available for the first time.
Another important provision of the new law requires insurers to spend most of what we pay them in premiums on medical care. In 1993, insurers on average were spending 95 percent of our premiums paying medical claims. That average has dropped steadily ever since. In many cases, especially in the individual and small-group markets, insurers have been spending as little as 50 percent on medical care. The law requires insurers to spend at least 80 percent (85 percent in the large-group market) on health care services or quality improvement activities. Those that don’t will have to pay rebates to their policyholders.
Coming Phases of Reform Will Help Control Costs
Other helpful parts of the law will be phased in. By 2014, for example, states will have to set up health insurance exchanges, which should help control costs. Between 2000 and 2010, American families saw annual premiums increase 114 percent on average from $6,438 to $13,770, according to the Kaiser Family Foundation. While employers often still pay the lion’s share of health insurance premiums, workers are seeing their portion increase every year. During the last decade, worker contributions to health care premiums increased 147 percent. The exchanges, if implemented as Congress intended, should bring down the cost of premiums by fostering competition among insurers. The exchanges will also require insurers to provide data that will enable us to make apples-to-apples comparisons among various benefit plans.
Even after the law is fully implemented, there will be much to do. While an estimated 30 million Americans will be brought into coverage, more than 20 million others will still be uninsured. There’s also still work to be done on addressing the underlying costs of health care in the United States.
But the Affordable Care Act is a start. Let’s consider it just that — a start — and an important one on our shared journey toward a health care system that works better for all of us. If we stop to think for a moment about what needed to be fixed, about why the health care system in the world’s richest country was failing an ever-growing number of Americans, I believe we will want to continue the journey.
By: Wendel Potter, Op-Ed Columnist, Center for Media and Democracy, March 24, 2011
The Anniversary of the Affordable Care Act: A Year Later, The False Attacks Continue
Conservatives often push myths and misconceptions of the Affordable Care Act of 2010 as a way to increase opposition. During the debate in Congress in the run-up to passage of the new health reform law, conservatives pushed wild accusations that the law would be a “government takeover” and establish “death panels,” claims that were labeled “the lie of the year.” Now, a year after the Affordable Care Act was signed into law, inaccurate claims and mistruths against the law continue.
Conservatives continue to make false claims against the law as a way to repeal it, undermine consumer protections, and put insurance companies back in charge of our health system. The reason these false statements endure is clear: There are those who would rather take us back to the way our health system was before when insurance companies were in charge rather than move forward and protect our care.
This issue brief is a response to recent false attacks conservatives have made against the law. As we will demonstrate, the Affordable Care Act will create jobs, lower health care costs for families, help small businesses provide health insurance to their employees while maintaining the private sector’s key role in health insurance, and ensure we provide quality health care to all Americans at a lower cost to them and American taxpayers.
The Affordable Care Act will help create jobs
The Affordable Care Act helps our economic recovery by bringing health costs under control, freeing businesses to use that money to invest in job creation. The real threat to job creation is the conservative push to take us back to the old health system where costs were on an unsustainable path. Harvard University professor and Center for American Progress Senior Fellow David Cutler found that repealing the Affordable Care Act—and going back to the unsustainable costs—would cost up to 400,000 jobs annually over the next decade.
To push this “job destroying” argument, conservatives cite the nonpartisan Congressional Budget Office’s estimates that the law will reduce the labor supply (although conservatives dismiss CBO reports when they conclude the law will cut the deficit and reduce premiums). Yet conservatives fail to recognize that one reason for this reduction is that older workers, now forced to hold on to jobs to get health insurance, will now be able to retire—with insurance—when they choose.
The Affordable Care Act lowers premiums and costs for families
The Affordable Care Act takes steps to get our health costs under control and lowers costs for families. The real threat to costs is the conservative push to repeal the law. Cutler found that repealing the Affordable Care Act would increase total health spending by $125 billion and raise family premiums by nearly $2,000.
More small businesses are providing health coverage to their employees, thanks in part to the Affordable Care Act
Conservatives try to downplay the impact of the small business tax credits to provide health insurance to their employees. The truth is that last year, more than 4 million small businesses were eligible to receive a tax credit to make health coverage more affordable. According to the Los Angeles Times, “major insurers around the country are reporting that a growing number of small businesses are signing up to give their workers health benefits,” adding that an “important selling point” was the small business tax credits.
The Affordable Care Act keeps the employer-based health system intact
Conservatives claim the Affordable Care Act will undermine the employer-sponsored health coverage that millions of Americans enjoy when the state health insurance market exchanges become functional. This is not true. According to Mercer’s recent “National Survey of Employer-Sponsored Health Plans,” the vast majority of employers, particularly large employers, will continue to offer their employees health coverage. Indeed, the survey notes that if the Affordable Care Act follows the Massachusetts health law, “few employers of any size” will choose to drop coverage.
The Affordable Care Act ensures quality care and has flexibility for states
The Affordable Care Act provides states with considerable flexibility. Each state gets to decide how to set up their own marketplace of health options for consumers to choose which plan suits them best. States have flexibility in how they implement insurance reforms and consumer protections. The law encourages state innovation by allowing them to obtain waivers from some requirements provided the alternative proposal provides comparable coverage and affordability. President Obama recently endorsed legislation from Sens. Ron Wyden (D-OR) and Scott Brown (R-MA) that would move the start date for those waivers by three years.
At the same time, conservatives argue there is not enough flexibility in the Affordable Care Act. They criticize the Obama administration for granting too many waivers on so-called “mini med” plans that have a low annual limit. Since many of the consumer protections and mechanisms to increase patient choice—such as the state marketplaces—are not operational until 2014, the administration has in some instances granted waivers from the law’s early requirements, to avoid leaving people with nothing. CAP Senior Fellow Judy Feder told Congress that until the law is fully implemented, the goal should be to “make matters better, without making them worse.”
States can save money from the Medicaid reforms under the law
Medicaid is a federal-state health program that provides health coverage to predominantly lower-income families, elderly people, and people with disabilities. The federal government matches state funding on the program. For people made newly eligible for Medicaid by the Affordable Care Act, the federal government will pay 100 percent of costs in the early implementation of the Affordable Care Act. In the later years, states will have to pay only 10 percent.
Conservatives charge that the Affordable Care Act will increase state Medicaid spending by $118 billion. An Urban Institute study, however, found that states will save between $40.6 billion and $131.9 billion from 2014-2019 by replacing state and local spending for uncompensated care and mental health with federal Medicaid funds and by replacing federal Medicaid funding for adults with incomes over 133 percent of the federal poverty level with federal subsidies in the marketplaces.
There is no secret $105 billion hidden in the law
Conservatives such as Reps. Michele Bachmann (R-MN) and Steve King (R-IA) claim that $105 billion of mandatory funding was secretly put in the law unbeknownst to members of Congress. This is false. The Washington Post’s Fact Checker said this claim is “bordering on ridiculous” and “does not have credibility.” The truth is there was a considerable amount of transparency before the Congress approved the Affordable Care Act. In the House alone, there were: 79 bipartisan hearings, totaling 100 hours; 181 witnesses; and 239 amendments considered. The House bill was posted online 30 days before committee markup.
The law keeps Medicare solvent and cuts the deficit
Conservatives argue that the Obama administration “double counted” the Medicare savings for the law, arguing it went to save the Medicare Trust Fund and cut the deficit. The facts are these: The law cuts the deficit by $1 trillion over the next two decades and keeps Medicare solvent until 2029—12 years longer than before the law was passed. The Center on Budget and Policy Priorities explained how this works before the House Budget Committee:
There’s no double-counting involved in recognizing that Medicare savings improve the status of both the federal budget and the Medicare trust funds. In the same way, when a baseball player hits a homer, it both adds one run to his team’s score and also improves his batting average. Neither situation involves double-counting.
Conclusion
The conservative false attacks are meant to repeal the Affordable Care Act and bring our health system back to the time when insurance companies could discriminate because of a pre-existing condition. Despite these false attacks, the facts are clear: Millions of families, small business owners, and seniors are seeing the benefits of the Affordable Care Act. More than 4 million small businesses are eligible to receive tax credits to make health coverage more affordable. As many as 4 million seniors received help to make their prescription drugs more affordable. Already this year, more than 150,000 seniors with Medicare had a free wellness exam. And children with pre-existing conditions can no longer be excluded from insurance plans. We should move forward with this law and tell those who want to repeal it that we won’t go back.
By: Tony Carrk, Center For American Progress, March 21, 2011
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