“The GOP’s Hypocrisy On Obamacare”: Republicans Get The Vapors And Become Outraged About The Problems They Created
Last spring, the Senate Finance Committee held a hearing on implementation of the Affordable Care Act, otherwise known as Obamacare. Sen. Max Baucus, a Montana Democrat and the chairman of the committee, was not pleased with how things were going.
The Obama administration originally had asked for more than half a billion dollars to spend on public relations and outreach for the law. House Republicans had returned with an offer of nothing. That’s right: zero dollars. Without necessary funds, the Department of Health and Human Services worried it would not have the necessary money to pay for navigators to help people enroll in health care, for the technology needed to implement the exchanges and for the public relations campaign that was required to inform citizens about what the law actually did.
HHS Secretary Kathleen Sebelius made the controversial move of asking insurance companies and nonprofit organizations to donate money and help. Republicans were outraged. She asked for more money. She was refused.
Then, when she tried to move some money from the PR budget to replace cuts to other areas, Baucus became quite upset. He was concerned that if the administration did not do more to inform people about the law and get implementation going, there would be problems:
“A lot of people have no idea about all of this,” he said. “People just don’t know a lot about it, and the Kaiser poll pointed that out. I understand you’ve hired a contractor. I’m just worried that that’s gonna be money down the drain because contractors like to make money. … I just tell ya, I just see a huge train wreck coming down.”
As I’ve said before, it’s important to note that the “train wreck” Baucus was describing was a botched implementation because not enough was being done to make things go smoothly.
It wasn’t a description of the law itself but of what might occur if the government did not devote enough resources to making it work. Sebelius’ response was not surprising to those who were paying attention. She said that she was “incredibly disappointed” that all her requests for resources were being denied by Republicans.
That was then. Today, implementation has arrived, and if it’s not a train wreck, then it’s certainly close. The administration is still under fire because people cannot get the insurance they want through the exchanges. But while I will continue to point out the problems with implementation and fault the administration for mistakes they’ve made, how does one ignore the apparent hypocrisy from many politicians who are now “outraged” about the very problems they’ve helped to create.
Republicans refused to appropriate money needed to implement Obamacare. When Sebelius tried to shift money from other areas to help do what needed to be done, she was attacked by Senate Republicans. At every step, Republicans fought measures to get money to put towards implementation.
Is it really a surprise then that implementation hasn’t gone smoothly?
Federal legislators aren’t the only ones to blame. Let’s remember that original versions of the bill called for one big national exchange. This would have been much easier to implement. But conservatives declared that insurance should be left to the states and kept out of the hands of the federal government. So as a compromise (yes, those did occur), exchanges were made state-based instead of national.
As a precaution, the law stipulated that if states failed to do their duty and enact exchanges, the federal government would step in and pick up the slack. This was to prevent obstructionism from killing the law. Surprisingly, it was many of the same conservative states that demanded local control that refused to implement state-based exchanges, leaving the federal government to do it for them.
That made implementation much harder.
There have been books, webinars and meetings explaining how to sabotage the implementation of Obamacare. There have been campaigns trying to persuade young adults not to use the exchanges. It is, therefore, somewhat ironic that many of the same people who have been part of all of this obstructionism seem so “upset” by the fact that people can’t easily use the exchanges.
For goodness sake, the government was shut down just a few weeks ago because some of the same people who are now bemoaning poorly functioning websites were determined to see that not one dime went to Obamacare.
Lest you think I’m defending this month’s rollout, I encourage you to review my last article here. I still maintain that the administration has had a failure in management in overseeing and reporting on progress towards October 1. But I’m also sympathetic that they’ve had a hard job to do. I would like to see this go better. I’d like to see millions more get insurance. I’d like to see the law of the land function as well as it can, and if it doesn’t, I’d like to see Congress continue to amend it to make it work better. I’d like a better health care system.
What I cannot ignore, however, are the many people who actively worked to see implementation fail now get the vapors over its poor start. The truth is, they got what they wanted. A victory lap is somewhat warranted, not concern-trolling.
If, on the other hand, their concern is real, then I’m sure the administration would welcome their help in making things right.
By: Aaron Carroll, Director, Center for Health Policy and Professionalism Research, Indiana University School of Medicine, Special to CNN, October 28, 2013
“Replace The Sequester, Not Sebelius”: While She Tries To Fix A Broken Website, Congress Allows Rest Of Government To Crash
An embarrassing mistake, which should be considered a scandal, has caused the Internal Revenue Service to perform far fewer tax reviews and cut back its fraud investigations, costing the Treasury billions of dollars. Have there been any angry House hearings? No.
That same mistake has forced the National Institutes of Health to cut more than 700 advanced research grants, delaying the progress of vaccines and experimental treatments. No hearings.
And it has cost the economy hundreds of thousands of jobs, according to the Congressional Budget Office, but there is no sign that Republicans want to investigate what went wrong.
That’s because the mistake is called the sequester, and Republicans know what went wrong: they caused it by threatening default in 2011 and then refusing any budget agreement that included new taxes the next year. They’d much rather investigate a serious bumble by the Obama administration in rolling out the health-care website — which will eventually be fixed — than examine the effects of their own actions.
The paradox of Republican complaints about the website’s failings has been widely noted: They are pretending to care about the technical problems of a law they want abolished. But in fact the hypocrisy goes much deeper than that. In virtually every department of government, the right wing has used the sequester to encourage government to stumble, creating backups and denials of service that will be far more damaging than the ones going on at www.healthcare.gov. The sequester, which has been the Tea Party wing’s sole legislative victory, is evidence that its members want government to do less with less, and that they aren’t interested in having it work efficiently in delivering services to the public.
Any lawmaker who came to Washington to improve government, rather than shrink it, would do everything possible to reverse the sequester, as Democrats will try to do in a budget conference beginning this week. (They will be joined in that effort by a few Republicans who want only to turn back the cuts to the Defense Department.) But most Republicans, ranging from Senate Minority Leader Mitch McConnell to the furthest extreme in the House, have said they have no intention of letting the budget caps expire, and certainly aren’t interested in replacing them with higher revenue.
The only thing they have clamored to replace is Kathleen Sebelius, the Health and Human Services secretary. While she tries to fix a broken website, Congress is allowing the rest of government to slowly crash.
By: David Firestone, Editors Blog, The New York Times, October 28, 2013
“GOP Crocodile Tears On Obamacare”: Their Entire Strategy Is To Create Noise, Not Solutions
One of the strange things about politics is that it is considered “smart” to make every conceivable argument against your foes, even when your arguments are contradictory or reveal you to be indifferent to people leading desperate lives. But rarely is this “throw the kitchen sink” tactic pursued with such hypocritical gusto as with the GOP’s primal scream over the Obamacare Web site’s rollout.
To listen to Republican laments about Healthcare.gov’s terrible launch, you’d think the GOP was deeply concerned that people who need affordable health insurance are being denied this essential protection thanks to the administration’s incompetence.
But of course nothing could be further from the truth. What conservative officials, pundits and advocates are screaming is closer to the following:
How dare you totally screw up something that we think shouldn’t exist!
How dare you make it hard for poor, uninsured workers to get health coverage we don’t want to subsidize them to purchase!
What did Kathleen Sebelius know and when did she know it, when it comes to the wreck of a train we’ve prayed would be a train wreck all along?
This is what the “logic” of a party of “no” sounds like — where the entire strategy is to create noise, not solutions.
I get that a chunk of the GOP thinks discrediting government’s competence is a political winner (many of these critics are themselves lifers in elected office, but nevermind). But please spare us the fallacious leap to the idea that these Web site snafus reveal that the left’s “technocratic hubris” in “taking over a sixth of the American economy” was bound to fail.
There’s a reason everything about Obamacare is unduly complex, but it has nothing to do with a federal takeover. It’s precisely the opposite. Obamacare is complicated because it seeks to expand coverage largely by relying on private insurers, and also by honoring our tradition of federalism.
The need to check an applicant’s eligibility and income, and to use this information in light of locally offered private health plans to compute associated levels of potential subsidy — all of which requires tying together a bunch of huge databases that weren’t designed to communicate instantly with each other — comes from the need to subsidize the purchase of private coverage in a tailored way.
If we just gave every American a wallet-sized card like they do in single-payer nations — or even an identical universal voucher folks could use to help pay for private health coverage (as diverse voices from Zeke Emanuel and Victor Fuchs to Pete Peterson have championed) — the system, along with its technology backbone, would be far simpler.
This isn’t an excuse; it’s a piece of an explanation.
Meanwhile, when Republicans argue that the Web site’s initial failure means we shouldn’t go forward with extending affordable coverage to the uninsured, it’s like saying that the other high-profile tech failure this month — of the Web-based Common Application used by hundreds of colleges — means we should tell this year’s high school seniors to put off college. I mean, if that nonprofit can’t get the application technology right, what other reasonable choice is there?
The phoniest tears come from conservative analysts who “fear” that the Web site meltdown will trigger an adverse selection problem. The meme of the month is that only the sickest people will be desperate enough to persist in getting coverage, leaving the whole system subject to actuarial implosion.
As my daughter and her friends might say, “Chill, people.” Let’s see how the next few months go. There’s something sad and misguided about talented right-wing wonks devoting immense energy to criticism, yet seeming unable to spare a brain cell for actual public problem-solving. Even a conservative mind is a terrible thing to waste.
The problem, as always, is that once the GOP turns to health-care solutions, they’ll be forced to fess up that Romney-Obamacare was theirs. And it works. That’s something Republican voters are now finding out beyond just Massachusetts.
Like Butch Matthews, 61, a former small-business owner and lifelong Republican from Little Rock. Matthews and his wife, too young for Medicare, had been paying over $1,000 a month in the individual market for a Blue Cross Blue Shield policy with a $10,000 deductible.
“I did not think that Obamacare was going to be a good plan,” he told the (highly functional) Web site ThinkProgress. “I did not think that it was going to help me at all.”
He thought wrong. The policy Matthews just bought from the Arkansas Obamacare marketplace will cost him nothing after income-based subsidies and has a deductible of $750. Doctor visits will cost him $8 instead of nearly $150. He stands to save at least $13,000 a year
“I still am a very strong Republican, but . . . I am so happy this came along,” Matthews said.
If enough Republican voters have happy endings like this, it won’t be long before the GOP’s crocodile tears turn real.
By: Matt Miller, Opinion Writer, The Washington Post, October 23, 2013
“First Do No Harm”: It’s Time To Rethink The Oath Of Office For People We Vote To Represent Us
First do no harm. That’s a tenet of medical ethics that future doctors worldwide are taught in medical school.
If only the people we elect to represent us were required to take such an oath when they’re sworn into office.
Because they aren’t, folks in Florida are facing having to pay far more for health insurance over the next two years than necessary. And health insurance executives will be laughing all the way to the bank.
Florida state lawmakers, in their ongoing efforts to block the implementation of Obamacare in the Sunshine State, recently passed a law that will allow health insurance companies to gouge Floridians more than any corporate boss dreamed was possible.
And if that weren’t bad enough, insurers will actually be required by law to mislead their Florida customers about why they’re hiking their premiums.
Republicans, who control the governor’s office as well as both houses of the Florida legislature, were confident the U.S. Supreme Court would declare the Affordable Care Act unconstitutional. Not only did they vote to prohibit the state from spending money to implement a law they just knew would be overturned by the high court, they refused to accept money from the federal government that would have enabled the state’s department of insurance to do a better job of regulating health insurers and enforcing new consumer protections in the law.
When the Supreme Court shocked Obamacare opponents last year by upholding the law, Florida lawmakers were in a pickle.
Their response? They passed a bill that prohibits the state’s Office of Insurance Regulation from protecting consumers from unreasonable rate increases for two years.
I learned about what is essentially a “first do as much harm as possible” bill in a letter the nine Democrats in the Florida congressional delegation sent to U.S. Secretary of Health and Human Services Kathleen Sebelius earlier this month pleading with her to step in to protect Floridians by taking an active role in regulating rate increases in the state.
The lawmakers said intervention by HHS was urgently needed because of a law signed in May by Gov. Rick Scott that specifically prohibits Insurance Commissioner Kevin McCarty from doing his job of reviewing rate increases and rejecting those he and his staff determine are unjustifiably high.
Until the passage of SB 1842, McCarty had the power to do that. Florida state lawmakers who voted for the bill, including a few Democrats who seemed to think HHS has more authority than it does, took the position that since the federal government was requiring insurance companies to be more consumer friendly, the federal government should assume the responsibility of enforcing the new consumer protections in Obamacare. The problem is that Congress gave the federal government no such additional powers. As a consequence, HHS really can’t take over what is still a state responsibility. And since Florida turned down the federal money that McCarty would have used to do his job, Floridians appear to be out of luck.
Last month, McCarty’s office said insurance premiums for individuals in Florida would be significantly higher than they are now. In their letter to Sebelius, the state’s congressional Democrats wrote that those increases are “not a coincidence, but rather the product of a cynical and intentional effort by Gov. Scott and the Florida legislature to undermine the Affordable Care Act and make health insurance premiums on the Florida Health Insurance Marketplace more expensive by refusing to allow the insurance commissioner to negotiate lower rates with companies or refuse rates that are too high.”
As PolitiFact noted in a recent analysis of the charges made by the Democrats in their letter (which PolitiFact ruled are true), the states that have authority to approve or disapprove rates were “able to extract significant reductions.” PolitiFact cited a Palm Beach Post story which noted that Maryland’s insurance department had used its regulatory powers “to push rates for next year’s premiums down by as much as a third.”
As Florida CHAIN, a state advocacy group, pointed out when Scott signed SB 1842, the law not only blocks McCarty’s office from protecting consumers, a provision in the law actually requires insurers to send deceptive and misleading notices about rate increases to consumers — and to blame Obamacare for them.
“The only ’public education’ of any sort authorized by the Legislature related to the ACA (Affordable Care Act) is a requirement … that insurers send extremely biased and incomplete notices this fall about the ACA and its effect on policyholders’ rates,” Florida CHAIN said in a statement.
“The sole purpose of the requirement is to create ‘sticker shock’ that can be blamed on the ACA. There will be no mention of the many uncertainties or any other relevant factors, such as past rate increases or how actual rates will be reduced for many by the availability of premium tax credits (to low and middle income earners.)”
So not only will many Floridians be harmed by SB 1842, they will, by law, be misled about who caused the harm.
Maybe it’s time to rethink the oath of office for people we vote to represent us.
By: Wendell Potter, The Center for Public Integrity, August 19, 2013
“Full Speed Ahead”: Republican Overreach Is Coming Soon
A number of people have asked whether the Republicans will overreach in their reaction to the current collection of scandal-ish controversies (by the way, someone really needs to come up with a name that encompasses them all). The answer to that question is, of course they will. Try to remember who we’re talking about here. Overreaching is their thing. Congress will be going home this weekend, and I’ll bet the Republicans are going to come back from their recess reassured that their constituents really, really want them to pursue Barack Obama to the ends of the earth. I’ll explain why in a moment, but in the meantime the National Journal has details on their strategy:
Congressional Republicans head into next week’s Memorial Day recess armed with a strategy designed to keep the controversies that have consumed Washington in the news back home.
Both House and Senate Republicans will focus on the Internal Revenue Service targeting conservative groups for extra scrutiny as well as the still-open questions about Benghazi. And more and more, they’ll try to tie them together into a made-for-2014 narrative of an unaccountable and out-of-control government.
In interviews on local television and radio programs and with newspapers, Senate Republicans plan to talk about the Obama administration’s “credibility gap.” They’ll throw into the mix Health and Human Services Secretary Kathleen Sebelius’s request that health industry officials help fund “Obamacare,” a move Republicans call a “shakedown” of the companies she regulates, according to a Senate GOP leadership aide.
Lawmakers will argue that a “lack of details, stonewalling,” and what they call an “ever-changing White House narrative” on both Benghazi and the IRS have led to a trust deficit with the public, a sentiment reflected in recent polls, the aide said.
Part of the aim is to get voters to question how they can trust the administration, and the IRS more specifically, to enforce key provisions of Obama’s health care law after improperly targeting Americans.
This fits into Republicans’ emerging scandal-riding midterm election strategy—one that the GOP’s congressional campaign committees think can blend easily into their anti-Obamacare message to help the party take the Senate in 2014.
When they return from this recess, Republicans are going to be more sure than ever that they’re doing the right thing. Think about what a member of Congress does when he’s home. He’ll be doing those media interviews with friendly talk-radio hosts, for whom outrage is the bread and butter of their programming. He might do a couple of town meetings, and who comes to those? People who like him already (i.e. the Republican base, who will tell him to keep up the scandal-mongering) and people who are pissed off about something. But right now, the people who think the scandal thing is going too far aren’t really pissed off, they’re just kind of disappointed. So they won’t be so inclined to show up. And then the representative will just go around town talking to folks, and once again the ones he’s most likely to hear from are his supporters who want to tell him to stick it to that no-good socialist in the White House.
After a few days of that, he’ll come back to Washington thinking, “Wow, my constituents are really fired up about this stuff. Full speed ahead!”
By: Paul Waldman, Contributing Editor, The American Prospect, May 14, 2013
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