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“Obamacare Is Here To Stay”: Kentucky Is Emblematic Of The States That Have Received Substantial Assists From Obamacare

You’ve heard of Obamacare, right?

It’s that disastrous, costly and intrusive policy that President Obama and his fellow Democrats rammed down the throats of Congress back in 2010 — a failed plan that conservative Republicans have pledged to “repeal and replace.” According to its critics, it is un-American; it destroys the health care system; it burdens businesses; it hollows out Medicare. Right?

Ah, wrong. Despite what you may have heard and despite the caprice of electoral campaigns, the changes wrought by the Affordable Care Act are here to stay. That’s because it accomplishes much of what it set out to do — and its beneficiaries mostly like it.

Don’t expect Republicans to try to turn back the clock. Oh, some of them will continue to bash Obamacare and to blame it for any negative effects on the country’s dysfunctional health care “system” — including rising costs. And some will even go so far as to continue to insist that it ought to be repealed.

Take Senate Minority Leader Mitch McConnell, who expects to lead the upper chamber if Republicans claim a majority. In a debate last month with his Democratic rival, Alison Grimes, McConnell suggested that he would repeal the Affordable Care Act but leave in place Kentucky’s popular state exchange program.

“… The best interest of the country would be achieved by pulling out Obamacare, root and branch,” he said. “Now, with regard to Kynect, it’s a state exchange. They can continue it if they’d like to.”

McConnell’s pronouncement was a tour de force of dissembling, a virtuoso performance of fabrications and disinformation. The Washington Post’s fact checker awarded him three Pinocchios.

That’s because the state’s health care exchange, Kynect, is a part of Obamacare, made possible by the 2010 law. If Obamacare is ripped out “root and branch,” the state exchanges could not continue to exist. (The GOP has continually pledged to find a mechanism to replace Obamacare, but its warring factions have failed to agree on any plan that would leave state exchanges in place.)

Here’s the rub: Kynect is very popular with Kentucky’s residents, many of whom are enjoying health insurance for the first time in their lives. They have been primed by Republican politicians to hate the president and any policy he endorses — including his signature health care plan — but they don’t want to give up Obamacare’s benefits.

Kentucky is emblematic of the states that have received substantial assists from Obamacare. It is largely rural and is among the poorest states. It has also long ranked near the bottom in several health indicators, including obesity and smoking rates and cancer deaths. Obamacare has been a boon for its residents, cutting the rate of uninsured in half.

According to The New York Times, people who live in rural areas are among the biggest winners from the Affordable Care Act. Other groups who have reaped substantial benefits are blacks, Latinos, women and younger Americans between 18 and 34.

Here’s another reason that Obamacare is here to stay: Its expansion of Medicaid is a boon to the states that have taken advantage of it. After the Supreme Court ruled that Medicaid expansion was optional, most Republican governors vowed to resist it — even though the federal government will pay 100 percent of the cost for the first three years and 90 percent thereafter.

But some of those GOP governors are now having second thoughts as rural hospitals are forced to close down for lack of funds and poor people are sidelined by preventable illnesses. Several GOP governors have already expanded Medicaid — which provides health insurance for the poor — and others are considering doing so.

Last month, Ohio’s Republican governor, John Kasich, advised his GOP colleagues to stop fighting the Medicaid expansion. The opposition, he said, “was really either political or ideological. I don’t think that holds water against real flesh and blood, and real improvements in people’s lives.”

Some Republicans have trouble admitting that on the campaign trail, but they all know it’s true.

 

By: Cynthia Tucker, The National Memo, November 1, 2014

November 3, 2014 Posted by | Affordable Care Act, Mitch Mc Connell, Obamacare | , , , , , , , | 3 Comments

“Creating Winners And Losers”: Are The Beltway Media Helping Mitch McConnell Stay In Power?

The Beltway media are at it again, creating winners and losers long before Election Day. Yesterday I wrote that Alison Lundergan Grimes beat Mitch McConnell in Kentucky’s one and only Senate debate, and if you watched the debate, you might agree.

But if you had only followed the media coverage, you might well believe that Grimes is a goner, that her refusal to say whether she voted for Obama was of such import that it rightly overshadowed all other issues the candidates fought over—minimum wage, jobs, climate change, student loans, healthcare—and that her demurral was far more worthy of coverage than McConnell’ s actual lies and deceptions about the healthcare of 500,000 Kentuckians.

And if Grimes’s non-answer wasn’t a pretend disaster enough for the media to hyperventilate over, they got more confirmation later yesterday when the Democratic Senate Campaign Committee announced it wasn’t going to spend more to run ads in Kentucky. Well, surely that showed that Big Dems agreed with Big Media that Grimes was out. Money speaks. She’s over. Or so it seems.

But the media have it wrong. First, on the debate: Columbia Journalism Review did a large round-up of the political media responses to Monday’s debate and found that the coverage was “imbalanced” and that it “calls into question the national media’s role in one of the most closely watched Senate races in the country.”

Democratic candidate Alison Lundergan Grimes made national headlines during the debate for again declining to share how she voted in previous presidential elections. At the same time, however, the Washington press corps barely covered a claim by incumbent Sen. Mitch McConnell that Obamacare, unpopular in Kentucky, could be repealed without dismantling Kynect, the popular statewide healthcare exchange funded through the law. McConnell’s argument is not only factually questionable, at best, but also seems to be of much more potential consequence to the state’s voters. Monday’s debate was the only televised face-off scheduled before the November election, and the imbalanced coverage calls into question the national media’s role in one of the most closely watched Senate races in the country.

Grimes’ non-answer received headline treatment on web stories at CBS, NBC ABC, and CNN. The Washington Post devoted an entire piece to the refusal, which led the Associated Press’ story , and Politico and National Journal both listed it as their top takeaway of the debate. Such stories either omitted McConnell’s claim or played it down relative to Grimes’ comment. FoxNews.com mentioned only the latter, meanwhile, and The Wall Street Journal left McConnell’s statement as its story’s kicker, unchallenged.

It’s not as if the media was hearing Mitch’s lie for the first time and simply lacked the time to study up on it. It had all been reported on before:

Liberalmedia and a few national outlets, such as the AP, challenged the five-term senator’s claim back [in May]. Indeed, an Obamacare repeal would have huge consequences for the Bluegrass State, as an estimated half-million residents have signed up for health coverage through its Kynect exchange. A Washington Post Fact Checker column soon after concluded, “the history of individual state exchanges shows it is not credible for McConnell to suggest that the state exchange would survive without the broad health-care system constructed by the Affordable Care Act, such as an individual mandate and subsidies to buy insurance.”

Given the availability of such reporting, not to mention McConnell’s hazy logic in a race in which Obamacare has been a central theme, it’s unclear why the national media didn’t pounce on his answer Monday. What’s more, local coverage of the debate suggests that Grimes’ voting history—a sign of her allegiance to President Barack Obama—is merely one of many concerns or Kentucky voters.

It is true that the DSCC stopped running ads in Kentucky in order to redirect funds to other state races. But the Democratic Senate campaign arm is still funding Grimes’s get-out-the-vote drive, and is “monitoring the race for future investments,” according to a DSCC official. In any case, Grimes is very well-funded herself, having just announced a record breaking nearly $5 million haul for the third quarter.

But the national media were quick to jump to the most melodramatic conclusion. As Daily Kos pointed out:

Today a rumor was spread throughout national media by irresponsible nationally-known media (Chris Cillizza, Jon Heilemann, Mark Halpirin, MSNBC, CNN) that “Democrats have abandoned Grimes”.

Heilemann and Halperin agreed on their program that “Her campaign is dead”.

This rumor was based upon the Democratic Senatorial Campaign Committee (DSCC) not having pre-purchased ad buys in KY market for last 3 weeks of campaign. The DSCC has been very active in the Kentucky market, with great ads playing. The DSCC acknowledged this was true, but that they were open to purchases if necessary.

Guy Cecil, the Executive Director of Democratic Senatorial Campaign Committee, posted at about 8:00pm eastern Tuesday night 10/14, on Twitter:

Guy Cecil ‏@guycecil 3h 3 hours ago

Just signed a $300,000 wire for the KY Get Out The Vote operation for @AlisonForKY. That’s an interesting view of “pulling out of the race”

And for all this, you’d never know that as of Wednesday afternoon, Alison Grimes is only three points behind Mitch McConnell in the RealClearPolitics average.

 

By: Leslie Savin, The Nation, October 15, 2014

October 17, 2014 Posted by | Media, Midterm Elections, Mitch Mc Connell | , , , , , , , | Leave a comment

“When A Politician Tells The Truth”: GOP Candidates Are Seeing Obamacare In A Different Light

In an interview with a reporter last month, Senator Thad Cochran (R-MS) “accidentally” made complimentary remarks about the Affordable Care Act, routinely known as Obamacare. (His campaign aides claim he misunderstood the question.) Some analysts say those remarks were among the missteps that have left the senator in danger of defeat as he faces a primary runoff against a Tea Party upstart, Chris McDaniel.

It’s possible that Cochran was confused when he told The Washington Post that the ACA “is an example of an important effort by the federal government to help make health care available, accessible and affordable.” It’s also possible that he committed the standard political gaffe as commentator Michael Kinsley defined it years ago: “… when a politician tells the truth — some obvious truth he isn’t supposed to say.”

Either way, Cochran’s comments are a reminder of a pronounced shift among Republican politicians discussing Obamacare on the campaign trail. Few of them are delivering feisty denunciations and declarations of repeal, as they did just a few months ago. Even in deeply conservative states, Republicans are muting their rhetoric, acknowledging positive tenets of the ACA and engaging in equivocation — or, in some cases, fabrication — to cover their tracks.

That’s because the political terrain has shifted beneath their feet. In practice, as its proponents have long predicted, the ACA has helped millions of people to obtain health care they would not have been able to afford otherwise. Surely it’s no surprise that few voters want to give up benefits they have just begun to enjoy.

That has meant some less-than-artful dodging by such indefatigable partisan warriors as Senate Minority Leader Mitch McConnell. In keeping with the GOP script, McConnell has been adamant about repealing the ACA.

But in his home state of Kentucky, Kynect, the state-run exchange that connects residents to Obamacare, is wildly popular, having signed up more than 400,000 people for health insurance. So McConnell takes advantage of voters’ confusion — many don’t understand that Kynect is Obamacare — to suggest he supports the exchange but not that foul law that made it possible. Indeed, he has gone so far as to declare that they are unconnected — a laughable lie, even in the warped reality of a political campaign.

Several other prominent Republicans have found themselves in a similar bind, as many facets of the law prove politically popular. Voters still don’t like “Obamacare,” but they like many of its provisions, including those that outlaw bans on patients who have pre-existing conditions.

Voters also support the provision that prevents lifetime caps on insurance payments — something that benefits those with serious, chronic illnesses — and the one that allows parents to keep their children insured until they are 26 years old. Indeed, the only provision that remains broadly unpopular is the mandate that requires every adult to buy health insurance (a necessary feature of the law, and one that many Republicans, including Mitt Romney, once believed in).

Perhaps the most dramatic shift among GOP pols has concerned Obamacare’s Medicaid expansion. The Supreme Court’s ruling affirming the ACA made the Medicaid expansion optional for states, and most Republican governors resisted it. That was foolish and shortsighted, since the federal government pays the overwhelming portion of the additional cost. Those governors — and their GOP colleagues in Congress — were willing to trade better health for some of their poorest residents for the chance to poke Obama in the eye.

But now some of them are seeing the error of that calculation. For one thing, it’s hard to own up to a willingness to shaft the working poor. For another, some rural hospitals can’t afford to stay open unless they receive additional Medicaid funds. Those hard facts have forced GOP Senate candidates such as Michigan’s Terri Lynn Land to back away from their diehard opposition to Obamacare.

And, as more Americans benefit, the resistance will grow weaker still. That was the historical cycle with Medicare — which the GOP establishment fought long and hard — and Obamacare will likely follow that path to broad acceptance.

 

By: Cynthia Tucker, Visiting Professor at The University of Georgia; The National Memo, June 7, 2014

June 9, 2014 Posted by | Affordable Care Act, GOP | , , , , , , , | Leave a comment

“Rand Paul’s Crazy Word Salad On Obamacare”: A Symbol Of GOP’s Larger Mess

Sen. Rand Paul made national news this weekend when he refused to say precisely whether he wanted to repeal Kentucky’s version of the Affordable Care Act, Kynect, along with the federal act itself. He bobbed and weaved like his boy Mitch McConnell, and most people have left it at that: another scared Republican afraid to tell the voters what he really thinks about a program that’s helped many of them. Reporters are used to that. Nobody except liberals even criticize it anymore, sadly.

But I want to look at Paul’s entire ludicrous soliloquy on Obamacare, Kynect and healthcare generally, because it shows how fundamentally unserious he is about domestic policy. Or if he is serious, he’s seriously delusional. It was every bit the nonsensical word salad we are used to being served by Sarah Palin, but maybe it’s sexism: Paul is never called out on it or mocked the way the former Alaska governor was. He ought to be.

I’ve written before that “Paul is what you get when traditional and corrosive American nepotism meets the 21st century GOP echo chamber: a pampered princeling whose dumb ideas have never been challenged by reality.” Ron Paul’s son has a tendency to look proud of himself whenever he shows a passing familiarity with facts and figures and ideas, even if he’s conflating or distorting them beyond any resemblance to reality. It’s on display in this interview with Kentucky reporters.

The junior senator from Kentucky starts out by acknowledging that Kynect gets a lot of praise, locally and nationally.

I think the real question that we have in Kentucky is people seem to be very much complimenting our exchange because of the functionality of it, but there are still the unknown questions or what’s going to happen with so many new people.

OK. Let’s take a look at “what’s going to happen with so many new people.” Here Paul rolls out some brand-new GOP anti-ACA scare tactics. First: The rapid expansion of Medicaid, he claims, is costing jobs.

I mean it’s basically about a 50 percent increase in Medicaid in one year. That’s a dramatic shot to a system. And my question is what will happen to local hospitals. If you look at [Glasgow, Kentucky, hospital] TJ Samson laid off 50 people and they’re saying they can’t afford the huge burden of Medicaid.

Oops, stop right there. While the hospital’s CEO did in fact link the layoff of 49 staffers to Obamacare in April, days later the Kentucky Cabinet for Health and Family Services disputed that account. It said the hospital would take in hundreds of thousands of dollars more in Medicaid funding annually, because it’s now being reimbursed for uninsured patients it used to treat without payment. Asked about the discrepancy, Paul just pointed to earlier reporting about the Samson CEO’s remarks and said: “All I know is what I read in the papers.”

So for President Rand Paul, the buck would presumably stop with the papers.

Then Paul raised the specter of folks getting their private health insurance subsidized under the Affordable Care Act, but with such high deductibles that they ultimately won’t be able to pay.

That’s gonna mean … you’re still just a non-payer, probably. And hospitals are going to have to figure out, we won’t know this for six months to a year, how many people who show up with subsidized insurance will actually be able to pay [their] deductible.

This could conceivably be a problem – actually, it was a big problem before the ACA – but Paul has no evidence the ACA made the problem worse. More likely it has helped some, because even with a high deductible plan, many preventive services are now provided without a co-pay. The point is, there’s no evidence of such a problem yet; Paul is just throwing trash at Obamacare to see what will stick.  And there’s more:

How many of the new people on Medicaid, how many of those people may have actually had insurance before? Did they go from being a non-payer to being a government payer? Or did they maybe have insurance, but now they’re on Medicaid because it’s easier than having insurance?

Paul could probably find out the answers to these questions, with staff work and a little consultation with the Kentucky Cabinet for Health and Family Services, but he would never bother. After hearing all of this bad news, much of it invented, a local reporter asked the senator the obvious question:

With all those unknowns, do you think Kynect should be dismantled?

And here Paul joins McConnell and punts. Or lies, since it’s pretty sure from his answer he thinks Kynect should be dismantled.

You know I’m not sure — there’s going to be … how we unravel or how we change things. I would rather —I always tell people there’s a fork in the road.

Oh, that fork in the road. Paul turns to boilerplate conservative rhetoric:

We could have gone one of two directions. One was towards more competition and more marketplace and one was toward more government control. The people who think that the government can efficiently distribute medicine need to explain why the VA’s been struggling for decade after decade in a much smaller system.

Points for working in the VA, the Obama scandal du jour. Let’s leave that alone, it’s a story in itself. Continue, Sen. Paul:

And they also need to explain, even though I think we all want Medicare to work better, why Medicare is $35 trillion short.

Huh? First of all, Paul doesn’t “want Medicare to work better,” he wants to repeal it. That’s something you don’t hear much about, but he sponsored a bill with Utah Tea Party Sen. Mike Lee to replace Medicare with the Congressional Health Care Plan members of Congress buy in to, essentially privatizing it. The bill would also raise the age of eligibility from 65 to 70. That ought to go over well with the GOP’s rapidly aging white base. That’s why Paul is forced to lie about his own Medicare position.

And the allegation that Medicare is “$35 trillion short”? I could find no documentation for it besides a Heritage Foundation blog post, and a ton of YouTube videos where Rand Paul makes the claim on Fox News.  It seems to refer to a 2011 estimate by Medicare trustees that the Part A Trust Fund would face a shortfall by 2026 unless payroll taxes were raised or program costs were trimmed – and the Affordable Care Act has been trimming them.  It’s bunk.

Then Paul turns briefly to the question of Kynect:

There’s a lot of questions that are big questions that are beyond the exchange and the Kynect and things like that. It’s whether or not how we’re going to fund these things.

But then he detours again, to take us back to the already debunked example of TJ Samson hospital’s Medicaid-induced “layoffs.”

If they lose 50 good paying jobs in the hospital, is that good? Then we’ve got more people in the wagon, and less people pulling the wagon.

With that profound Kentucky take on Paul Ryan’s “makers vs. takers” narrative, he walks away. And we’re back to Mitt Romney’s deriding the “47 percent.” In Paul’s more colorful telling, the problem is that some of us pull the wagon, while freeloaders and layabouts just lounge in it. For 50 years, Republicans have tried to tell voters the folks “in the wagon” are minorities. But in Kentucky, which is 88 percent white, they’re mainly white. So Rand Paul, the great 2016 hope, is really a prisoner of the elitist 2012 narrative that cost the GOP the White House.

Even though there’s so much to explore in Paul’s Kynect two-step – delusion, ideology, outright lies – the media mostly ignored it. Those who’ve paid attention simply covered the admittedly newsworthy Obamacare evasion. But I think Paul’s entire stand-up act, his performance art — Being a Very Serious Senator, or at least playing one on TV — deserves more attention. It’s only the soft bigotry of the media’s low expectations for Republicans, and maybe a little of society’s sexism, that makes Rand Paul someone to contend with in 2016, when Sarah Palin is widely just a punch line.

 

By: Joan Walsh, Editor at Large, Salon, June 2, 2014

 

June 3, 2014 Posted by | Affordable Care Act, Health Insurance, Rand Paul | , , , , , , , | Leave a comment

“McConnell’s Obamacare Policy”: Repeal It, Then Immediately Reinstate The Whole Damn Thing

I think there’s one way, and only one way, to interpret Mitch McConnell’s position on the Medicaid expansion in Kentucky, and last night the Washington Post’s fact checker confirmed it. McConnell wants to repeal the Medicaid expansion (along with the rest of Obamacare) and then let the people who run the state of Kentucky (i.e. people other than him) decide whether to reinstate it, and pay for it out of state coffers.

That’s a difficult position to support, which explains why his campaign obscures it behind a bunch of rambling designed to convince people (including very politically savvy people) that McConnell has come around to supporting the Medicaid expansion.

But it’s actually identical to his position on Kynect—the state’s health insurance exchange—and perhaps he’ll apply it to other integral parts of Obamacare as well. As a general matter it amounts to arguing that Obamacare should be repealed, and then reinstated in full at the state level. But that’s a total fantasy.

When Obamacare is repealed, the funding Kynect relies upon, as well as the health plans and rules that make it a popular and widely used portal, will disappear as well. No biggie, says McConnell. Once they’re gone, the state can decide whether it wants to reinstitute those things on its own.

But of course, as with Medicaid expansion, it’s almost impossible to imagine states riding to the rescue of those harmed by Obamacare’s repeal. Running the exchange is fairly expensive on its own, but its costs would dwarfed by the resources required to recreate the actual market Obamacare has created in Kentucky. Remember, Kentucky flirted with creating Obamacare’s coverage guarantee without creating any incentives for everyone to purchase insurance. No mandate, no subsidies. And the system predictably collapsed. But it’s unlikely that Kentucky could afford to reinstate ACA-style subsidies on its own. And without them, the plans will be too expensive to justify a mandate. And so under McConnell’s policy, Kentucky’s newly insured would be left with nothing.

The idea that ACA politics are gruesome for Democrats is so deeply ingrained in the national media’s belief system that it won’t be shaken loose by McConnell’s dissembling alone. But if it were true, why would Republicans across the country be hiding their true views about Obamacare behind the word “fix”? Why would any Republicans, let alone the Senate GOP leader, be saying they want to get rid of everything Obamacare does except the things it does in their own states?

 

By: Brian Beutler, The New Republic, May 30, 2014

June 1, 2014 Posted by | Affordable Care Act, Mitch Mc Connell | , , , , , , | Leave a comment

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