“GOP’s New Immigration Spin”: If We Can’t Pass Reform, It’s Obamacare’s Fault
If you’ll recall the recent legislative history of “comprehensive immigration reform,” this has been the cycle: Democrats and senior Republicans all agree that we should do it, some proposals are proposed, and then it dies, usually in the House, because conservatives are very opposed to comprehensive immigration reform. Some time passes, and then we all try again. There will be another doomed-to-fail attempt this year, according to Democrats and senior Republicans. As usual, Republicans have preemptively assigned blame for its failure to President Obama.
Before his 2012 reelection, Republicans frequently argued that Barack Obama wanted immigration reform to fail, so that he could make Republicans look bad to Hispanics and use that to win reelection. After his reelection, when Obama decided to make another push for reform, under the assumption that a chastened GOP would play along, it eventually became clear that no immigration bill that provided an opportunity for citizenship for currently undocumented residents could pass the House. The end, for Immigration Reform 2013. On to Immigration Reform 2014.
Here’s the latest: Speaker of the House John Boehner will “unveil a set of Republican principles for immigration reform before Obama’s Jan. 28 State of the Union address.” He and Majority Leader Eric Cantor told fellow Republicans that reform would be a priority this year. Barack Obama has been described by Senator Chuck Schumer as “cautiously optimistic” that the House would pass something this year. It’s all finally happening!
Or what is happening, at least, is that John Boehner has decided that Republicans once again need to appear open to the idea of creating a more humane immigration process.
This Politico piece basically explains Boehner’s strategy. His list of principles will include “beefed-up border security and interior enforcement,” and “earned legal status,” presumably instead of “citizenship,” for undocumented immigrants. Plus, it won’t be one big bill, because Republicans have spent the entire Obama administration decrying long bills, for their length.
The draft principles will also include a promise that immigration reform will be done on a step-by-step basis and will foreclose the possibility of entering into conference negotiations using the Senate’s comprehensive package — pledges that could soothe some Republicans.
Mm-hmm. Soothe some Republicans, and also allow those Republicans to vote for more border security without voting to legalize anyone. That’s always been the point of passing reform “step-by-step.” Not that anyone even actually expects this limited, piecemeal proposal to pass!
The secret talks are taking place even as leaders doubt that such efforts will be fruitful, in part because of opposition from conservatives who sank the prospects for reform last year. That dynamic hasn’t changed. But Republicans think stating their position is important and could help chart a path forward for reform in 2015 after the midterm elections.
And that’s the paragraph that should end all 2014 “could this be the year comprehensive immigration reform passes” pieces. (We finished early this year, everyone!) Republicans think “stating their position” — a position they will state by claiming it is their position, not by voting to make their ostensible position law — is important, for branding reasons, but the House is still full of conservatives, so there’s still no hope for reform.
That’s why this year, just like last year and the year before, immigration reform won’t happen: There aren’t enough votes for it in the House, because conservatives oppose it and Boehner won’t try to pass it with mostly Democratic votes.
There is an alternative explanation, though. One that, conveniently, makes the failure of immigration reform the fault of people other than the ones who explicitly don’t support it. This is the explanation Andrew Stiles takes for a test drive at the National Review. Maybe immigration won’t happen because … Obamacare!
A number of House Republicans, including Majority Leader Eric Cantor (R., Va.), have argued that the Obamacare fiasco is to blame for their reluctance to tackle immigration reform.
I see. Please, Marco Rubio, regretful former member of the Senate immigration “gang of eight,” explain:
Other Republicans, including Senator Marco Rubio (R., Fla.), one of the architects of the Senate bill, have suggested that President Obama cannot be trusted to properly implement a large-scale immigration reform, given the countless waivers and exemptions he has handed out with respect to Obamacare. Conservative skeptics have long argued that there would be little stopping the administration from fully implementing aspects of the new law it likes, such as legalization and citizenship for illegal immigrants, while completely ignoring the provisions it doesn’t like, such as increased border security and interior enforcement. As Rubio told conservative radio host Laura Ingraham yesterday, “even people that would like to do something on [immigration reform] are finding it hard to argue against that.”
This is not a terribly surprising message from Rubio, who began trashing comprehensive immigration reform about 10 minutes after the bill he helped craft passed the Senate with his support, but it is a fun new variation on the classic Senate “I can’t support this thing I support because of this unrelated thing” argument. It certainly is strange that conservatives opposed immigration reform before the botched Healthcare.gov website rollout, if that botched rollout is why they can’t pass reform, isn’t it?
“Obamacare” is a great excuse to avoid ever doing anything. How can we trust this administration to go to war against Iran if it can’t build a website? We should probably destroy our nuclear arsenal, before the Obungler bungles his way into armageddon. And don’t get me started on the NSA! I didn’t do my homework because I cannot trust this administration to grade it correctly.
“We can’t pass reform because we don’t trust the president” isn’t really a better or more convincing argument than the last one (“the president doesn’t want us to pass reform because he wants us to look bad”), and I don’t expect it to make the Republican Party look more compassionate or appealing to people who currently (correctly) think conservatives are excessively hostile to immigrants in general and Latinos specifically. But the point isn’t really to make an immediate play for the Latino vote in 2014. It’s sort of light legislative extortion: If you want reform to pass, you’d better elect a Republican president. It would almost be convincing — a pro-reform Republican president would be more likely to convince or force congressional Republicans to vote for reform than a hated Democratic president has been — if it weren’t for the fact that Congress already tried this under President George W. Bush, and it failed. Because conservatives control the GOP and most conservatives oppose granting undocumented immigrants legal status. It’s that simple.
As the ACLU notes, there is still one thing that could upend the entire immigration debate: the potential deportation of pop superstar Justin Bieber. We can only hope that mere possibility will finally spur Congress to act.
By: Alex Pareene, Salon, January 20, 2014
“Let’s Not Forget Medicare Advantage”: Selective Outrage Over Federal Health Care Costs
Knowing I’ve been both a critic of insurance company practices and a supporter of efforts to reform the industry, a FOX news producer reached out last week to get my take on accusations by conservatives that Obamacare will actually result in a bailout of big insurance companies.
Under the headline, “Bailing Out Health Insurers and Helping Obamacare,” The Weekly Standard on Monday urged Republicans to insist that future debt ceiling increases contain a no-bailout provision. The magazine also cited Sen. Marco Rubio’s, R-Fla., bill to repeal a provision of the Affordable Care Act designed to limit potential initial losses of insurers selling policies on the new health insurance exchanges.
I reminded the FOX producer that Republicans have been supporting — and vigorously defending — a much more expensive transfer of taxpayer dollars to private insurers than the one Obamacare foes are now concerned about.
Here’s the issue:
Lawmakers who drafted the Affordable Care Act knew that insurers would be reluctant to participate in the new health insurance exchanges — also called marketplaces — if the government didn’t create a temporary program to protect them against what’s known in the insurance world as adverse selection.
Insurers were concerned, for good reason, that the first people to sign up for coverage through the exchanges would be folks previously shut out of the insurance market — people who were older and sicker than the population at large. Those people couldn’t afford to buy coverage previously because insurers were able to charge them far more than younger, healthier people.
In many cases, insurers refused to sell coverage at any price to prospective customers with preexisting conditions. That’s a big reason why the number of uninsured Americans had reached nearly 50 million when Congress passed the reform law.
So it wasn’t the least bit surprising that the first few million who have signed up for coverage since the exchanges opened on Oct. 1 skew older than many expected. People who have been denied coverage for years are far more motivated to get insurance — and fast — than anyone else. There is not the same pent up demand among the young and healthy.
In anticipation of this, drafters of the reform law established a $25 billion risk fund to insulate insurers from big losses during the first three years. Although the risk fund has always been in the law, conservative pundits apparently just became aware of it.
Yes, $25 billion is a lot of money, but it is pocket change compared to the enormous amount of taxpayer dollars that have been flowing to private insurance companies for nearly three decades to keep them in the Medicare Advantage program, which has had the unwavering support of Republicans.
Republicans have long supported efforts to privatize Medicare, and the Medicare Advantage program is one of the ways they’ve tried to do it. Medicare Advantage is billed as a private alternative to traditional Medicare. When Americans reach 65, they can enroll in traditional Medicare or in a private plan operated by an insurer. If they opt for a private plan, the federal government still picks up the tab and transfers money to the private insurer every month.
As the U.S. Government Accountability Office explains it, the Centers for Medicare and Medicaid Services (CMS) adjusts the monthly payments it sends to private insurers to account for each beneficiary’s health status. As part of this risk adjustment process, CMS assigns each Medicare Advantage beneficiary a risk score — “a relative measure of expected health care costs,” as the GAO puts it.
We’re talking a lot of money here. In 2012 alone, the GAO calculated that the federal government spent about $135 billion on the Medicare Advantage program. The problem for taxpayers is that, according to the GAO, the government has been more than generous over the years to private insurers, having paid them way more than it should have because of shortcomings in how the risk scores are developed.
Interestingly, but not surprisingly, there was no mention of that, or any reference at all to the Medicare Advantage program, the biggest champion of which are Republicans, in The Weekly Standard’s “bail-out” story last week. If they are sincere in their alarm that Obamacare might reward private insurers with an extra $25 billion between now and the end of 2016, they should be apoplectic about the ongoing bailout known as the Medicare Advantage program.
By: Wendell Potter, The Center for Public Integrity, January 20, 2014
“Obamacare’s a ‘Bailout’ Now?”: Conservative Critics Are Getting Desperate
Conservatives used to say Obamacare is socialized medicine. Now they say it is a “government bailout” of insurers.
The new claim is just as misleading and cynical as the old one.
The latest conservative playing thing is a pair of previously obscure Obamacare features: “reinsurance” and “risk corridors.” Their mechanisms are a bit complicated to explain. (Read here if you want the details.) What matters is their shared purpose, which is to reimburse insurance companies that end up taking heavy losses—say, because the new marketplaces don’t attract enough young, healthy subscribers. Remember, insurers depend on premiums from people in good health to subsidize the costs of the sick. Without the right mix, the premiums insurers collect won’t be sufficient to cover the cost of clams. They’ll lose money, raise premiums in the future, drop out of the market altogether, or some combination of the three. In short, bad stuff will happen.
To Obamacare supporters, reinsurance and risk corridors are tools for stabilizing the insurance market and easing the transition from the old system to the new. (That’s why I’ve been calling them “shock absorbers.”) But the provisions started attracting scrutiny from the right in the fall, when policy watchers like David Freddoso of Conservative Intelligence Briefing first wrote about it. Now reinsurance and risk corridors are getting more sustained attention from the Weekly Standard, Fox News, and the conservative movement writ large. Republican Senator Marco Rubio has sponsored a bill to repeal the risk corridors. “Why should taxpayers have to bail out health insurance companies in the increasingly likely event that ObamaCare leaves them with financial losses?” Rubio wrote this week, in an op-ed for the Fox website. “This is government favoritism and corporate cronyism at its worst, and it’s taxpayers that will pay the price unless we stop it.” Insurers are sufficiently spooked that, as Buzzfeed’s Kate Nocera has reported, they are undertaking a lobbying campaign to keep the provisions in place.
The bailout analogy is potent. And it’s certainly accurate to say that, under Obamacare, some insurers may collect payments from the government to help offset losses. But the analogy breaks down after that.
Bailouts typically start with companies taking egregiously irresponsible actions and end with the government forking over mind-boggling sums of money to save them. Think of the savings and loans institutions misleading the public about the state of their finances in the 1980s—or the financial industry making those bad home loans and risky investments a decade ago. Each of those involved grievous management errors, frequently skirting the limits of legality. The federal outlays to save those banks were in the hundreds of billions of dollars.
With Obamacare, the situation is different. Projecting future insurance costs inevitably involves a little guesswork. With a brand new program like Obamacare, it inevitably involves a lot of guesswork. Even the smartest, most responsible actuaries might not get the numbers right, for reasons Sy Mukherjee of ThinkProgress explains:
Insurance companies were sort of shooting in the dark when they set premiums for Obamacare’s first year. They had to approximate how many people would enroll, how old the customers would be, how sick they would be, how much insurers would have to pay out in claims — but the whole enterprise was, ultimately, a series of educated guesses.
Will the guesses prove wrong? Humana officials told investors last week that the risk pools look a little worse than they had anticipated. But, as Sarah Kliff of the Washington Post just reported, officials at Wellpoint say their risk pools seem ok while the CEO of Aetna described the demographics as “better than I thought they would have been.”
Truth is, no insurer will be sure about its beneficiaries for many months, until the open enrollment period ends and the newly insured have a few months in which to file claims. That makes it impossible to know what kinds of losses, if any, insurers will take. But even if the losses are significant, the taxpayers won’t be in for another Wall Street-style bailout.
For one thing, the reinsurance money comes from the insurers themselves, who pay a tax on each beneficiary. It’s basically a transfer of funds, from all carriers to those companies inside the Obamacare marketplaces that end up with unusually unhealthy members. In this sense, it’s an insurance policy for the insurers—and one they more or less finance on their own.
The payouts from risk corridors are a little different, in the sense that those dollars come directly from government funds and have no actual limit. But the risk corridors also build up government funds—in effect, by claiming some of the profits from insurers who reap unexpected windfalls. The Congressional Budget Office, in its overall cost estimates for the Affordable Care Act, assumed that the inflow and outlfow would be roughly the same, so that the risk corridor program as a whole would be budget neutral. Even if CBO’s prediction is wrong, and the government ends up spending more than it raises, the difference is likely to be modest. The formula for payouts calls merely for government to share in high losses or gains, not to take them on completely. It’s enough to protect the insurers, the thinking goes, but not enough to cause a massive outlay. Meanwhile, lower-than-expected premiums are likely to save the government much more money than the risk corridors would ever pay out.
Conservatives might object to reinsurance and risk corridors on principle, regardless of amounts involved. That would be a perfectly legitimate argument, except for one thing: Reinsurance and risk corridors are already a feature of some government programs, most prominent among them Medicare Part D. The reinsurance and risk corridors in Obamacare and Medicare Part D are remarkably similar, except that Obamacare’s are temporary and Medicare Part D’s are permanent—which is to say, they are still part of the program.
What’s that? You haven’t heard Republicans attacking Medicare Part D as an insurer bailout? Maybe that’s because of one other, obvious difference between Part D and the Affordable Care Act. Only one of them was signed into law by a guy named Barack Obama.
Update: The Rubio bill would repeal only the risk corridors. Originally, I wrote that it would repeal both provisions. My apologies for the error.
By: Jonathan Cohn, The New Republic, January 16, 2014
“One Trick Pony”: Ted Cruz Cements His Position As The GOP’s Master Troll
On the Internet, a troll purposely inflames anyone he can to attract attention to himself, in hopes of wasting everyone’s time and energy. In the Republican Party, a troll does the same thing and he becomes a hero of the far right and a frontrunner for the 2016 Republican presidential nomination.
Senator Ted Cruz (R-TX) announced on Monday that he had hired Paul Teller as his deputy chief of staff.
Teller — a favorite of outside conservative groups like Club for Growth — was swiftly fired from his position as executive director of the far-right Republican Study Committee in December after leaking conversations between House members.
Cruz’s new hire immediately won praise from Red State’s Erick Erickson, a leader in the movement to push the Republican Party further to the right by demanding continued standoffs in Congress and supporting primary challenges to incumbents, including Senate Minority Leader Mitch McConnell (R-KY).
House Speaker John Boehner (R-OH) joined McConnell in speaking out against outside conservative groups in December, after several opposed the budget deal Rep. Paul Ryan (R-WI) negotiated with Senator Patty Murray (D-WA). By hiring Teller, Cruz cements his allegiance with the groups who championed his effort to shut down the government over Obamacare, which he was able to pull off with the help of the House GOP’s so-called “suicide caucus,” many of whom are members of the Republican Study Committee.
Cruz’s willingness to spurn his party’s leaders represents just one trick in his impressive arsenal of trolling tactics.
The Harvard-educated lawyer, who argued in front of the Supreme Court nine times, recently published a 10,000-word article in the Harvard Law Review that speaks to one of the darkest fantasies of the Tea Party movement: How the United Nations is coming to take our golf courses.
The Daily Beast‘s Ben Jacobs points out that Cruz is artfully speaking to the fear of a world government, a fringe idea that’s surprisingly widespread among the Republican base. If he spoke about his concerns about the UN on network television, he would be deemed “wacky” or “wackier.” So instead, he’s presenting them in one of the most prestigious law journals in the world.
The senator’s immense intellect gives him the ability to frame his extremism in acceptable venues. And it also enables him to make convenient arguments against the president that serve his agenda but crumble under scrutiny.
In an attempt to brand Obama as “imperial,” Cruz attacked the president for ignoring federal law in effectively allowing Colorado and Washington state to legalize marijuana.
This critique raised the hackles of Jacob Sullum at Reason.com, who points out that the federal government has virtually never prosecuted personal marijuana use. The Department of Justice has retained the right to crack down at any time, something the senator decided not to point out. But for now, the DOJ has decided to use its “limited investigative and prosecutorial resources to address the most significant threats in the most effective, consistent, and rational way” — as it always has.
But since Cruz lumped his concerns about marijuana legalization in with a screed against Obamacare, he knows that few in the audience he’s trying to reach will parse out what he’s saying.
The shutdown that the senator championed has led to new lows in popularity for the Republican Party.
However, a big chunk of the GOP’s unfavorable rating comes from the party’s base.
In a recent YouGov/Economist tracking poll, 37 percent of Republicans viewed the members of their own party unfavorably, compared to 10 percent of Democrats. Many Republicans believe the party actually gave up too soon in the government shutdown standoff. They want constant, unwavering opposition and charges of lawlessness against the president.
Essentially, they want the party to be made up entirely of Ted Cruzes.
We’ve been telling you about the remarkable descent of Senator Marco Rubio (R-FL) from Republican savior to Tea Party troll.
But Rubio’s problem is that compared to Cruz, he’ll always be a squish. He’s dabbled in bipartisanship and proposed “amnesty” for “illegals.” Even if the junior senator from Florida ultimately votes against his own bill, he’ll still be the kind of Republican Ted Cruz lives to crush, even if the senators agree on almost every conceivable issue.
This isn’t because Rubio is not intent on being disruptive or contentious or a “walking press release announcing a no vote.” It’s because he’ll always be in the shadow of a true master of the form.
By: Jason Sattler, The National Memo, January 14, 2014
“Enemies Of The Poor”: Republicans Are Doing All They Can To Hurt The Poor
Suddenly it’s O.K., even mandatory, for politicians with national ambitions to talk about helping the poor. This is easy for Democrats, who can go back to being the party of F.D.R. and L.B.J. It’s much more difficult for Republicans, who are having a hard time shaking their reputation for reverse Robin-Hoodism, for being the party that takes from the poor and gives to the rich.
And the reason that reputation is so hard to shake is that it’s justified. It’s not much of an exaggeration to say that right now Republicans are doing all they can to hurt the poor, and they would have inflicted vast additional harm if they had won the 2012 election. Moreover, G.O.P. harshness toward the less fortunate isn’t just a matter of spite (although that’s part of it); it’s deeply rooted in the party’s ideology, which is why recent speeches by leading Republicans declaring that they do too care about the poor have been almost completely devoid of policy specifics.
Let’s start with the recent Republican track record.
The most important current policy development in America is the rollout of the Affordable Care Act, a k a Obamacare. Most Republican-controlled states are, however, refusing to implement a key part of the act, the expansion of Medicaid, thereby denying health coverage to almost five million low-income Americans. And the amazing thing is that they’re going to great lengths to block aid to the poor even though letting the aid through would cost almost nothing; nearly all the costs of Medicaid expansion would be paid by Washington.
Meanwhile, those Republican-controlled states are slashing unemployment benefits, education financing and more. As I said, it’s not much of an exaggeration to say that the G.O.P. is hurting the poor as much as it can.
What would Republicans have done if they had won the White House in 2012? Much more of the same. Bear in mind that every budget the G.O.P. has offered since it took over the House in 2010 involves savage cuts in Medicaid, food stamps and other antipoverty programs.
Still, can’t Republicans change their approach? The answer, I’m sorry to say, is almost surely no.
First of all, they’re deeply committed to the view that efforts to aid the poor are actually perpetuating poverty, by reducing incentives to work. And to be fair, this view isn’t completely wrong.
True, it’s total nonsense when applied to unemployment insurance. The notion that unemployment is high because we’re “paying people not to work” is a fallacy (no matter how desperate you make the unemployed, their desperation does nothing to create more jobs) wrapped in a falsehood (very few people are choosing to remain unemployed and keep collecting benefit checks).
But our patchwork, uncoordinated system of antipoverty programs does have the effect of penalizing efforts by lower-income households to improve their position: the more they earn, the fewer benefits they can collect. In effect, these households face very high marginal tax rates. A large fraction, in some cases 80 cents or more, of each additional dollar they earn is clawed back by the government.
The question is what we could do to reduce these high effective tax rates. We could simply slash benefits; this would reduce the disincentive to work, but only by intensifying the misery of the poor. And the poor would become less productive as well as more miserable; it’s hard to take advantage of a low marginal tax rate when you’re suffering from poor nutrition and inadequate health care.
Alternatively, we could reduce the rate at which benefits phase out. In fact, one of the unheralded virtues of Obamacare is that it does just that. That is, it doesn’t just improve the lot of the poor; it improves their incentives, because the subsidies families receive for health care fade out gradually with higher income, instead of simply disappearing for anyone too affluent to receive Medicaid. But improving incentives this way means spending more, not less, on the safety net, and taxes on the affluent have to rise to pay for that spending. And it’s hard to imagine any leading Republican being willing to go down that road — or surviving the inevitable primary challenge if he did.
The point is that a party committed to small government and low taxes on the rich is, more or less necessarily, a party committed to hurting, not helping, the poor.
Will this ever change? Well, Republicans weren’t always like this. In fact, all of our major antipoverty programs — Medicaid, food stamps, the earned-income tax credit — used to have bipartisan support. And maybe someday moderation will return to the G.O.P.
For now, however, Republicans are in a deep sense enemies of America’s poor. And that will remain true no matter how hard the likes of Paul Ryan and Marco Rubio try to convince us otherwise.
By: Paul Krugman, Op-Ed Columnist, The New York Times, January 12, 2014
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