“Stuck Between Obamacare And A Hard Place”: As A Massachusetts State Senator, Scott Brown Voted For Romneycare
Former Massachusetts Sen. Scott Brown will officially kick off his campaign to unseat New Hampshire Democratic Sen. Jeanne Shaheen tonight, as he attempts to return to the world’s greatest deliberative body (or something) after being ousted from his Bay State Senate seat by Democrat Elizabeth Warren two years ago. According to leaked excerpts of the speech he plans to deliver tonight, Brown will be campaigning against Obamacare, just as he did in 2010 when he won an upset in the race to succeed the late Sen. Edward Kennedy.
“Along with our money and our health plans, for a lot of us, it feels like we’re losing our liberty, too. Obamacare forces us to make a choice, live free or log on — and here in New Hampshire, we choose freedom,” Brown plans to say. (Get it? Because New Hampshire’s state motto is “live free or die.” But wait, if Obamacare is the major assault on freedom Republicans claim it is, do you have the choice to live free under it? Or is it just that “log on or die” didn’t send the right message? But I digress.)
There’s definitely a danger for Brown in taking this approach. Yes, the health care law has, according to a recent WMUR Granite State poll, a less than stellar approval rating in New Hampshire, with only 34 percent saying they approve of it while 53 percent say they oppose it. (Let’s add the caveat that the poll doesn’t say what portion of the opposition thinks the law goes too far and what portion thinks it doesn’t go far enough.) But Brown will have a hard time getting around the various problems other Republicans are running into when it comes to making Obamacare a focal point of a campaign.
For starters, the law may be unpopular in theory, but in practice, signups under Obamacare’s New Hampshire exchange have exceeded expectations. Does Brown have a plan for providing for those folks? Or how about the estimated 50,000 people who are going to receive health insurance under New Hampshire’s recently approved Medicaid expansion, which was made possible by Obamacare and on which Brown has thus far been mum? Those are real people who are experiencing real benefits from the law.
And therein lies the problem for Republicans, which Brown is eventually going to run into as well: Providing the benefits of Obamacare requires something that looks like Obamacare. Just look at this quote a Republican aide gave to Talking Points Memo’s Sahil Kapur (emphasis added):
As far as repeal and replace goes, the problem with replace is that if you really want people to have these new benefits, it looks a hell of a lot like the Affordable Care Act. … To make something like that work, you have to move in the direction of the ACA. You have to have a participating mechanism, you have to have a mechanism to fund it, you have to have a mechanism to fix parts of the market.
And Brown knew this once upon a time. As my former colleague Igor Volsky noted, as a state senator Brown voted for the Massachusetts health reform law that looks a whole lot like Obamacare.
This is exactly why the long awaited Republican health care alternative never actually comes to fruition. (Sure, some individual lawmakers have proposed plans, but the party hasn’t coalesced around one bill.) To actually craft an alternative, the GOP would either have to admit that Obamacare is a pretty darn conservative measure or admit, like House Budget Committee Chairman Paul Ryan did the other day, that the popular provisions and benefits of Obamacare have to go away as well in order to enact a more Republican-y plan.
Will that latter approach work in still quite blue New Hampshire? Or will Brown try to get away with hand waving about an Obamacare alternative that will never materialize? Either way, spouting “live free or log on” will be no slam dunk.
By: Pat Garofalo, U. S. News and World Report, April 10, 2014
“Irrational Hatred Of Obamacare Is Hard To Fathom”: The GOP’s Relentless Opposition Has Been Puzzling
My friend Isatou has just received an invoice from Kaiser Permanente, testament to her new coverage through the Affordable Care Act — usually called “Obamacare.” She’s thrilled to finally have health insurance so she can get regular checkups, including dental care.
A reasonably healthy middle-aged woman, she knows she needs routine mammograms and screenings for maladies such as hypertension. But before Obamacare, she struggled to pay for those things. She once had to resort to the emergency room, which left her with a bill for nearly $20,000. (She settled the bill for far less, but it still left her deeply in debt.)
She is one of more than 7 million people who have signed up for health insurance through the ACA, stark evidence of the overwhelming market demand. Despite a badly bungled initial rollout, a multimillion-dollar conservative media campaign designed to discourage sign-ups, and a years-long Republican crusade against it (50 votes to change the law), millions got health insurance.
That hardly means Obamacare is a raging success. It’s much too early to know how it will affect health outcomes for the previously uninsured. But it’s abundantly clear that the ACA has already made great strides in improving access to health care. And that alone is quite an accomplishment.
Now, young adults can stay on their parents’ health insurance policies until they are 26 years old — a boon in an economy where many young folks are struggling to find decent jobs. Now, patients with previously diagnosed illnesses (“pre-existing conditions,” in insurance lingo) can’t be denied coverage. Now, the chronically ill don’t have to worry about hitting a lifetime cap that would deny them essential procedures or pharmaceuticals. Now, working folks who don’t get insurance through their employers can purchase affordable policies.
Factoring in the Medicaid expansion, the ACA has extended health care coverage to an additional 9.5 million people, according to the Los Angeles Times, which gathered data from national surveys. Needless to say, millions more would have been covered if so many Republican governors, mostly located in Southern states, had not callously refused to accept the Medicaid expansion despite the fact that it is largely paid through federal government funds.
The GOP’s relentless opposition has been puzzling. Republicans have resorted to extreme measures to try to derail Obamacare, including an implicit threat to prevent the National Football League from participating in a marketing campaign to encourage people to sign up.
Oh, did I mention 50 votes to repeal or alter the law?
Even acknowledging that our politics have become bitterly polarized, I don’t understand this one. Even taking into account the GOP’s irrational hatred for President Obama, I don’t get it. Even though I know that Republicans believe in less government, I don’t understand their approach to Obamacare.
First off, the ACA adheres to market-based ideas, many of which were first suggested by conservatives. Instead of a single-payer system like, say, Medicare, the ACA relies on private insurance companies. It adopts the individual mandate that was supported by many Republicans, including Newt Gingrich, back in the 1990s and later adopted by Mitt Romney in Massachusetts.
Second, Republicans are free to offer up a health care scheme that is more in keeping with conservative principles. But the “repeal and replace” mantra is rarely heard anymore since it has become increasingly clear that the GOP has no intention of coming up with a plan to replace Obamacare. While there are various counter-proposals floating about, none has garnered the support of a majority of Republicans in Congress.
Is the ACA perfect? Absolutely not. There is much in the law that needs to be worked on, refined, improved. But the GOP doesn’t seem interested in that. Instead, its members have taken to engaging in increasingly ridiculous criticisms, including the charge that the White House has made up the number of successful enrollees.
It’s strange. Could it be that Republicans are simply furious that millions of Americans like Isatou finally have health insurance?
By: Cynthia Tucker, Winner of the 2007 Pulitzer Prize for Commentary, is a Visiting Professor at the University of Georgia; Published in The National Memo, April 5, 2014
“Blood On GOP’s Hands”: How Many Would Be Covered Without Its Sabotage Plan?
The cynicism of the GOP’s anti-Obamacare strategy has been obvious forever, but some particular kinks in it only became clear as the enrollment deadline approached and it seemed the Obama administration would not just meet but beat its public-exchange enrollment target. Republicans went from shrieking about what an awful program it was to complaining that not enough people had signed up, and then, when the goal was met, complaining that not enough uninsured people had gotten coverage, and of course lying about that, too.
The lunacy of their complaint – “This program is a nightmare – but not enough people are being helped by it!” – is like the old joke about the kvetchy restaurant patron who complains the food is terrible, and the portions are too small. It would be funny if it weren’t sad.
I confess that the freakout over the federal exchange’s rocky start had me convinced the administration would miss its enrollment target. So hitting the seven million mark is cause for elation, but also anger: Imagine how many people might have enrolled if the entire Republican Party coast to coast hadn’t spent the last six months telling them not to?
Let’s take it further: Imagine if all 50 states had implemented their own exchanges, instead of just 17 of them. Imagine if all 50 states had expanded Medicaid, instead of just 27. Imagine if a well-funded noise machine, from Fox to Rush to the online swarm hadn’t publicized every glitch and every allegation of someone losing their insurance, often fabricating the problems, sometimes lying outright, while ignoring every positive story.
It’s absolutely true that this first enrollment period still leaves most of the uninsured without insurance. Still, at least 9.5 million of the uninsured now have care, thanks to the state and federal exchanges, Medicaid expansion and people buying coverage privately. (On Fox, Charles Krauthammer simply lied when he says it’s only 1 million.) It must be noted that states that built their own exchanges and expanded Medicaid did much better when it comes to covering the uninsured. The Los Angeles Times estimates that at least 27 percent of the newly insured were previously uninsured; in Kentucky, it’s 75 percent and in New York it’s 70 percent. If Republican governors and legislatures hadn’t sabotaged the program in roughly half the states, we would see numbers like that nationwide.
When you add in young people covered by their parents’ insurance and people with pre-existing conditions who can now get coverage, the number goes higher still. As President Obama noted in his Rose Garden victory lap, 100 million people have received free preventive care under new regulations for insurance plans. It’s no wonder that the latest Washington Post/ABC News poll showed approval of the Affordable Care Act topping disapproval for the first time ever, with approval jumping from 40 percent in November to 49 percent last week. Barring a major meltdown, those numbers are likely to climb too.
This is, of course, what the GOP feared – not that the plan would fail, but that it would work. Again, it’s not perfect – we still don’t know exactly who signed up, and whether the balance of young and old, sick and well will make plans affordable. But this enormous milestone should make Democrats smarter about how to make Republicans pay for their obstruction in 2014. The conventional wisdom is that Obamacare will be a millstone in the midterms, especially for red state Democrats, but conventional wisdom is often wrong.
Democrats should challenge Republicans to take away that free preventive care from 100 million Americans. Challenge them to transfer money from women back to men, by letting insurance companies once again charge women more, sometimes much more, for health insurance. Take insurance away from people with pre-existing conditions; kick young people off their parents’ plans. Roll back Medicaid expansion in the 27 states that participated. Go on and tell the American people you’re going to do that, Republicans. The midterms might not be the cakewalk you think.
By: Joan Walsh, Editor at Large, Salon, April 2, 2014
“Laying It All Out On Medicare”: No Mistaking Paul Ryan’s Policy
The release of a new Paul Ryan budget plan is always the occasion for a lot of ridicule from liberals, for a whole bunch of reasons, and this year’s will be no different. Ryan’s budgets always manage to combine a remarkable cruelty toward poor people with a sunny optimism that draconian cuts to social services will result in a veritable explosion of economic growth, allowing us to balance the budget without taking anything away from the truly important priorities (like military spending) or, heaven forbid, forcing wealthy people to pay more in taxes.
I’m sure there are other people preparing detailed critiques of the Ryan budget, but I want to focus on one thing this brings up: the question of how we talk about Medicare. As he has before in his budgets, Ryan proposes to repeal the benefits of the Affordable Care Act, like subsidies for middle-class people to buy insurance and the expansion of Medicaid, but he’d keep the tax increases and Medicare cuts that the bill included in order to pay for it all, which helps him achieve his “balanced” budget.
Yes, it’s true that when Ryan was running for vice president, he joined Mitt Romney in condemning those very Medicare savings. But nobody really believed he was doing anything at the time but being a team player. So we can give him credit for taking at least a step toward putting his money where his mouth is on Medicare. Sure, it may be couched in some misleading words (the document refers to “strengthening Medicare” no fewer than ten times), but there’s no mistaking the policy.
Because the rest of his party is, to put it kindly, of two minds when it comes to the program. On one hand, they will tell you, Medicare is unsustainable, a ravenous beast that will devour the entire nation’s financial well-being if we don’t find a way to suppress its appetite. In Washington-speak, this is translated as “doing something about entitlements.” We have to Do Something About Entitlements! If you don’t want to Do Something About Entitlements, you’re just not serious about our nation’s fiscal challenges.
On the other hand, Republicans believe that Medicare is utterly sacrosanct, a jewel whose every facet is so perfect that even the most modest attempt to curtail its costs should be met with howls of anguish and outrage. Or at least that’s what they believe at election time, when they’ll air one ad after another condemning Democrats for cutting the Medicare seniors so desperately need. Democrats all over the country have been subjected to ads saying, “Congressman Fnurbler voted to cut $716 billion from Medicare!” over a picture of an elderly couple sitting at the kitchen table, looking over their bills with an engulfing despair, then meeting each other’s eyes in a tragic look that says, “Thanks to Congressman Fnurbler, all is lost. If only we had been able to pay our gas bill so we could stick our heads in the oven and end it all right now.”
Republicans are so deeply opposed to the idea of cutting Medicare that they can’t even stomach anyone trying to see if Medicare is spending its money wisely. Mention the Independent Payment Advisory Board, a component of the ACA that was designed to restrain Medicare costs if they rose too fast, and steam will come out of their ears. (The IPAB would make recommendations to Congress on ways to save money, and Congress would have to act on them. But since Medicare spending has slowed dramatically in the last couple of years, the requirement has yet to kick in, and President Obama hasn’t bothered to appoint anyone to what is still a theoretical board.) They waged a virtual war on comparative effectiveness research, effectively saying that it was dangerous to even ask which competing treatments work well and which don’t.
In other words, most Republicans believe we must, must, must reduce the cost of Medicare—excuse me, Do Something About Entitlements—but are adamantly opposed to every step that has been taken to reduce the cost of Medicare. I’m sure that lots of them are sympathetic to Ryan’s vision, which is to essentially turn the program into a voucher system, in which the government helps you buy private insurance, and over time costs magically go down (and if you’re thinking that sounds a lot like what people are getting on the Obamacare exchanges, any Republican will tell you that it’s totally different because freedom).
So let’s give Paul Ryan some credit. Sure, his numbers might not add up. But when he puts out a budget, there’s no mystery about where he’s coming from and what he wants to do.
By: Paul Waldman, Contributing Editor, The American Prospect, April 1, 2014
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