“Republicans Are Out Of Excuses”: President Obama’s Budget And The Put-Up-Or-Shut-Up Challenge
As promised, President Obama sent Congress his budget for the 2014 fiscal year this morning, and there’s just enough in it to make everyone unhappy from a variety of directions.
Republicans won’t like everything about this plan that makes it progressive: it expands Medicaid, undoes sequestration cuts while ignoring Paul Ryan’s demands to slash public investments, pursues a universal-preschool initiative though new tobacco taxes, expands the Earned Income Tax Credit, invests another $50 billion in job-creating infrastructure, gives a big boost to federal R&D, and takes away breaks for Big Oil.
Democrats won’t like everything about this plan that makes it conservative: it includes additional Medicare reforms, it adopts chained-CPI to lower Social Security benefits, and it focuses more on the spending side of the ledger than the revenue side. On a fundamental level, Obama’s budget starts in the middle, rather than the left, making negotiations that much more difficult.
But whichever side you fall on, there’s an underlying strategy here. Ezra Klein’s summary sounds right to me:
Today’s budget is the White House’s effort to reach the bedrock of the fiscal debate. Half of its purpose is showing what they’re willing to do. They want a budget compromise, and this budget proves it. There are now liberals protesting on the White House lawn. But the other half is revealing what the GOP is — or, more to the point, isn’t — willing to do. Republicans don’t want a budget compromise, and this budget is likely to prove that, too.
As the White House sees it, there are two possible outcomes to this budget. One is that it actually leads to a grand bargain, either now or in a couple of months. Another is that it proves to the press and the public that Republican intransigence is what’s standing in the way of a grand bargain.
So, which of these two outcomes is more likely?
I think the smart money is on the latter. The president has called every GOP bluff and put his cards on the table — Republicans said Obama wouldn’t have the guts to go after entitlements and isn’t tough enough to risk the ire of his base. And now we know these assumptions were wrong — the president has presented a White House budget that includes the very entitlement “reforms” GOP leaders asked for, and liberals are furious.
It is, in other words, “put up or shut up” time. Republicans, out of excuses, can either meet Obama half-way or they’ll be exposed as craven. And if the last several years are any indication, GOP lawmakers will chose the latter without a moment’s thought.
Indeed, as Greg Sargent noted, congressional Republican leaders have already spent the afternoon arguing that Obama should simply give the GOP what it wants, and abandon the Democratic priorities, reinforcing the perception that Republicans still do not yet understand the difference between an offer and a gift.
In fact, I should mention that I received an email the other day from a long-time reader asking why I don’t seem more worked up about chained-CPI. The reader asked whether I support it (I don’t) and whether I’ve been relatively quiet about it out of some ideological or partisan predisposition.
I’ll tell you what I told him: I’m not worked up about it because I don’t see the scenario in which Republicans get chained-CPI by giving Obama hundreds of billions of new revenue. It’s easy to remain detached about a bad idea that seems highly unlikely to go anywhere. As Kevin Drum added today, “I don’t doubt that Obama’s offer is sincere, but it doesn’t matter. Republicans aren’t going to take it. Obama will get his proof that Republicans simply aren’t willing to negotiate seriously, and who knows? Maybe it will do him some good. But that’s all he’ll get.”
For me, the more interesting question is how the political world will process these developments when they occur. The Beltway said Obama needed to reach out to Republicans, so he reached out to Republicans. The Beltway said Obama needed to schmooze Republicans in a more personal way, so he did that, too. The Beltway said Obama needed to be willing to alienate his own supporters, and the president’s base has been duly outraged. The Beltway said Obama needed to put Medicare and Social Security on the table, and they’re on the table.
Will pundits who continue to blame “both sides” for partisan gridlock look ridiculous in the coming months? I sure as hell hope so.
By: Steve Benen, The Maddow Blog, April 10, 2013
“Insurance And Freedom”: How Many Americans Will Be Denied Essential Health Care In The Name Of Freedom?
President Obama will soon release a new budget, and the commentary is already flowing fast and furious. Progressives are angry (with good reason) over proposed cuts to Social Security; conservatives are denouncing the call for more revenues. But it’s all Kabuki. Since House Republicans will block anything Mr. Obama proposes, his budget is best seen not as policy but as positioning, an attempt to gain praise from “centrist” pundits.
No, the real policy action at this point is in the states, where the question is, How many Americans will be denied essential health care in the name of freedom?
I’m referring, of course, to the question of how many Republican governors will reject the Medicaid expansion that is a key part of Obamacare. What does that have to do with freedom? In reality, nothing. But when it comes to politics, it’s a different story.
It goes without saying that Republicans oppose any expansion of programs that help the less fortunate — along with tax cuts for the wealthy, such opposition is pretty much what defines modern conservatism. But they seem to be having more trouble than in the past defending their opposition without simply coming across as big meanies.
Specifically, the time-honored practice of attacking beneficiaries of government programs as undeserving malingerers doesn’t play the way it used to. When Ronald Reagan spoke about welfare queens driving Cadillacs, it resonated with many voters. When Mitt Romney was caught on tape sneering at the 47 percent, not so much.
There is, however, an alternative. From the enthusiastic reception American conservatives gave Friedrich Hayek’s “Road to Serfdom,” to Reagan, to the governors now standing in the way of Medicaid expansion, the U.S. right has sought to portray its position not as a matter of comforting the comfortable while afflicting the afflicted, but as a courageous defense of freedom.
Conservatives love, for example, to quote from a stirring speech Reagan gave in 1961, in which he warned of a grim future unless patriots took a stand. (Liz Cheney used it in a Wall Street Journal op-ed article just a few days ago.) “If you and I don’t do this,” Reagan declared, “then you and I may well spend our sunset years telling our children and our children’s children what it once was like in America when men were free.” What you might not guess from the lofty language is that “this” — the heroic act Reagan was calling on his listeners to perform — was a concerted effort to block the enactment of Medicare.
These days, conservatives make very similar arguments against Obamacare. For example, Senator Ron Johnson of Wisconsin has called it the “greatest assault on freedom in our lifetime.” And this kind of rhetoric matters, because when it comes to the main obstacle now remaining to more or less universal health coverage — the reluctance of Republican governors to allow the Medicaid expansion that is a key part of reform — it’s pretty much all the right has.
As I’ve already suggested, the old trick of blaming the needy for their need doesn’t seem to play the way it used to, and especially not on health care: perhaps because the experience of losing insurance is so common, Medicaid enjoys remarkably strong public support. And now that health reform is the law of the land, the economic and fiscal case for individual states to accept Medicaid expansion is overwhelming. That’s why business interests strongly support expansion just about everywhere — even in Texas. But such practical concerns can be set aside if you can successfully argue that insurance is slavery.
Of course, it isn’t. In fact, it’s hard to think of a proposition that has been more thoroughly refuted by history than the notion that social insurance undermines a free society. Almost 70 years have passed since Friedrich Hayek predicted (or at any rate was understood by his admirers to predict) that Britain’s welfare state would put the nation on the slippery slope to Stalinism; 46 years have passed since Medicare went into effect; as far as most of us can tell, freedom hasn’t died on either side of the Atlantic.
In fact, the real, lived experience of Obamacare is likely to be one of significantly increased individual freedom. For all our talk of being the land of liberty, those holding one of the dwindling number of jobs that carry decent health benefits often feel anything but free, knowing that if they leave or lose their job, for whatever reason, they may not be able to regain the coverage they need. Over time, as people come to realize that affordable coverage is now guaranteed, it will have a powerful liberating effect.
But what we still don’t know is how many Americans will be denied that kind of liberation — a denial all the crueler because it will be imposed in the name of freedom.
By: Paul Krugman, Op-Ed Columnist, The New York Times, April 7, 2013
“Inside The Anti-Obamacare Resistance”: A Facinating Glimpse Into Warped Conservative Ideology And Tactics
The two largest states that have so far failed to join in the Medicaid expansion provided for in the Affordable Care Act are Florida and Texas, where Republicans control the legislature and the governor’s office. Looking more closely at the intra-Republican battle over how and whether rich new federal funds can be captured without “surrendering” to the hated Obama provides a fascinating glimpse into conservative ideology and tactics.
Florida offers the murkiest situation. Gov. Rick Scott, who was beginning to look rather toasty in his 2014 re-election prospects, roiled conservative circles in his own state and nationally by suddenly coming out for Medicaid expansion in exchange for permission from the Obama administration to move Medicaid beneficiaries into private managed care plans. But Scott’s been stopped cold by GOP legislators, who in turn seem split between outright rejectionists centered in the state House and those in the Senate who want an even better “deal” that would utilize the state’s CHiP program, which is a privatized premium support scheme, instead of Medicaid for the expansion.
A conservative Florida reporter presents the views of the rejectionist camp quite vividly:
Tom Lauder, a reporter for Media Trackers Florida, which is closely following the Florida Obamacaid debate, says House Republicans appear likely to stand firm….
“Grassroots conservatives are particularly upset with Gov. Scott using the language of the left in his efforts to build momentum for Obamacaid,” Lauder explained. “When Scott argues, ‘I cannot, in good conscience, deny the uninsured access to care,’ he asserts that the only time people have access to goods and services is when government gives it to them as an entitlement. Scott has enraged his conservative base by making this big-government argument. This isn’t a question of whether government should give Medicaid to the poor and disabled, because the poor and disabled already qualify for Medicaid.”
At issue, Lauder says, is the rejection of Scott’s argument that federal funding will come without cost to state taxpayers.
“Scott’s conservative base also resents Scott talking about federal funding as if it were free money,” Lauder added. “Even if the federal government kept its promise to fund most of the Florida Medicaid expansion, which many conservatives doubt will be the case, Floridians pay federal taxes in addition to state taxes. Federal dollars flowing into Florida are not free dollars, even for Floridians.
In other words: Florida’s “true conservatives” don’t much care what mechanism is being used to expand coverage; they’re just flatly against it.
In Texas, meanwhile, the rejectionist camp is led by Gov. Rick Perry, as Ron Brownstein explains in a National Journal column:
Republican state Rep. John Zerwas, a health care leader who represents a district outside Houston, says legislators are getting an earful at home from providers and local officials worried about the state rejecting the money.
Against that backdrop, Zerwas and some GOP state House colleagues are searching for ways to steer Texas into the expansion. They assume the state will not move more people into the existing Medicaid program. But they consider it misguided to simply reject the federal money and deny insurance coverage to so many people who could obtain it. “We are not going to make this better … without doing something that substantially reforms how we deliver Medicaid,” Zerwas says. However, “we have to have a solution for this group of people.”
Last week, Zerwas introduced legislation that would authorize state health officials to negotiate with the Obama administration to expand while delivering coverage for the newly eligible through new means. He likes the deal the administration is discussing with Arkansas, which could allow the state to use Medicaid expansion dollars to instead buy private insurance for its eligible adults, and he believes that approach could be “sellable to the governor.”
Many here, though, wonder if Perry would take any deal. The widespread belief is that he intends to seek the GOP presidential nomination again in 2016, and accepting more Medicaid money would smudge his image of Alamo-like resistance to Obama.
This is an interesting scenario given recent efforts from the Perry camp (outlined earlier this week in another National Journal piece by Michael Catalini) to depict the swaggering, gaffe-prone Texan as “ahead of his time” in understanding the need for Republican outreach to Latinos. Notes Brownstein:
[I]f state Republicans reject federal money that could insure 1 million or more Hispanics, they could provide Democrats with an unprecedented opportunity to energize those voters—the key to the party’s long-term revival. With rejection, says Democratic state Rep. Rafael Anchia of Dallas, Republicans “would dig themselves into an even deeper hole with the Hispanic community.”
It’s unclear how this will all play out in Florida and Texas. But nobody recently has lost any money betting on the hard-core conservative approach, particularly on an issue as incendiary to the Right as Obamacare. That rejecting any sort of coverage expansion beyond that absolutely required by the ACA would mean leaving vast sums of federal money on the table would in fact be considered a badge of honor by a lot of the people involved.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, March 22, 2013
“Victory For The Middle Class”: On Obamacare’s Third Birthday, There Are Already Reasons To Be Grateful
On March 23, 2010, Obamacare — formally known as the Patient Protection and Affordable Care Act — was signed into law by President Obama.
Three years later, the bulk of the first serious attempt at near-universal health care has not yet taken effect. Health marketplaces are still being formed, states are still deciding if they’ll take Medicaid expansion and the subsidies that will help tens of millions of Americans afford health care won’t roll out until January 1, 2014.
Implementing Obamacare won’t be easy, as even some of the biggest fans of the program admit. Expanding Medicare to cover all Americans would have to be an even simpler solution but a complete political impossibility — given that Joe Lieberman (I-CT), whose vote was necessary to pass the law, single-handedly vetoed a provision that would allow 55- to 64-year-olds to buy into Medicare. It’s a compromise solution that uses unpopular provisions — like the individual mandate — to achieve extremely popular results — ending lifetime limits and banning insurance companies from dropping patients once they become sick.
There will be plenty of time to debate the efficacy of Obamacare — especially with insurance companies enjoying record profits threatening to raise rates in order to justify changes to the law.
But right now we should celebrate the greatest victory for the middle class since Medicare and Medicaid. At its heart, Obamacare is a program that asks the rich and corporations to pay a little more to help working Americans get insurance they can count on, thus lowering the cost of health care for everyone. We already pay for each other’s health coverage, but just in the dumbest possible way — emergency rooms.
Here are five reasons to be grateful for Obamacare, which is already making life better for the middle class.
Obamacare Frees Workers And Entrepreneurs
One of the most popular aspects of Obamacare is that beginning in 2014, insurance companies will no longer be able to deny people coverage because of pre-existing conditions. Because insurance companies had been able to do this, many people avoided going to the doctor for fear of being diagnosed with a disease or condition that would brand them for the rest of their lives. Some stayed in jobs they didn’t want and others didn’t take the leap to start a new business for fear of not being able to get coverage. These changes especially free women — who by federal law can no longer be charged more for care because of their gender — to pursue new opportunities.
Insurance Companies Pay You Back
Insurance companies are required for the first time to prove that they’re spending between 80 and 85 percent of premiums, depending on the size of the company, on actual health care. If companies don’t spend that amount on coverage, they have to return that money to their customers — $1.2 billion was returned in 2012 to self-employed Americans whose insurers didn’t hit the proper ratio.
Millions Of Young People Already Covered
An estimated six million college students are already taking advantage of Obamacare’s provision that lets them stay on their parents’ insurance until the age of 26. This has led to a record drop in uninsured young people, allowing them to go back to school or pursue graduate degrees without taking on as much student loan debt.
Seniors Spend Less On Drugs
One of the most immediate benefits of Obamacare was the closing of the Medicare D prescription drug “donut hole,” which requires seniors to pay for the coverage gap between their deductible and yearly limit, at which point the plan covers all medication — $6.1 billion in drug coverage has already been distributed to seniors, which leads to the irony that Republicans ran and won in 2010 on saying that Obamacare cuts Medicare when, in fact, benefits for seniors have only increased. All the savings come from reforming the way providers are paid.
The Red States Get To Pay The Blue States Back
When the Supreme Court ruled that the mandate in Obamacare was Constitutional, it also gave states the chance to opt out of the Medicaid expansion that will provide free public health care for those not already on Medicaid, but who earn up to 133 percent of the poverty level. The states that are turning down the expansion, unfortunately, are some of those that need it the most. All of the states that have rejected the federal extra funding — which begins at 100 percent of the cost of the expansion and goes down to 90 percent — are states that generally vote Republican.
You probably know that most red states take in more federal money than they contribute, as Republican policies encourage growth of programs like food stamps. Though Republican governors can reject the benefits of Medicaid expansion, their richest citizens and corporations will still have to pay the taxes. As a result, they won’t be such “takers.”
Unfortunately, the working poor of red states — who earn too much to be on basic Medicaid — will suffer without the health insurance they need. Those on Medicare and Medicaid will likely see fewer doctors who want to accept clients from these programs, as Medicaid expansion was supposed to make up for the cut in reimbursement rates that begins in 2014. And all residents will not enjoy the slowdown in the growth of health care costs that will come from shrinking the number of the uninsured.
For red state governors, it’s a chance to fulfill the prophecies of doom Republicans made when Obamacare passed. But for residents of blue states, it’s a chance to make America’s health care system more equitable, with red states finally paying closer to their fair share.
By: Jason Sattler, The National Memo, March 22, 2013; Photo: The Advisory Board Company
“Explain That Budget, Please”: Let’s Have Less Sanctimonious Talk About Your Principles And Vision Mr. Ryan
Today’s opening meditation, coinciding with the beginning of that annual speechapaloosa of the Right, CPAC, is from a belligerant remark made by Paul Ryan in an interview with National Review‘s Andrew Stiles, responding to incredulity that he’s back with more or less the same old budget for the third time:
Even some conservatives have questioned the idea of refighting old battles, as opposed to confronting the new reality with new solutions. But Ryan is sticking to his guns. “So just because the election didn’t go our way, that means we’re supposed to change our principles? We’re supposed to just go along to get along? We reject that view,” he tells National Review Online in an interview at his Capitol Hill office. “A budget is supposed to be a display of your vision,” he adds. “Our vision is a world without Obamacare.”
Ryan points out that Obama was not the only one who was returned to power in 2012; House Republicans maintained their majority. “We’re here, and we won our elections based on limited government, economic freedom, and we should not shy away from espousing those views,” he says.
If you’re like me, you’ve heard those words expressed by conservative ideologues so many times you barely register their content anymore: conservative principles, conservative principles, limited government, freedom, bark bark woof woof. Ryan may rely for his reputation in D.C. on a perception that he is some sort of genius-wonk, but the reason “the base” went nuts with joy when Mitt Romney lifted him to the national ticket last year is that right-wing activists believe he’s found a way to reflect their “conservative principles” in a blizzard of numbers.
But if you get out of the trance-state of believing everything Ryan says, and that his fans say about him, do his budgets actually reflect, or disguise, his “principles?”
Let me once again quote a key paragraph of Ryan’s speech last November at the Jack Kemp Foundation dinner wherein he discussed his “vision,” which is a world not only without Obamacare, but without any real public safety net:
Not every problem disappears through the workings of the free market alone. Americans are a compassionate people. And there’s a consensus in this country about our obligations to the most vulnerable. Those obligations are beyond dispute. The real debate is how best we can meet them. It’s whether they are better met by private groups or by government – by voluntary action or by government action.
Think about this approach for a minute. Ryan begins from the premise that the free market will if left alone solve most social and economic problems; you don’t even get into the discussion of a public role until we’re talking about “the most vulnerable.” And once we are there, the conservative side of the argument is to press for “voluntary action” by “private groups”–i.e., public abandonment, perhaps with a tax credit and hearty good wishes, but abandonment all the same.
Is that what you get when you peel back all the numbers and look for Ryan’s “principles?” I guess so, since the numbers themselves are actually pretty opaque. Why won’t Ryan specify the impact his spending assumptions would have on non-defense discretionary spending? Why won’t he address what happens to the Medicare “premium support” payment if all the market magic he’s assuming does not radically reduce health care inflation? If his “vision” is that federal support for and regulation of the program we now call Medicaid is to whither away, why not say so? Why go through the subterfuge of a “block grant” if the idea is that states would eventually liberate the poor from dependence on this program as they compete to cut costs and reduce eligibility?
And why, in the third iteration of his budget, why does Ryan remain unwilling to specify the content of that vast magic asterisk he identifies as “tax reform?”
Sure, all these evasions can be justified on Machiavellian grounds, but I thought we were talking about a bold expression of “conservative principle,” a “vision” here, not some mendacious effort to sneak “principle” through the bedroom window!
But this should come as no surprise after a 2012 campaign in which Ryan outdid Romney in posing as the maximum champion of Medicare because he opposed reductions in provider payments even though he included those same reductions in his own budget, and is doing so again today. What “principles” did that Medagoguery reflect? What “vision” are we supposed to glimpse? A world in which wealthier people over 55–which also happen to be the most pro-Republican group of people in the electorate–are insulated from any budget cuts while mothers with children under the poverty line are asked to make “sacrifices?” Spell it out, Paul Ryan!
It’s not just Ryan, of course. Republican pols generally are reluctant to tell us how they envision the country’s future. This is why when they occasionally let the mask slip and attack the New Deal or “government schools” or the very idea of income taxes or popular election of senators or any limitation on property rights or any concept of reproductive rights or any “entitlement” to public resources among those people–they are greeted with a feral roar of recognition and joy from the activist base for telling it like it is.
That is precisely what Paul Ryan won’t do. So love him or hate it, but let’s have less sanctimonious talk from him and his conservative fans about his “principles” and “vision.” He’s hiding both.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, March 14, 2013
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