“The GOP Crusade Against The UnInsured”: Republicans Are Doing Everything They Can To Sabotage Obamacare
When House Speaker John Boehner declared Obamacare the “law of the land” two days after his party took a drubbing in the election, the real reveal came in what happened next: he walked it back in record speed and re-affirmed his commitment to getting rid of it.
Having failed to repeal the Affordable Care Act at the national level, Republicans are now dedicating their efforts to botching its implementation at the state level. And having failed to invalidate the law at the Supreme Court, they’re now seeking alternate legal avenues to weaken its regulations.
Republican governors are turning down the law’s Medicaid expansion, a move made easier by the Supreme Court decision that made the expansion optional. Among them are Bobby Jindal of Louisiana, Phil Bryant of Mississippi and Nikki Haley of South Carolina. Given that the federal government pays the vast majority of the cost in the medium term, these states are, in effect, rejecting an extraordinarily generous financial incentive to insure their residents.
Implementing the expansion in full would insure about 17 million people. “If [many states] don’t accept the Medicaid expansion you’re going to have millions of low income Americans who will remain uninsured and without access to health care,” said Tim Jost, a health care expert at Washington and Lee University who supports the Affordable Care Act.
Some dozen Republican governors are refusing — and about a dozen more are considering refusing — to build state-based insurance exchanges, the law’s primary vehicle for expanding and improving coverage. These governors, which include John Kasich of Ohio, Rick Perry of Texas, Nathan Deal of Georgia and Mary Fallin of Oklahoma, are consequently empowering the federal government to build one for them.
The law does not set aside funds for the federal government to construct or operate exchanges, creating implementation headaches for the Obama administration. But it can be self-sustained through user fees, and Jost argues that state residents with governors who are uncommitted would be better served by a federal exchange that wants to cover them.
Conservative thinkers are also resurrecting their argument, championed by top Republicans, that federally-administered exchanges lack the legal authority to provide tax subsidies, which are critical to making them work. Although the language of the law is vague on this question, the IRS has said federal exchanges are permitted to provide the premium subsidies.
“I don’t believe they’re going to win on that one,” Jost said. “If they did win that would do serious damage to what Congress intended, which is to have a federal fallback exchange.”
Utah Gov. Gary Herbert (R) is flirting with continuing his state’s existing insurance exchange even though it does not comply with rules in the Affordable Care Act.
Meanwhile, conservative advocates are advancing a separate legal challenge to the law’s requirement that insurance plans cover contraception for women as part of a copay-free preventive services package. Cheered on by congressional Republicans, Catholic institutions such as the Archdiocese of Washington and University of Notre Dame are moving forward with lawsuits that could end up in the Supreme Court.
All in all, Republicans and conservatives are telegraphing that they’re not chastened by years of failed efforts to wipe away Obamacare. The crusade shows no signs of ending, and could still do serious damage to the law.
By: Sahil Kapur, Talking Points Memo, November 21, 2012
“It’s Galling Season Again”: The GOP’s Phony New Compassion
When someone in any social cohort decides to act like Ebenezer Scrooge, it’s easy and quite natural for everyone else to fall into the role of Bob Cratchit. This is what several Republicans are now doing in reaction to Mitt Romney’s remarks about Barack Obama and his “gifts” to his core constituencies. But Republicans allegedly competing for the loyalties of the 100 percent is a movie we’ve seen. It doesn’t work, and it doesn’t work for a straightforward reason: free-market solutions to many of the problems faced by the 47 percent simply don’t exist. The GOP has no answer to these problems, and it really doesn’t want to have any. But, boy oh boy, are we about to enter a galling period of hearing them pretend otherwise.
In fact, it’s already started. Bobby Jindal kicked this off by saying in response to Romney, “We need to continue to show how our policies help every voter out there achieve the American dream.” Marco Rubio weighed in with the reassuring news flash that, in fact, he does not think there are “millions and millions of people in this country that don’t want to work.” Fellow Floridian Rick Scott—bless him, the Rick Scott who ripped off Medicare before he became governor and has tried to block Democrats from voting since occupying the office—says Republicans have to say that “we want to take care of every citizen of our state.” Scott Walker, Haley Barbour, Michael Steele, Susanna Martinez, and others have made similar remarks. All well and good. So now, let’s match this lovely rhetoric to the Republican record of the past decade or so.
Let’s start with health care, a big problem in the lives of many 47 percenters. True, the GOP, when George W. Bush was president, passed the Medicare prescription drug-coverage bill. That was mostly a good thing, although the bill didn’t pay for the program and it created the famous doughnut hole problem that is finally being solved by Obamacare. What else beyond that? Most obviously, they opposed the subsidized coverage for millions of working poor that is at the heart of Obamacare, defenestrating their own proposal (the individual mandate) while doing so.
And how about S-CHIP, the health plan for poor children? Children! They fought it tooth and nail. It was supposedly an imposition on private insurers who were positioned to offer similar coverage. Yet of course, they did not do so. If they had, there’d have been no need for S-CHIP in the first place.
The one health care idea they’ve come up with, health savings accounts, are widely known to be riddled with problems. They work fine until people really need ongoing care, kind of like a car that gets you where you’re going on normal days but won’t start during emergencies. Yet they tend to have very high deductibles, and people can still be thrown off if they get really sick. This is the GOP’s great contribution to addressing the health needs of the working class.
What other problems do the 47 percent face? Hardship in old age surely ranks up there. It’s they, after all, who depend wholly or mostly on their Social Security checks (which average about $1,400 a month) to get by. And what did they see Republicans try to do on this front? Privatize it—a proposal so unpopular that it died with almost no support in Congress from even the GOP, and this after Bush spent weeks barnstorming for it. People clearly don’t want Social Security privatized—just as they don’t want Medicare voucherized.
What else? Paying for college? Oh, the GOP record here is particularly stellar. Republicans in Congress spent loads of political capital fighting the Democrats’ effort in 2010 to lower student-loan interest rates. The Obama student-loan reform has been widely hailed—in addition to helping students by offering lower interest rates, it actually saves taxpayers money by eliminating the middleman (private lenders). This year’s GOP platform called for undoing the reform and going back to the old system, which, wouldn’t you know it, is the position of the big banks.
Believe me, I could go on and on and on for pages. The bottom line is this. These private-sector “solutions” Jindal and others invoke to the problems faced by people of limited means already exist. They have either been implemented and been seen to fail (or at least create big new problems), or they’ve not been implemented because a wary public knows better and has risen up to say no.
Government programs were created for a reason: needs arose that the private sector wasn’t responding to. There was no profit to be made, or not enough, or too much risk to be assumed, in providing health coverage to working-class people and their children, who were more likely to have health issues and be expensive to care for; in offering student loans to people who might not be able to pay them back; et cetera. There just were not and are not practical free-market solutions to these problems. That’s why government stepped in.
If the entire Republican Party were made up of nothing but David Frums and David Brookses, maybe well-designed and good-faith market-based attempts to address some of these problems could have a chance. But the actually existing Republican Party is more accurately represented by another David—Vitter, the Louisiana senator—who dismissed S-CHIP as “Hillarycare.”
And it’s Vitter rather than the other Davids who typifies the party because that is how the party’s voting base wants it. The darkly amusing thing about all this distancing from Romney is that in truth, all he was doing was expressing the views of the overwhelming majority of the party’s conservative base, which rose up in a mighty rage in 2009 against these “moochers” and their “gifts.”
I wish Jindal and the rest of them luck, in spite of it all. If they’re sincere and serious, we’ll have a very different Republican Party five years from now from the one we’ve known. In the meantime, permit me my skepticism. They don’t have good solutions to working people’s problems because the record shows that at bottom, they don’t really want to solve them.
By: Michael Tomasky, The Daily Beast, November 18, 2012
“Life, Death And Deficits”: There Is No Good Case For Denying Older Americans Access To Medicare And Social Security
America’s political landscape is infested with many zombie ideas — beliefs about policy that have been repeatedly refuted with evidence and analysis but refuse to die. The most prominent zombie is the insistence that low taxes on rich people are the key to prosperity. But there are others.
And right now the most dangerous zombie is probably the claim that rising life expectancy justifies a rise in both the Social Security retirement age and the age of eligibility for Medicare. Even some Democrats — including, according to reports, the president — have seemed susceptible to this argument. But it’s a cruel, foolish idea — cruel in the case of Social Security, foolish in the case of Medicare — and we shouldn’t let it eat our brains.
First of all, you need to understand that while life expectancy at birth has gone up a lot, that’s not relevant to this issue; what matters is life expectancy for those at or near retirement age. When, to take one example, Alan Simpson — the co-chairman of President Obama’s deficit commission — declared that Social Security was “never intended as a retirement program” because life expectancy when it was founded was only 63, he was displaying his ignorance. Even in 1940, Americans who made it to age 65 generally had many years left.
Now, life expectancy at age 65 has risen, too. But the rise has been very uneven since the 1970s, with only the relatively affluent and well-educated seeing large gains. Bear in mind, too, that the full retirement age has already gone up to 66 and is scheduled to rise to 67 under current law.
This means that any further rise in the retirement age would be a harsh blow to Americans in the bottom half of the income distribution, who aren’t living much longer, and who, in many cases, have jobs requiring physical effort that’s difficult even for healthy seniors. And these are precisely the people who depend most on Social Security.
So any rise in the Social Security retirement age would, as I said, be cruel, hurting the most vulnerable Americans. And this cruelty would be gratuitous: While the United States does have a long-run budget problem, Social Security is not a major factor in that problem.
Medicare, on the other hand, is a big budget problem. But raising the eligibility age, which means forcing seniors to seek private insurance, is no way to deal with that problem.
It’s true that thanks to Obamacare, seniors should actually be able to get insurance even without Medicare. (Although, what happens if a number of states block the expansion of Medicaid that’s a crucial piece of the program?) But let’s be clear: Government insurance via Medicare is better and more cost-effective than private insurance.
You might ask why, in that case, health reform didn’t just extend Medicare to everyone, as opposed to setting up a system that continues to rely on private insurers. The answer, of course, is political realism. Given the power of the insurance industry, the Obama administration had to keep that industry in the loop. But the fact that Medicare for all may have been politically out of reach is no reason to push millions of Americans out of a good system into a worse one.
What would happen if we raised the Medicare eligibility age? The federal government would save only a small amount of money, because younger seniors are relatively healthy and hence low-cost. Meanwhile, however, those seniors would face sharply higher out-of-pocket costs. How could this trade-off be considered good policy?
The bottom line is that raising the age of eligibility for either Social Security benefits or Medicare would be destructive, making Americans’ lives worse without contributing in any significant way to deficit reduction. Democrats, in particular, who even consider either alternative need to ask themselves what on earth they think they’re doing.
But what, ask the deficit scolds, do people like me propose doing about rising spending? The answer is to do what every other advanced country does, and make a serious effort to rein in health care costs. Give Medicare the ability to bargain over drug prices. Let the Independent Payment Advisory Board, created as part of Obamacare to help Medicare control costs, do its job instead of crying “death panels.” (And isn’t it odd that the same people who demagogue attempts to help Medicare save money are eager to throw millions of people out of the program altogether?) We know that we have a health care system with skewed incentives and bloated costs, so why don’t we try to fix it?
What we know for sure is that there is no good case for denying older Americans access to the programs they count on. This should be a red line in any budget negotiations, and we can only hope that Mr. Obama doesn’t betray his supporters by crossing it.
By: Paul Krugman, Op-Ed Columnist, The New York Times, November 15, 2012
“Dishonest Introspection”: Mitt Romney’s Sneering Farewell To The “47 Percent”
Trying to explain away his decisive, sweeping, and very expensive rout to his disappointed supporters—those one-percent Republicans—Mitt Romney offered a new version of the discredited “47 percent” argument that was so ruinous in its original form. In a Wednesday afternoon conference call, the defeated Republican nominee told donors and fundraisers that President Obama had won by lavishing generous “gifts” upon certain groups, including young voters, African-Americans, and Latinos.
“With regards to the young people, for instance, a forgiveness of college loan interest was a big gift,” said Romney, after apologizing for losing what he called a “very close” election that he lost by more than 100 electoral votes and no less than three percent of the popular vote (as indicated in “The Ass-Whuppin’ Cometh” by James Carville and Stan Greenberg).
“Free contraceptives were very big with young, college-aged women. And then, finally, Obamacare also made a difference for them, because as you know, anybody now 26 years of age and younger was now going to be part of their parents’ plan, and that was a big gift to young people. They turned out in large numbers, a larger share in this election even than in 2008… Likewise with Hispanic voters, free health care was a big plus. But in addition with regards to Hispanic voters, the amnesty for children of illegals, the so-called Dream Act kids, was a huge plus for that voting group.”
It’s amusing that at this late date, the Republican who distanced himself from health care reform — and constantly vowed to repeal the Affordable Care Act even though he knew that would be bad policy — claims that Obamacare helped Obama to win.
Now, before dispensing with Romney for good — as most Americans (including many Republicans) are understandably eager to do — it is worth noting that these churlish excuses to his donors represent the ultimate falsification, not only of his campaign, but of his own character.
Recall how he disowned the “47 percent” remarks when he realized how damaging they were to his chances for victory, telling Sean Hannity on Fox News that what he had been caught saying at a $50,000-a-plate Boca Raton fundraising event was “just completely wrong.” That mea culpa was factually accurate, of course – as we have discovered again lately with the news that so many food stamp recipients reliably vote Republican.
But as a matter of feelings rather than facts, Romney evidently cannot stop himself from sneering at society’s struggling people and the politicians who seek to improve their lives. It is not as if the donors he was addressing don’t want “gifts” from government – such as the big new tax breaks that Romney had promised them, the huge increases in defense spending that would swell their profits, or the various individual corporate favors that they regard as their very own “entitlements.” Just don’t expect that kind of honest introspection from Romney or his crowd.
By: Joe Conason, The National Memo, November 15, 2012
“A Word To The Not So Wise”: You Come At The King, You Best Not Miss
If you want a sense of how remarkable Barack Obama’s re-election victory is, think back to last summer. At the time, the president was struggling to reach a deal with House Republicans, who were threatening not to raise the debt ceiling and plunge the economy into a second recession. Unemployment was high—9.2 percent—Obama’s approval had dipped to the low 40s, and to anyone paying attention, the first African American president looked like a one-term failure.
But beginning in the fall, Obama began to reassert himself. With the American Jobs Act, he outlined a viable plan for generating economic growth and kick-starting the recovery. With his widely praised speech in Kansas, he outlined a populist agenda of greater investment and higher taxes on the wealthiest Americans. Over the course of 2012, he built good will with important communities, from LGBT Americans with an endorsement of same-sex marriage to Latino immigrants and their families with a measure meant to emulate the DREAM Act. What’s more, the economy began to pick up: Job growth increased, unemployment dropped, and the overall economic picture began to brighten.
Together with one of the most hard-nosed campaigns of recent memory, Obama managed to bounce back from the nadir of 2011 to one of the broadest re-election victories since Reagan’s 1984 landslide. At this point, news networks have called New Hampshire, Iowa, Wisconsin, Colorado, Nevada, Virginia, and Ohio for President Obama. Only Florida has yet to be called, where the remaining votes are in traditionally Democratic areas of the state. Compared with 2008, Obama lost only two states: North Carolina and Indiana. When all is said and done, Barack Obama will have won re-election with 332 electoral votes—a much larger margin than the last president to win re-election, George W. Bush
Over the next week, I’ll write about the details of Obama’s victory, in particular his huge advantage with nonwhite voters—without historic margins (and turnout) among African Americans, Latinos, and Asian Americans, it’s likely Obama would have failed in his quest for a second term. Indeed, it should be said that Republicans have themselves to blame for a good deal of this. If not for their categorical opposition to health-care reform, the Affordable Care Act would have never been passed in its current form. If not for their harsh approach to immigration, they might have won greater Latino support over the last four years. If not for their embrace of misogyny, they might have closed the gender gap. If not for their willingness to indulge the worst conspiracies about Obama, they might have made inroads with young people and college-educated voters.
In the meantime, it’s worth noting what Obama’s victory means for the next four years of public policy.
Obamacare will be implemented in full, and the United States will begin its journey toward universal health-care coverage. Millions of Americans will be covered by the bill’s Medicaid expansion, and millions more will—for the first time—have access to affordable health insurance. Likewise, Dodd-Frank will survive, and the federal government will begin to craft regulations that will—with any luck—prevent a repeat of the 2008 financial collapse. Obama’s re-election shields core liberal commitments—on social insurance, anti-poverty policy, and environmental regulation—from conservative assault, and gives Democrats a chance to reshape the Supreme Court and the federal judiciary writ large.
Thanks to last night’s results, liberals have four years to cement a host of policies and achievements that could prove as transformative as the Great Society or even the New Deal. And this is on top of an economic recovery that will almost certainly boost Democrats’ standing with the public.
It’s still far too early to make a judgment about Barack Obama’s overall historical standing. But by virtue of winning re-election, he has become the most successful Democratic president since Lyndon Johnson, and one of the most successful of the 21st century.
Not bad for the skinny Hawaiian kid with a funny name.
By: Jamelle Bouie, The American Prospect, November 7, 2012
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