The Republican Alternative To “ObamaCare” Is ObamaCare
On Saturday, David Fahrenthold wrote that “more than a year after Republicans first pledged to ‘repeal and replace’ President Obama’s new health-care law, the GOP is still struggling to answer a basic question. Replace it . . . with what?”
This shouldn’t be such a problem. Health care is a big issue. It’s been around a long time. The Republican Party should, in 2011, have a position on it. To understand why it doesn’t, it’s worth reading Newt Gingrich’s April 2006 comments on then-Gov. Mitt Romney’s Massachusetts reforms.
“The most exciting development of the past few weeks is what has been happening up in Massachusetts,” wrote Gingrich, or someone speaking for Gingrich, in his “Newt Notes” newsletter. “The health bill that Governor Romney signed into law this month has tremendous potential to effect major change in the American health system. We agree entirely with Governor Romney and Massachusetts legislators that our goal should be 100% insurance coverage for all Americans. … Individuals who can afford to purchase health insurance and simply choose not to place an unnecessary burden on a system that is on the verge of collapse; these free-riders undermine the entire health system by placing the onus of responsibility on taxpayers.”
In 2006, in other words, the Republican Party had an alternative to Obamacare. The only problem? It was Obamacare.
Between 1990 and 2007, the reigning Republican theory of health-care reform was that instead of handing the health-care system over to the government, they would put private insurers and personal responsibility at the core of their health-care reforms. During this period, everyone from Bob Dole to Jim DeMint to the Heritage Foundation endorsed this approach. But then Democrats, looking for a compromise, endorsed those same plans. And then Republicans, rather than pocketing the policy win, ran from their own ideas.
But insofar as the Republican Party had a plan for health-care reform, the individual mandate was it. That’s why Mitt Romney, Newt Gingrich, Tim Pawlenty, and Jon Huntsman either passed, endorsed, or expressed openness to an individual mandate. And that’s why Romney hasn’t paid for his plan: Almost every other serious candidate for the Republican nomination supported an individual mandate, too. It’s hard for Gingrich to take a clear shot at Romney for proposing what Gingrich called “the most exciting development” in health-care reform.
It’s also why the Republican Party can’t figure out an alternative to the Affordable Care Act. The Affordable Care Act was their alternative. Now they need an alternative to the alternative. But there are only so many policy approaches that make sense as an answer to our health-care problems. And Republicans have pretty much run out of them.
By: Ezra Klein, The Washington Post, December 27, 2011
The Ohio Tea Party’s Big “Obamacare” Fail
Ohio tea partiers will finally get their big moment at the ballot box on November 8. That’s when Ohioans vote on Issue 3, a referendum spearheaded by tea party groups that would amend the state constitution to ban any law or rule requiring that citizens buy health insurance. The intent is obvious: to rebuke President Obama by blocking the individual mandate—the part of the Affordable Care Act (ACA) that requires Americans to buy health insurance or pay a fine. Issue 3 was also seen as a way to fire up conservative voters in an off-year election when the fate of Gov. John Kasich’s anti-union SB 5 bill is on the line.
But the measure backfired. Not only won’t it block the ACA’s individual mandate, but it’s so vague, legal experts say, that it could have the damaging, unintended effect of undermining key public services and regulations in Ohio, including blocking the state’s ability to collect crucial data on infectious diseases. If passed, it could also spark a wave of costly lawsuits, with taxpayers likely footing the bill. “It’s extremely sloppy and extremely overbroad,” says Jessie Hill, a professor at Case Western Reserve University School of Law. “I hesitate to say whether these potentially extremely troubling consequences were intended or whether the amendment was just misguided.” And if you trust the polls, Issue 3 isn’t even energizing Ohio conservatives.
Issue 3 is the brainchild of the Ohio Liberty Council, a coalition of tea party chapters, 912 groups, and other liberty-loving activists. The Council tried to put Issue 3—which it calls the “Healthcare Freedom Amendment”—on the ballot in November 2010, but fell short in the signature-gathering process. This year, the group redoubled its efforts and managed to gather nearly 427,000 signatures, enough to put the issue before voters. (The Liberty Council did not respond to multiple requests for comment.)
The amendment, endorsed by Ohio Right to Life and Republican state Sen. Bob Peterson, was pitched as a direct response to Obama’s Affordable Care Act. An early pamphlet (PDF) created by the Ohio Project, the grassroots group created to promote the amendment, focuses entirely on defusing “the new federal health care measure passed by Congress.”
But if Issue 3 passes, it won’t affect the Affordable Care Act. Richard Saphire, a professor at the University of Dayton Law School, says passage of Issue 3 might deliver a symbolic rejection of the individual mandate, but legally it would have zero effect, because Article VI of the US Constitution says that federal law trumps state law. “It’s very defective,” he says. “Folks that come out and vote for it, probably most of them are going to think they’re going to accomplish something that they’re not going to accomplish, which is prevent federal law from going into effect.”
Issue 3 supporters now concede this. But they insist the measure will still prevent a Massachusetts-style, state-based individual mandate from becoming law in Ohio and will set the stage for individual Ohioans to challenge the Affordable Care Act in court. Ohioans could say “you are fundamentally restricting our liberty and property here, and there was no due process,” Chris Littleton, a cofounder of the Ohio Liberty Council, said at an Issue 3 debate in late October.
While Issue 3 won’t derail “Obamacare,” it would have potentially “massive and disastrous impacts” on health care delivery and public health regulation in Ohio, says Case Western’s Hill.
A report (PDF) cowritten by Hill and released by Innovation Ohio, a liberal public policy group that opposes Issue 3, found that the amendment’s overbroad language could undermine a slew of programs that include some form of mandate. The amendment reads, in part:
No federal, state, or local law or rule shall compel, directly or indirectly, any person, employer, or health care provider to participate in a health care system.
Although the amendment would exempt laws in place before 2010, any new reforms to, say, workers’ compensation, which requires employers to buy insurance in case of workplace injuries, would violate the measure. State law also requires that public schools pay to immunize students whose families can’t afford it; reforms of that program would be blocked under Issue 3 because the immunization requirement is a type of mandate, according to the Innovation Ohio report. The amendment, the report noted, would likely render unconstitutional a key reporting element in a state law to regulate so-called pill mills, because it compels “participation” in a “health care system.” And Issue 3 would handcuff the state’s ability to gather data on infectious diseases including HIV and influenza for the same reason.
Hill and Saphire both say Issue 3’s passage would likely set off a wave of litigation aimed at discovering the true meaning and reach of the amendment. And it would be Ohioans, Hill says, footing the bill for those lawsuits.
Issue 3 isn’t getting much love from Ohio opinion makers, liberal or conservative. Despite its opposition to the “deeply flawed” Affordable Care Act, the conservative editorial board of the Columbus Dispatch, the state’s largest newspaper, urged a “no” vote on the measure. Arguing that state constitutions should not be subject to “short-term political gamesmanship,” the Dispatch wrote that “trying to counter the federal law with an ineffective amendment to the Ohio Constitution is a bad idea. This is not where that battle should be fought.” Every major newspaper editorial board in Ohio that’s taken a position on Issue 3 has opposed it.
If recent polls are any judge, Issue 3 hasn’t done much to mobilize conservative voters, either. An October 28 survey by the University of Akron Bliss Institute of Applied Politics found that 34 percent of respondents favor Issue 3 and 18 percent oppose it. The remaining 48 percent remained undecided less than two weeks before the vote. More importantly, the Akron survey found much more enthusiasm around Issue 2—which polls suggest will be defeated, repealing Kasich’s SB 5 bill—than around Issue 3, which polls suggest will pass.
If Issue 3 becomes law, it wouldn’t be the first time voters approved an amendment to a state constitution that didn’t serve its intended purpose, Saphire says. After the US Supreme Court’s 1954 Brown v. Board of Education ruling declared racial segregation in public schools unconstitutional, a handful of states passed symbolic amendments expressing opposition to the Brown decision. The Supreme Court is expected to decide the fate of the ACA’s individual mandate in its upcoming term. If the high court decides to uphold the law, Ohio tea partiers—Issue 3 or no—will have to buy health insurance or pay a fine.
By: Andy Kroll, Mother Jones, November 3, 2011
Blame Greed, Not Obama For Rise In Health Insurance Premiums
It’s Obama’s fault
Isn’t everything? I can’t believe what I am hearing and reading. Insurance companies are raising their premiums and, of course, that is President Obama’s fault. It’s that damn “Obamacare.” Ah, no, it isn’t.
Insurance companies have been raising their subscriber’s premiums for years before Mr. Obama was president; actually, even before he was “Senator Obama.”
I have a family plan to cover my husband and our two children; but I also own two small businesses and cover my employees’ healthcare at both companies. The large private PPO provider who I won’t name, but has the color of the sky in their title (ahem), has increased my premiums for both group plans and my individual family plan at least once a year for the past five years. And when I phone them and ask why, they don’t have an answer. They certainly don’t say: It’s President Obama’s fault and the passage of the Affordable Care Act.
As a matter of fact, the president of Kaiser also stated that healthcare reform is not the reason for the increased premiums; at best, it might contribute to 1 percent; so what is the other 99 percent? What is the reason these insurance companies keep increasing our premiums?
How can healthcare reform increase our premiums? Due to the increased number of people being covered by the reform act (mostly children and students who may remain on their parent’s plan), there are more people purchasing plans, whether employers or employees, which actually brings more money to those insurance companies. So why the increase?
Every time my plan has been increased, I have phoned to ask what additional benefits I am receiving for that cost increase; and every time the answer is the same: none. When I ask why, no one knows. But I know, it’s greed.
All, not some, all of the heads of these insurance companies earn millions of dollars a year in their paychecks. The insurance companies are one of the few in America not being negatively affected by our economy. Don’t believe me? Check their stock prices, or the stock prices of most medical related companies for that matter.
Actually, the increase in premiums, whether a person has an HMO or a PPO, just helps to support the need not only for healthcare reform, but for further reform, specifically a public option.
These increases are proof that the public needs another option, an affordable option. And the mandate? That drives business to the insurance companies, so they should be reducing the premiums. Insurance companies will say that many people are requesting a higher deductible; of course we are, it’s a bad economy and most of us want to pay less per month, taking the risk that we won’t end up in the E.R. or need surgery, etc.
And according to my doctor-husband, that’s a big risk. He’s an orthopedic surgeon. Patients used to come see him when they were in pain—let’s say their knee hurt. Now they come when their bones are sticking out—when they’re chronic.
So the increased prices by the insurance companies should be blamed on the insurance companies. They are hurting our healthcare system, doctors’ ability to provide proper care, and the economy as well; especially when so many Americans head to the E.R. once they’re chronic, which further bankrupts the system.
Bottom line—don’t blame Obama. Blame the insurance companies. They’re the bad guys this time around.
By: Leslie Marshall, U. S. News and World Report, September 29, 2011
“The Rising”: Return Of The Big GOP Medicare Lie
The participant’s in last night’s GOP presidential debate once again took the opportunity to pretend that the Affordable Care Act (“Obamacare”) put a massive dent in Medicare by cutting $500 billion from the program.
Michele Bachmann told us that “We know that President Obama stole over $500 billion out of Medicare to switch it over to Obamacare.” Mitt Romney intoned “He cut Medicare by $500 billion. This is a Democratic president the liberal, so to speak, cut Medicare.”
Yeah…except that nobody stole anything and Medicare was not cut by $500 billion.
Here are the facts:
For starters, nobody cut anything from the Medicare budget in the health care reform bill. The actions taken in the legislation are designed to slow the growth of Medicare spending without cutting benefits. Further, not one cent that would have gone to Medicare is somehow being shifted over to a program created by Obamacare (for first time readers, I readily use the term Obamacare because I believe that this name will ultimately stand as an honor to the President who made it happen.)
With respect to the infamous $500 billion, the non-partisan Congressional Budget Office has made it clear that the bulk of the projected savings will come from two primary sources—ending the subsidies to health insurance companies who offer Medicare Advantage programs and reining in the growth of payments to physicians. The remainder will, hopefully, come from cutting back on the waste and fraud that have long been rampant in the Medicare system.
Let’s begin with the Medicare Advantage program. Established via the Medicare Modernization Act of 2003. the program—a Bush/GOP creation—was ostensibly invented to encourage Medicare beneficiaries to gravitate towards privately operated insurance programs pursuant to the theory that the private sector could do a better job of delivering care to our seniors than the government.
I say ‘ostensibly’ because the true purpose was to create a windfall for the private insurance companies who have done so much for so long for so many Republican elected officials.
The way the script played out, the private insurance companies said that they would only be able to paricipate in the program if, and only if, the government gave them a head start by agreeing to subsidize their “start up costs” until the year 2010.
As a result of the deal, Medicare found itself paying, on average, an 11% surcharge on medical services and procedures provided by Medicare Advantage plans. This was enough to guarantee the insurance providers a tidy profit fully comprised of the government subsidies, creating one of the greatest examples of corporate welfare in the history of the nation.
Not surprisingly, the health insurers took advantage of the windfall to attract customers by offering very low premium charges, not to mention free gym memberships, one pair of eyeglasses per year, spa treatments, zero co-pays and assorted other benefits not available to those who opted to take their Medicare directly from the government. And why not? The insurers don’t need to make a penny from those who were insured as each customer guarantees them an 11 percent return on any medical benefit receieved courtesy of the Medicare program. Thus, they are more than happy to offer a free toaster to anyone who agrees to sign up.
What Obamacare did was put an end to the subsidies, thereby reducing future costs to the program by billions while continuing to provide Medicare beneficiaries with the benefits promised.
By any standards, this was a no-brainer in terms of reigning in the growing costs of Medicare and creating a system that is fair to all beneficiaries.
Now, the doctors.
This gets a bit tricky and, to be honest, I don’t really believe that these savings will ever materialize.
At the heart of the discussion is a formula that was designed during the Clinton Administration called the Medicare Sustainable Growth Rate, or SGR. The approach was created in an attempt to control Medicare spending for physician services with the idea being that the yearly increase in the expense per Medicare beneficiary should be tied to the growth in GDP. Thus, when actual Medicare spending exceeds the annual target in a given year, the SGR requires that physicians, and other system providers, must take a cut in order to bring the spending back in line with the annual spending targets.
The docs, understandably, do not like the idea of taking less in their Medicare payments. As a result, Congress has been delaying the cuts for years, constantly rolling them over into the next year at which time they roll them over again and again. Were Congress to ever stop delaying the SGR cuts, the physicians would find themselves feeling the cumulative pain of the delays with a one time Medicare rate reduction in excess of 20 percent.
These cuts are factored into the Medicare savings projections, along with hoped for savings to come by encouraging physicians to try some different approaches to practicing medicine.
Will this ever happen? Probably not.
So, while a skeptic can argue that these projected savings may never materialize, one cannot argue that this is, somehow, a cut to the Medicare program.
The bottom line is that there is nothing in the ACA that takes anything away from Medicare beneficiaries, now or in the future. Yet, the GOP continues to do its best to scare the hell out of seniors, the most reliable voter block in the nation.
We need to take this very seriously.
If the 2010 elections taught us anything, it is that a frightened voter population will do some crazy things. So, it’s on us to make sure that our grandparents and parents understand that Repubican fear peddlers are selling nothing but lies and that falling for the lies could result in the end of Medicare as we know it if the Republicans are permitted to gain full control of the government.
If you would like more information on this to share with family and friends, just let me know. The effort to mislead our senior citizens worked well in 2010. We simply cannot permit it to work again in 2012.
By: Rick Ungar, Mother Jones, September 13, 2011
Fact Checking The CNN And Tea Party Express Debate In Tampa
The Republican presidential debate in Tampa, Fla., co-hosted by CNN and the Tea Party Express, was feisty and provocative, with many of the candidates relying once again on bogus “facts” that we have previously identified as faulty or misleading.
The debate marked a remarkable shift in tone by Texas Gov. Rick Perry on the issue of Social Security, barely five days after he labeled the venerable old-age program “a Ponzi scheme” doomed to fail. This week, he said it was a “slam dunk guaranteed” for people already on it.
Last week, we explained why the Ponzi scheme label was not true — and also provided readers with a primer on Social Security for those who want to learn more. In Monday night’s debate, Perry and former Mass. Gov. Mitt Romney tangled over the issue again, and Romney had better command of the facts, as far as the two men’s books were concerned.
“The real issue is that in writing his book Governor Perry pointed out that, in his view, that Social Security is unconstitutional, that this is not something the federal government ought to be involved in, that instead it should be given back to the states … . Governor Perry, you’ve got to quote me correctly. You said ‘it’s criminal.’ What I said was Congress taking money out of the Social Security Trust Fund is like criminal, and that is, and it’s wrong.”
— Mitt Romney
Romney gets points for correctly quoting both Perry’s book, “Fed Up,” and his own book, “No Apology.” On page 58, Perry labels Social Security, Medicare, Medicaid and even unemployment insurance as “unnecessary, unconstitutional programs.” While promoting his book last year on MSNBC’s “Morning Joe,” Perry went further, suggesting Social Security should be dismantled and simply become a state responsibility.
“Get it back to the states. Why is the federal government even in the pension program or the health-care delivery program?” Perry said on Nov. 5, 2010. He said that ending the federal government’s role in Social Security would be “one of the ways this federal government can get out of our business.”
(Perry also added: “I wouldn’t have written that book if I wanted to run for presidency of the United States. … I have no interest in going to Washington.”)
Romney’s book, by contrast, contains mostly a sober description of various ways to fix the long-term funding problems of Social Security, with the exception of the suggestion that members of Congress are doing something criminal with Social Security funding (page 158). People can differ, but we think comparing Social Security (a government retirement and disability insurance program) to a trust fund managed by a bank is an inappropriate analogy.
“We know that President Obama stole over $500 billion out of Medicare to switch it over to Obamacare.”
— Rep. Michele Bachmann (Minn.)
“He cut Medicare by $500 billion. This, the Democrat president, the liberal, so to speak, cut Medicare — not Republicans, the Democrat.”
— Romney
Bachmann in particular loves to make this claim, but we have repeatedly explained why it just isn’t correct.
Under Obama’s health-care law, Medicare spending continues to go up year after year. The law tries to identify ways to save money, and so the $500 billion figure comes from the difference over 10 years between anticipated Medicare spending (what is known as “the baseline”) and the changes the law makes to reduce spending.
The savings actually are wrung from health-care providers, not Medicare beneficiaries. These spending reductions presumably would be a good thing, since virtually everyone agrees that Medicare spending is out of control.
In fact, in the House Republican budget this year, lawmakers repealed the Obama health-care law but retained all but $10 billion of the nearly $500 billion in Medicare savings, suggesting the actual policies enacted to achieve these spending reductions were not that objectionable to GOP lawmakers. So it is misleading for Romney to say that Republicans did not make these cuts.
For a more detailed explanation, please see our longer examination of this subject in June, when we gave Bachmann two Pinocchios for making this claim at the first GOP debate.
“Let me say I helped balance the budget for four straight years, so this is not a theory”
— Former House Speaker Newt Gingrich (Ga.)
Gingrich at least indicates there was a president — Bill Clinton — when the nation briefly began to run budget surpluses. And certainly the Republican Congress led by Gingrich prodded Clinton to move to the right and embrace such conservative notions as a balanced budget.
But the budget was balanced in part because of a gusher of tax revenues from Clinton’s 1993 deficit-reduction package, which raised taxes on the wealthy and which Gingrich vehemently opposed. The budget was also balanced because the Democratic White House and Republican Congress were in absolute legislative stalemate, so neither side could implement grand plans to increase spending or cut taxes.
Gingrich is wrong to suggest there were four years of balanced budgets when he was speaker. He left in January 1999; the budget ran a surplus in the fiscal years 1998, 1999, 2000 and 2001. So he can at best claim two years.
During the surplus years, moreover, the gross debt (including bonds issued to Social Security and Medicare) rose by $400 billion. Gross debt is the figure that conservatives tend to use. During Gingrich’s time as speaker, the public debt was essentially flat and the gross debt rose $700 billion.
Obama “had $800 billion worth of stimulus in the first round of stimulus. It created zero jobs.”
— Perry
Perry is wrong. The surplus created jobs; it also saved jobs. But there has not been a net gain in jobs because so many jobs were lost early in Obama’s presidency. Since the stimulus bill was signed, the number of overall jobs in the United has declined by about 1.9 million.
Economists differ on the effectiveness of the stimulus, but most say it has at least some effect (ie, created at least some jobs.) A recent review of nine different studies on the stimulus bill found that six studies concluded the stimulus had “a significant, positive effect on employment and growth,” and three said the effect was “either quite small or impossible to detect.”
“I was one of the only people in Washington that said: Do not raise the debt ceiling. Don’t give the president of the United States another $2.4 trillion blank check. You’ve got to draw the line in the sand somewhere and say: No more out-of-control spending.”
— Bachmann
Ever hear of a “blank check” with a number attached to it? In any case, Congress has already committed to spend much of this money, under budgets passed in previous years. Lifting the debt ceiling merely means that the Treasury now has the authority to make good on bills that are coming due.
“We have cut taxes by $14 billion, 65 different pieces of legislation.”
— Perry
That’s one side of the ledger. We are not sure if Perry’s figure is correct but as Politifact Texas has documented, he has also raised taxes repeatedly, including on cigarettes, to make up revenue for cuts in local property taxes.
“What we saw with all of the $700 billion bailout is that the Federal Reserve opened its discount window and was making loans to private American businesses, and not only that, they were making loans to foreign governments. This cannot be.”
— Bachmann
Bachmann is significantly overstating the case. Bloomberg News, which filed the Freedom of Information Act request that resulted in the disclosure of the Fed loans to foreign banks (some of which had had some government ownership), noted: “The Monetary Control Act of 1980 says that a U.S. branch or agency of a foreign bank that maintains reserves at a Fed bank may receive discount-window credit.” All of the loans were paid back, according to Fed officials.
“And I happen to think that what we were trying to do was to clearly send the message that we’re going to give moms and dads the opportunity to make that decision with parental opt-out. Parental rights are very important in the state of Texas. We do it on a long list of vaccines that are made.”
— Perry
Perry skated close to the edge of the truth here as he tried to defend his controversial order to require the vaccine that is said to prevent cervical cancer. As Politifact Texas reported in 2010, Perry “ordered the Department of State Health Services to allow parents dissenting for philosophical or religious reasons from all immunizations — not just this one — to request a conscientious objection affidavit form.”
Just 0.28 percent of students filed such forms, which must be updated every two years to remain viable — and not all private schools accept the form. So as many as 15 percent of girls did not have the possibility of opting out of the requirement to receive the vaccine if they wanted to continue in their schools.
While Romney denied Bachmann’s charge that there was a connection between his order and a $5,000 campaign donation, Texas media reported that Perry’s chief of staff held a meeting on the vaccine plan on the same day the donation was received. Perry’s aides said the timing was a coincidence.
“This is the election that’s going to decide if we have socialized medicine in this country or not. This is it. Why? I just have to say this. It’s because President Obama embedded $105,464,000,000 in Obamacare in postdated checks to implement this bill.”
— Bachmann
It’s wrong to say the health-care law — which builds on the existing private system — will result in socialized medicine, but apparently some people will never be convinced.
But Bachmann’s assertion of $105 billion “embedded” in the health-care law is another bogus claim for which she has previously earned four Pinocchios. We looked closely at her assertion in March and concluded that her charge that this money was “hidden” does not have credibility. The money for these programs was clearly described and analyzed by the Congressional Budget Office before the legislation was voted into law. And since then, the Obama administration has issued a new release every time it spent some of the funds.
By: Glenn Kessler, The Fact Checker, The Washington Post, September 13, 2011
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