“Grappling With Their Shortsighted Rejection”: The Tough Politics Of Medicaid For Republicans
In the world of Republican politics, there is no surer bet than opposing ObamaCare. But conservative obstruction to the health care overhaul may finally be catching up with a handful of Republican governors running for re-election. Their rejection of ObamaCare’s expansion of Medicaid — the federal health assistance program for the poor and disabled — has been them losing both the argument and voters.
Princeton political scientist Sam Wang recently published an analysis of polling data from this year’s gubernatorial races. It found that Republican incumbents who resisted ObamaCare’s Medicaid expansion — including Wisconsin’s Scott Walker, Pennsylvania’s Tom Corbett, and Kansas’ Sam Brownback — are in much tighter races than those who accepted it. “Republican governors who bucked their party’s stance and accepted the policy are faring better with voters — in these races, an average of 8.5 percentage points better,” Wang discovered.
This shouldn’t be surprising. Setting aside the incendiary politics surrounding ObamaCare and its alleged freedom-killing agenda, the simple truth is that Republican governors have blocked health insurance for nearly six million citizens. And they’ve done so despite the fact that under ObamaCare, the federal government covers all the cost of expanding Medicaid for the next six years, and at least 90 percent of the cost in 2020 and beyond.
Why have Republican governors spurned this incredibly good deal? Their ostensible justification has been disbelief that the federal government would hold up its end of the bargain, leaving states to pick up the tab.
But researchers at the Urban Institute threw cold water on this argument in a study last month. They found that the federal government has almost never reduced funding to the states for Medicaid. In fact, it has not done so since 1981, when President Reagan and Congress imposed a temporary funding cut.
Indeed, Congress has been far more likely to increase funding for state Medicaid programs. It has done so twice in recent memory — in 1997 and in 2005 — boosting state funding even while making other cuts to the program.
The sanctity of the federal commitment to Medicaid has only grown in recent years. As evidence of federal faint-heartedness, conservatives point to an administration proposal floated during 2011 budget negotiations that would have reduced federal Medicaid funding to the states.
But this bad idea was dropped after the states got newfound bargaining power from the Supreme Court’s 2012 decision making the Medicaid expansion entirely voluntary. With the expansion now optional, the administration can ill afford to weaken the financial carrot for red states to buy in. This has also made the administration agreeable to some conservative twists on traditional Medicaid, like using public dollars to enroll people in private health plans in Arkansas and Iowa.
The Urban Institute also quantified how much intransigent red states are losing by resisting ObamaCare. They’re turning down $400 billion in free federal money over 10 years. They will have missed out on over 172,000 new jobs in 2015 alone. And they’ve cost their hospitals $168 million, enough to completely offset ObamaCare’s reimbursement cuts to hospitals for Medicare and Medicaid.
And, of course, these states have also frozen themselves at pre-ObamaCare rates of high uninsurance. “While the number of uninsured in other states fell by 38 percent since September 2013,” the researchers explain, “non-expanding states experienced a decline of just 9 percent.”
As the midterm elections approach, Republican candidates are discovering that the politics around health care reform are becoming unexpectedly complicated. Trailing badly in the polls, Gov. Corbett announced last month that Pennsylvania will expand its Medicaid program. In states that have already expanded their programs, pro-repeal conservative candidates are stumbling to explain how they would handle new Medicaid enrollees.
But this is what happens when you engage with the actual policy implications of health care reform. Conservatives can whip up fear and hostility over an abstract big-government monolith called ObamaCare. But the actual programs contained therein (like expanding public health insurance for the poor) tend to be pretty appealing to voters.
As their arguments are rendered hollow, obstructionist Republicans are paying the electoral price for thwarting these types of programs. When they picked a fight against expanding Medicaid, conservatives chose the wrong bulwark for massive resistance against national health care reform.
By: Joel Dodge, The Week, September 9, 2014
“Not So Fast Bucko’s”: Anti-Obamacare Desperation Lawsuit Just Got More Desperate
The D.C. Circuit just agreed to hear the Halbig lawsuit. The short explanation of what this means is that it has closed off the easiest path to crippling Obamacare. Here’s the long explanation:
1. The Halbig lawsuit is the right’s most recent desperate effort to retroactively nullify the Affordable Care Act. The lawsuit is a wildly tendentious argument that, based on an extremely narrow reading of one ambiguous passage in the health-care law, people in states with federal-run insurance exchanges should be ineligible. Since the tax credits make insurance affordable for most consumers, the lawsuit would wreck the exchanges for some 6.5 million people, which is its entire point.
2. The Halbig suit has previously been laughed out of court, but in July, two out of three judges from the D.C. Circuit agreed with it. This ruling reflected the luck of the draw — the two judges were Republican appointees on a court consisting mostly of Democratic appointees.
3. This created a split, with some courts dismissing Halbig and another one embracing it. The split created an obvious window for the Supreme Court to take up the case — contrasting opinions between Federal Courts is a common reason for the Supreme Court to take up a case.
4. The split would close if the entire D.C. Circuit took up the case. In important cases with split decisions, the entire court usually weighs in. Conservatives desperately wanted to avoid this, for the reason stated above. They undertook a furious public campaign (see, for instance, here and here) to persuade the Court not to hear Halbig as a whole. Their rationale is that the Halbig lawsuit is not legally important enough to merit a full hearing. That argument is as ridiculous and transparently partisan as it sounds. Nicholas Bagley explains why here.
5. What happens next is that the entire D.C. Circuit will hear the case. Since the logic of the lawsuit is so ludicrous only a wildly partisan Republican jurist would ever accept it, it stands zero chance of success.
6. After that, Federal Courts will be unanimous in opposition to the Halbig lawsuit. The Supreme Court could still take up the case then, but it could just as easily decide not to hear it.
By: Jonathan Chait, Daily Intelligencer, New York Magazine, September 4, 2014
“It’s Not My Job”: Scott Brown, “I Am Not Going To Create One Job”
Former Sen. Scott Brown (R-Mass.), on the campaign trail in New Hampshire, appeared on a local radio show this week and caused a bit of a stir. Specifically, he suggested his supporters in neighboring states should come to the Granite State, take advantage of same-day registration, and vote for him, in effect calling for voter fraud on a massive scale.
The problem, of course, was that Brown was kidding. If you listen to the audio, it seems he probably wasn’t serious about the scheme, though given his personal circumstances, this is an odd thing for Brown to joke about.
But a day later, the former senator was entirely serious when he made these comments to a group of voters:
“Here’s the thing. People say, ‘What are you going to do to create jobs?’ I am not going to create one job, it is not my job to create jobs. It’s yours. My job is to make sure that government stays out of your way so that you can actually grow and expand. Obamacare’s a great example. The number one job inhibitor right now is Obamacare…. We have to repeal it.”
As is too often the case, Brown seems a little confused about public policy. On health care, there’s literally nothing to suggest the Affordable Care Act is undermining job growth, just as there’s literally nothing to suggest unemployment will improve if Scott Brown takes health care benefits away from millions of Americans. The very idea is bizarre.
But that, of course, is secondary to the Republican’s boast that he is “not going to create one job.” This is so misguided, it’s the kind of comment that’s likely to linger for a while.
Note, for example, Brown is simply wrong on the basics of economic policy. The public sector creates jobs all the time. How a former U.S. senator can fail to understand this is a bit of a mystery.
Also, when he was in Massachusetts, Brown used to say that he could, in fact, create jobs through government policymaking. What caused the former GOP lawmaker to change his mind when he changed states? Why did he think he could create jobs in Massachusetts, but not in New Hampshire?
For that matter, just as a matter of rudimentary political competence, what kind of candidate tells voters, “I am not going to create one job”?
By: Steve Benen, The Maddow Blog, September 4, 2014
“It’s Your Money”: Speaker Boehner’s Lawyer Is Charging The American Taxpayer $500 An Hour To Sue Obama
Last January, a Washington attorney named David Rivkin co-authored an article in Politico Magazine that laid out a legal theory that Speaker John Boehner (R-OH) now plans to use to sue President Obama because the president is not implementing Obamacare fast enough. Yet, as ThinkProgress laid out shortly after Boehner announced that he would file the lawsuit, Rivkin’s legal theory rests upon “a glaring misrepresentation of a recent Supreme Court decision that undermines much of the basis for this lawsuit.”
Nevertheless, Boehner decided to hire Rivkin to represent the GOP-led House in its suit against the president. Rivkin’s price? $500 an hour, all charged to the American taxpayer.
The contract caps Rivkin’s fees at a total of $350,000, although, if past is prologue, this cap will rise quickly. During the litigation challenging the Defense of Marriage Act, Boehner hired former Solicitor General Paul Clement to defend anti-gay discrimination at a fee of $520 per hour. Although an early iteration of Clement’s contract capped his total fees at $500,000, the total cost of Boehner’s legal services rose to $2.3 million. Clement’s legal fees were also charged to the American taxpayer.
However much money Rivkin ultimately collects from the American people, he is unlikely to win his lawsuit if the judges who consider it follow existing law. As a general rule, a plaintiff bringing a lawsuit must have actually been injured in some way by the person they are suing. Neither Boehner nor any other member of Congress, however, has been injured by President Obama’s decision to delay implementation of the provision of the Affordable Care Act at issue in this case. Additionally, in a 1997 case called Raines v. Byrd, the Supreme Court explained that suits brought by members of Congress alleging that their institutional rights as lawmakers have been injured are highly discouraged.
Nevertheless, it’s worth noting that the Roberts Court has shown a willingness to abandon established law when Obamacare is involved, so there is no guarantee that Rivkin will lose.
By: Ian Millhiser, Think Progress, August 25, 2014
“Taking Cover Behind What’s Left Unsaid”: The GOP’s Midterm Strategy Is As Hollow As Their Ideas Are
The most interesting thing about Senator Mark Pryor’s decision to tout his support for the Affordable Care Act in a well-financed, statewide television ad isn’t that he stands apart from other embattled Democrats this election cycle. It’s that Republicans scrambled to spin the story, insisting to reporters that Pryor couldn’t possibly be running on Obamacare if he won’t refer to the law by name.
This was poorly disguised Calvinball, a standard that Republicans invented for the special case of the ACA. Literally no other members of Congress are expected to refer to the laws they’ve helped pass by name or nickname. Republicans in the aughts weren’t expected to refer to the “Economic Growth and Tax Relief Reconciliation Act,” or “EGTRRA,” or “the Bush tax cuts,” or “the Bush tax cuts for the rich,” no matter how unpopular the moniker became. They ran on having cut taxes, and wanting to renew those tax cuts. And sure enough when President Obama set about trying to let “the Bush tax cuts” expire, he conveniently omitted the popular ones. Which is to say, the vast majority of them. He made those permanent.
Nevertheless, several reporters fell into line. And good for the ref workers. Score one for them.
But if Obamacare is a huge liability for Democrats, why are conservatives and GOP operatives desperate to control the narrative surrounding Pryor’s decision to run on the law? If your opponent’s stepping on rakes, why not just stand back and let him?
The answer is that with respect to both Obamacare and other issues Republicans must rely on diversions from policy and outcomes when expressing their substantive and strategic views. We’ve reached a point in the fight over Obamacare where the best thing Republicans have on their side is the law’s unpopular brand. Particularly in states like Arkansas, where President Obama is widely loathed but his signature law has cut the uninsurance rate nearly in half. It’s deeply silly to argue that Pryor isn’t running on Obamacare unless he refers to it using one of two unpopular slogans. But that’s the argument.
Instead, Pryor says, “I helped pass a law that prevents insurance companies from canceling your policy if you get sick or deny [sic] coverage based on pre-existing conditions.” Maybe he shouldn’t have said anything about “a law” at all, but that’s a niggling, semantic critique. That Republicans working to defeat Pryor are asking reporters to squeeze the word “Obamacare” into this sentence is an admission that they’ve lost the policy fight. They criticize Pryor for eschewing the label, because the label’s just about the only thing they’re comfortable assailing. In this way, they resemble Democrats six and eight years ago, running against the Bush tax cuts (for the rich), knowing that they had no intention of letting anything but the most regressive of those tax cuts expire.
In that sense, the GOP’s obsession with the moniker, and only the moniker, is excellent news for Obamacare’s political durability. But only if the people who cover politics are clear about the implications of the GOP’s rhetoric. Unlike Democrats, who were generally clear about the fact that they planned to make most of the Bush tax cuts permanent, Pryor’s opponent, Representative Tom Cotton, acknowledges that the pre-Obamacare status quo, in which insurers denied coverage to people with pre-existing health conditions, was “broken,” but nevertheless maintains that his goal is to repeal the law that makes that practice illegal.
Cotton repeated that mantra just this week, on the trail with Mitt Romney, who, in an amusing twist, tried to save Cotton from himself. “Tom Cotton is going to make sure that we change Obamacare, making sure that people can keep insurance and those that have pre-existing conditions can have coverage,” Romney said, “but he doesn’t want to see the federal government telling people in Arkansas what kind of insurance they have to have or making it more expensive.” Those are remarkably accommodating priorities. They’re just not ones Cotton is prepared to espouse just yet.
In this way, the politics of Obamacare in Arkansas mirror the politics of legislative brinksmanship in Kentucky. Just two days ago, Mitch McConnell, the embattled Senate minority leader who hopes to become majority leader next year, vowed to lard up appropriations bills with partisan policy riders and allow the president to choose between a veto, precipitating a government shutdown, and a bitter pill. A classic take it or leave it proposition.
McConnell said it would be up to the president to decide whether to veto spending bills that would keep the government open.
Obama “needs to be challenged, and the best way to do that is through the funding process,” McConnell said. “He would have to make a decision on a given bill, whether there’s more in it that he likes than dislikes.”
It wouldn’t be much of a challenge to Obama if McConnell plans to cave the moment the president whips out his veto pen. So the threat is pretty clear. Nevertheless, McConnell’s campaign wasn’t pleased by the ensuing deluge of stories about how a GOP majority would embrace high-stakes confrontations and potentially shut down the government again. And in a very narrow sense they have a point—McConnell never said he’d shut down the government. Political scientist Jonathan Bernstein, no McConnell partisan, was among those who defended McConnell on this score.
But much like Cotton can’t credibly claim to support protections for people with pre-existing medical conditions when his plan is to repeal Obamacare, McConnell can’t sidestep the implications of his publicly declared strategy. He can’t say “when we’re in power, we’re going to put two and two together,” and then get angry when the headlines say, “McConnell promises four.”
That won’t stop him from trying to, though. And to an unappreciated extent, the broader Republican strategy heading into November is to speak in abstractions, and take cover behind what’s left unsaid.
By: Brian Beutler, The New Republic, August 22, 2014
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