“The Human Consequences”: Cost Of The Medicaid Expansion Rejection In Lives As Well As Dollars
The more research that is done on the human toll of denying people health insurance, the easier it is to place a price in lives as well as dollars of decisions like that made by nearly half the states to reject the Medicaid expansion provided for in the Affordable Care Act. At Politico Magazine (in a piece given the wonderful, Celine-esque title, “Death on the Installment Plan”) Harold Pollack of the University of Chicago utilizes the findings of last week’s study on the lives saved by RomneyCare in Massachusetts to make some suggestions for those that might be saved by making Medicaid available to more non-elderly adults:
As a matter of fiscal policy, [rejecting the Medicaid expansion] makes little sense. The federal government would initially cover 100 percent of the costs. Its share will gradually drop to 90 percent over the coming years. Over the next decade, the federal government will cover more than 95 percent of the Medicaid expansion’s total cost. Edwin Park of the Center on Budget and Policy Priorities notes that the ACA raises state expenditures on Medicaid and the Children’s Health Insurance Program (CHIP) by only 1.6 percent, when compared with what expenditures would have been in the absence of health reform.
Even the above figures overstate states’ true fiscal burden, since these federal dollars would cover many services such as mental health care, public hospital services and services to the correctional population that would otherwise be supported by states and localities. Medicaid expansion is a significant economic stimulus to the states that have adopted it. Even in deeply conservative states such as Texas, the expansion is strongly supported by the medical community, hospitals, cities and localities and other key constituencies.
Texas and other huge states like Florida are leaving tens of billions of dollars on the table. When asked to give an accounting of themselves, officials offer flimsy justifications to evade two obvious realities: First, Republican politicians do not want to embrace the centerpiece domestic policy achievement of the Obama presidency. Second, many of these same politicians display conspicuously tepid concern for the wellbeing of the expansion’s most obvious beneficiaries: poor, nonwhite, politically marginal residents of their own states….
Nearly 5 million low-income Americans are income-eligible for Medicaid under the ACA, yet live in states that now reject the Medicaid expansion. Within this rather small but critical low-income population, that same one-per-830 estimate [made in the Massachusetts study] implies that almost 5,800 people will die every year as a result of being left uninsured. That’s only an estimate. It may overestimate—or underestimate—the true human consequences. In my view, there’s no escaping the fact that partisan opposition to the ACA is costing thousands of actual human lives every year.
That’s a hell of a toll for scoring an ideological point.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, May 12, 2014
“Obama’s Transformational Presidency”: He Should Be In The “All-Time-All-World Politics Hall Of Fame”
Is it safe to say that Barack Obama’s presidency will be remembered as the most consequential since Ronald Reagan’s — a presidency that “changed the trajectory of America” and “put us on a fundamentally different path”?
That was the audacious goal Obama set for himself during his 2008 campaign. Now is a useful time to assess his progress because the sixth year of any president’s tenure tends to be seen as a low point. Familiarity breeds impatience and frustration — among commentators, at least, whose narrow focus on which party is perceived as “winning” the day or the week misses the bigger picture.
In both the domestic and foreign spheres, Obama has had transformational impact. And there is more to come.
Reagan’s great achievement at home was to shift the political spectrum to the right. People tend to forget how radical his ideas once seemed. Tax cuts and massive deregulation were somehow going to produce more revenue? Wealth would inevitably trickle down and benefit the middle class and even the poor? It was not a Democrat but a fellow Republican, George H.W. Bush, who mocked the whole concept as “voodoo economics.”
That’s what I’d still call Reagan’s program, but he altered the political debate to such an extent that what once were fringe ideas came to be seen as centrist. By the time Obama took office, the combination of Reaganite policies — taken to extremes the Gipper might never have contemplated — and globalization had produced a nation where the rich were becoming obscenely rich and everyone else was struggling to tread water.
Obama’s impact has been to bring the words “fairness” and “equality” back into the political lexicon.
His biggest legislative accomplishment, the Affordable Care Act, is a landmark because it establishes the principle that health care should be considered a right, not a privilege. Democrats such as Harry Truman — and Republicans such as Richard Nixon — sought for decades to move the nation toward universal care. The fact that Obama succeeded where others failed is, in itself, a huge achievement.
Perhaps as important, however, is the fact that while Republicans still claim they want to repeal Obamacare, the debate within the party centers on how best to expand health insurance coverage. Returning to the way things were before the ACA is not an option.
Health care is part of a larger suite of issues on which Obama has swung the pendulum back to the left. He made the case, for example, that more regulation of the financial sector was needed. Republicans were forced to give way. The president has been hammering away in speeches about the need for an increase in the minimum wage. Republicans haven’t caved on this yet, but in the end they almost surely will because of widespread public support for it.
Whether Democrats lose the Senate or not, Obama will have a tough time getting significant legislation passed in his final two years. Please don’t tell me he simply needs to be a better politician, like Bill Clinton. Obama ran rings around both Clintons in 2008. A black man with the middle name Hussein who gets elected president twice should be in the all-time-all-world Politics Hall of Fame.
But he can still have transformational impact. Working through the Environmental Protection Agency, Obama can take major steps to limit carbon emissions. I don’t know whether he’ll go as far as I believe he should, but whatever he does will be, by definition, a big deal.
In foreign policy, Reagan applied pressure to the weak points of the Soviet empire and helped break it apart. Obama has taken on an equally big and important task: redefining the U.S. role in a vastly changed world.
Obama is not the first president to endorse multilateralism, but he may be the first to mean it. He agreed to use force in Libya only after France and Britain nominally took the lead. He has kept the NATO allies together in cautiously dealing with the Ukraine crisis. He has refused to be drawn into Syria because he is unsure whether intervention would make the situation better or worse.
The president realizes that even the most powerful nation on earth cannot mediate every dispute, take sides in all wars, alleviate all suffering. He acknowledges our limitations and more narrowly defines our national interest. The public approves, even if some foreign policy sages are apoplectic.
Obama can be reserved and introspective. Usually, however, I find him energized, confident, determined — and fully aware that he is shifting the ground.
By: Eugene Robinson, Opinion Writer, The Washington Post, May 8, 2014
“Time For Some Happy Talk From Democrats”: Ban The Word “But” Until After The Election
Democrats, if you want to win in the fall, take some advice from Pharrell Williams: “Clap along if you feel like happiness is the truth.”
The Mountie-hat-wearing pop singer’s infectious “Happy” should be the Democratic Party’s theme song for the midterm election. Despite Republican claims to the contrary, things are definitely looking up. Democrats ought to be clicking their heels and spreading the good news.
Friday’s announcement that unemployment fell to 6.3 percent was huge. The fact that the economy added 288,000 jobs in April — despite continued bad weather early in the month in parts of the country — suggests that the recovery has greater momentum than pessimists had feared. Economists were expecting decent numbers. These are great.
The stock market, meanwhile, is flirting with an all-time high. The Dow has risen about 10 percent over the past year; the S&P 500, more than 16 percent; the Nasdaq, about 22 percent . During President Obama’s term in office, the Dow has more than doubled. If he were a socialist, as his harshest critics claim, he’d be a truly lousy one.
The numbers prove that Obama is, in fact, a skillful capitalist who guided the economy out of its worst slump since the Great Depression. He accomplished this feat despite being saddled with a Republican opposition in Congress that reflexively opposes his every initiative — even those based on policies the GOP supported in the past.
Speaking of which, the Affordable Care Act — which is based, you’ll recall, on a framework developed in Republican think tanks — is clearly a success and may soon be seen as a triumph. More than 8 million people have signed up for insurance through the federal and state exchanges; Obama’s benchmark had been 7 million. Enough of these enrollees are young and healthy to ensure the program’s continued viability.
The disasters predicted by the Republican Party have not come true. Critics have stopped talking about a hypothetical “death spiral” in which the health insurance reforms collapse of their own weight, since it is now clear that nothing of the sort will happen. Early indications are that any increase in premiums for next year will be modest. Republicans will keep attacking Obamacare because it fires up the base, but the program is here to stay.
Democrats now have a positive story they can tell in their campaign ads and speeches: “We promised you that these were the right policies to get the economy on track and reform health care. We said it would take time to see results and asked for patience. You gave us your trust, and now we’re seeing the benefits. This is just the beginning. Give us a mandate to keep moving forward on an agenda that is working.”
This is what Democrats are saying, more or less. But would it hurt to show a little enthusiasm?
Obama can be excused for his brief and relatively low-key reaction to the jobs numbers Friday. He spoke in the White House Rose Garden alongside German Chancellor Angela Merkel, with whom he had just met, and the situation in Ukraine was clearly weighing on both leaders’ minds.
“The grit and determination of the American people are moving us forward,” Obama said, “but we have to keep a relentless focus on job creation and creating more opportunities for working families.”
I propose that Democrats ban the word “but” until after the election.
Republicans are giving “but” a workout. Unemployment may be down to 6.3 percent, they say, but too many people are leaving the workforce. The jobs numbers for April may look good, but we don’t know if this rate of growth can be sustained. Enrollment numbers for the Affordable Care Act may be impressive, but have all those people actually paid their premiums?
These are not honest caveats. Republican claims about enrollees not paying their insurance premiums, for example, are based on a survey taken before many of those premiums were even due. The GOP wants to foster the notion that nothing is going well with Democrats in charge of the White House and the Senate — and that it’s time for a change.
When Democrats sound like the old “Saturday Night Live” character Debbie Downer — emphasizing what’s still ailing about the economy, promising to “fix what’s broken” in Obamacare — they reinforce the Republicans’ message rather than refute it.
Listen up, Democrats. You fixed the economy. You expanded access to health care. Oh, and you ended two wars.
Show a little happiness. It’s contagious.
By: Eugene Robinson, Opinion Writer, The Washington Post, May 5, 2014
“Hey Dems, Thinking About Not Voting In The Midterms?”: Here’s What Happens When The GOP Takes Over The Senate
Passing a federal law banning almost all abortions after 20 weeks. Defunding parts of Obamacare. Weakening the Environmental Protection Agency. Kneecapping the Consumer Financial Protection Bureau, Elizabeth Warren’s baby, the new agency within the Fed to police consumer fraud. And—maybe, just maybe—letting a Supreme Court seat sit vacant until after the next presidential election.
That’s just the start of what happens if the Republicans win back the Senate this November. Imagine, posits a top aide to Mitch McConnell, a steady stream of legislation, much of it conservative, that will force Barack Obama to start vetoing bills for essentially the first time in his presidency.
And imagine a Republican Congress, with an eye toward 2016, that could take a number of steps to make life harder for presumed Democratic front-runner Hillary Clinton. First and foremost: continuing their investigations—indeed redoubling them—into the Benghazi tragedy.
Democrats have been feeling a wee bit better lately about this November. The Affordable Care Act is looking stronger. Southern incumbents like Mark Pryor and Mary Landrieu have seen some friendlier poll numbers.
But the fact remains that the GOP has a decent to good shot at taking the Senate this fall. A brand new Washington Post/ABC poll splashed a little cold water across Democratic faces. It finds Obama’s approval at an all-time low in Post polls. More ominously, Republican respondents said they were planning on voting in far greater numbers than did Democrats. So this is a reality Democrats and liberals, like it or not, have to think about.
In recent weeks, I talked with a broad range of Democratic senators and progressive insiders—and a few Republican and conservative ones—about this GOP future. Verdict: While most thought things would be worse, I was mildly surprised by the number who said that strangely enough, matters might actually improve a little. And I came away thinking that while Republicans in full control of Congress would obviously be well-positioned to tee things up for their presidential candidate, they’d more likely end up doing the opposite.
Yes, Things Can Get Worse
Let’s start with the bleak view. “If the Republicans win the Senate,” says Norman Ornstein of the American Enterprise Institute, “the conclusion they’re going to draw is ‘obstruction works,’ and they’re going to double down on it. So they’ll be thinking, ‘Why go out of our way to do stuff and why compromise when in two years we can win it all?’”
Ornstein’s frequent collaborator, Thomas Mann of the Brookings Institution, thinks that while it should make sense that Republicans eyeing a 2016 White House win would want to have some accomplishments to point to, we shouldn’t bet on it. “The interests of the party in ’16 are clear, but whether that proves sufficient to produce something positive out of the Republicans in Congress is a big reach,” says Mann. “They almost have an incentive to keep the economy going at a more tepid rate.”
Neera Tanden, president of the Center for American Progress, agrees. “A GOP Senate takeover would be terrible for Obama’s presidency,” Tanden says. “It would spell the end of any progress on any legislative action and with GOP control of both houses of Congress, Republicans would set up debates to help their presidential candidates in 2016. And of course, investigations of the administration would double.”
What about the senators themselves? New York’s Chuck Schumer predicts: “It would let loose six years of right-wing frustration. The potential for gridlock is enormous.”
Two of his more liberal colleagues, Elizabeth Warren and Sherrod Brown, emphasized the huge change in priorities we’d see if Republicans were in control of the Senate calendar. That, after all, is one of the main things a Senate majority can do—decide what does and does not get to the floor for consideration. With Mitch McConnell or any other Republican in charge of that calendar instead of Harry Reid, the Senate becomes an entirely different body.
“Their whole effort is grounded in their contempt for government,” Brown says. “On Medicare, on Social Security, on consumer protection, on regulation of Wall Street… If you want to know what a wholly Republican Congress would do, the thing to do is to look at what they’ve done in state capitals where they can. In Ohio, they’ve gone after voters’ rights, workers’ rights, women’s rights. They’d bring that to Washington.”
Warren notes another aspect of majority control that doesn’t get as much attention as floor votes but is also important: what kind of work the committees do and don’t do. Committee hearings rarely have the drama of, say, Henry Waxman hauling those tobacco executives up to the Hill a few years ago. But they matter. Groundwork is laid for future legislation, and that happens because the majority gets to determine what the hearings are about as well as the bulk of the witness list.
Warren had a fresh example at the ready on the day I spoke to her. “Right now, I just came out of a hearing on payday lending,” Warren told me. The payday lenders, who charge usurious loan rates to people living paycheck to paycheck, are one of Warren’s top targets—but they have a powerful lobby, and Republicans generally do their bidding. “If Republicans get in charge of the Senate,” says Warren, “a hearing like that has no chance of happening. They’ll get to roll over the issues of importance to the American people.”
The Pressure to Govern
But here’s the counterintuitive view, expressed by several folks: If Republicans have full control of Congress, they won’t have Harry Reid to kick around anymore. In a divided Congress, each party can point its finger at the other and say: “Obstructionist!” But if one party is running the show, the responsibility for getting results falls entirely on that party’s shoulders.
“If I were a Republican looking forward to 2016, I would actually want to get a little something done,” says William Galston of Brookings. “And if the president has any desire for his last six years to be anything other than trench warfare over the ACA [Affordable Care Act, as the Obamacare law is officially known], then maybe he’ll want to do something, too.”
Several people I spoke with noted that we do have precedent for this, and it’s hardly ancient history. “The model is the late ’90s template,” says Nicholas Eberstadt of the American Enterprise Institute. “Maybe a little less cordial.”
Or a lot less. But he has a point. In the 1994 election, the GOP took over the House and the Senate. At first, Republicans under Bob Dole and especially Newt Gingrich threw everything they could at Bill Clinton. But after a short while, Gingrich softened, and he and Clinton did pass some things—a landmark budget, and welfare reform.
“When Newt took over, at first, they were awful revolutionaries,” says Jim Kessler of Third Way, the centrist Democratic group. “They passed things that went nowhere. It was a Bataan Death March to a dead end. Then with the shutdown [in early 1996] they went too far, and then they realized that to keep their majority they had to govern.”
Hence, West Virginia Democrat Joe Manchin’s advice to the president: “My recommendation immediately would be for President Obama to sit down with Clinton and ask him how he did it. You don’t have to reinvent the wheel here.”
Having such a conversation couldn’t hurt. Bill Clinton is sitting on a library full of good political advice, and Obama should probably call him more often. But whether the Clinton-Gingrich model could be so easily transferred to Obama-Boehner—or, Lord help us, Obama-Cantor—is a wide open question. The parties are more dug in now than they were 15, 18 years ago, especially the Republicans. And they would probably think, as Norm Ornstein noted above, why should they play ball with 2016 coming? The best thing for them to do—in political terms, that is, albeit not for the country—is dig in, and drag down Obama’s poll numbers.
This would be the most effective way to harm Hillary Clinton, assuming she’s the Democratic choice in ’16. Says Bill Galston: “The most significant thing they can do to harm Hillary Clinton is to keep Obama’s approval numbers down. If you are running to succeed a two-term incumbent from your own party, you are in some sense running for his third term.”
There could be a few areas where agreement could be reached—for example, it might very well be in Republicans’ interest (with 2016 Latino voters in mind) to pass an immigration bill. On the other hand, they might not see it that way. They might see it as in their interest to try to paint Obama into a corner on immigration. And this raises the question of how the president would react to this new reality.
Can Obama Learn to Veto?
Here’s an undeniable truth that would flow from a fully Republican Congress. “Ironically,” says Don Stewart, a top aide to McConnell, “more legislation will actually pass, because we’ll just start passing things the House passed. Right now, Senator Reid’s main job is to be goaltender—to block President Obama from having to veto things.” To Stewart, Reid has prevented any number of bills that passed the House and could pass the Senate because “he wants the story to be ‘Republicans block.’ They’ve poison-pilled everything. We’ll take those out and pass things.” And then, what would Obama do?
This issue of the veto would surely be one of the main arenas of conflict if Republicans control both houses. Obama has vetoed less legislation than any president in modern history: just two bills, both in late 2010. George W. Bush vetoed 12 (and he had a cooperative Congress for six of his eight years); Clinton issued 37; George H.W. Bush, 44 (in four years!); and Ronald Reagan, 78. To find a president who’s vetoed fewer bills than Obama, you have to go back to 1881 and James Garfield, who logged zero vetoes, in no small part because just 200 days into his presidency, he was assassinated.
Obama hasn’t broken out his veto pen, says Robert Borosage of the liberal Campaign for America’s Future, because he hasn’t really wanted to be seen as confrontational. Let Reid and McConnell or Nancy Pelosi and John Boehner tear each others’ flesh; he’s wanted to float above that. With a wholly GOP Congress, says Borosage, that dynamic ends: “It dramatically forces the president to do something he’s never wanted to do, which is to define himself as a pole in the debate and be willing to stand up and veto things. That’s so against his character.”
But if this scenario comes to pass, he’ll have to veto. The Republicans will send him budgets and other bills with little—or big—poison pills. “With a Republican Senate, all kinds of things are going to reach his desk,” says Bill Samuel of the AFL-CIO. “There’ll be bills he needs to sign—funding the Defense Department, say—that they can add all kinds of malicious things to.”
To Grover Norquist, this is precisely the plan. Norquist doesn’t see major showdowns in the offing—just a series of minor ones that would nevertheless establish GOP priorities on the budget process, on the bet that the veto-shy Obama wouldn’t really change his stripes. “Lots of little things would slip in, and that’s the difference,” Norquist says. “Riders on appropriations. New EPA rules. Just make a list of everything he’s done by executive order and undo it by law in appropriations bills and make Obama sign or veto it.”
This circles us back to immigration. It seems far more likely that rather than pass a bill Obama could happily sign, Republicans would pass one he’d rather not sign—one without a path to citizenship, say—and box him in politically. “You could come up with an immigration reform that Obama would have a very hard time vetoing,” Norquist argues. “DREAMers, border security, STEM, and legal status. If you’re Obama, do you really want to say no to that?”
Frank Sharry, executive director of the pro-immigration reform America’s Voice, thinks that “the Republican dream of passing an immigration bill that puts Democrats in a pickle is a fantasy,” in large part because there are too many divisions within the GOP on the issue, divisions that will only be highlighted as their presidential contenders take center stage. Sharry might be right about that. But McConnell is nothing if not cagey. If he wins re-election and becomes majority leader, we can be sure he’ll think of plenty of ways to try to force Obama to accept GOP priorities, especially on budgetary matters, or issue a veto that would be difficult for some red-state Democrats to defend.
The GOP Policy Agenda: Look out ACA, CFPB, and Contraception
Political gamesmanship aside, there’s the question of what actual Republican policy priorities might be. Here’s where the liberal activists really get nervous.
Almost certainly, Republicans would pass bills with items similar to what’s been in the budgets written by Paul Ryan over the past few years: reducing Pell grants, food stamps, money for renewable energy. They’d target the EPA, as Norquist suggested, and they’d almost surely go after the Consumer Financial Protection Bureau, the new agency created by Dodd-Frank that reins in the bad practices of banks and other lenders. They’d try to change the oversight of the CFPB, giving business interests more control, or take it out from under the Federal Reserve Bank, where it’s now housed, which could reduce its authority.
This list could go on and on, but let’s look at just one issue area—contraception and reproductive rights. Right now, according to Donna Crane, the vice president for policy at NARAL-ProChoice America, the GOP House has passed or could quickly pass four bills that a Republican Senate would presumably endorse too:
*A law that would make it a federal crime for an adult to accompany a teen across state lines for an abortion and hold doctors liable for knowing that. “Think about that,” Crane says. “This would be the first time we’ve ever made a person carry their state with them, so to speak.”
*A law to ban abortion coverage in all state health-care insurance exchanges.
*A law to ban abortions after 20 weeks with an exception only for the life of the mother. This, Crane notes, has already passed the House.
*A law to end the contraception benefit in the ACA.
And speaking of Obamacare, what about that? It’s not clear Senate Republicans would even waste their time on repeal. That, they know Obama would veto in an instant. Don Stewart, of McConnell’s office, says they’ll go after specific items like doing away with the medical device tax, which appears to have 60 votes in the Senate right now.
AEI’s Nick Eberstadt muses: “The tactical opposition would be to starve the ACA by budgetary means. What happens if Congress doesn’t pass the health budget the president requests? That would be clarifying.”
It’s not clear just yet the extent to which that would be possible. The big-money portions of Obamacare—the Medicaid expansion, most notably—would have to be changed via legislation, which won’t happen as long as a Democrat is president. But smaller parts of the bill are subject to the appropriations process. “My gut sense is that the GOP won’t be able to truly destroy ACA,” says Harold Pollack, a health policy expert at the University of Chicago who had input into the law. “But they will have some success in cutting expenditures required to properly implement ACA and in generally making things nasty for the administration.”
And Finally, Looking Toward 2016
There’s more that I haven’t covered. Two big matters in particular: the filibuster, and presidential nominations. How would McConnell, if he’s majority leader, change the filibuster rules? Would he try to make it apply to fewer situations, so he could pass bills with 51 Republicans and just a few Democrats for cover? And what about nominations, especially judicial ones? Imagine, for example, that Ruth Bader Ginsburg were to retire in 2015. Would a GOP Senate even give her successor a hearing? And assuming it would, just how conservative a jurist would Obama have to nominate to get through a Senate that’s in Republican hands? I asked nearly everyone I interviewed this question, and while there wasn’t unanimity, there was a clear consensus that it wouldn’t be surprising to see the GOP give a nominee a hearing but sit on the vote, leaving the Supreme Court with only eight members until we see who wins the presidency.
And what of oversight and investigations? A Republican Senate could try to keep the Benghazi attack in the headlines until the day Hillary Clinton gives her acceptance speech, and beyond. This point underscores the extent to which 2016 hovers over everything discussed in this article. If the Republicans move into the Senate’s majority offices in the Capitol next January, they’ll be doing so at a time when the party’s 2016 nominee will start being more public in their intentions.
A Congress wholly controlled by the opposition party has plenty of ways it can help its presidential contenders. It can pass constructive legislation, it can pass “positioning” legislation that attempts to checkmate the other party; it also has the simple ability to help keep favorable issues in the news and unfavorable ones out.
But remember this: Legislators don’t take votes thinking about their presidential candidate’s career. They take votes thinking about their own careers, as Third Way’s Jim Kessler observes: “Congressional Republicans will do what they think is best for them to keep their majority in the House and the Senate. Legislative bodies are selfish, and they rarely sacrifice for others. They’d like a Republican president, but that’s a luxury.”
That’s exactly right. To return to Gingrich: He decided that passing welfare reform was in his caucus’ interest. Doing so took a big club out of Bob Dole’s hands. But that’s politics. Now, in the present day, passing immigration reform would probably help a GOP nominee. But legislators would have to decide: Would it help them? So far they haven’t thought so. Legislators will do what they think will help them. If it helps the nominee, great. If it doesn’t, too bad. And remember, many of these legislators represent deep-red districts and states, which probably don’t add up to more than 200 electoral votes—70 shy of what it takes to win.
And so, even if Republicans gain more power on the Hill, they may find that that power, and the imperative of keeping it, makes 2016 an even steeper climb than it already seems against Clinton. But that shouldn’t be much comfort for Democrats. A Republican Senate won’t be able to undo the president’s signature achievement, but it’ll take as many bites as it can out of what Obama has accomplished in the last six years. And trust me, those bite will hurt.
“John Boehner Is A Ridiculous Man”: Lacking Political Courage, The Republican Establishment Has A Problem
As soon as I saw what John Boehner had done, I knew that the folks at Red State would lose their minds. While speaking at the Middletown, Ohio, Rotary Club, Speaker Boehner dismissed the possibility of truly repealing ObamaCare and mocked his colleagues in the House who lack the political courage to pass some kind of immigration reform.
On ObamaCare, Boehner said repeal wasn’t even the goal. The goal was to “repeal and replace.” But, as soon as he began to describe what replacing would mean, he made it clear that much of what had been done could not be undone:
“The challenge is that Obamacare is the law of the land. It is there and it has driven all types of changes in our health care delivery system. You can’t recreate an insurance market over night.
“Secondly, you’ve got the big hospital organizations buying up doctor’s groups because hospitals get reimbursed two or three times doctor’s do for the same procedure just because it’s a hospital. Those kinds of changes can’t be redone.
“So the biggest challenge we are going to have is — I do think at some point we’ll get there — is the transition of Obamacare back to a system that empowers patients and doctors to make choices that are good for their own health as opposed to doing what the government is dictating they should do.”
In other words, repeal is out of the question and “replace” means “tinker.”
Over at Red State, Daniel Horowitz is apoplectic:
Which means that he has no intention to repeal it.
It’s funny how we warned those who opposed the effort to defund Obamacare that they would never repeal it at a later date. They denied the charge at the time; now they are embracing it.
Maybe even more troubling to the base is Boehner’s attitude about immigration reform.
“Here’s the attitude. Ohhhh. Don’t make me do this. Ohhhh. This is too hard,” Boehner whined before a luncheon crowd at Brown’s Run County Club in Madison Township.
“We get elected to make choices. We get elected to solve problems and it’s remarkable to me how many of my colleagues just don’t want to … They’ll take the path of least resistance.”
Boehner said he’s been working for 16 or 17 months trying to push Congress to deal with immigration reform.
“I’ve had every brick and bat and arrow shot at me over this issue just because I wanted to deal with it. I didn’t say it was going to be easy,” he said.
Of course, a majority in the House wants to pass immigration reform, so Boehner could do it tomorrow if he was willing to put up with the grumbling in his own party. If he thinks it would cost him his leadership position, then he’s lacking political courage, too.
Here’s Horowitz’s response:
Yes, Mr. Boehner. We actually want to solve the immigration problem.
We want to deal with the problem of criminals being let out of jail.
We want to deal with the problem of Obama suspending deportations.
We want to deal with birthright citizenship and other magnets that allow foreigners to violate our sovereignty and take advantage of the welfare state.
We want to make immigration work for the American people, not for your donors.
Sadly, you have no interest in joining us in combating the President’s malfeasance. You are the one who is too scared to make hard decisions. It’s a lot easier to go along with the political class and cowardly hide behind the misleading canard of “reform” just for the purpose of pushing the same failed amnesty that has engendered endless cycles of illegal immigration and that is already spawning a new wave. It’s akin to saying conservatives are cowards for not dealing with “healthcare reform” because they don’t support Obamacare.
In the aftermath of the 2012 election, the Republican National Committee did a study to figure out why they lost and what they needed to do differently to win in the future. They basically concluded that they lost because they sounded too much like Red State. They couldn’t ignore the need for immigration reform anymore. They couldn’t continue to oppose gay equality. The New York Times’ Tom Edsall described the problem this way:
There is at least one crucial problem that the authors, all members of the establishment wing of the party, address only peripherally and with kid gloves: the extreme conservatism of the party’s primary and caucus voters — the people who actually pick nominees. For over three decades, these voters have episodically shown an inclination to go off the deep end and nominate general election losers in House and Senate races — or, in the case of very conservative states and districts, general election winners who push the party in the House and Senate to become an instrument of obstruction.
Ironically, it was Senate Minority Leader Mitch McConnell who conceived of the Party of No strategy that the GOP has followed with almost psychotic glee. President Obama’s reelection did not alter that strategy one iota. Somehow, the folks at Red State took the strategy seriously, as if it were about principle instead of a failed attempt to destroy Obama’s presidency.
So, now the Republican Establishment has a problem. They cannot govern according to their own lights. They literally cannot lead their own caucuses. When they whine about the results, they invite nothing more than simple ridicule.
By: Martin Longman, Washington Monthly, Ten Miles Square, April 25, 2014
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