“Republicans Can’t Win By Attacking Health Care In 2014”: We will Turn The Corner If Progressives Do Not Sit On The Sidelines
For me, the fact that Republicans keep using the Affordable Care Act – Obamacare – as a political football is a tragedy. Sure, the law has problems, but it is already saving lives and improving the health of millions of Americans.
Thankfully, it seems that Republicans who are counting on attacking the health reform system to get them into the end zone will be stopped short of the goal line based on numbers coming out of a March special election for a Florida House seat
For me, the Affordable Care Act comes down to people’s lives and health. Consider the story of a young man I met who told me that this new avenue to becoming insured had saved his life.
He had some symptoms that made him worry about his health. But he, like many Americans without insurance, ignored them, as he couldn’t afford to see the doctor. After the Affordable Care Act became law, he got coverage through his parents’ health insurance plan, and on visiting a doctor, found out he had stage 4 — that’s advanced — cancer. Fortunately, he got to the doctor in time to save his life.
That young man is far from alone. As of the end of February, some 11 million Americans have health coverage under the new law. Repealing it, as Republicans continue to insist, would take away coverage from each and every one of them.
In the Florida election, Republican David Jolly said “I’m fighting to repeal Obamacare, right away.” His opponent, Democrat Alex Sink, countered, “We can’t go back to insurance companies doing whatever they want. Instead of repealing the health care law, we need to keep what’s right and fix what’s wrong.”
The key part of Sink’s message was to remind voters why people wanted health care reform in the first place. As one of Sink’s TV ads said, “Jolly would go back to letting insurance companies deny coverage.”
That’s an effective reminder of the huge problems Americans have had for decades, when insurance companies could deny care because of a pre-existing condition, charge people higher rates because they were sick, and even charge women higher rates than men. The ACA ended all that.
The candidates in Florida pushed especially hard for the votes of seniors, which is not surprising given both Florida’s high senior population and the fact that seniors vote more frequently than other age groups.
In its ads for Jolly, The Republican Congressional Campaign repeated the same misleading charge that Republicans used successfully in 2010 to scare seniors against the ACA, that it cut $716 billion from Medicare. But unlike 2010, when Democrats did not respond to attacks on the ACA, Sink pushed back.
She reminded seniors that the ACA actually provides important new Medicare benefits, including closing the infamous prescription drug “donut hole.” Sink’s ads accurately said, “His [Jolly’s] plan would even force seniors to pay thousands more for prescription drugs.”
By Election Day, voters had a clear contrast between the positions of the candidates on the ACA. It was a close election, with Jolly winning by a small margin (48.4 percent to 46.5 percent) in a district with an 11-point Republican advantage, one that has been represented by the GOP for nearly 60 years.
But polling found that independent voters in the district supported the “keep and fix” position over the “repeal” position by a margin of 57 percent to 31 percent. Sink actually gained ground over Jolly during the election on the question of which candidate had a better position on the ACA.
I am very much looking forward to the time when Congress can start having real debates on how, as Sink said, “we can keep what’s right and fix what’s wrong” with the Affordable Care Act. However, it looks like it will take at least one more election, in 2014, to get us to that point.
We will turn the corner if progressives do not sit on the sidelines, but instead welcome the debate that Republicans insist on having about repealing the ACA.
That debate is an opportunity for people to be reminded in concrete terms that the new health care program, for all its shortcomings, is about providing every American with the peace of mind that comes with having health coverage.
By: Richard Kirsch, Senior Fellow at The Roosevelt Institute; Published in The National Memo, March 20, 2014
“Keep Calm And Carry On”: Jolly’s Win Does Not Presage Republican Wave
David Jolly won an upset victory over Democrat Alex Sink in Tuesday’s special election in Florida’s 13th congressional district, sending another Republican to the House of Representatives, and unleashing a torrent of breathless predictions that Democrats are doomed in 2014.
A National Journal article by Josh Kraushaar, titled “Why a Republican Wave in 2014 is Looking More Likely Now,” and Joe Scarborough’s declaration that “we may have something historic here happening, where you have one act [Obamacare] actually causing grave damage to a political party two midterms in a row” typify this brand of speculative political analysis.
That makes for an easy narrative, but it’s grounded in very few facts. It’s entirely possible — or even probable — that Republicans make major gains in the 2014 midterms. They may even win a Senate majority. But if they do, it will have nothing to do with what happened in Pinellas County on Tuesday night.
For starters, as political scientist Alan Abramowitz pointed out after a 2011 special election in New York — in which Republican Bob Turner upset Democrat David Weprin, prompting excited (and false) reports of an impending Republican wave in 2012 — the results of special elections do not accurately predict the results of subsequent general elections.
“An analysis of the results of all special House elections since World War II shows that while there is a weak relationship between the net party swing in special elections and the net party swing in the subsequent general election (the correlation is .32), special election results have no impact once you control for other factors such as the party of the president in midterm elections, seats held by the parties going into the election and the incumbent president’s approval rating,” Abramowitz wrote.
A quick look at the specifics of Florida’s special election makes it clear that this contest is no exception.
First, turnout was very low. Just 183,634 voters cast ballots in the election, down from 329,347 in the 2012 general election, and 266,934 in the 2010 midterm. To be clear, Republicans — who have a narrow registration advantage in the district — did a much better job getting their voters out to the polls than Democrats did. But Florida Democrats’ failure to convince voters to turn out for Alex Sink in March tells us exceedingly little about, say, Alaska Democrats’ ability to get out the vote for Mark Begich in November.
Second, there’s no evidence that Obamacare — which has been widely labeled as the hinge on which the election swung — actually served as a decisive factor in the election. There is no exit polling available for the race, but polls leading up to election day suggested that voters had other priorities; a Februrary Tampa Bay Times/Bay News 9/WUSF Public Media poll, for example, found that while 39 percent said the Affordable Care Act was “very important” to their voting preference, 33 percent said it was just “somewhat important,” and 26 percent said it is “not at all important” (in fairness, that poll also said that Sink would win).
And while the Affordable Care Act featured prominently in the barrage of television ads that saturated the airwaves throughout the campaign, it was hardly the sole focus of the race. In fact, Jolly didn’t even mention the law in his victory speech, choosing instead to focus on his commitment to local issues.
But even if it turns out that Obamacare did seal the victory for Jolly, there’s no reason to assume that the issue will spark a Republican wave. As Abramowitz reminds us, the way that 180,000 Floridians feel about the law in March tells us very little about how some two million voters in North Carolina or Georgia will feel about it eight months from now. And national polls suggest that the law is not set up to be a clear electoral winner for either party.
Finally, in Florida’s election, one must consider Libertartian candidate Lucas Overby, who won about 5 percent of the vote. As Nick Gillespie points out in Reason, Overby’s platform makes it very plausible that he pulled more votes away from Sink than he did from Jolly (in the same manner that Libertarian Robert Sarvis pulled more votes from Democrat Terry McAuliffe than he did from Republican Ken Cuccinelli in Virginia’s recent gubernatorial election). Again, with no exit polls, it’s impossible to know for sure. But there’s a chance that were Overby not in the race, Sink would have won. If that were the case, would the media be running with overheated reports that Democrats will be in the catbird seat come November?
There’s no question that Sink’s loss should be a major disappointment for Democrats, who squandered a real shot at winning a seat that Republicans have held for decades. And there’s also no question that Democrats, saddled by an unfriendly electoral map and an unpopular president, are in danger of suffering big losses in the midterms. But there is simply no reason to believe that last night’s result provides a roadmap for future elections across the nation. If Republicans do make big gains in November, it will have nothing to do with David Jolly or Alex Sink.
By: Henry Decker, The National Memo, March 12, 2014
“Health Care’s Resistors And Adapters”: Why The ‘Bette’ And ‘Boostra’ Stories Fall Apart
You’ll recall that Washington state Rep. Cathy McMorris Rodgers, in delivering one of the 17 GOP State of the Union responses, spoke of “Bette,” the Spokane woman whose premiums were going up under Obamacare by $700 a month. The state’s jackboot, according to McMorris-Rodgers, was planted right on Bette’s throat, and there was nothing she could do about it. Bette would “have no choice” but to pay the extra, socialistic freight. Awful, awful, awful.
But the Spokane newspaper tracked Bette down and got the whole story, which was that her insurer did indeed cancel Bette’s then-current plan, which didn’t meet all the new ACA coverage requirements. When she called, the insurer tried to steer her to a plan that cost around $500 a month more. However, Bette never went to the Washington state web site to check out all the options available to her. If she had, the LA Times reported, she’d have found that in fact many options were available to her, “and with a deductible far lower than the $10,000 she was paying under the old plan and broader coverage, though lacking a provision for four free doctor visits a year provided by her old plan.” But Bette just didn’t want to go on “that Obama web site at all.”
Now, the Detroit News has found another Bette. Julie Boonstra has cancer, and last month she starred in a Koch Brothers-funded ad for one of the Republican candidates for U.S. Senate. The ad claimed that Obamacare would make her medication so unaffordable that she might die. The News looked into the details of her new plan and found that she is going to save $1,200 a year. Here’s how the News summarizes the details:
Boonstra’s old plan cost $1,100 a month in premiums or $13,200 a year, she previously told The News. It didn’t include money she spent on co-pays, prescription drugs and other out-of-pocket expenses.
By contrast, the Blues’ plan premium costs $571 a month or $6,852 for the year. Since out-of-pocket costs are capped at $5,100, including deductibles, the maximum Boonstra would pay this year for all of her cancer treatment is $11,952.
Like Bette, Boonstra just isn’t buying it. It “can’t be true” and “I personally don’t believe that.” She’s the ex-wife of a former GOP county chairman who was named by the Republican governor to a seat on the state Court of Appeals, though she told the News she’s never been political.
Maybe not. And she does have cancer, so the point here is not to lay into her. The point is the way people’s views have been set in concrete because of all this hatred and all these lies coming from Republicans and groups like the Koch’s Americans for Prosperity.
Most people love the feeling of having their anger and suspicions confirmed. The chance to say “I knew it!” is rare enough in this world, and most people relish it. They relish it on some level even more than being wrong but ending up pleasantly surprised, at least in cases where for whatever reason they’ve developed some kind of emotional commitment to the outcome that confirms their worst fears.
So people were told: Obamacare is going to screw you over. Most people—conservatives, of course, but just general people with a default distrust of government—accepted this as logical. So they looked only for evidence that would support their being screwed over. Evidence to the contrary, even when it benefits them, is dismissed. Bette and Boonstra both do this. Bette wouldn’t even go look at the web site, where she’d have seen she had numerous options. Boonstra, told by newspaper reporters the objective facts of her situation, said she simply doesn’t believe it.
I wrote a piece a couple of months ago for which I went on the recently fixed up ACA web site, pretended to be a married, modest-income guy from Kansas, and found that I was offered a staggering 42 different plans, from very cheap (and really high deductible) ones to quite pricey ones, with lots of stops in between. Most people who bother to look will find the same thing.
But they have to look. The baseline question, as it so often is in politics these days, is about emotional resistance. How long will it take before people who get letters about changes to their insurance just go on the ACA web site and calmly shop around? Some smallish number does that now, but I daresay there are more Bettes and Boonstras. One big determinant of how Obamacare ends up playing in the elections this November will be how many resistors have become adapters.
Meanwhile, it’s comical, but also kind of sick, that the law’s opponents keep producing these lies and can’t find any real victims. I’m sure some are out there, but far, far more people will benefit from the fine print of this law, which is why these stories fall apart.
By: Michael Tomasky, The Daily Beast, March 11, 2014
“Almost Anything Would Be More Important”: Memo To Fiscal Hawks, The Long-Term Deficit Doesn’t Matter
Over the weekend I got in a long argument with some ally of the deficit hawk group Fix the Debt on Twitter, and while most of the conversation turned on who should be blamed for mass unemployment, it did reach an interesting place in one respect. This person took as a given that long-term deficit reduction is a policy priority of the first rank — a belief that is very common among America’s elite.
This priority is misguided both in detail and in general. Here’s why.
There are two points to make here: First, long-term deficits are entirely about the rising cost of health care. Centrist elites insist that this is a reason to make our social insurance programs less generous, but the reality is that America’s high prices are driven by inefficient service provision, not by excessively generous programs. American health care is unfair, monopolistic, and captured by specialist doctors, and our policies are designed poorly, which is why we pay about half again as much as the next-most-expensive developed nation for what is in fact a pretty threadbare safety net.
This point is crucial. What it means is that making our social insurance more stingy, by raising the Medicare eligibility age for example, will accomplish almost nothing. Unless you tackle the skyrocketing cost problem, the budgetary headroom created by benefit cuts will be eaten almost immediately by rising prices. In other words, no matter how many grannies you put into the poorhouse, on predicted trends eventually a single ibuprofen will cost the entire federal budget. (Unless, of course, you just repeal all social insurance altogether and let sick, poor, and old people go bankrupt and die in the hundreds of thousands per year.)
Fortunately, we just passed a gigantic health care reform package. You might have heard of it: It’s called ObamaCare, and it seems to be helping slow health care inflation.
Second, even if we set that issue aside and talk about the Platonic ideal of long-term deficits, there again the case for action is weak at best. The political problem is that America does not actually have the consensus necessary to reduce deficits on a long-term basis, despite the constant whining about it one hears all the time on cable news. One of our two political parties is composed of total hypocrites on this issue — just look at Paul Ryan. It is a near-certainty that any long-term work on the deficit would be immediately squandered on tax cuts for the rich the moment Republicans got a chance — it’s what happened in 2001.
But even on the merits, if you actually run through the economic reasoning (PDF), the case for worrying about the long-term deficit is weak at best. The U.S. is indebted in its own sovereign currency and cannot go bankrupt. Inflation could be a worry, but given current mass unemployment it’s a hypothetical concern at best.
So don’t worry about the deficit in 2050 or whatever. People ain’t got no jobs. People ain’t got no money. That’s what matters.
By: Ryan Cooper, The Week, March 3, 2014
“Just Die Already!”: GOP Would Bar Poor From Health Care Altogether
During a Republican primary debate in the last presidential election cycle, there was a dispiriting moment in which Tea Party audience members cheered at the idea that a comatose uninsured American — unable to afford health insurance — would be left to die. That infamous outburst, among others, has prompted GOP bigwigs to try to cut back on primary season debates, hoping to limit appearances that might expose the party’s baser impulses.
But that mean-spirited and contemptuous attitude toward the sick is alive and well in the Grand Old Party, as its maniacal (and futile) resistance to Obamacare has made clear. Now, one Republican politician is pushing that callousness to new lows: He wants to bar the uninsured from hospital emergency rooms.
Last week, Georgia Gov. Nathan Deal criticized a decades-old federal law that requires all hospitals that receive Medicare funds and have emergency facilities — and that’s most — to treat any patient who walks in needing care, regardless of his ability to pay. “It came as a result of bad facts,” Deal said, according to The Atlanta Journal-Constitution. “And we have a saying that bad facts make bad law.”
Deal says that many people use emergency rooms unnecessarily, and those patients inflate health care costs. He is factually correct. But there are other facts that undercut his arguments and reveal his hypocrisy.
First off, Deal is among those red-state Republicans who have vociferously opposed the Affordable Care Act, which makes health insurance available to hundreds of thousands of people who couldn’t otherwise afford it. If more people had health insurance policies that paid for doctors’ visits, fewer would use emergency rooms for routine complaints.
Second, Deal, like many Republican governors, has refused the Medicaid expansion made possible by Obamacare, even though the federal government would pick up 100 percent of the cost for the first three years and 90 percent until the year 2022. That expansion is the best chance many Georgians without means have for getting health insurance.
So, to sum up, Deal hates Obamacare and refuses its Medicaid expansion, which would keep the working poor out of emergency rooms. In addition, he wants to deny them access to emergency rooms unless they can pay. Really, governor? Don’t you insist that your values are “pro-life”?
It’s no wonder that GOP strategists shuddered when audience members responded so cruelly during the CNN/Tea Party Express debate in September 2011. It portrays the party as pitiless — a reputation unlikely to attract a majority of voters.
Quiet as it’s kept, most Americans support keeping Obamacare, despite the relentless pounding it has taken from Republicans. (And despite a website rollout that was infuriatingly incompetent.) A new poll by the Kaiser Family Foundation found that 56 percent of Americans favor keeping it in place, while just 31 percent want to repeal it. (Twelve percent want to replace it with a GOP plan.)
That’s likely because most voters, no matter their reservations about Obamacare, know that the Republican Party has no good solution for the millions of Americans who work every day but still don’t earn enough money to buy a health care plan. Americans have struggled with the nation’s dysfunctional health care “system,” and they know it’s overdue for an overhaul.
Meanwhile, as the midterm elections draw closer, the GOP struggles to come up with a plan that pretends to overhaul the health care system. Looking to avoid being painted as mere obstructions, House Republican honchos are working to draw their caucus together behind a bill that would replace Obamacare with a workable alternative.
But the most sincere plan so far — one offered by Sens. Richard Burr (R-NC), Tom Coburn (R-OK) and Orrin Hatch (R-UT) — would probably offer policies too skimpy to do any good once a policyholder gets sick.
Besides, even that replacement idea seems unlikely to draw broad support among the far-right Tea Partiers, who believe that allowing the uninsured poor to die is the appropriate government response to the health care crisis.
That’s a hulking bit of hypocrisy for a party that advertises itself as “pro-life.” Deal’s latest proposal is one more reminder of how little that label means.
By: Cynthia Tucker, The National Memo, March 1, 2014
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