“They’ll Never Rally Behind A Single Plan”: The GOP’s Push To Replace ObamaCare Is Cynical And Doomed
On Friday, House Majority Leader Eric Cantor (R-Va.) is gathering key members of his caucus to work toward coming up with a single, official Republican alternative to the Democrats’ Affordable Care Act (ACA), or ObamaCare. Republican lawmakers have several competing bills to work with, and putting the party’s weight behind one plan or piece of legislation would be great for the country: Finally, America could have a real discussion about the best way to reform America’s health care insurance system.
But an official Republican health care plan would also be great for Democrats — which is reason No. 1 Republicans aren’t going to actually rally behind a single plan.
They will, of course, make a public effort. “GOP leaders have been clear that ahead of the 2014 elections, the conference wants to show what it is for, not simply what it is against,” says Daniel Newhauser at Roll Call. “Similarly, they want to show that they are not in favor of simply returning to the old health care system, which is viewed unfavorably by the electorate.” But any viable plan needs 218 votes from the fractured GOP caucus.
Cantor and his fellow House Republicans have at least three separate House bills to consider — from Reps. Tom Price (R-Ga.), Paul Broun (R-Ga.), and Phil Roe (R-Tenn.) — and a plan from Sens. Tom Coburn (R-Okla.), Richard Burr (R-N.C.), and Orrin Hatch (R-Utah) that was unveiled to much fanfare in January. There’s also a bill, from Rep. Todd Young (R-Ind.), that would raise ObamaCare’s definition of full-time employment to 40 hours a week, from 30. And a George W. Bush administration economist named Edward Lazear is pushing what he calls BushCare.
As they sort through these plans, what criteria will they use? If they can agree on one proposal, says Roll Call‘s Newhauser, it’s “likely to include poll-tested measures that have broad agreement in the GOP conference, including allowing the purchase of health insurance across state lines, allowing insurance portability between jobs, expanding access to health savings accounts, and limiting medical malpractice lawsuits.”
Another way of putting that: Republicans are looking for popular talking points that sound different enough from ObamaCare to win support from the more conservative factions of the GOP caucus. The problem, as The Washington Post notes, is that “there are only so many ways to preserve the patient protections that the ACA offers, which Republicans say they want to keep, while maintaining a private insurance market and assisting those who can’t afford coverage.”
Once Republicans hold up a specific plan, the Congressional Budget Office gets to issue its verdict and the public gets to weigh the proposals not just against ObamaCare but also the GOP’s attacks against ObamaCare.
The CBO analysis for Rep. Young’s bill to raise full-time employment to 40 hours, for example, found that the bill would raise the federal deficit by $74 billion while reducing the number of people getting employer-sponsored health insurance by about a million; about half of those people would go on Medicaid or other public programs, the other half would be uninsured.
It’s not clear the other Republican proposals would be popular in practice, either. Some of them, as the Washington Post editors note, would be better than ObamaCare at holding down health care costs and incentivizing people to buy private health insurance. But they are more disruptive to the status quo — especially post-ObamaCare — and almost all of them would be ripe for articles about sick people losing coverage or watching their health insurance costs skyrocket.
All of the GOP alternative plans, in other words, have their own drawbacks. Some people will lose, and some people will win. They would reduce the role of the federal government in most cases, but increase the power of insurance companies. Many of the policies are really interesting. Here are some examples of the big ideas from the GOP plans:
Cap or end employer tax breaks for providing health insurance: The idea here is that the insurance market is distorted by the tax incentives for employers to offering their workers insurance. It’s a fair point. But capping the tax breaks, as Coburn-Burr-Hatch does, or eliminating them would almost certainly cause employers to drop their plans. Almost 60 percent of Americans get their health insurance through work.
Provide tax breaks for individuals to buy their own insurance: With no employer-offered health plans, individuals and families would buy their own insurance on the open market. The Coburn-Burr-Hatch plan, for example, offers age-adjusted tax credits to people at up to 300 percent of the federal poverty line: Individuals 18 to 34 would get $1,560 a year, while those 50 to 64 would get $3,720 a year (families would get more than double those figures). Lazear’s BushCare would give all Americans with any type of health insurance $7,500 a year in tax breaks, or $15,000 for families; if people opted to buy low-cost, low-coverage insurance, they’d pocket the difference.
Allow insurance to be sold across state lines: This is a perennial GOP proposal to lower health insurance costs. The idea is that if insurers could sell the same policies to any state, regardless of that state’s own insurance regulations, it would increase market competition and drive down prices. A 2005 CBO report estimated those savings to consumers at about 5 percent overall, with the savings skewed toward the young and healthy; the old and sick would pay more. Enacting this option would require scrapping the minimum standards required for all plans under ObamaCare — a selling point for conservatives who argue we use too much health care, anyway.
“The fact that Republicans are coalescing around healthcare reform plans of their own could be very bad news for ObamaCare,” says Sally C. Pipes at Forbes. “Once voters see that the Republican alternative adds up to sensible and affordable health care, ObamaCare’s days will be numbered.”
But the opposite is almost certainly true. And House Republicans know that.
The GOP has gotten a lot of mileage out of its push to repeal ObamaCare — with a big assist, since October, from the Obama administration — but now the law is signing up real people (four million and counting) for real insurance policies. Republicans have to do better than provide plausible-sounding alternatives. They have to come up with a plan that Americans will think is much better than ObamaCare, and worth the disruption of overhauling the health care system again.
Here’s the bottom line: If reforming America’s health care system to provide near-universal affordable coverage were easy, it would have been done 60 years ago — or at any point since. Several Democratic presidents had tried and failed before President Obama. If Republicans had wanted to take their own bite at the apple, they had plenty of chances, too.
This isn’t spitballing. If Republicans want to be relevant voices in the health care debate, they have to come up with something. They should come up with a plan they can try to sell to America.
“One of the unseemly aspects of the last four-plus months is watching some on the right root for ObamaCare to fail,” says Forbes‘ Avik Roy, one of ObamaCare’s wonkiest critics. Among some conservatives, “there has been a kind of intellectual laziness, a belief that there’s no need for critics to come up with better reforms, because Obamacare will ‘collapse under its own weight,’ relieving them of that responsibility.” But it’s clear now that’s not going to happen, he adds. “And that makes the development of a credible, market-oriented health-reform agenda more urgent than ever.”
Well, don’t hold your breath.
The Affordable Care Act was written and enacted by Democrats — with a few exceptions — and that’s one of its main weaknesses: If Republicans had helped shape and pass the law, they probably wouldn’t have spent the last four years attacking and undermining it. They now have at least 10 months left to criticize the law without having to take any serious action to replace it. Don’t expect them to squander the opportunity.
By: Peter Weber, The Week, February 26, 2014
“Texas, Where Crazy Gets Elected”: There’s Crazy, And Then There’s Texas Crazy
So what happens in Texas when the Republican gubernatorial candidate invites Ted Nugent to the state to campaign for him not long after the Motor City Motormouth has called the President of the United States a “subhuman mongrel,” not to mention a “Communist” and a “gangster”? Would you believe, as Maxwell Smart used to say, that the candidate increases his lead? Well that’s what has happened. There’s crazy, and then there’s Texas crazy.
In a poll that came out Monday, conducted as the Nugent controversy was brewing, Republican Greg Abbott leads Democrat Wendy Davis by 11 points, which Politico notes is up from six points in a poll last year. Now there are surely other reasons for this little surgette, but it certainly shows that Abbott’s decision to keep company with Nugent did him no harm at all in the state.
You think that’s bad, get a load of this, from the same poll. The candidate leading the Democratic field for the right to seek John Cornyn’s Senate seat is a woman named Kesha Rogers. Two of her top ideas? Impeach Barack Obama and repeal the Affordable Care Act. Yes, you read it right. She’s the leading Democrat. She’s also a La Rouchie, a fact that far from hiding she seems intent to rub in the other candidates’ faces: I can ramble on about crazy worldwide banking conspiracies all I want, she seems to be saying, but as long as I want to impeach Obama and repeal Obamacare, you can’t touch me! There’s crazy, and there’s Texas crazy.
This would all be merely amusing, but there’s another side to Texas crazy. Let’s get serious now for a few paragraphs.
If you read me often enough, you know that one of my themes is that the Democrats, with enough money, creativity, and guts, ought to be able to turn Obamacare into a positive. Millions of people across the country, especially in the states that opted in and accepted the Medicaid money, have insurance now and the peace of mind about themselves and their children that comes with it. Besides which, have you noticed that all the Republican hoo-ha about these alleged horror stories never holds up on examination? Paul Krugman wrote a terrific column on this topic Monday. Literally every high-profile Obamacare-nightmare story retailed by one of these yoyos turns out, once reporters start poking around, not to be at all as advertised. So we have a party that loathes the ACA and its effects and many millions of dollars to go find its victims, and so far it hasn’t really turned up one.
Now—back to Texas. Two recent briefing papers from academics affiliated with the excellent Scholars’ Strategy Network shed considerable light on what Obamacare could be doing for Texas, if only its politicians would permit it.
Texas—hold on to your ten-gallon hat, because this is a shocker—leads the country in the percentage of its people who are uninsured; a gaudy 24.6 percent. Nearly 37 percent of Hispanics are without coverage, as are 22 percent of African Americans, and 23 percent of women. That’s a small army of people who would benefit from the state having accepted the federal Medicaid money and set up an exchange. But Texas’s leaders from Rick Perry on down are having none of it.
In one paper, Jessica Sharac, Peter Shin, and Sara Rosenbaum of George Washington University cite a recent study noting that “if Texas had agreed to expand Medicaid, more than two million uninsured people would likely have gained health insurance.” In another, Ling Zhu and Markie McBrayer of the University of Houston compare how poor people are faring so far in Texas and California, the latter of course being among the states that have accepted the Medicaid expansion. They write: “More than 2.2 million Californians were added to that state’s expanded Medicaid program by the end of January, compared to just over 80,000 Texans who signed up after realizing they were already eligible for the existing state Medicaid program.”
Together, the papers (they’re very short, you should go read them) paint the picture you’d expect. Our two largest states, one working to insure its people and the other doing everything in its power to prevent that. And remember—Texas could be doing this at very minimal cost. Washington is paying full freight on the expansion until 2016, and then a slightly declining share, but still, 90 percent every year after 2019. It’s almost free. And Texas ain’t playin’. Indeed Perry turned down (cue Dr. Evil) nine billion dollars.
So now let’s circle back to the governor’s race. Of course, Abbott opened his campaign last fall pounding Davis on Obamacare, thundering that she’d open the door to this iniquity. Davis has been talking a lot about Ted Nugent, but she’s had rather little to say on the subject of Perry refusing, and Abbott vowing to continue to refuse, $9 billion.
Would all those uninsured Latinos and blacks and women be energized to come out and vote for the candidate who dared to make a big issue of this? I admit it’s hard to say. But Davis is a long shot anyway. Nothing against her—Jesus himself could come back and run as a Democrat in that state, and rather than pull that Democratic lever for Him, most Texans would just wonder when the Redeemer went socialist on them (answer: he always was!).
Of course it would be risky. Of course she’d drop in the polls for a while. But she’d still have nearly eight months to explain to people that $9 billion is real money, that all this is happening anyway whether Texas Republicans like it or not, and since it is happening well by cracky she’s not going to leave millions of Texans not getting what their counterparts in other states are getting. As it is, those people have no one really fighting for them. That’s Texas crazy, too.
By: Michael Tomasky, The Daily Beast, February 26, 2014
“Willful Republican Obfuscation”: The GOP Takes Another ObamaCare Study Way Out Of Context
It’s no secret that Republicans are pinning their midterm election hopes on ObamaCare.
So it should be no surprise that the GOP has tried to cast virtually all news about the health care law as proof that ObamaCare will kill jobs and send insurance costs soaring. The only problem with that strategy is that the underlying arguments are often disingenuous.
In the latest case, a new report from the Centers for Medicare & Medicaid Services estimates that ObamaCare could raise insurance premiums for nearly two-thirds of small businesses, affecting some 11 million employees. Before ObamaCare, those small businesses were paying below-average rates — often by having younger, healthier workers whom insurers could charge less to cover — but new rules designed to level the insurance marketplace will cause those rates to rise, according to the report.
Naturally, right-wing blogs and Republican lawmakers seized on the report to bash ObamaCare. The report revealed another “broken promise” from the Obama administration, House Speaker John Boehner (R-Ohio) said in a statement, calling it “another punch in the gut for Americans already struggling in the president’s economy.”
The reality of the report’s conclusions, though, are a bit more nuanced.
While the report did find that insurance premiums would probably go up, it did not determine that insurance costs overall would spike. That’s because the report focused only on the impact of ObamaCare’s new rules, and not, crucially, on the impact of its new benefits.
ObamaCare contains a wealth of subsidies, tax breaks, and the like — many of them geared specifically toward small businesses — that are intended to drive down individuals’ insurance costs. When you factor in all the positives, “Obamacare may well be the best thing Washington has done for American small business in decades,” The New Yorker’s James Surowiecki wrote last year.
The CMS report acknowledged that fact, hedging that there was “a rather large degree of uncertainty associated with this estimate” and that the true impact “will be based on far more factors than the three that are focused on in this report so understanding the effects of just these provisions will always be challenging.” And the report specifically mentioned one nongovernmental analysis of the entire law which found that it would have a “minimal” impact on small business premiums.
Moreover, the report estimated that costs would drop for the remaining one-third of small businesses. Why? They’re currently paying above-average rates, so the market-leveling rules will actually benefit them.
The GOP hand-wringing comes on the heels of its failed attempt to claim a separate federal report confirmed that ObamaCare will be a job killer. That nonpartisan Congressional Budget Office report actually found that the law would lead to a reduction of labor, not jobs, as incentives made it easier for people to work less or retire early. The GOP’s claim was so bogus, in fact, that the CBO released a follow-up statement thoroughly debunking it as an egregious distortion of the truth.
Republicans understandably want to make the health care law look bad to boost their election prospects. But skewing the findings on ObamaCare only hurts their credibility and reveals the party’s willful obfuscation on the issue.
By: Jon Terbush, The Week, February 25, 2014
“It’s Easier Than Honesty”: Winning A Debate By Quashing Scrutiny
In her party’s official response to the State of the Union a few weeks ago, Rep. Cathy McMorris Rodgers (R-Wash.), the House Republican Conference chair, shared an anecdote about “Bette in Spokane,” the latest in a series of “Obamacare victims.” As is usually the case, within a day or two, the story was debunked.
Once McMorris Rodgers realized her story was wrong, the congresswoman, instead of apologizing, tried to go on the offensive. “It’s sad partisan politicians are attacking Bette,” she argued.
In reality, no one had “attacked” the woman in the story. Rather, McMorris Rodgers’ anecdote was fact checked and proven to be wrong. To suggest that scrutinizing suspect claims is somehow improper is absurd, but that was nevertheless the congresswoman’s reaction.
It was apparently a sign of things to come.
Last week, the Koch-financed Americans for Prosperity launched a new attack ad targeting Rep. Gary Peters, a Democratic U.S. Senate candidate in Michigan. The spot features Julie Boonstra, a Michigan woman who’s paying less money for better insurance without having to change doctors, but who was nevertheless presented in the ad as yet another ACA victim.
Peters, not surprisingly, believes AFP should provide more information to bolster the claims in its ad. The right, no longer willing to defend the deceptive commercial, has decided to attack Peters.
U.S. Rep. Gary Peters, D-Mich., wants to be a United States senator, but he has a problem. He’s engaged in a “war on women” – make that a single woman – whom he’s trying to silence because he doesn’t like the story she has to tell. […]
Julie Boonstra deserves a medal for what she is doing. Peters should hang his head in shame.
It’s a fascinating rhetorical gambit, worth appreciating for its rare combination of audacity and mendacity. What’s more, it’s increasingly becoming the standard response to one of the right’s more glaring problems in the health care debate: all of the conservatives’ evidence keeps falling apart.
Let’s say you have a movement of sorts and your goal is to deliberately tear down the nation’s health care system, no matter the consequences. Let’s also say you have the bright idea of using anecdotal evidence to highlight “victims” in order to prove how awful the system is, only to have pesky reporters discover that all of your evidence is bogus and the victims haven’t really been victimized at all.
At this point, you have a few choices. You could, for example, find a new hobby and stop trying to prevent Americans from having access to affordable health care. Or you could cast a new line, hoping to find some elusive, legitimate horror stories that won’t be debunked a day or so later.
But these are strategies based on conventional thinking. What you really need is a very different kind of plan: one in which you keep presenting bogus anecdotes, but discourage those who know what they’re talking about from pointing out your errors. What you want is to promote misleading propaganda with impunity – more mendacity, less scrutiny.
And how do you do that? By lashing out angrily against those noting the facts. Those who recognize the AFP’s Boonstra ad as misleading are obviously attacking a woman with cancer and should be ashamed of themselves – or so the story goes.
I suppose it’s clever, in an Alice in Wonderland sort of way, but it’s no way to have a credible policy debate. Indeed, it seems some of these conservatives are effectively giving up on the very idea of a serious discourse – they not only want to present misleading anecdotes, they also want to intimidate those who might dare to note reality by accusing them of being heartless bullies.
As Greg Sargent put it the other day, many on the right have essentially declared “that the emotional content of these victims’ stories should shield such ads from scrutiny.” Fact-checking suspect claims “will be met with charges of insensitivity to the victims.”
I guess it’s easier than honesty.
Postscript: The Wall Street Journal ran a piece yesterday arguing that the Affordable Care Act cost a woman her cancer medication. The piece was quickly embraced by the right, but it was debunked by Michael Hiltzik a few hours later.
If recent history is any guide, this means Hiltzik should expect to be accused of not caring about people with cancer. Sorry, Mike.
By: Steve Benen, The Maddow Blog, February 25, 2014
“A GOP Sociopathetic Scam”: Why Actual ACA ‘Victims’ Are So Elusive
It’s practically a running joke at this point. The Affordable Care Act’s conservative detractors have spent the last several months in a desperate search for “Obamacare victims” to be used in various partisan attacks, and quite a few regular folks have received quite a bit of attention.
The problem, of course, is that all of these examples, once they’re subjected to even minor scrutiny, have fallen apart – the “horror stories” really aren’t so horrible. Michael Hiltzik speculated last week that there may not be any genuine anecdotes to bolster the right’s claims.
What’s going on here? Paul Krugman offers one possible explanation.
Even supporters of health reform are somewhat surprised by the right’s apparent inability to come up with real cases of hardship. Surely there must be some people somewhere actually being hurt by a reform that affects millions of Americans. Why can’t the right find these people and exploit them?
The most likely answer is that the true losers from Obamacare generally aren’t very sympathetic. For the most part, they’re either very affluent people affected by the special taxes that help finance reform, or at least moderately well-off young men in very good health who can no longer buy cheap, minimalist plans. Neither group would play well in tear-jerker ads.
That’s as good an explanation as any. What the right needs are sympathetic figures – real, relatable Americans who are struggling, and whose plight was made worse by the Affordable Care Act. The most notable recent example came last week with a Michigan woman, Julie Boonstra, featured in an Americans for Prosperity attack ad and in RNC events, who’s paying less for better insurance without having to change doctors.
In other words, as far as health care policy is concerned, it’s not much of a horror story, though it’s presumably the best the right can come up with.
But taking this one step further, let’s also acknowledge the extent to which the right is using ACA beneficiaries as a cudgel to undermine their own interests.
Brian Beutler did a nice job this morning explaining that the practice of using Americans to harm their own health security is a “sociopathic new scam.”
[W]e’re really just talking about Julie Boonstra here.
If she and AFP get their way, she’ll be just as much a victim of Obamacare repeal as all the people who face health circumstances similar to hers. And the saddest part of that tragic irony is that Boonstra doesn’t even seem to understand what her circumstances are, or why it doesn’t make sense to devote her energies to repealing the law. Boonstra told the Dexter Leader, “People are asking me for the numbers and I don’t know those answers — that’s the heartbreak of all of this. It’s the uncertainty of not having those numbers that I have an issue with, because I always knew what I was paying and now I don’t, and I haven’t gone through the tests or seen my specialist yet.”
But that’s just not so. Anyone who’s studied the law knows it’s not so. Anyone who’s paid unexpected health bills in installments knows it’s not so. And well-heeled Affordable Care Act foes like Americans for Prosperity certainly know it’s not so. And in that sense AFP, and everyone else on the right “supporting” Julie Boonstra, are using her as a weapon in a war against herself.
To a very real degree, it’s tragic to watch the developments unfold in real time. For much of 2013, especially in the months leading up to the open-enrollment period, assorted far-right groups launched an organized campaign to encourage the uninsured to stay that way – on purpose – in order to help conservative organizations advance their ideological agenda. It was a truly offensive display in which wealthy activists on the right urged struggling Americans to deliberately put their wellbeing in jeopardy.
Months later, we’re at a similarly painful moment in the debate, in which many of the same groups and activists are now exploiting people to create misleading attack ads, all in the hopes of keeping people from having access to affordable health care.
By: Steve Benen, The Maddow Blog, February 24, 2014
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