“No Defense For Nonsense”: How Not To Argue Against Medicaid Expansion
Medicaid expansion is a sensible move for literally every state, but Mississippi, with more than its share of residents who lack insurance, live near the poverty line, and suffer from poor health, needs the policy more than most. Even Mississippi’s insurance commissioner, a conservative Republican, has urged Gov. Phil Bryant (R) to put aside ideology and embrace the provisions of “Obamacare” for the good of the state.
But Bryant has refused. Last March, the governor said he wouldn’t accept Medicaid expansion in part because the Affordable Care Act is not “the law of the land.” By any standard, the argument was gibberish.
This week, the Republican governor came up with a new argument.
“For us to enter into an expansion program would be a fool’s errand. I mean, here we would be saying to 300,000 Mississippians, ‘We’re going to provide Medicaid coverage to you,’ and then the federal government through Congress or through the Senate, would do away with or alter the Affordable Care Act, and then we have no way to pay that. We have no way to continue the coverage.”
Let’s think about this for a minute. There are, by everyone’s estimation, several hundred thousand folks in Mississippi who would benefit from Medicaid expansion. According to Bryant, the state could help them, but he doesn’t want to – because in his mind, Congress might repeal the health care law at some point in the future, and the state wouldn’t be able to afford to pick up the slack.
But even by GOP standards, it’s impossible to take this seriously. For one thing, it’s pretty obvious Congress isn’t going to repeal the law, as even the most right-wing lawmakers on Capitol Hill are grudgingly conceding.
For another, even in the extraordinarily unlikely event that the law is repealed sometime after 2017, Mississippi could simply revert back to its current policy once the federal well runs dry. In other words, Bryant is effectively telling struggling families, “We’ll refuse to help you now because of the remote possibility we may no longer be able to help you later. It’s better to leave you with nothing now and for the foreseeable future than risk helping you and your family for the next several years.”
There is simply no defense for such nonsense.
Postscript: In the same interview, the governor was asked about drug testing, and why it’s limited to welfare recipients, as opposed to corporate leaders whose companies get state tax money and/or public employees like himself.
“If I was receiving any federal or state benefits to help raise my family, I’d be glad to take a drug test,” he replied.
Bryant receives $122,160 a year in taxpayer money as his salary. He also has the people of the state of Mississippi to thank for his health care benefits.
By: Steve Benen, The Maddow Blog, January 2, 2014
“Republicans Could Care Less”: Millions More Denied Coverage By GOP Refusal To Expand Medicaid Than Obamacare Cancelations
For weeks as HealthCare.gov foundered, Republicans focused on President Barack Obama’s claim that “if you like your plan, you can keep it,” which was dubbed PolitiFact‘s Lie of the Year. Republicans purposely neglected to differentiate between the number of Americans whose plans were being canceled and those whose entire coverage was lost.
Now it turns out that the millions of notices that were sent out will result in just thousands of Americans losing access to affordable insurance.
A new report, however, from the minority staff of the House Committee on Energy and Commerce shows that only 0.2 percent of the approximately five million cancelations – the number often referenced by the Republican Party – will lose coverage because of Obamacare, and be unable to regain it.
In other words, only 10,000 people will lose complete coverage.
The report assumes that 4.7 million people will receive cancelation letters about their current plans. It then finds that half of that number will have the option to renew their 2013 plans, due to an administrative fix to the health law. Of the remaining 2.35 million Americans, 1.4 million would be eligible for tax credits through the ACA exchanges or Medicaid coverage, and out of the 950,000 individuals left, according to the report, “fewer than 10,000” people would lack access to an “affordable catastrophic plan.”
As the Washington Post notes, “there’s no doubt that for those 10,000 people, the health care law left them worse off than before.” Still, that number is significantly less than the amount of people who did not have access to any coverage prior to Obamacare.
“This new report shows that people will get the health insurance coverage they need, contrary to the dire predictions of Republicans,” says Democratic representative Henry Waxman (CA). “Millions of American families are already benefitting from the law.”
Ironically, as Republicans fret over the approximate 10,000 people who will lose coverage in 2014, they are to blame for the nearly five million Americans who will not have any health insurance this year because of the GOP’s refusal to expand Medicaid in various states across the country.
Though the Affordable Care Act provides complete funding through 2016 for Medicaid expansion in all states – and 90 percent funding in the following years – 25 Republican-controlled states have still refused to expand the program that offers coverage to the poor.
As a result, approximately 4.8 million people will find themselves inside the so-called “coverage gap,” which one report suggests could cost 27,000 Americans their lives in 2014.
By: Elissa Gomez, The National Memo, January 1, 2014
“Stunning New Report Undermines Central GOP Obamacare Claim”: The Arguments Made By Republicans Simply Lack A Firm Factual Basis
A crucial GOP line of attack against the Affordable Care Act (ACA) is that millions of people will supposedly lose coverage thanks to shifting requirements on the health insurance exchanges — a flagrant violation of President Obama’s infamous “if you like your plan, you can keep it” proclamation. The truth has always been more complicated, of course. Republicans are constantly blurring the line between people who lose a plan and people who lose coverage. That is, many people might lose a particular insurance plan but immediately be presented with other options.
Now, a new report from the minority staff of the House Committee on Energy and Commerce has destroyed the foundation of that particular GOP claim. It projects that only 10,000 people will lose coverage because of the ACA and be unable to regain it — or in other words, 0.2 percent of the oft-cited 5 million cancellations statistic.
The report starts with an assumption that 4.7 million will receive cancellation notices about their 2013 plan. (Notably it doesn’t endorse that figure, just takes it on for the sake of argument.) But of those, who will get a new plan?
- According to the report, half of the 4.7 million will have the option to renew their 2013 plans, thanks to an administrative fix this year.
- Of the remaining 2.35 million individuals, 1.4 million should be eligible for tax credits through the marketplaces or Medicaid, according to the report.
- Of the remaining 950,000 individuals, fewer than 10,000 people in 18 counties will lack access to an affordable catastrophic plan.
“This new report shows that people will get the health insurance coverage they need, contrary to the dire predictions of Republicans,” said Rep. Henry Waxman (D-Calif.), the ranking committee member. “Millions of American families are already benefiting from the law.”
The report is somewhat speculative, of course, since there is no central repository of data on the individual health insurance market. But the methods are clear, and the onus is now on Republicans to explain why it isn’t true.
As we’ve noted, Republicans have had an awful hard time finding people who completely lost coverage because of the ACA. (Think of the man who starred in Americans for Prosperity ads last week and whose story still hasn’t been fully explained.) Perhaps it’s because there just aren’t that many of them.
Of course, there’s no doubt that for those 10,000 people, the health-care law left them worse off than before. And by no means is the rocky political ride over for Democrats — back-end problems still present a serious threat to implementation. But as is sadly too often the case, the arguments made by Republicans simply lack a firm factual basis — and deserve much more scrutiny that they’ve received in many sectors of the mainstream press.
By: George Zornick, The Plum Line, The Washington Post, December 31, 2013
“A Warning For Republicans In 2014”: Francis Proves Fighting Yesterday’s Culture War Is Folly
What a difference a year makes. And what a difference a pope makes. At Christmas services this year, the priest at our local church told the families gathered for the children’s pageant that Jesus loves and is represented in everyone, including gays and lesbians. Our local church isn’t Jesuit, nor particularly liberal, but before Pope Francis stepped up with a new message of inclusivity, none of us had ever expected to hear anything like that at church, let alone at Christmas Eve mass. The congregation cheered.
The priest also pressed his core Christmas theme that the greatest joy we will experience is the joy we feel when serving others. Serving the poor is another significant shift in focus that Francis has brought to reinvigorate the church. Surely, there is no message more central to Jesus’ teaching and the Christian tradition than serving others and loving humanity, and, yet, prior to Francis’ ascent, it was a message eclipsed by a Catholic Church bent on fighting culture wars and chastising those who stray from its teachings. All too often, serving the poor had taken a backseat to the Church’s war on abortion and gay marriage.
Francis called an end to those culture wars, urging bishops to spend more time healing their flock and less time fighting political battles. He started a revolution by answering a reporter’s question about gay priests with the question, “who am I to judge?” and then later, elaborating, urged bishops to drop their “obsession” with gays, abortion and contraception and to create a welcoming church that is a “home for all.” Recently, Pope Francis removed a conservative American cardinal from a key Vatican committee after the cardinal said, “One gets the impression … that [the Pope] thinks we’re talking too much about abortion [and gay marriage.] But we can never talk enough about that.”
Instead of focusing on political fights, Francis is urging a renewed focus on serving the poor, pushing his cardinals to abandon their “psychology of princes” and get out of the lavish Vatican. He, himself, has rejected the posh apartment, cars and wardrobe of previous popes to live, travel and dress simply and humbly. He celebrated his recent birthday with homeless men, and has drawn attention for kissing and embracing a severely disfigured man and washing the feet of girls in a juvenile jail. Surely, there is no Catholic leader this Christmas who is closer in his own practices to the teachings and life of Jesus. In retrospect, his selection of his papal name seems perfectly apt: Francis of Assisi, the 13th-century patron saint of the poor.
Where the previous Catholic Church hierarchy had denied communion to elected officials who voted to give poor women the right to terminate unwanted pregnancies, the current pope exhorts that communion is open to all and not to be treated as “a prize for the perfect but a powerful medicine and nourishment for the weak.”
What a difference a year makes. Actually, it’s been a mere nine months.
There are some lessons here for Washington. And for the Republican party in particular.
The first lesson is how quickly things can change. Republicans starting 2014 giddy about the coming elections for Congress may not want to count their chickens before they’ve hatched. Much of their giddiness rides on the poorly handled roll-out of Obamacare and resulting negative public opinion about both health care reform and the president. But the federal website – healthcare.gov – is rapidly improving. Although only about 30,000 people were able to enroll in the launch month of October, the same number was able to enroll in the first two days of December, alone, with nearly 1 million people enrolling in December overall.
Americans are starting to find out for themselves what affordable, high-quality health care looks like without pre-existing conditions, lifetime limits and caps on coverage, now that insurance companies no longer call the shots. And they like it. Over this year, word will spread around America about people too young for Medicare – but too old and sick to find a new job or to buy individual insurance – who finally have insurance, or kids with cancer who finally get care, or women who don’t lose their insurance simply because they become pregnant or get breast cancer. And, as that word spreads, minds will change. Republicans who gloat today over projected victories in November based on their presumption of public distaste for Obamacare are vulnerable to a quickly changing future.
The second lesson to take to heart is that culture wars may not be as popular as those waging them think. No doubt many American bishops leading the war against gay marriage and contraception believed the majority of their flock, as well as their fellow Catholic leadership, was behind them. Today, they are shocked to hear words of chastisement from the Vatican and surprised at how Francis’ message of inclusivity and economic justice is garnering sky high public approval ratings – from 88 percent of American Catholics and three-quarters of non-Catholic Americans, in a CNN poll shortly before Christmas – and landing him on the cover of Time and other magazines as person of the year.
Just like their political allies among conservative American bishops, Republican obsessed with social issues are somewhat out of touch with the general public, yet they remain unaware of this critical fact. And this is their Achilles heel. They were surprised on election night this year to find their extremism rejected at the polls in Virginia, Alabama and elsewhere, and they continued to believe they lost because they had not pushed their extremist agenda harder – out of touch with the polling that showed American voters rejected extremism and favored leaders willing to work across the aisle to forge compromise and get results.
Republican leaders obsessed with so-called family values while simultaneously breaking up undocumented families, slashing food stamps and cutting off unemployment insurance will be as disappointed in November as conservative American bishops were this fall when they discovered they were out on a limb in their culture wars without sufficient backing among either their flock or their colleagues in Rome.
By: Carrie Wofford, U. S. News and World Report, December 30, 2013
“More Bark Than Bite”: Tomorrow’s Obamacare Controversy, Today
If past is precedent, Republicans on the House Oversight Committee will soon release a draft memo they requested and received from the Health and Human Services Department just before most Washingtonians decamped for the Christmas holiday.
At first glance, the memo, obtained by National Journal, looks very bad for the Obama administration. In the Sept. 24 document, a top information security officer for the agency overseeing the Obamacare insurance exchanges warns that the marketplace “does not reasonably meet … security requirements” and that “there is also no confidence that Personal Identifiable Information (PII) will be protected.” Teresa Fryer, the chief information security officer at the Centers for Medicare and Medicaid Service, continues: The federal marketplace will likely “not be ready to securely support the Affordable Care Act … by October 1, 2013.”
It plays right into the Republican narrative about HealthCare.gov: The administration knew the website would not be ready by the launch date but went ahead with it anyway. And the site may still not be adequately protecting consumers’ information.
But, in context, the draft memo becomes much less exciting.
On the Friday before Christmas, Rep. Darrell Issa, the chairman of the House Oversight Committee, released a partial transcript from an interview conducted by the panel’s staff with Fryer. That partial transcript, shared with ABC and CBS, suggested that Fryer warned the administration that there were two findings of serious vulnerabilities in the system.
However, when Democrats on the Oversight Committee released parts of the transcript omitted from Issa’s version, Fryer’s comments looked far less explosive, and ABC updated its story to reflect the change. It turns out that by Sept. 27, a few days after Fryer raised her concerns about the security at launch, extensive new security measures were added.
As she told the committee’s investigators, “The added protections that we have put into place in accordance with the risk decision memo … are best practices above and beyond what is usually recommended.” She went on to describe her confidence in the three-level security system and to note that there have been “no successful breaches [or] security incidents.”
Which brings us back to the draft memo we obtained. We should note that it was just a draft, and was never sent or reviewed by more senior officers in the chain of command, and was written three days before the mitigation strategies went into effect. She later told Oversight Committee investigators that her earlier recommendation against giving the go-ahead to launch the site—the “authority to operate,” as it’s called—did not take into account the mitigation strategies laid out in the Sept. 27 Authority to Operate memo.
The investigators asked Tony Trenkle, then-CMS’ top information executive, this: “So as long as the mitigation strategy described in the [ATO] memo was carried out, you considered that it was, it would be sufficient to mitigate the risks described in the memo?” He responded, “Yes.”
She added that she was “satisfied” with the current security testing, and that she did not object when another CMS information security officer decided to move ahead with the launch. Again, she stated: “All systems are susceptible to attacks. There have been no successful attempts.”
As the Los Angeles Times‘ Pulitzer Prize-winning business columnist Michael Hiltzik noted, “Issa has absolutely no evidence” to support his broader claims that the system’s deep vulnerabilities put all kinds of consumers’ government data at risk, and that CMS moved ahead anyway to avoid embarrassing the White House.
Of course, sleight of hand with opaque bureaucratic documents is nothing new for Issa, but the potential to dissuade Americans from obtaining health insurance through the federal exchanges because of trumped up security fears has pushed relations between the committee chair and the administration to a new low. It’s one thing to say without evidence that the administration is corrupt, but it’s another to tell Americans that their Social Security number is at risk when there’s nothing to suggest that’s true.
But perhaps we can head off another round of this farce by putting out Fryer’s memo before Issa does—in its full context.
By: Alex Seitz-Wald, The National Journal, December 24, 2013
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