“An Ideological Hurdle They Can’t Clear”: Why There’s No Republican Health Care Plan
Where’s the Republican alternative to the Affordable Care Act? The question is generally best suited for milk cartons – it’s pretty clear GOP officials would love to “repeal” the federal health care law, but we’ve been waiting for years to know what they’d “replace” it with.
This observation is an ongoing point of annoyance for the right, which is quick to argue that a variety of Republicans have presented reform plans of their own. Americans for Tax Reform’s Grover Norquist and Patrick Gleason push the argument in a new Politico piece, and Sen. Pat Toomey (R-Pa.) made a related case in the Republicans’ official weekly address over the weekend.
“There are common-sense, bipartisan solutions to our health care problems that don’t require ObamaCare’s wholesale government take-over of the system,” Toomey said. “Now, in a nutshell, we can make insurance more accessible, more affordable, and more responsive to individuals and families. And put patients and their doctors in charge of health care decisions, instead of politicians and government bureaucrats.” […]
Toomey did not mention a specific proposal, but he voiced support for allowing people to transfer insurance from job to job and purchase it across state lines.
And just like that, we’re reminded all over again why Republicans love to attack what exists, but struggle to craft a credible alternative of their own. Toomey still doesn’t quite understand that the Affordable Care Act is not a “wholesale government take-over” of the health care system, and more importantly, can’t get past the “nutshell” phase of the GOP’s rival policy.
In fairness, it’s worth emphasizing that Republicans did present something resembling a health care plan in 2009. Following up on our previous coverage, GOP officials missed a series of self-imposed deadlines in 2009, but eventually threw together a half-hearted joke – the GOP “policy” largely ignored the uninsured, did nothing for those with pre-existing conditions, and offered nothing for those worried about losing coverage when it’s needed most.
As Matt Yglesias noted at the time, the Republican approach to reform sought to create a system that “works better for people who don’t need health care services, and much worse for people who actually are sick or who become sick in the future. It’s basically a health un-insurance policy.” And as ThinkProgress added, the CBO crunched the numbers and found that the Republican alternative would leave “about 52 million” Americans without access to basic medical care.
Pressed for some kind of alternative to Obamacare, this was the best congressional Republicans could do.
Since then, GOP lawmakers have periodically stepped up with alternatives, all of which looked pretty similar. Indeed, a few months ago, when the Republican Study Committee said they’d finally put together an “Obamacare” rival, Ed Kilgore predicted before its unveiling that the policy would feature high-risk pools, interstate sales, tax credits, tort reform, and entitlement reform. A couple of hours later, the RSC unveiled its proposal and it was … exactly what Kilgore predicted it would be.
Months later, Toomey used his party’s weekly address to reiterate support for the same cliches.
The result is a stunted debate. We don’t have two competing approaches to solving a problem that has plagued the nation for decades; we have one party with a solution and another party that hates the solution but has no serious alternative. And this isn’t likely to change anytime soon – NBC’s First Read reported two weeks ago, “House Republicans wouldn’t commit Tuesday to offering their own formal alternative to the Affordable Care Act, instead vaguely describing their preference for a ‘patient-driven health care system.’”
As for why Republicans have no rival plan, as we discussed in September, there’s no great mystery. Every credible, effective solution requires some combination of regulating the private insurance market and investing in broader coverage for consumers. There’s just no way around that, and as a result, GOP officials are left with an ideological hurdle they simply cannot clear.
And so Republicans spin their wheels, condemning a policy that they used to like – remember, the basic ACA blueprint was a conservative approach to health care reform – while pretending to have an alternative they can’t identify in earnest.
By: Steve Benen, The Maddow Blog, December 16, 2013
“We Don’t Want Nothing Out Of This Debt Limit”: Paul Ryan Says He Isn’t Done Holding The Economy Hostage
In the spectacular Republican burnout at the end of the October government shutdown, it was easy to miss that America came within just hours of a full economic meltdown.
The brinksmanship over the demand to defund Obamacare or at least completely maim it lasted for 16 days and cost an estimated $24 billion. But if the standoff had gone on just another day longer, the debt ceiling would have been breached, causing economic chaos.
It’s difficult to predict what kind of damage the economy might have suffered, because no Congress had ever been stupid enough to default on our debts on purpose. The debt limit crisis of 2011 cost the stock market thousands of points and stunted job creation for months. There wasn’t a similar effect in 2013 because Wall Street assumed the GOP was crying wolf, and they were right.
But one mistake, one procedural error, one coup against a congressional leader could have sparked the beginning of a default. And many economists believe the results would have resembled the 2008 financial crisis — but worse.
As she’s sold the budget deal she negotiated with House Republicans that doesn’t extend the debt limit, Senator Patty Murray (D-WA) has said, “We have brought certainty and stability.”
And the economy does seem to be more stable since the GOP capitulated in October. “The volatility of the U.S. dollar in the last 90 days fell to 4.93 percent on Dec. 13 from a yearly high of 7.34 percent in September as a shutdown and debt ceiling crisis loomed, according to the Bloomberg U.S. Dollar Index that represents 10 major currencies weighted by liquidity and trade flows,” Bloomberg‘s Derek Wallbank and Kathleen Hunter noted.
But Murray’s partner, Rep. Paul Ryan (R-WI), seems intent on disrupting that stability.
“We don’t want nothing out of this debt limit,” he told Fox News Sunday.
In other words, House Republican demands are forthcoming. The last time they put together a list of such demands, it was an insane laundry list of right-wing wishes cribbed from the Koch Brothers’ letter to Santa. Somehow being the party held responsible for the greatest financial crisis in a half-century has given Republicans the freedom to boldly threaten a return to such a crisis again and again, without fear of destroying their party.
The president offered, in return, nothing. Obviously regretting setting the precedent that the economy could be held hostage, President Obama has vowed never to negotiate over the debt limit again.
With Republican factions warring with themselves and everyone in Washington seeing their approval ratings shrink, would they dare play chicken with the economy as the midterm elections rapidly approach?
Paul Ryan knows he can’t afford not to at least seem as if he’s willing to do so without losing the Tea Party support that makes him such an asset to House Speaker John Boehner (R-OH). And the president knows he can’t afford to give in.
The result is that another crisis has been averted, but a far worse one looms.
By: Jason Sattler, The National Memo, December 16, 2013
“Standing For What People Will Fall For”: Rick Scott Backs Off Medicaid Expansion Days After Announcing Re-Election Bid
Just after making his 2014 re-election campaign official, Florida governor Rick Scott (R) appears to be backtracking on Medicaid expansion, avoiding questions concerning his past support on the expansion of the program in his state.
During an appearance on Wednesday, reporters asked the governor if Florida would pursue federal funds available through the Affordable Care Act to expand the state’s Medicaid program.
Scott ignored the question and instead focused on criticizing the health care reform law, which he says will cause “300,000 people in our state” to lose their insurance before the new year.
The comments echoed those made just a day before, when Scott dodged another question about expanding Medicaid, saying that “the biggest issue we’re dealing with right now” is the health care cancelations he says people in his state are “concerned about.”
“On top of the fact you see the plans that have been proposed, they have high deductibles, so I’m concerned about cost, quality, and access to health care, that’s our biggest problem right now,” Scott said.
The comments hint that Scott is now retracting his support for Medicaid expansion – a stance he surprisingly took earlier this year when he said that he would accept Obamacare funding to expand the program for low-income Americans in his state.
Even though $51 billion in federal funds are available for Florida, the state’s GOP-controlled legislature refused to pass a budget that included funding for Medicaid expansion.
At the time, Scott declared that “while the federal government is committed to paying 100 percent of the costs, I cannot, in good conscience, deny Floridians who need access to healthcare.”
Scott’s most recent change of heart is not too surprising now that his re-election bid is official, but it does offer his Democratic challenger — and former Florida Republican governor — Charlie Crist a point of attack.
Considering that Florida has the second-highest uninsured rates in the nation, Medicaid is especially important to constituents, specifically the approximately 850,000 Floridians who do not qualify for subsidized insurance under the federal law, but also do not qualify for Medicaid.
Without an extension of the program, those 850,000 low-income Floridians will continue to go uninsured.
The entire state also stands to lose should Scott decide to reject federal funds to expand Medicaid; a report released by the Commonwealth Fund finds that not extending the program — which “generates a net loss of federal funds” — will cost Florida taxpayers a whopping $9.2 billion by 2022.
By: Elissa Gomez, the National Memo, December 12, 2013
“There’s Only So Far You Can Follow Your Extremists”: Conservative Anger Over Budget Deal Now Purely To Save Face
Have we finally reached a point where the perpetual anger of Washington conservatives is no longer a threat to the republic? The budget deal announced yesterday suggests that it may well be, at least for the moment. It isn’t that conservatives aren’t raising a stink about it—they’re displeased that it doesn’t repeal the Affordable Care Act, slash Social Security and Medicare, and do more to punish food-stamp recipients, among other things—because they certainly are. Indeed, they were decrying it even before it was announced, which tells you how concerned they are about the details. But they seem to be just going through the motions. Send the press releases, say you’ll vote against it, tell Fox News why it doesn’t get to the real problems … and then we’ll all move on. The budget will pass, mostly because it averts the possibility of a government shutdown (at least over the budget, though not over the debt ceiling) for two more years. And even the most conservative Republican knows that’s a good thing for their party.
Just look at how John Boehner is acting. Boehner, who spent the entire period of the shutdown (and the weeks leading up to it) stepping gingerly around his party’s right wing as though it were a Bengal tiger that could rip his throat out with a single swipe if angered, now feels free to attack the likes of Heritage Action, obviously without concern that they can make him pay for his insolence:
At a press conference Wednesday, a visibly angry Boehner said conservative groups who oppose the two-year budget deal struck by Rep. Paul Ryan (R-WI) and Sen. Patty Murray (D-WA) are “using our members and they’re using the American people for their own goals. This is ridiculous.” Moments earlier, during a closed-door meeting, Boehner told House Republicans that the well-funded and influential organizations “aren’t acting out of principle, and they’re not trying to enact conservative policies. They’re using you to raise money and expand their own organization,” he said, according to a source in the room.
Those are some pretty strong words. Meanwhile, primary challenges to Republicans who have sinned against purity aren’t exactly looking formidable at the moment. Steve Stockman, who could well be the single nuttiest Republican in the House (and that’s saying something), is mounting a challenge to already extremely conservative Texas senator John Cornyn, one that will produce some moments of comedy but is almost certainly doomed. There are other primary challenges in progress to high-profile Republicans like Lindsey Graham, but most of those will probably fail as well.
That doesn’t mean that the Tea Party is irrelevant, or that events couldn’t conspire to renew their power and influence over the Republican party. For the moment, however, it does appear that the shutdown provided everyone in the GOP a valuable lesson: there’s only so far you can follow your extremists before they lead you off the cliff, and once you’ve plunged to the bottom, you don’t much want to climb back up and hurl yourself off again.
By: Paul Waldman, Contributing Editor, The American Prospect, December 11, 2013
“The Tea Party Is Pissed And That’s A Good Sign”: Here’s The Real Story, The GOP Has Surrendered On Repealing Obamacare
Rep. Paul Ryan (R-WI) and Senator Patty Murray (D-WA) both referred to the budget deal they announced on Tuesday evening as “historic.” They were correct — but not because of any of the cuts or fees in the modest deficit-reduction plan.
What’s historic about Ryan and Murray’s bipartisan deal, which eases the automatic sequester cuts, is that it quietly funds Obamacare for the next two years, rejecting the Tea Party argument to defund/repeal the president’s signature legislative accomplishment until at least 2017.
Yes, Republicans are giving in and accepting the Affordable Care Act, right as the law and the president are near all-time popularity lows.
Two months of severe problems with the website compounded confusion and frustration with an already complex law. Most of the problems have been fixed, but the public perception of the law will take months to heal, if it ever does. But Republicans have figured out, after their failed attempt to dive-bomb the law with a shutdown in October, that they have no hope of getting rid of it — at least until President Obama is out of office.
The Ryan-Murray agreement isn’t the only sign that many Republicans are nearing the “acceptance” phase of mourning the existence of Obamacare.
Senator Ron Johnson (R-WI), who repeatedly said that the president’s health reform was an abomination that compelled him to run for office, now says he can accept the law’s state insurance exchange system.
Five of the 25 Republican-led states that have rejected Medicaid expansion are edging toward accepting federal money to help insure millions who earn just a bit too much to qualify for Medicaid. Republican governors in the key swing states of Ohio, Michigan and Pennsylvania are already working toward implementing expansion.
Another sign that most Republicans understand that they’re going to have to live with Obamacare is that the Tea Party is pissed.
Red State‘s Erick Erickson — one of the leading voices for primarying just about every incumbent Republican senator — put it this way:
Last month Republicans bailed on the Obamacare fight and declared sequestration their line in the sand. Now they are saying they’ll bail on sequestration, but they’ll hold the line on unemployment benefits.
Why should we believe them anymore? Is it any wonder that poll after poll shows Republican voters hate their Republican congressmen and senators?
Bend over America, here it comes again.
Republicans had two months of unity as they celebrated the miserable rollout of HealthCare.gov. Now the GOP is back to where it was in October, stuck with a base that’s pretty much furious at its leadership for surrendering — again.
By: Jason Sattler, The National Memo, December 11, 2013
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