“The GOP Culture Is Quite Ill”: The Republican Anti-Obamacare Purity Cult
Sahil Kapur at TPM has a fine report today looking at how hatred of Obamacare has become such an ideé fixe in the Republican party that even the mildest possible concession—or failing to be sufficiently enraged in one’s condemnation of the law—has become grounds for a harsh primary attacks:
[One] victim is Sen. Mike Enzi (R-WY), who is fending off a primary challenge from Liz Cheney in 2014. An outside group called Americans for Job Security last week released an ad attacking him for praising the concept of insurance market exchanges — the vehicle for Obamacare, which was modeled on conservative principles — early in 2010. “These exchanges can be good,” Enzi said then, in a clip that the ad repeatedly plays.
“Good?” says the narrator in the 30-second ad. “Wyoming’s Obamacare exchange has the most expensive premiums in the country, and it’s marred by glitches. Tell Mike Enzi we don’t like these liberal, big government Obamacare exchanges.” The attack forced Enzi’s campaign to defend him by touting his efforts to “stop the worst parts of the law.”
…[AEI scholar Norman] Ornstein summed it up this way: “These are the talking points and if you don’t apply them, then you’re a traitor.” He confessed that he’s “never seen anything like that before. I mean, you can certainly find party litmus tests…But this has been taken to a level that I think is almost bizarre.”
The comparison everyone is making is to McCarthyism in the 1950s, but there are some notable differences. The McCarthy era was all about nutty right-wing witch hunts, heavily laden with antisemitism and paranoia about fluoridated water and vaccines, led by an alcoholic, power-mad bully. But more to the point, red paranoia was widely shared throughout society. Both parties were fervently anti-communist. There really was a Soviet Union, which really did have nuclear missiles and an extensive spying apparatus. There really was terrible anxiety about another world war.
Whereas the Republican Obamacare purity rituals are restricted to their party only, and from the outside are frankly bizarre. They treat a moderate, incremental reform of the healthcare sector, based largely on Republican ideas, like New Lefters treated Nixon’s bombing of Cambodia. I’m reminded more of Maoist “struggle sessions,” where enemies of the party were publicly beaten and forced to confess their ideological crimes, real or imagined.
But in any case, the historical analogies one reaches for to describe this trend are telling in themselves. The GOP culture is quite ill, and shows little sign of improving anytime soon.
By: Ryan Cooper, Washington Monthly Political Animal, December 2, 2013
“Kicked To The Curb”: Republicans’ Self-Hatred Swells To The GOP Vs. Its Own Base
Does any modern political party besides the GOP hold a huge segment of its base in contempt? I’ve written a lot about how Republicans have failed to make inroads with Latinos, young voters or women since their 2012 defeat, but what’s really interesting is the way they continue to deride many of their older, white, working-class voters, too.
When Mitt Romney insulted “the 47 percent” of Americans who pay no federal income taxes, he failed to notice that the vast majority of them are white, most of them white seniors, the most reliably Republican voters in the country. A large portion of the people Paul Ryan describes as “takers” – vs. productive “makers” – are likewise older whites. And although Ryan and his party want to turn Medicare into a voucher program – run by exchanges, much like the Affordable Care Act – they tried to hide that fact during the 2012 race because it was hugely unpopular with their base.
The latest insult came from former senator and 2012 presidential runner-up Rick Santorum. On CNN’s “State of the Union” Sunday Santorum complained that the Affordable Care Act has meant that “sicker, older” people are getting health insurance (h/t Crooks and Liars.) Santorum told Candy Crowley and former Gov. Howard Dean:
Well, let me just add that one of the solutions that President Obama tried to accomplish was to let people keep their own insurance. It turns out that a lot of insurance companies are actually allowing that to happen, and that could cause even more problems for Obamacare, because that means fewer and fewer people getting into the exchanges. And the ones who, at least to date, it’s just facts Gov. Dean, the ones in the system are much older.
I talked to one insurance company today, a third of their enrollees are over sixty years of age. That is not how an insurance system would work, but those are the people signing up and the folks who can keep their plans because they’re more customized and lower cost, will now. And the folks who are going to get into these exchanges are going to be probably sicker, older, and as a result, premiums are even going to go higher.
First of all, it’s not clear Santorum is right about this. Some states are seeing unexpectedly high proportions of younger people sign up for coverage. In Kentucky, 41 percent have been under 35; in California, it’s 22 percent, which is proportionate to their share of the population. Still, the enrollment rate in California is highest for people over 55. That’s not surprising, or permanent: Based on the experience of Massachusetts, older people tend to sign up for coverage first; younger enrollees do it closer to the deadline.
But assuming that Santorum isn’t wrong (admittedly a leap), what is he saying? That people over 60 who don’t have coverage shouldn’t be able to get it? We know these people are white, and presumably – since they’re not eligible for Medicaid, which covers many of the poor and unemployed — they’re working people. But Santorum says “that’s not how an insurance system should work.”
Luckily Howard Dean was there to disagree. “I think it’s great that we’re insuring people who can’t get insurance that are over 55 and 60,” he told Santorum and Crowley. “That’s what this is supposed to do.”
Of course, if insurers are unhappy with their older customers, Rep. Alan Grayson has an answer: his “Medicare for All” bill, which would allow anyone who wanted to to sign up for Medicare instead of a private insurance plan. Back during the ACA debate many liberals wanted to see that option, but it was vetoed by insurance interests. Opening up Medicare to people 55 and older would help stabilize the program – although they’re the older edge of the ACA pool, they’d be younger and healthier subscribers in the Medicare pool – and provide an alternative for those priced out of or under-served by the private market.
Still, the big news this weekend was that the federal website that lets most people access insurance exchanges, Healthcare.gov, is mostly fixed. That’s why Santorum was reduced to railing against those takers in the GOP base. On Fox News Sunday, Chris Wallace attacked the ACA as “income redistribution.”
And, of course, Santorum insisted that the ACA’s troubles raised questions about “the president’s competence.” Dean wasn’t having that either.
“That’s right-wing talking points against this president,” Dean replied. “From day one, they’ve tried to undermine him as a human being … I lose my patience with this nonsense. I do believe that the facts are going to be determined by what happens on the ground. Three months from now, a lot more people are going to have health insurance, and a lot more people are going to be happy with all this.”
By: Joan Walsh, Editor at Large, Salon, December 2, 2013
“Like It Or Not, Obamacare Is Moving Forward”: For Certain People, This Isn’t As Good A Story As The Website’s Implosion Was
HealthCare.gov just tweeted that more than 375,000 had visited the refurbished federal website as of noon today. White House press secretary Jay Carney confirmed the figure shortly after.
So demand still appears to be there, despite weeks of deservedly awful press about the website and the law, and weeks of Republican claims that the law is so disastrously flawed that it cannot be rescued.
Along those lines, Kevin Drum captures what matters most about the news of the moment in one half a sentence:
if you need to buy health coverage via healthcare.gov, you can do it
This really is the rub. Sure, there will be continued problems. Charles Ornstein personally had a terrible experience. Sarah Kliff found the site is still not working for everybody. And the snafus at the back end may persist, too.
But the big picture is that far more people who need health insurance — whether they were bumped from plans or whether they were previously uninsured — will now be mostly able to go online, do some shopping, and buy health insurance. Before, they couldn’t.
This isn’t as good a story as the website’s implosion was, and if the site continues to function as expected, it will mostly stop getting media coverage. The press will move on to the next Obamacare disaster story, should it materialize: The “keep your doctor” saga, coming soon via Republican press release directly to reporters’ inboxes.
But the current fix has mostly tamped down concerns among Democratic lawmakers, and barring some truly catastrophic change, they just aren’t going to abandon the law in any meaningful sense. Meanwhile, demand looks likely to continue, even as insurance companies redouble their efforts to entice people on to the exchanges, which means enrollment will continue piling up, too.
Will it be enough? It’s too soon to say. Republican lawmakers and their voters have been 100 percent certain for some time now that Obamacare has already collapsed, but for everyone else, the law’s long term prospects will turn mostly on what that enrollment looks like over time. And for that, we’ll just have to wait.
By: Greg Sargent, The Washington Post, December 2, 2013
“If Preventing Hospital Layoffs Is So Important”: Maybe Republicans Should Stop Blocking Obamacare Medicaid Expansion
If you received an email this week from your angry uncle who watches Fox News all day, outraged by reports that “Obamacare” is causing layoffs at the Cleveland Clinic, let him know he can relax.
On November 25, The Daily Caller published an article titled, “Top U.S. hospital laying off staff due to Obamacare.” On Fox Business’ Markets Now, host Connell McShane reported on the “massive layoffs.” America’s Newsroom host Bill Hemmer claimed that the Cleveland Clinic was going to “shed workers.” Later, during the America’s News HQ, Fox reporter Chris Stirewalt claimed that the layoffs “rocked the community there in northeastern Ohio.”
But there’s one problem: the Cleveland Clinic is not laying off any employees.
Imagine that. After conservative media ran with this, Media Matters talked to Eileen Sheil, the Cleveland Clinic’s Executive Director of Corporate Communications, who said, “There have been several mis-reports and they keep mentioning that we’re laying off 3,000 employees. We’re not.” The medical facility is offering voluntary retirement to 3,000 eligible employees, but those aren’t “massive layoffs,” and blaming the Affordable Care Act for staffing decisions that have happened elsewhere for years is a stretch.
Indeed, Sheil added that the Clinic supports the law conservative media is so eager to denigrate: “We believe reform is necessary because the current state is unsustainable. The ACA is a step toward that change and we believe more changes will come/evolve as there are still many uncertainties. Hospitals must be responsible and do what we can to prepare and support the law.”
And while this incident offers another reminder about the reliability of conservative media outlets, there’s another angle to keep in mind. Though it doesn’t get as much attention as it should, Medicaid expansion is incredibly important to state hospitals, which will struggle badly in Republican-led states that reject the policy. Indeed, in some states, hospitals may end up closing their doors altogether, at least in part due to the political decision.
And when state hospitals close, there are actual “massive layoffs,” which affect the employees and the economy. It’s one of the reasons so many hospitals lobby Republican officials in “red” states to be more responsible on Medicaid expansion, though their appeals are generally ignored.
So here’s the question for conservative media: when hospital staffs are laid off because Republicans blocked Medicaid expansion, and it’s “Obamacare” that could have saved those jobs, how many reports will we see chastising GOP officials for their callousness and economic recklessness?
Probably not too many. Call it a hunch.
By: Steve Benen, The Maddow Blog, November 27, 2013
“Exploiting Consumers”: Republican Obamacare “Fix” Is Junk, Just Like The Junk Insurance Plans It Protects
In an effort to cynically score political points, the Republicans have taken up the cause of people who have received health insurance “cancellation” notices. The problem is that the Republicans aren’t helping these people, they are exploiting them. They’re peddling a “fix” that will stick consumers with lousy insurance policies, put the insurance companies back in charge of our health care and deceive people who deserve a straight answer about what’s going on with their health coverage.
If you’re one of the people who received a notice, it’s unsettling and confusing to say the least — and you don’t need a political party to play politics with your life. You need to know the truth and learn the available options.
People are receiving cancellation notices because they were sold health insurance policies that provide bare-bones coverage and expose them to financial ruin if they get sick or injured. Insurance companies sold these plans knowing full well that consumers could not keep them after the Affordable Care Act (ACA) standards are fully implemented on Jan. 1. The insurance companies didn’t tell their clients that they couldn’t keep the plans they sold them, and they certainly didn’t tell them that the plans were junk. Now the Republicans want to allow the industry to continue to sell these policies for another year in the name of letting people keep the plans “they like.” This is hypocrisy and politics at its worst, not to mention terrible policy.
There are roughly 15 million Americans who buy health plans in the individual market, and they represent 5 percent of people with private insurance. About half of them got cancellation notices, which naturally leaves people anxious to find out what they’ll do next year.
Instead of passing a law allowing insurers to keep selling bad policies that provide little for their premium money, we should tell people what their coverage options are and how much better they’ll do under the ACA. Because the enrollment web site HealthCare.gov has yet to work properly, most folks don’t realize they will save money and get better insurance if they shop in the new insurance marketplaces and take advantage of generous instant tax credits that will drastically cut their premiums.
People can save a lot of money when they buy their insurance through the online marketplaces: Seventeen million people will qualify for tax credits to reduce the cost of their insurance. As many as 7 million people may have no premium costs at all. Six of 10 uninsured Americans will pay $100 or less in monthly premiums. While it sucks to get canceled, the vast majority of those folks will see that getting coverage through the ACA marketplaces is a better deal.
The GOP-led legislation is bad public policy. It will disrupt the insurance market and make things worse now and in the future. You can’t mend our broken health insurance system if millions of people can opt out of participating in it. That’s how we got into this mess in the first place.
Allowing inferior insurance plans to exist alongside quality ACA policies will destroy the economic foundation of the law — the idea that financial risk must be spread and shared — and give our health care back to the insurance companies. Nothing could be worse for the health and the pocketbooks of everyday Americans.
For example, the Republican proposal would prompt younger, healthier people to opt out of enrolling in the marketplace plans, meaning the ACA policies will cover mostly older and sicker people who are more costly to insure. As a result, marketplace premiums would spike and millions of Americans would lose out on health coverage they can afford. People would be denied insurance or charged sharply higher premiums because of their medical history. Consumers would be at the mercy of the health insurance companies. That’s not why we enacted health reform. America reformed our health insurance system so everyone could have insurance with real benefits — not benefits that are only revealed to be phony in the middle of a medical crisis. We did it based on the simple principle that we all do better when we all do better.
The Republican bill would be a disaster for consumers. As we learned during the drive to pass the ACA, junk policies cause nothing but trouble. There are millions of stories of bankruptcy filings, homes and jobs lost, college educations abandoned and dreams deferred because someone with fake insurance got sick and was overwhelmed by medical bills. We can’t go back to those days.
The GOP is using overhyped cancellation stories as a pretext to destroy the ACA, a law they have attacked with a single-minded fervor never before seen in American politics. When the Republicans’ bill, H.R. 3350, reaches the floor, it will be the House GOP’s 46th vote to repeal Obamacare.
Any fixes to the Affordable Care Act should be judged by whether they help people and improve the law. The Republican-led proposal does neither.
By: Ethan Rome, HCAN Blog, November 14, 2013
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