“Obamacare Is Killing The GOP”: Republicans’ Opiate Obsession With The Law Will Be The Party’s Undoing
It’s not an exaggeration to say Republicans have bet their future on the disaster they expect from Obamacare. “The implementation of the law over the next year is going to reveal a lot of kinks, a lot of red tape, a lot of taxes, a lot of price increases,” RNC spokesman Brad Dayspring told The New York Times last month. “It’s going to be an issue that’s front and center [in 2014].” GOP intellectuals see Obamacare as the centerpiece of the party’s strategy even well beyond then. “Republicans are likely to seize on every sad [implementation] story as justification for dramatic changes—and in 2016, mount campaigns designed to replace the system in whole or in part with plenty of material to use in their cause,” the conservative wonk Ben Domenech wrote approvingly in March.
And, of course, the party’s base is completely, unremittingly, obsessed with the issue. The mere anticipation of an implementation quagmire is “reinvigorating the movement,” Jenny Beth Martin, a national Tea Party official, told The Hill in early May. “We’re doing street rallies and protests over the next month to three months, initially. We’re working to recruit candidates that can talk about this.”
I happen to be agnostic about whether health care implementation will help the GOP in 2014. On the one hand, anything that energizes conservatives in a low-turnout election should benefit Republicans, much as it did on 2010. On the other hand, as The Washington Post’s Greg Sargent points out, much of the public antipathy toward Obamacare is already baked into the polls. The people who disapprove haven’t liked it from the get-go; similarly for the people who approve. It’s possible that a series of implementation snafus will move those numbers at the margins—a new poll suggests public opinion has soured a bit lately, perhaps as a result of all the “train wreck” chatter. On the other hand, it’s also possible that implementation will go relatively smoothly and people will embrace the program, netting Democrats a few more votes.
What I do know is that the GOP’s health care preoccupation is absolutely destroying its long-term prospects. However well the issue may work in the midterms, when an uptick in conservative turnout can flip a few dozen House seats, 2012 proved that it’s at best a wash in a presidential election, when Democrats can swamp that turnout with their demographic edge, and when the GOP’s challenge is to win moderates and independents as a result. Conservatives argue that the only reason health care didn’t work in 2012 is that Romney was a flawed messenger, given his patrimonial link to Obamacare. But with the Supreme Court largely blessing the law last June, the issue was mostly settled in the public mind, making it at best a non-factor among swing voters.
Even if implementation goes terribly, it isn’t likely to rekindle widespread angst. Most people will be untouched by implementation—even a disastrous implementation—for the simple reason that they won’t be relying on Obamacare. As Bloomberg’s Josh Barro has explained, 78 percent of us get coverage through Medicare, Medicaid, or our employers, a figure isn’t likely to change very much, or at least very quickly. Meanwhile, my colleague Jonathan Cohn points out that life for many people who do end up on Obamacare will improve, however flawed the program is, because it translates into insurance they didn’t have before.
Having said all that, the real problem with conservatives’ Obamacare strategy isn’t that it won’t work. It’s that the Obamacare obsession is actively sabotaging the GOP. Earlier this week The Washington Post ran an article about the ongoing dysfunction among House Republicans. Easily the most telling anecdote had to do with a largely symbolic measure called the Helping Sick Americans Now Act, concocted by Majority Leader Eric Cantor to help Republicans look like they care about the problems of ordinary people. (The bill feinted at easing the lot of the uninsured.) That, apparently, is where Cantor erred. As the Post explains:
A few dozen Republicans opposed the modest Helping Sick Americans legislation because they said it came from nowhere. Instead, Cantor pulled the bill and held another vote to repeal Obamacare — their 37th attempt to repeal part or all of the landmark health-care law — to appease conservatives.
To put the problem in Marxian terms, Obamacare has become the opiate of the GOP. By its own admission, the party must broaden its appeal to Latinos, gays, and young voters. It needs an economic agenda that encompasses more than tax cuts for the rich and brutal spending cuts. It has to persuade voters it’s more than just a nihilistic force bent on triggering global financial apocalypse if it doesn’t get its way in Washington. And yet, when party leaders so much as broach these liabilities, conservatives revolt and the leadership caves, appeasing them with an issue whose political utility peaked two-and-a-half years ago. (Suffice it to say, after the last few years, the words “reinvigorating the Tea Party movement” won’t exactly help Cantor and Boehner sleep at night.)
If you want to appreciate how truly incorrigible conservatives are on the subject, I recommend watching them grapple with the early news about Obamacare implementation, which has suggested the program could work better than anticipated. It’s a bit like watching a speculator learn he’s bet his life savings on a failing company—which is to say, chock full of denial and elaborate self-delusion.
For example, in late May, when the head of California’s insurance exchange announced that insurers were submitting cheaper bids than the state expected (and cheaper than many critics predicted), the conservative columnist Avik Roy tried to disprove the claims by visiting an online clearinghouse for private insurance plans. Roy solicited bids for a healthy 25-year-old male and a healthy 40-year old male, then pointed out that they came in far below what coverage would cost through the Obamacare exchange. All fine and good, except that Roy’s hypothetical bids were neither here nor there. The point of Obamacare is to provide affordable insurance to people who may be sick or older.
Alas, the fact that Roy basically affirmed the rationale for a program he set out to discredit—healthy, affluent young people are the one group that will do worse under Obamacare; everyone else will do better; no one has ever disputed this—didn’t stop every conservative outlet on the Internet from trumpeting his analysis. “Obamacare drives up insurance premiums by up to 146 percent in California,” screamed The Daily Caller. Even after a succession of wonks highlighted the glaring flaws, the editorialists at The Wall Street Journal leaned on Roy to declare an “ObamaCare Bait and Switch.”
The desperation here is palpable, but also understandable. If, instead of trying to fix your party’s deepest pathologies you wagered its entire future on a high-risk strategy that was starting to turn bad, you’d be a little desperate, too. Perhaps it’s a subset of Obama Derangement Syndrome that afflicts conservatives when they talk about health care—call it Obamacare Derangement Syndrome. Maybe one day, once the dust has settled, it’ll be covered under Obamacare, too.
By: Norm Scheiber, Senior Editor, The New Republic, June 7, 2013
“No Shedding Crocodile Tears Here”: Obamacare Critics Should Stop Using Young Men To Fuel Their Arguments
In January, one of Obamacare’s most controversial provisions will come into effect:
Every person in America will be required to either have health insurance or pay a penalty.
Overall, the effect will likely be a net positive: Because of subsidies, the cost of insurance will be kept down for many households, and in many states, a Medicaid expansion will help even more families pay for their health care. But while the outlook is great for millions of workers, things are going to be tougher for at least one group: healthy, financially secure men in their twenties.
So, guess which group Obamacare critics have focused on when they attack the effects of the program? I’ll give you three guesses, but you’ll probably only need one.
On Wednesday, New York magazine’s Jonathan Chait pointed out the surprising trend, noting that critics of the Affordable Care Act have almost universally cited the group in their attacks. Likening the move to an old-time patent medicine show (“You, sir – the healthy 25-year-old in front who has never been hospitalized or needed medication in his life! Step right up!”), he suggested that the attacks on Obamacare are, to put it mildly, skewed.
On the surface, targeting the law’s impact on healthy 25-year-old men seems like a masterstroke. After all, it’s hard to argue for the fairness of a system that charges healthy young people to pay for the health care needs of sickly older ones. The trouble is, today’s healthy 25-year-old male could easily become tomorrow’s hit-and-run victim, desperately in need of long-term medical care. And, barring that, today’s healthy 20-something will, with any luck, become a less-healthy 50-something, in need of an affordable method to cover his medications and regular doctor’s visits.
(Or, as happened to me when I was an uninsured man in my mid-20s, today’s healthy young 25-year-old could be tomorrow’s guy paying out-of-pocket for wisdom teeth extraction.)
Obamacare has numerous provisions that will extend coverage and make health insurance cheaper. Among other things, it will help cover the Medicare Part D coverage gap, will end exclusions for pre-existing conditions, and will require health care plans to cover preventative care.
For tens of millions of people, these provisions, and others, will translate into lower medical costs, a previously unimaginable access to health care, and a generally improved quality of life. Given the huge potential benefits, maybe it’s time for Obamacare’s critics to stop shedding crocodile tears for the relatively small portion of the populace that is going to have to take one for the team — and, in the process, get insurance that may well make them safer and healthier.
By: Bruce Watson, Business Insider, Originally Published in DailyFinance, June 10, 2013
“Managing Expectations”: How Conservatives Are Helping Obamacare
Yuval Levin, among other conservatives, has made an offer to liberals: Let’s delay the implementation of Obamacare for a year and make everybody better off:
Congressional Democrats surely want to avoid being blamed for a meltdown of American health care during a congressional election year, the people implementing this law at every level could certainly use the time, and Republicans believe that more time would not make Obamacare more popular but would allow them to further develop and articulate their alternatives (and allow another election to intervene earlier in the rollout process, making a replacement more plausible).
Liberals, wisely, are saying no. What’s funny about this conversation is that conservatives have been accidentally managing expectations for implementation: By harping constantly on what a disaster the rollout is going to be, they will make what actually happens look good by comparison.
Jonathan Cohn has a good piece in the New Republic arguing that implementation won’t be as bad as people are saying. This is his really important observation:
Notice that the worries about implementation chaos apply strictly to people who would otherwise be uninsured or at the mercy of the existing individual insurance market, in which plans are inconsistently priced, full of coverage holes, and of unpredictable reliability — and in which financial assistance for buying private coverage is not available at all. Even if it takes these people a while to get insurance, and even if finding that coverage is a maddening experience, they’re going to end up with something they don’t have now: Coverage that meets more of their needs and is available to them, with substantial financial assistance. Don’t forget: Today, people with pre-existing medical conditions frequently cannot get any coverage on the individual market.
This is something that has been lost in the discussion of Obamacare implementation difficulties:
Implementation won’t much affect the 78 percent of Americans currently covered through Medicaid, Medicare, or employer group health plans. It will make some people who currently buy individual coverage worse off. But only 5 percent of Americans get insurance through the individual market, which is already hugely dysfunctional. Three times as many Americans are currently uninsured, and they can only stand to gain from Obamacare implementation, even if it does not go smoothly.
For those 5 percent who buy individual coverage now, the new law will be a mixed bag. Some people will probably have frustrating bureaucratic experiences with the new exchanges that they didn’t have buying directly from insurers. And some people (particularly young and healthy people) will see their premiums go up. But others will see their premiums go down, either because they currently pay a lot because of age or health status, or because income-based premium subsidies will more than offset any premium increase.
There will also be people who lose group health coverage, when premium subsidies make it attractive for their employers to send them to shop in the exchanges. (Others will gain group coverage if employers decide it is better to offer it than to pay a penalty for uninsured workers.) But neither this effect nor any problems faced by people with existing individual insurance is likely to create a clamor for repeal that is any more effective than the din of the last three years.
That is because the most obvious way to fix the problem of those who have trouble in the health exchanges will be to fix the exchanges, not repeal them. Let’s say your employer dropped group coverage and you’re having trouble with the exchange. Will you want the whole law repealed in the hope that will lead your employer to reverse course and offer a group plan again? Or will you want the exchange fixed so you are guaranteed access to coverage?
Cohn looks back to Medicare Part D and the Children’s Health Insurance Program and argues that those programs got through their rocky implementations in large part because benefits obtained with bureaucratic difficulty are better than no benefits at all. He’s right, and this is why conservatives are “magnanimously” offering to delay implementation of Obamacare. They realize that once people have guaranteed access to health coverage, they won’t want to give it up, even if there are implementation problems.
The political landscape is already dire for those who still hope to repeal Obamacare, and they’re actually making their position worse by talking constantly about what a nightmare implementation is going to be. This fall, as the exchanges come on line, tens of millions of people are going to find they can get health coverage they never could before. They are likely to be quite happy about that, especially if they’ve been hearing for months in advance that it will be a mess.
By: Josh Barro, Bloomberg, April 29, 2013
“Ugly And Getting Worse”: A Republican House Divided Against Itself
It didn’t get much attention last week, but House Majority Leader Eric Cantor (R-Va.) suffered a significant defeat last week. The Virginia Republican, as part of a larger rebranding campaign, crafted something called the “Helping Sick Americans Now Act,” which intended to transfer money from the Affordable Care Act to high-risk pools for the uninsured.
Democrats saw through the scheme, but more importantly, House Republicans hated the idea, seeing it as a plan to “fix” Obamacare. Humiliated, Cantor was forced to pull his bill without a vote.
The overlooked fiasco was a problem House GOP leaders saw coming.
Less than two weeks ago, House Majority Whip Kevin McCarthy walked upstairs to Majority Leader Eric Cantor’s Capitol office to discuss a sensitive issue: Why did Cantor schedule a vote before McCarthy had the chance to survey Republican support?
The meeting — described as “tense” by several people familiar with it — ended with McCarthy abruptly standing up and storming out of the room. Aides downplayed the exchange. But a week later, it turned out that McCarthy’s pique was merited: The health care-related bill was suddenly pulled from the floor in what was the most recent stumble for House Republicans.
If this was a rare misstep, and the Republican-led House ran like a well-oiled governing machine, it’d be easy to overlook. But the trouble with Cantor’s bill appears to be evidence of a much larger and deeper problem.
We talked a month ago about House Speaker John Boehner’s (R-Ohio) “Make the Senate go first” rule that effectively takes the House out of the governing process altogether, but Jake Sherman’s report makes it seem as if Boehner doesn’t have much of a choice — this is a House “in chaos.” Republican leader are “talking past each other”; the House conference “is split by warring factions”; and influential outside groups are fighting their ostensible allies.
It’s ugly, and it’s getting worse.
There appear to be a series of factions, which clearly don’t see eye to eye. Right-wing lawmakers want to invest their time and energy into combating Democrats and voting on health care repeal; Cantor and his allies are focused on rebranding and conservative-friendly solutions; and Boehner has some big-ticket items in mind as he weighs the future of the so-called “Hastert Rule.”
In the meantime, four months into the new Congress, the House has no policy agenda, and according to the Politico report, GOP leaders even consider immigration reform a “long shot” in the lower chamber.
I’m not entirely convinced that the House is so far gone that governing is literally impossible, especially if the Speaker’s office is willing to forgo the “majority of the majority” and start passing bills with Democratic votes. Boehner has already done this four times this year, and if he’s willing to do it some more, this Congress may not be a complete disaster.
But clearly House Republicans are divided against themselves. There’s no meaningful leadership; no interest in cooperation or compromise; and post-policy nihilism rules the day. The demise of Cantor’s health care bill was a reminder that House Republicans will reject their own party’s policy ideas with nearly the same speed as they’ll reject Democratic ideas.
For many Beltway pundits, the inability of House Republicans to act like a governing caucus is mainly President Obama’s fault — if only he’d schmooze with them, form personal relationships, and act like a character in an Aaron Sorkin movie, maybe these radicalized nihilists would be more likely to get something done.
But all available evidence suggests the collapse of the House GOP is out of Obama’s hands. The House Republican conference is simply broken.
By: Steve Benen, The Maddow Blog, May 1, 2013
“Everything That’s Rotten About Congress”: Fixing The Part Of Sequestration That Affects Rich People
After a month or so of the sequestration budget cuts only affecting people Congress doesn’t really care about, the cuts hit home this week when mandatory FAA furloughs caused lengthy flight delays cross the country. Suddenly, sequestration was hurting regular Americans, instead of irregular (poor) ones! Some naive observers thought this would force Congress to finally roll back the purposefully damaging cuts that were by design never intended to actually go into effect. Those observers were … sort of right! The U.S. Senate jumped into action last night and voted to … let the FAA transfer some money from the Transportation Department to pay air traffic controllers so that the sequestration can continue without inconveniencing members of Congress, most of whom will be flying home to their districts today. The system works! (For rich people, like I’ve been saying.)
The Washington Post says, “The Senate took the first step toward circumventing sequestration Thursday night,” though in fact what it did was work to ensure that the sequester continues not affecting elites, who fly regularly. I am embarrassed that I did not predict this exact outcome in my column Tuesday morning. The Senate, which can’t confirm a judge without months of delay and a constitutional crisis, passed this particular bill in about two minutes, with unanimous consent. The hope is that the House can get it taken care of today, I guess in time for everyone to fly to Aspen or wherever people whom Congress listens to fly to on Fridays.
After that Congress will be done fixing all the various problems with the design and implementation of the sequestration:
But House action on a broader deal to undo the across-the-board cuts appears remote. House conservatives say much of the impact has been exaggerated by the White House, and they have relished the success of forcing visible spending cuts on a Democratic administration.
“I think it’s the first time we’ve saved money in Washington, D.C.,” said Representative Raúl Labrador, Republican of Idaho. “I think we need to move on from the subject.”
Move on, people who may become homeless! We fixed the airports, what more do you want?
There was a big to-do yesterday about a Politico story insisting — explosively! morning-winningly! — that Congress was trying to exempt itself from Obamacare. Because this is Politico, the story was based on equal parts misunderstanding of policy and desire to create a fuss. The actual story is that Republicans proposed forcing members of Congress and their staffs to only use healthcare plans created by Obamacare or available in the exchanges. Democrats passed the amendment, as a sort of fuck you. But the exchanges are designed for people who don’t have employers who pay for healthcare. Congressional staffers get employer-sponsored health benefits. The exchanges are explicitly not designed for employees of large employers who pay for healthcare, so some people are right now trying to figure out how to make sure staffers continue to get healthcare. It may end up not being a big deal, or it may require a tweak to the law. But it’s not a scandal. (Honestly, it’s all a pretty good argument for ditching employer-based healthcare in favor of universal single-payer but then again everything is.)
But the fuss was already created. The story will live forever, and no amount of debunking in the world will kill the popular myth that Congress attempted to secretly “exempt” itself from Obamacare. So self-serving!
Their staffers are generally the poorest people members of Congress know, and trying to make sure their healthcare is paid for is seriously the closest our legislature gets to altruism. But while the story of Congress working to make sure its staffers don’t have to shoulder the entirety of their premium costs because of Republican political stuntmanship was treated as a scandal and an example of everything rotten about Congress, the story of Congress hurriedly making sure the well-off minority of Americans who fly regularly don’t get briefly inconvenienced — while ignoring the costs of brutal cuts on programs for low-income Americans facing housing or hunger crises — is treated as a wonderful and encouraging display of bipartisanship.
Have a great flight home, senators!
By: Alex Seitz-Wald, Salon, April 26, 2013
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