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“Things Are Neither Perfect Nor Disastrous”: Obamacare Panic To Enter Even Stupider New Phase

No, Democrats are not abandoning it en masse, and no, it isn’t going to be repealed.

I want to follow up on what I wrote Friday about those who are deciding that because of a) web site problems and b) the largely manufactured controversy over people who have one private insurance plan but now face the unfathomable horror of moving to a different private insurance plan, the Affordable Care Act is an unrecoverable disaster that has destroyed Barack Obama’s second term. I’m sensing that this is about to move into a new phase of inane speculation that we should think about before it starts.

I’ll just use one article as an example. This morning, under the headline “Why Obamacare Is On Life Support,” Josh Kraushaar of the National Journal all but declares that the law is about to be repealed. “Unless the HealthCare.gov website miraculously gets fixed by next month,” he writes, “there’s a growing likelihood that over time, enough Democrats may join Republicans to decide to start over and scrap the whole complex health care enterprise.” That’s so blindingly stupid I’m almost not sure where to start, but let’s give it is a shot. First, would it really be “miraculous” if Healthcare.gov got fixed by next month? It’s a website. Yes, a complicated one, and yes, one that had many problems. But it isn’t as though those problems are somehow beyond the ken of human ingenuity to solve, requiring heavenly intervention. The administration isn’t trying to achieve faster-than-light transport or make us all immortal. It’s a website. It may not be perfect, but it’ll work.

Kraushaar then goes through some counting of vulnerable Democratic seats in both houses to argue that it’s a real possibility that a repeal of the entire ACA could not only pass, but pass with a wide enough margin to override a veto from the President. His main evidence is the 39 House Democrats who voted last week for a symbolic Republican proposal to undo some of the individual-market reforms; he thinks the number for full repeal of the ACA will be even greater. But that’s completely backwards. It would take some kind of as-yet-unforeseen utter catastrophe to transform even those votes into a vote for full repeal. As Jonathan Bernstein says, “There’s an enormous difference between playing along on a symbolic vote and abandoning a policy Democrats are stuck with, like it or not.” Not even House Democrats from swing districts are dumb enough to think that voting to repeal the law would serve their political interests, despite Kraushaar’s bizarre and demonstrably false assertion that already, “Even [the ACA’s] most ardent supporters are running for the hills.”

If you’re going to start speculating about repeal, you have to confront what’s going to happen six weeks from now, on January 1. Let’s have a little reminder:

  • Millions of people will begin getting coverage through Medicaid. Repeal would mean kicking these people off their insurance.
  • Millions of people will begin getting subsidies to pay for private insurance. Repeal would mean taking away their subsidies, making it unaffordable for them to get insurance.
  • Denials for pre-existing conditions will be officially over. Repeal would mean that once again, insurers could deny people coverage if they’ve ever been sick.
  • Annual limits on coverage will be outlawed. Repeal would mean that people will once again start being forced to pay huge medical bills, in many cases forcing them into bankruptcy, if they have a serious illness or accident.

And that’s not to mention the parts of the bill that have already gone into effect, like “rescission” becoming illegal, children not being allowed to be denied coverage for pre-existing conditions, or young people being allowed to stay on their parents’ insurance until they’re 26. You think some news stories about people in the individual market having to pay more for a new insurance plan tug at lawmakers’ heartstrings? Wait until you see the stories about the 5-year-old girl with leukemia who’ll get kicked off her coverage if Republicans in Congress have their way. Right now we’re talking about a few people who are supposedly the “losers” in the ACA, but the most they’ve lost is some money they’ll have to pay for a more comprehensive plan. If you repeal the law, the country would be overflowing with people whose losses are genuinely catastrophic.

January 1 is the end of any talk of repeal, and Republicans know it—as many of them have been saying all along, once you start giving people benefits, it’s all but impossible to take them away. That doesn’t mean there isn’t still work to do, and it doesn’t mean there aren’t things that could go wrong. Nor does it mean there might not be piecemeal fixes to one or another provision debated in the future; there almost certainly will be. But unless you think that in the next six weeks Republicans are going to manage to put together a two-thirds majority in both houses of Congress to repeal the ACA—something you’d have to be nuts to believe—it’s never going to happen.

I realize that there’s an impulse as a reporter or a pundit to cast everything in the most dramatic terms possible. “Things are neither perfect nor disastrous” is a much less interesting assertion to make than “Everything has changed! Earth-shattering developments are afoot!” But that happens to be the truth.

 

By: Paul Waldman, Contributing Editor, The American Prospect, November 18, 2013

November 19, 2013 Posted by | Affordable Care Act, Politics, Republicans | , , , , , , | 1 Comment

Mad Men and Mad Women: Republicans And Social Engineering

Republicans hate social engineering, unless they’re doing it.

Wishing they had the power to repeal the repeal of “don’t ask, don’t tell” and get back to the repressed “Mad Men” world they crave, some conservative lawmakers grumpily quizzed upbeat military brass on Friday.

“We’re starting to try to conform the military to a behavior, and I remember going through the military, we took behaviors and we formed it to the military,” said Representative Allen West of Florida, warning ominously (and weirdly) that “this could be the camel getting his nose under the tent.”

The House Armed Services subcommittee hearing was led by Joe Wilson, the oh-so-subtle Republican congressman from South Carolina famous for yelling “You lie!” at President Obama. Wilson started off the hearing by saying that the legislation to let gays stop lying while they risk dying was rushed through in an “undemocratic” lame-duck session.

Two top Pentagon officials testified that the transition was going swimmingly, yet Republicans scoffed. Representative Austin Scott of Georgia demanded the price tag. Clifford Stanley, an under secretary of defense, replied that the training materials cost only $10,000.

Scott harrumphed, “If something was done at D.O.D. for $10,000, I would like to know what it was.” He said that hundreds of thousands had been spent training a soldier in his district to disarm I.E.D.’s, but the soldier wouldn’t re-enlist because of the “social policy.”

The Democrat Chellie Pingree of Maine jumped in to note that the cost of purging gays between 2004 and 2009 was $193.3 million: “It’s not only unconscionable … but the costs are horrendous.”

Scott persisted in looking for trouble, even after Vice Adm. William Gortney, director of the joint staff, said the Pentagon had seen no problems so far.

The congressman asked the admiral if he had ever dismissed anyone. Gortney said he had dismissed a young sailor who acknowledged being gay after “don’t ask, don’t tell” first passed.

“Did you discharge him from the service because he was gay?” Scott asked. “Or because he violated the standard of conduct?”

“Because he was gay,” Gortney said.

“He did not violate the standard of conduct before he was dismissed?” Scott pressed.

“He did not,” Gortney said.

“Well,” Scott said, once more at a loss, “that’s not the answer I thought you would give, to be honest with you.”

Gortney assured him there were “very few cases” of gays’ being dismissed for violating the standard of conduct.

After the Republican rout in November, the story line took hold that because of the recession and Tea Partiers’ fervent focus on the debt as a moral matter, divisive social issues were going on the back burner. But lo and behold, social issues have roared back. Many in the Tea Party have joined that chain-smoking, cocktail-quaffing Mad Man John Boehner in the martini party to put a retro focus on wedge issues, from gays to abortion.

Like Boehner, who complained that Democratic leaders were “snuffing out the America that I grew up in,” some Tea Partiers are jumping in a time machine. They can’t stop themselves from linking social issues to the budget.

“This pulls the mask back a little bit on the Tea Party movement,” said Representative Chris Van Hollen, a Democrat from Maryland. “Adding riders against Planned Parenthood and gutting the environmental laws indicate that the Tea Party is focused on imposing a right-wing ideological agenda on the country and using the budget as a vehicle.”

Whether it’s upholding the Defense of Marriage Act, trying to defund Planned Parenthood, or aiming cuts at the Environmental Protection Agency, the National Endowment for the Arts, NPR and even AARP, House Republicans are in a lather that occludes their pledges to monomaniacally work on the economy.

When Mitch Daniels, the Indiana governor and Republican presidential aspirant, dared to urge his party to “mute” social issues, he was smacked.

“We cannot repair the economy without addressing the deep cultural issues that are tearing apart the family and society,” said Andy Blom of the American Principles Project. The presidential hopeful Rick Santorum even posited last week that abortions might be breaking the bank on Social Security.

The snowball of social rage will speed up as we head toward 2012, given that the Iowa caucuses are dominated by social conservatives. Pawlenty, Barbour and Huckabee have already talked about vitiating the repeal of “don’t ask, don’t tell.”

Because independent voters considered President Obama too partisan in his debut, they shifted their loyalties — and swept in one of the most ideological and partisan Republican caucuses in history. Now Obama will get back some of the independents because he seems reasonable by comparison.

One thing independents like to be independent of is government meddling in their personal lives. 

By: Maureen Dowd, Op-Ed Columnist, The New York Times, April 2, 2011 

April 2, 2011 Posted by | Congress, Conservatives, Democracy, GOP, Independents, Politics, Privacy, Republicans, Right Wing, Swing Voters, Tea Party, Voters | , , , , , , , , , , , , , , | 1 Comment

Remember The Uninsured?

In February 2007, Deamonte Driver died of an infected tooth. But he didn’t really die of an infected tooth. He died because he didn’t have consistent insurance. If he’d had an Aetna card, a dentist would’ve removed the tooth earlier, and the bacteria that filled the abscess would never have spread to his brain.

Deamonte Driver was 12. His insurance status wasn’t his fault.

If all you knew about the Affordable Care Act was what you gleaned from watching the Republicans make their case against it, you probably would not know that the legislation means health-care coverage for more than 30 million Americans. Or, if you did know that, you’d be forgiven for not realizing it’s relevant: It almost never gets mentioned (see this congressman’s rundown of the bill’s contents, for instance), and the repeal legislation the Republicans are pushing does nothing to replace the coverage the Affordable Care Act would give to those people.

The lack of concern for how more than 30 million Americans will get their health-care coverage makes for an ugly contrast with the intense concern that Rep. Andy Harris — a proponent of repeal — found when he heard that his congressional health-care coverage wouldn’t begin until a month after he took the oath of office. “He stood up and asked the two ladies who were answering questions why it had to take so long, what he would do without 28 days of health care,” recalled one of the session’s attendees. He knows his taxpayer-subsidized insurance is important. But what about Driver’s?

We have a tendency to let the conversation over health-care reform become a bloodless, abstract discussion over cost curves and CBO models. We do that for two reasons: First, cost is important. Second, it’s important to the people who have political power, which is, by and large, not the same group who doesn’t have health-care insurance. Someone involved in the 2008 campaign once told me he’d seen numbers showing that 95 percent of Obama’s voters were insured. The numbers for McCain were, presumably, similarly high, or even higher. These are the people the political system is responsive too.

But that doesn’t make the plight of the uninsured any less wrenching. The Urban Institute estimated that 22,000 people died in 2006 because they didn’t have health-care insurance. John Ayanian, a professor of medicine and health-care policy at Harvard Medical School, testified before Congress on this issue. “Uninsured adults are 25 percent more likely to die prematurely than insured adults overall,” he said, “and with serious conditions such as heart disease, diabetes or cancer, their risk of premature death can be 40 to 50 percent higher.” And none of that takes into account the unnecessary suffering and physical damage that flourishes in the absence of effective medical care. Nor does it speak to the economic devastation that illness unleashes on uninsured families.

These numbers shouldn’t surprise us: We pay a lot of money for health-care insurance. We’ve directed the government to spend even more money subsidizing that insurance for the elderly, the disabled, some of the poor and everyone who gets health-care coverage through their employer. We value this product so highly for a reason: Most of us would agree that being able to afford to see a doctor isn’t a luxury. It’s a necessity. Rep. Harris certainly feels that way.

The same goes for the uninsured. In fact, it’s often more true for them, as many haven’t received reliable care for some time and have multiple health problems that haven’t been effectively treated. That’s why, when a temporary free clinic set up shop in Los Angeles, 3,000 people lined up for treatment. It’s why the famed RAND health insurance experiment found the people who benefited from insurance most clearly were the poor, as they were often plagued by easy-to-treat conditions like hypertension.

The Affordable Care Act covers the vast majority of the uninsured. It covers everyone who makes less than the poverty line, and almost everyone who makes less than 300 percent of the poverty line. It does all this while spending about 4 percent of what our health-care system currently spends in a year, and it offsets that spending — and more — to make sure the deficit doesn’t bear the burden of society’s compassion. Perhaps there’s a better way to achieve those goals that can pass Congress. If so, I’m open to hearing about it. But to repeal the bill without another solution for the Deamonte Drivers of the world? And to do it while barely mentioning them? We’re a better country than that. Or so I like to think.

By: Ezra Klein, The Washington Post, January 19, 2011

January 27, 2011 Posted by | Affordable Care Act, Uninsured | , , , , , , , , , , , | Leave a comment

   

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