“An Obvious Problem”: Chris Christie Needs Republicans To Have A Terrible 2014
I wouldn’t say that New Jersey Governor Chris Christie is the presumptive frontrunner for the Republican presidential nomination in 2016—though, like Ross Douthat, I’m not sure who could beat him—but it is true that he is the official candidate of the GOP establishment. And, with a reelection coalition of Republicans, Democrats, young people, Latinos, and African Americans, Christie stands as the only potential presidential nominee that can claim a credible path to victory.
It doesn’t come as a surprise, then, to learn that his rivals are already throwing shade in his direction. NBC News has a good round-up of the Republican presidential contenders who have opened fire on the New Jersey governor:
Even after the disaster of the shutdown and Ken Cuccinelli’s loss in the Virginia gubernatorial race, the operating assumption of right-wing Republicans is that success will come when conservatives take a doctrinaire approach to their ideology. The available evidence makes clear that this isn’t true—Ted Cruz, for instance, won his election, but he underperformed Romney—but this doesn’t matter to either the GOP base or lawmakers like Cruz.
This poses an obvious problem for Christie. Insofar that his message of electability has any chance of resonating with Republican primary voters, it will be because they have given up the quest for purity, and are desperate to win, which means that, for Christie, the best thing that could happen is for Republicans to have a terrible 2014. If the GOP continues down its path of extremism, and loses its shot at capturing the Senate as a result, Christie has perfect ground for making his pitch.
Unfortunately for him, the more likely outcome is that Republicans do pretty well. The combination of a sluggish economy and voter discontent will hurt incumbents, which threatens the Democratic majority in the Senate and precludes the party from making real gains in the House. And a GOP base that does well—or even okay—in next year’s midterms is one that doesn’t have much interest in Christie’s message.
By: Jamelle Bouie, The Daily Beast, November 7, 2014
“This Is Why We Need Obamacare”: Life And Death Is When You Need Care And Can’t Afford To Get It
The biggest health care crisis in America right now is not the inexcusably messy rollout of Obamacare.
No, far more serious is the kind of catastrophe facing people like Richard Streeter, 47, a truck driver and recreational vehicle repairman in Eugene, Ore. His problem isn’t Obamacare, but a tumor in his colon that may kill him because Obamacare didn’t come quite soon enough.
Streeter had health insurance for decades, but beginning in 2008 his employer no longer offered it as an option. He says he tried to buy individual health insurance but, as a lifelong smoker in his late 40s, couldn’t find anything affordable — so he took a terrible chance and did without.
At the beginning of this year, Streeter began to notice blood in his bowel movements and discomfort in his rectum. Because he didn’t have health insurance, he put off going to the doctor and reassured himself it was just irritation from sitting too many hours.
“I thought it was driving a truck and being on your keister all day,” he told me. Finally, the pain became excruciating, and he went to a cut-rate clinic where a doctor, without examining him, suggested it might be hemorrhoids.
By September, Streeter couldn’t stand the pain any longer. He went to another doctor, who suggested a colonoscopy. The cheapest provider he could find was Dr. J. Scott Gibson, a softhearted gastroenterologist who told him that if he didn’t have insurance he would do it for $300 down and $300 more whenever he had the money.
Streeter made the 100-mile drive to Dr. Gibson’s office in McMinnville, Ore. — and received devastating news. Dr. Gibson had found advanced colon cancer.
“It was heartbreaking to see the pain on his face,” Dr. Gibson told me. “It got me very angry with people who insist that Obamacare is a train wreck, when the real train wreck is what people are experiencing every day because they can’t afford care.”
Dr. Gibson says that Streeter is the second patient he has had this year who put off getting medical attention because of lack of health insurance and now has advanced colon cancer.
So, to those Republicans protesting Obamacare: You’re right that there are appalling problems with the website, but they will be fixed. Likewise, you’re right that President Obama misled voters when he said that everyone could keep their insurance plan because that’s now manifestly not true (although they will be able to get new and better plans, sometimes for less money).
But how about showing empathy also for a far larger and more desperate group: The nearly 50 million Americans without insurance who play health care Russian roulette as a result. FamiliesUSA, a health care advocacy group that supports Obamacare, estimated last year that an American dies every 20 minutes for lack of insurance.
It has been a year since my college roommate, Scott Androes, died of prostate cancer, in part because he didn’t have insurance and thus didn’t see a doctor promptly. Scott fully acknowledged that he had made a terrible mistake in economizing on insurance, but, in a civilized country, is this a mistake that people should die from?
“Website problems are a nuisance,” Dr. Gibson said. “Life and death is when you need care and can’t afford to get it.”
The Institute of Medicine and the National Research Council this year ranked the United States health care system last or near last in several categories among 17 countries studied. The Commonwealth Fund put the United States dead last of seven industrialized countries in health care performance. And Bloomberg journalists ranked the United States health care system No. 46 in efficiency worldwide, behind Romania and Iran.
The reason is simple: While some Americans get superb care, tens of millions without insurance get marginal care. That’s one reason life expectancy is relatively low in America, and child mortality is twice as high as in some European countries. Now that’s a scandal.
Yet about half the states are refusing to expand Medicaid to cover more uninsured people — because they don’t trust Obamacare and want it to fail. The result will be more catastrophes like Streeter’s.
“I am tired of being the messenger of death,” said Dr. Gibson. “Sometimes it’s unavoidable. But when people come in who might have been saved if they could have afforded care early on, then to have to tell them that they have a potentially fatal illness — I’m very tired of that.”
Streeter met with a radiologist on Thursday and is bracing for an arduous and impoverishing battle with the cancer. There’s just one bright spot: He signed up for health care insurance under Obamacare, to take effect on Jan. 1.
For him, the tragedy isn’t that the Obamacare rollout has been full of glitches, but that it may have come too late to save his life.
By: Nicholas D. Kristof, Op-Ed Contributor, The New York Times, November 2, 2013
“Portrait Of A Man Republicans Can’t Trust”: Four Basic Problems Stand Between Chris Christie And The 2016 Nomination
The emergence of Chris Christie as one of America’s most popular national figures comes as a godsend to the Republican Party. Having angrily turned down every opportunity to compromise with an electorate that spurned them a year ago, they now see the enticing chance, in the form of Christie’s all-but-declared presidential candidacy, to right their course without veering left. “The road to Republican political redemption may well run through Trenton, N.J,” says Politico’s Ben White. Savvy operative Ralph Reed, whose ties run from the Grover Norquists of the party to its Christian wing, gave the governor his blessing, seemingly paving the way for Christie to clear the party’s ever-more-stringent ideological purity tests. Christie used his acceptance speech to establish the themes for this run, repeatedly highlighting his support from Democratic constituencies and his record of cutting taxes and spending.
There is only one flaw with the plan: Shepherding Christie through a competitive Republican primary will be vastly more difficult than anybody seems to be figuring at the moment. Four basic, interrelated problems stand between Christie and the 2016 nomination:
1. His ideological deviations are not fake. They’re real. Christie has openly endorsed gun control, called for a path to citizenship for illegal immigrants, and conceded the legitimacy of climate science (“But when you have over 90 percent of the world’s scientists who have studied this stating that climate change is occurring and that humans play a contributing role it’s time to defer to the experts.”)
The largest, and least appreciated, of Christie’s betrayals of party doctrine is his decision to participate in the expansion of Medicaid under Obamacare. Some other Republican governors have made the same decision, but they have all faced unrelenting and bitter opposition from legislators of their party and conservative activists. Unyielding hatred to every aspect of Obamacare, regardless of its practical impact, has become the main doctrinal tenet of conservative thought. That alone could potentially disqualify him.
2. Christie’s popularity is somewhat fluky. Christie has some real political talent. But he has benefitted from his juxtaposition against a corrupt, divided, ineffectual state Democratic Party that consistently allowed him to claim the good government high ground. Even so, Christie’s approval ratings hovered in the low-to-mid-fifties, until he achieved beatification through Hurricane Sandy.
Christie benefitted in two ways from Sandy. One was through the kind of active, sleeves-rolled-up response to disaster that can lend politicians stratospheric approval (like the sort Rudy Giuliani won after 9/11, and sought, unsuccessfully, to leverage into higher office.) Second, and more significantly, Christie defined himself as above partisanship by metaphorically and literally embracing President Obama.
In a bitterly partisan era, Christie’s cooperation and apparently warm personal relations with Obama made him a uniquely appealing figure. In particular, it is the key to his lofty standing in the African-American community: In pointed contrast to the ceaseless rage and contempt displayed by his party, Christie treated the nation’s first black president with open respect and affinity.
Of course, having safely won reelection, Christie can undertake a campaign of vilification against Obama. He’ll have to – the taint of collaboration with the hated Obama, if not scrubbed away, would prove as fatal as Joe Lieberman’s kiss proved to his plane crash of a presidential campaign in 2004.
But in so doing, he’ll undercut the bipartisan appeal that is the source of his national standing, eroding the incentive for party elites to rally around him as the sole electable nominee. It’s not an impossible line to walk, but it will require a very deft touch.
3. Christie lacks a deft touch. The Christie method for retaining the goodwill of his party has been, whatever he loses through policy squishiness, he wins back in personal abuse. In the past I have heavily discounted the possibility that this kind of style can translate beyond New Jersey. It is possible that I am underselling Christie’s personal appeal in states that have not spawned The Sopranos and Jersey Shore. Maybe America is truly ready for a loud, angry man in the White House.
But are Republican voters? They may like the spectacle of Christie heaping verbal punishment upon random Democrats who challenge him. It’s another thing altogether if he gives this treatment to Rand Paul, Ted Cruz, Paul Ryan, Scott Walker, or other fellow partisans. If Christie tries to bully fellow Republicans in good standing, it would seem more likely to confirm the accusation that Christie, not them, is the cultural and ideological alien. And if he can’t use bluster, what tools are available to him? It’s not like Christie can cut legislative deals with his primary opponents the way he did in New Jersey.
It is easy to forget how culturally foreign the northeast is to a Southern-dominated party, and how Christie’s belligerent tone may confirm the worst suspicions about him. Conservative columnist Phillip Klein once reported the frequent murmurings of disapproval he found among primary voters when he was covering Giuliani’s race: “one thing I kept running into among voters in early states when covering the campaign was that his background as a New Yorker was a real turnoff and made voters view him as rude and somehow shady.”
4. Christie may actually be shady. Mitt Romney wanted to make Christie his vice-presidential nominee, but took a close look at what the vetters came up with and, my colleague John Heilemann and Mark Halperin report in their new book, promptly changed his mind. Romney’s prudish disdain for Christie’s weight commanded gossipy attention, but the sheer breadth of the potential issues surrounding Christie suggests serious trouble:
The vetters were stunned by the garish controversies lurking in the shadows of his record. There was a 2010 Department of Justice inspector general’s investigation of Christie’s spending patterns in his job prior to the governorship, which criticized him for being “the U.S. attorney who most often exceeded the government [travel expense] rate without adequate justification” and for offering “insufficient, inaccurate, or no justification” for stays at swank hotels like the Four Seasons. There was the fact that Christie worked as a lobbyist on behalf of the Securities Industry Association at a time when Bernie Madoff was a senior SIA official—and sought an exemption from New Jersey’s Consumer Fraud Act. There was Christie’s decision to steer hefty government contracts to donors and political allies like former Attorney General John Ashcroft, which sparked a congressional hearing. There was a defamation lawsuit brought against Christie arising out of his successful 1994 run to oust an incumbent in a local Garden State race. Then there was Todd Christie, the Governor’s brother, who in 2008 agreed to a settlement of civil charges by the Securities and Exchange Commission in which he acknowledged making “hundreds of trades in which customers had been systematically overcharged.”
That’s … a lot of potential scandals. On top of all that, the report about Christie’s expenses “raised questions for the vetters about Christie’s relationship with a top female deputy who accompanied him on many of the trips.” That detail, published in the book but not the excerpts, seems very potentially troublesome.
All these potential problems – Obamacare, Obama, Christie’s exotic cultural background, and the swirl of scandal – all feed into each other. Collectively they form the portrait of a man Republicans fundamentally can’t trust.
Am I suggesting Republican voters would never trust Christie? No. Under the right circumstances, Christie could overcome his many hurdles. After all, Mitt Romney also possessed enormous ideological baggage, and overcame it. But Romney benefitted from enormous luck: his only opponents were staggeringly incompetent, broke, repellant to the party establishment, or all three. Romney staggered to a drawn-out victory while running virtually unopposed.
Christie seems likely to face off against real opponents with credibility and money. The case they have to make against him is strong.
By: Jonathan Chait, New York Magazine, November 6, 2013
“Once Again, The Pundits Get It Wrong”: The Virginia Election Was A Big Win For Obamacare.
As the Affordable Care Act was about to go fully into effect last month, the New York Times ran a big front-page article highlighting the fact that millions of Americans would go uncovered by the law as a result of the Supreme Court decision making it possible for states to opt out of the expansion of Medicaid. Half of the states have made this choice, creating a confounding scenario in which middle-income people can qualify for subsidies to obtain private coverage but the neediest working poor, who were supposed to be covered by Medicaid, are getting no help at all.
“How can somebody in poverty not be eligible for subsidies?” an unemployed health care worker in Virginia asked through tears. The woman, who identified herself only as Robin L. because she does not want potential employers to know she is down on her luck, thought she had run into a computer problem when she went online Tuesday and learned she would not qualify.
At 55, she has high blood pressure, and she had been waiting for the law to take effect so she could get coverage. Before she lost her job and her house and had to move in with her brother in Virginia, she lived in Maryland, a state that is expanding Medicaid. “Would I go back there?” she asked. “It might involve me living in my car. I don’t know. I might consider it.”
Last night, the prospects for Robin L. and the estimated 400,000 Virginians who would be eligible under a Medicaid expansion brightened considerably. The gubernatorial election was won by Terry McAuliffe, who made the Medicaid expansion such a central part of his campaign that for a time he was even threatening to shut down the state government unless legislators included it in their budget. The expansion, which is now being studied by an ad hoc state panel, still faces big hurdles—the General Assembly remains firmly in Republican control, and the Koch brothers are spending heavily to pressure those Republican state legislators who dare to support the expansion. Still, the odds of the expansion happening are infinitely greater with McAuliffe in the Governor’s Mansion than with the fiercely anti-Obamacare Ken Cuccinelli.
So, the election was a clear win for Obamacare, right? Nope, say the pundits. The fact that Cuccinelli finished closer than recent polling suggested, they say, is a clear sign of strong public opposition to Obamacare, which Cuccinelli made a centerpiece of his campaign in the final days.
From CNN.com:
Virginia was the first swing state to hold an election after the Affordable Care Act website’s troublesome rollout, a controversy that has permeated national news coverage for weeks. Almost 30% of Virginia voters said health care was the most important issue in the race. While Democrat Terry McAuliffe narrowly beat out conservative Republican Attorney General Ken Cuccinelli, analysts credit a GOP focus on Obamacare for boosting Cuccinelli’s vote total. “This is what kept this race close,” CNN’s John King said Wednesday on “New Day.”
And Politico proclaimed: “Obamacare almost killed McAuliffe”:
Exit polls show a majority of voters—53 percent—opposed the law. Among them, 81 percent voted for Cuccinelli and 8 percent voted for Libertarian candidate Robert Sarvis. McAuliffe won overwhelmingly among the 46 percent who support the health care overhaul.
Cuccinelli actually won independents by 9 percentage points, 47 percent to 38 percent, according to exit polls conducted for a group of media organizations. They made up about one-third of the electorate. “Obamacare helped close the gap,” said Richmond-based strategist Chris Jankowski, the president of the Republican State Leadership Committee.
I’m not sure when I last saw such a stark example of election spin and punditry floating away from the substantive reality of governing and its impact on actual people. There is no mention in these accounts of the greatly enhanced prospects for the Medicaid expansion in Virginia as a result of McAuliffe’s win. No, it’s all about the exit polls and what it might mean for Obama and the Democrats. But Obama’s not on the ballot again, ever, and the Democrats aren’t on it again for another year. Who knows what voters will think of Obamacare then—the troubles with the rollout will either have resolved by then or they will not have. All we know right now is that after a very rough patch for the law, the guy who ran strongly in support of it beat a guy who was strongly opposed to it, in the most purple state in the country. And as a result, hundreds of thousands of working poor may get health insurance coverage. How removed from the reality of these people’s lives does one have to be to chalk up such a result as a loss for Obamacare?
By: Alec MacGillis, The New Republic, November 6, 2013
“Sanctifying Defenders Of The Status Quo”: The GOP’s Obsession With Rate Shock Victims
Last week, the Obamacare war room detected a twist in the national narrative that concerned them. The media’s obsessive focus on the failed website launch was beginning to give way to stories about individuals who found higher-than-expected prices on the exchanges. A memo instructed participants to prepare for such “media inquiries”: “The media attention will follow individuals to plan selection and their ultimate choices; and, in some cases, there will be fewer options than would be desired to promote consumer choice and an ideal shopping experience,” warned the memo. “Additionally, in some cases there will be relatively high-cost plans.”
CNN’s Jake Tapper obtained the memo. Here is how he described it: “Officials expressed concern that the next shoe to drop in the evolving story about the Affordable Care Act would be disappointment from consumers once they are able to get on the troubled Healthcare.gov website — disappointment because of sticker shock and limited choice.” Notice the crucial difference in framing. The memo simply acknowledged that in some cases — a caveat that appeared twice — consumers would have fewer options and higher prices than the administration would like. In CNN’s characterization, the caveat disappears altogether. Tapper portrays the problem as “disappointment from consumers,” writ large. The minority facing sticker shock has become a stand-in for the entire public.
This turns out to be a synecdoche for the entire Obamacare narrative now. The world of the Republican Party’s fever dreams has sprung to life in the mainstream media, where the Affordable Care Act now exists primarily as a series of cruel, oppressive acts of theft against innocent Americans. Here are CBS News, The Wall Street Journal, and the Washington Post chronicling the parade of horribles.
The stories often turn out to be either more complicated than initially depicted, or wildly overblown. But it is surely true that some people will find themselves worse off, at least immediately, under the new law. That their fate has blotted out everything else about the law explains why health-care reform is so maddeningly difficult to enact in the first place.
Everybody knows about the two main ways in which the American health-care system is awful: It’s the most expensive in the world, by far, and also the only advanced health-care system that denies basic care to many citizens. There’s also a third awful trait as well: The system is resistant to change. The very insecurity of American health care, the ever-present fear of finding one’s insurance lifeline snapped and plunging into the howling void of the 50 million uninsured, renders those with insurance understandably terrified of change.
The Affordable Care Act worked around the inherent change aversion of the system by leaving the vast majority of it in place. Insuring tens of millions of Americans costs money, and that money has to come from somewhere, but the law’s author’s carefully apportioned the burden in a relatively painless way. Some of the money comes from higher taxes on the rich — a source of anger and resentment on the right, though conservatives have shrewdly recognized that complaining about higher taxes on wealthy investors to pay for covering the uninsured is not a winning message. Some of it comes from reshuffling Medicare spending, so that the government essentially shifts funds from reimbursing hospitals for treating uninsured patients in emergency rooms to basic medical care, a clear positive-sum transfer.
And, yes, some of the cost is borne by the minority of healthy individuals paying higher premiums. (These individuals will, of course, go from Obamacare victims to Obamacare beneficiaries the moment anybody in their household develops a serious medical condition, in the same manner that fire insurance is a bad deal for people whose houses don’t burn.)
Why has their plight attained such singular prominence? Several factors have come together. The news media has a natural attraction to bad news over good. “Millions Set to Gain Low-Cost Insurance” is a less attractive story than “Florida Woman Facing Higher Costs.” Obama overstated the case when he repeatedly assured Americans that nobody would lose their current health-care plan. There’s also an economic bias at work. Victims of rate shock are middle-class, and their travails, in general, tend to attract far more lavish coverage than the problems of the poor. (Did you know that on November 1, millions of Americans suffered painful cuts to nutritional assistance? Not a single Sunday-morning talk-show mentioned it.)
The point here is not that Obamacare represents a perfectly optimal restructuring of the health-care system. Almost nobody would regard it as such. The point is that it represents the least-disruptive, least-painful way to clear the minimal threshold of any humane reform. The preferred alternatives of both right and left would impose an order of magnitude of more dislocation — creating not a few million “victims,” but tens of millions. What’s on display at the moment is a way of looking at the world that sanctifies defenders of the horrendous status quo and places all the burden upon those trying to change it.
By: Jonathan Chait, New York Magazine, November 5, 2013
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