“The GOP Grand Swindle”: “We’re Not Going To Do Anything To Address Health Care”
It’s been nearly three months since House Majority Leader Eric Cantor (R-Va.) declared, “This year, we will rally around an alternative to ObamaCare and pass it on the floor of the House.” Last week House Majority Whip Kevin McCarthy (R-Calif.) said the plan is being delayed “at least a month.” A month from when? He didn’t say.
ThinkProgress reports that Rep. Dennis Ross (R-Fla.) is telling his constituents that his party doesn’t intend “to do anything” on this issue for the rest of the year.
CONSTITUENT: You’ve voted to repeal it approximately 50 times. Had zero votes on a replacement. So my question is, why do you think it is so good to deny seniors on Part D to make them pay more, about $4,000 more for medicine, and people with pre-existing conditions get denied insurance, have 26-year-olds have a harder time getting insurance because they can’t get on their parents’? Why do you think those are good ideas?
ROSS: I don’t. And let me tell you, I think one of the most unfortunate things my party did the last three years was not offer an alternative to health care. I’ve always felt that way. I think it’s absurd when I tell people that this isn’t what you should do, but I don’t have an alternative for you…. I wish we had an alternative. For the next six months, we’re going to go into an election knowing that we’re not going to do anything to address health care. Because we’ve gone so far in the last few years saying “no” that we don’t have an alternative to say “yes” to.
It’s not too common to hear House Republicans referring to their own party’s posture on health care as “absurd,” which make Ross’ comments fairly striking on their own.
There’s also the news that Ross is apparently under the impression that his party won’t bother with an ACA alternative at all in 2014, despite literally years of Republican promises to the contrary.
But perhaps most interesting of all was the two-word answer in response to the question from Ross’ constituent: “I don’t.”
The question made a lot of sense: here’s a Republican congressman who voted several dozen times to repeal – either in whole or in part – the Affordable Care Act, including all kinds of popular provisions, benefits, and consumer protections. Why is Ross against them?
He’s not, he says.
It’s part of an increasingly common pitch from congressional Republicans: they share the goals of “Obamacare,” they say, but disagree with how the reform law achieves those goals.
Rhetorically, that’s not a bad idea. Substantively, as Brian Beutler explained, it’s nonsense.
Republicans have replaced an unabashed “full repeal!” mantra with a deluge of weasel words meant to conceal the fact that “repeal” is still the beginning and end of their health-care reform agenda. It’s still the goal – they’re just a little ashamed of it now. And that places an onus on Dems (and reporters and anyone else who believes politicians should own the consequences of their policies) to be extremely explicit about the benefits Obamacare is conferring, and what an unvarnished rendering of GOP health policy would really look like.
This is clearly true of Ross, who went on to tell his constituents how much he likes all kinds of ACA provisions, making it sound as if he were somehow sympathetic to the law he voted to repeal several dozen times.
But real health care policy doesn’t work this way. A policymaker can’t (1) vote to gut the federal health care system; (2) endorse the goals of the federal health care system; (3) talk up the need for a credible alternative; (4) and offer no credible alternative, all at the same time.
It is, as Beutler added, “a grand swindle.”
By: Steve Benen, The Maddow Blog, April 17, 2014
“The Right’s Ugly Food-Stamp Obsession Is Back!”: Why Lying Dog-Whistle Politics Returned
“Welcome to Obama’s America,” Fox’s Eric Bolling told his audience Tuesday – a dystopia where people now use food stamps to patronize “strip clubs, liquor stores, pot dispensaries.” Following up on its rubbishy August 2013 faux-exposé “The Great Food Stamp Binge,” Fox again profiled “surfing freeloader” Jason Greenslate, who is allegedly “livin’ large” in San Diego, thanks to the SNAP program, commonly known as food stamps. After Bill O’Reilly’s errand boy Jesse Watters caught up with Greenslate again Monday night, “The Five” used the lazy surfer as “the representative of literally millions of Americans,” in Bolling’s words. It was epic.
“He’s playing the system, he’s stretching the rules to their limits,” Bolling told Fox’s angry, fearful, mostly elderly viewers. “But what would you expect with a $105 billion program that’s almost tripled under Obamanomics? That’s what you would expect, right there, take a look at it. But what’s next? Strip clubs, liquor stores, pot dispensaries? Oh, that’s already going on, folks. Welcome to Obama’s America.”
Bolling’s rant came a day after Dick Cheney visited Fox and attacked Defense Secretary Chuck Hagel’s military cuts, telling Sean Hannity, bizarrely, that Obama “would much rather spend the money on food stamps than he would on a strong military or support for our troops.”
The right just can’t leave that old dog-whistle alone. It’s 2012 all over again – Newt Gingrich will be reviving his claim that Obama’s “the food stamp president” any minute now. In “Obama’s America,” the right is determined to make the president the tribune of a moocher-rewarding, ever-expanding welfare state, even if they have to lie to do so.
Of course in Obama’s America (and everyone else’s) SNAP regulations prohibit buying alcohol or tobacco with food stamps, let alone drugs, and they can’t be used at restaurants or bars, let alone strip clubs. But Bolling wants Fox viewers in a perpetual state of moral panic, and the notion that slackers like Greenslate are “livin’ large” – Fox’s term — on the public dime just works, the facts be damned.
Cheney’s rant was in some ways more offensive. Charging that the cuts proposed by Defense Secretary Chuck Hagel are “really devastating,” Cheney went on: “It does enormous long-term damage to our military. They act as though it is like highway spending and you can turn it on and off. The fact of the matter is he is having a huge impact on the ability of future presidents to deal with future crises that are bound to arise.”
Of course, as Think Progress noted back when Cheney began lobbying against defense cuts in 2012, the former vice president himself presided over a 25 percent cut to the defense budget back when he was defense secretary under George H.W. Bush. The fighting force was reduced by 500,000 active-duty soldiers, a move that was blessed by Joint Chiefs of Staff chair Colin Powell.
That was then. These cuts are the work of Obama’s team. So not only must they be attacked as dangerous, they’ve got to be framed as something the corrupt Chicago “gangster” is doing to reward his coalition of slackers, moochers and lazy white surfers.
Now, maybe it’s progress that Fox is making a white surfer the poster boy for food stamp abuse – but it’s the link to “Obama’s America” that updates Reagan’s old imagery about Cadillac-driving welfare queens and “young bucks” using food stamps to buy “T-bone steaks.”
In fact only 1 percent of SNAP funds are wasted in fraud. Three-quarters of SNAP households include an elderly or disabled person or a child, and fully 42 percent of adult recipients are also working, but making too little to feed themselves and their families. Among the nation’s food stamp recipients are almost a million military veterans, who were slurred by Cheney, and thousands of active duty military too. Military families spent $100 million in food stamp funds at military grocery stores in 2013.
Fox and Cheney don’t want you to think about the veteran or the soldier or the single mother or the disabled senior on food stamps. They don’t want Fox viewers to ask why 42 percent of recipients make such low wages that they qualify for food assistance, or why so many veterans and even active-duty soldiers need help. To distract from an economy that’s increasingly hoarding rewards at the top, they point to a cartoonish moocher and blame Obama.
By: Joan Walsh, Editor at Large, Salon, February 26, 2014
“The Insurance Company Bailout That Republicans Love”: The GOP Has Found A Way To Be Even More Hypocritical Than Before
Remember when Republicans found insurance company bailouts outrageous? Good, because the Republicans don’t.
On Friday, the Obama Administration announced proposed payment rates for Medicare Advantage plans, the private insurance option within Medicare. The federal government pays insurers a fixed fee for each senior they enroll. The program’s goal is to provide seniors with more options and, ideally, foster competition that will lead to better management of care both within the traditional program and for those who get private insruance instead. But, for a long time, experts have said the federal government is actually paying the insurers too much—in other words, more than it costs to provide the same coverage through traditional Medicare.
In the late 1990s, when the program was known as “Medicare+Choice,” the Clinton Administration attempted to rectify this by reducing insurer fees. But experts subsequently found the government was still paying the plans too much, so the Obama Administration and its allies included additional Medicare Advantage cuts in the Affordable Care Act—leaving discretion over the exact rates to the Department of Health and Human Services and its actuaries. On Friday, HHS revealed its calculations for next year’s rates, based in part on projections for how health care spending for the country as a whole is changing.
The payment formula is complicated and even now, with a weekend to digest the announcement, analysts aren’t entirely sure how insurers would react and what that would mean for seniors in the plans. (As Phil Galewitz of Kaiser Health News reports, many independent experts seem to think the effects would be pretty minimal.) But insurers, who say better benefits account for whatever extra funds they get, have warned that cuts of virtually any magnitude will force insurers to offer less generous benefits, charge higher premiums, or withdraw from the program altogether—as some of them did in the late 1990s, following those cuts the Clinton Administration implemented. The insurers are lobbying the administration to use its discretion to reduce the cuts or, ideally, eliminate them altogether. If you live in Washington and have seen those ubiquitous “Seniors are Watching” advertisements on billboards and buses, you have some idea of how strongly the insurers feel about this.
But insurers aren’t the only ones making a fuss. Republicans are too—and they have been for a while. As you may recall, Republicans pounced on the new Medicare Advantage cuts as proof that Obamacare was bad for seniors—in the 2010 midterms and then, again, in the 2012 presidential election. It was pure political gold, since seniors (particularly white seniors) were among those most skeptical of Obama and his health care law in the first place. Of course, House Republicans voted for the very same cuts when Paul Ryan’s budgets had them. But that didn’t stop Republicans from attacking the cuts then—and it’s not stopping them now. “ObamaCare has already caused millions to lose the healthcare plans they liked, and now it is directly harming seniors who rely on the care they have through Medicare Advantage,” Eric Cantor, the House Majority Leader, said on Friday. “Our nation’s grandparents should not have to wake up tomorrow worried they no longer can access the care they want because of Obamacare.”
With this latest salvo, however, Republicans have actually found a way to be more hypocritical than before. For the last few weeks, Republicans and their allies have been in high dudgeon about Obamacare’s so-called risk corridor program, in which the federal government will subsidize insurers that take heavy losses for the next three years. Republicans and their allies have decried risk corridors as a “taxpayer bailout” of the insurers. But the policy justification for risk corridors is straightforward and, even to some conservatives, incontrovertible: They will ease the transition to a newly regulated insurance market, so that it’s possible to provide universal coverage through a system of private plans. And unlike the additional Medicare Advantage payments, the risk corridor program might actually end up being a net boon to the taxpayers, since the government also shares in unexpected insurer gains. (The Congressional Budget Office has actually predicted as much, though, as with many such projections, there’s a lot of uncertainty there.)
Maybe Republicans think that’s insufficient reason to pay the Obamacare insurers money—fine. But then how can they simultaneously insist government keep paying higher fees to Medicare insurers, given the case for them is a lot more dubious?
Congressional Democrats haven’t exactly covered themselves in glory over this issue. New York Senator Charles Schumer was among the Democrats who signed a bipartisan letter to HHS, urging the administration not to harm beneficiaries with payment reductions, though the senators stopped short of calling for outright reversal of the cuts. But the current Republican position makes no sense whatsoever, unless the GOP’s real priorities are (a) opposing anything the Obama Administration supports (b) sucking money away from the traditional, government-run Medicare program (c) stopping programs and spending that benefits the non-elderly uninsured. Readers can decide for themselves which of those explanations make the most sense—or whether, perhaps, it’s all of the above.
By: Jonathan Cohn, The New Republic, Fenbruary 24, 2014
“Didn’t See That One Coming”: How Paul Ryan Helped Save Medicare And Social Security By Trying To Gut Them
President Obama’s new budget will not include a proposal to implement “chained CPI” to slow the growth of Social Security benefits, according to White House officials.
And there’s one man who deserves most of the credit for making sure there will be no cuts to benefits to seniors until at least 2017 — ironically the politician who has worked the hardest to reduce the promises made to America’s retirees — Rep. Paul Ryan (R-WI).
The president had included the reform measure in his 2013 budget as an attempt to provoke a so-called Grand Bargain with House Republican leaders. Such a deal would have required them to end some tax breaks for the rich. That was never going to happen and the White House’s acceptance of this fact helps focus the 2014 elections on votes most Republicans in Congress have taken in the past to cut both Social Security and Medicare, thanks to Paul Ryan.
The chairman of the House Budget Committee’s first budget plan in 2011 not only privatized Social Security — a proposal that President George W. Bush could not even get a vote on when the GOP controlled both houses of Congress — it remade Medicare into a voucher program that radically shifted the financial burden to seniors without doing much to reduce the overall cost of health care. The plan was so popular — at least with Republican donors — that it instantly made Ryan a national hero and possible presidential candidate.
The chances of enacting the plan with President Obama in office were zero, but Ryan, buoyed by his new stardom, helped guide House Speaker John Boehner (R-OH) into a debt-limit crisis that shook global markets still dizzy from the financial crisis. House Republicans demanded a dollar in cuts for every dollar the debt ceiling was raised and President Obama obliged with a plan that not only included chained CPI, but also raised the Medicare eligibility age. To sell this plan to Democrats, the president demanded a small percentage of new revenues by ending tax breaks on upper-income Americans.
Boehner was about to make the deal, when Ryan “dropped a bomb” on it, fearing it would guarantee Obama’s re-election. Instead both sides settled on the sequester.
Ryan released another budget in 2012 that dropped Social Security privatization and added a public option to his Medicare plan. Desperate for Tea Party credibility, Mitt Romney selected Ryan to be his running mate after being forced to embrace the congressman’s budget during the primary. Together, the two men re-elected the president.
After Obama’s re-election, Speaker Boehner reportedly tried to take the offer Ryan had rejected in 2011. The president told him it was off the table, and likely will be for the rest of his term unless Republicans consider higher taxes on the rich, which they won’t.
In the past two years, the deficit has been cut in half and is projected to be even lower within 10 years as a share of GDP than if the Simpson-Bowles debt plan or Paul Ryan’s first budget had become law. If the reforms to Medicare implemented in the Affordable Care Act continue to slow the growth of costs as they have since 2010, our long-term debt crisis may be solved, despite Paul Ryan’s best efforts.
By: Jason Sattler, The National Memo, February 20, 2014
“Republican Alternative To Obamacare”: Pay More, Get Less, Put The Insurance Companies Back In Charge
Boy, can Democrats have fun with the new Republican alternative to Obamacare. It puts the health insurance companies back in charge and raises costs for almost all Americans. In particular, it substantially raises costs and threatens to cut coverage for the half of all Americans who get health insurance at work. Seniors, the group that Republicans have scared witless about Obamacare, would lose the real benefits they receive under Obamacare. The proposal from three Republican senators is a golden opportunity for Democrats to contrast the specific benefits of the Affordable Care Act (ACA) with what a repeal-and-replace agenda would really mean for Americans’ lives and health.
When it comes to the politics of health care reform, my first adage is “the solution is the problem.” That is because once you get past vague generalities, like lowering costs and making coverage available, to proposing specifics, people will look to see how the proposals impact them personally. This is why health reform is such a political nightmare. Unlike most public policy issues, the impact is very understandable and real.
With the ACA as the law of the land, in analyzing the Republican proposal we must compare its impact to the law it would repeal. The pre-ACA model of health insurance is irrelevant. Here is how the Republican plan would impact people, compared with the ACA:
People who get health insurance at work – bottom line: pay more for worse coverage.
Almost half of all Americans (48 percent), or 148 million people, obtain health insurance at work. The Republican plan would tax 35 percent of the average cost of health insurance benefits at work. This is a big tax increase on working people and is extraordinarily unpopular, as the Obama campaign used to devastating impact on John McCain. And while people would pay more, they would get less coverage, as the GOP plan would allow insurance companies to once again limit the amount of benefits they will pay out in one year and return to the day when employers could offer bare-bones plans.
While taxing health benefits would apply to all employer-provided coverage, the Republicans would give the 30 percent of people who work for businesses who employ fewer than 100 workers a tax credit. That might balance out the increased taxes for some people. However, doing so would create a huge set of economic distortions, as employers might seek to keep firm size under the 100-employee threshold.
Individuals who buy coverage on their own or who are uninsured – bottom line: insurance companies could again deny coverage for pre-existing conditions and offer bare-bones coverage, while the cost of decent coverage would go up for most people.
This is the group that the ACA is most aimed at helping, including the 5 percent of Americans who buy private health insurance and the 15 percent who are uninsured, totaling 64 million people. The ACA offers income-based subsidies to these people when they earn between 100 percent and 400 percent of the federal poverty level (FPL) and enrolls people under 133 percent of FPL in Medicaid, when states agree.
The Republican plan is toughest, in comparison with the ACA, on the lowest-income people and on the higher-income middle class, compared with Obamacare. But many families in between will do worse too.
The Republican plan would wipe out the expansion of Medicaid to people earning less than 133 percent of FPL, a provision the Supreme Court has made optional. It would cut back on Medicaid, ending the federal government’s offer to pay 90 percent of the cost of expanded coverage and replacing that with the federal government paying what it has paid historically, which is between half and three-quarters of the cost of Medicaid, with poorer states getting a bigger share. Crucially, the funding would only be for pregnant women, children and parents with dependent children who earn under the poverty level, as opposed to the ACA’s funding of all adults up to 133 percent of FPL. That means many fewer people covered and states getting less Medicaid money. Republican governors may not complain, but you can bet hospitals will. Adults without dependent children would not be covered by federal Medicaid, which means millions will stay uninsured or lose coverage they now have, unless states pay for coverage without federal support.
For individuals not covered by Medicaid or employees of firms with fewer than 100 workers, the Republican plan would replace the ACA’s sliding-scale subsidies, which now go to 400 percent of FPL, with a subsidy that is the same for everyone of the same age who is under 200 percent of FPL and lowersubsidies for people from 200 percent to 300 percent. In addition, the subsidies would be higher for older people than younger. The Republican plan also would take away the requirements that insurance plans offer decent benefits and free preventive care and charge women the same prices as men for coverage, along with every other consumer protection, with the exception of keeping in place no lifetime caps for covered benefits.
Comparing the value of the Republican plan subsidies vs. the ACA subsidies for the people who would still qualify depends on income, age, and family size. Generally, it appears that the Republican subsidies are much less than the ACA for people under 150 percent of the FPL ($35,000 for a family of four) and much less than the ACA for younger people, but more for older people. However, insurance rates for younger people would go down some at the expense of older people, who insurance companies could charge a lot more than under ACA. And families with incomes above $70,000 for a family of four would lose subsidies entirely.
Seniors and the disabled on Medicare – bottom line: seniors would pay more for prescription drugs and preventive care.
By repealing the ACA, the Republican plan would take away its two concrete benefits for seniors. One is that preventive care services are now free under Medicare (as they are under all insurance). The other is that the ACA is lowering drug prices for seniors by slowly closing the “donut hole,” under which seniors must pay the full cost of prescription drugs even though they are paying premiums for drug coverage. In other words, the Republican plan is simply bad news for seniors, the constituency that they have scared the most about Obamacare… groundlessly.
It is not surprising that Republicans have been reluctant to come up with a replacement for Obamacare. It’s much easier to throw darts – or bombs – at the ACA than to come up with a replacement that meets Republican ideological tenets of less regulation and less government. Any plan that meets the ideological test will be much worse for people in ways they can understand. It is our job to explain it to the public clearly: pay more, get less, put the insurance companies back in charge. This debate is not simply the political game Republicans want to make it. It is about our health and our lives.
By: Richard Kirsch, The National Memo, January 29, 2014
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