“Ending Medicare As We Know It”: Here’s Why There Won’t Be A Republican Alternative To Obamacare
Republicans are sick of people saying they don’t have an alternative to Obamacare.
They have plenty!
And not just, “Don’t get sick! And if you do get sick, die quickly,” as Rep. Alan Grayson (D-FL) said in 2009.
The Republican-controlled House of Representatives just hasn’t voted on even one Obamacare alternative because it’s hard to fit stuff in when you only work 28 hours a week and have to squeeze in all those Obamacare repeals.
But they’re going to fix that problem in 2014, says Rep. Tom Price (R-GA).
The congressman has introduced his Obamacare alternative — the Empowering Patients First Act — three times since 2009. Price’s bill has never been given a vote, even though it has 50 co-sponsors, including the eminent Rep. Michele Bachmann (R-MN).
Price told Fox News that after the first of the year, Republican leaders are going to bring forth a bill that will “unite Republicans around health care issues” because “you can’t beat something with nothing.”
This logic runs contrary to Town Hall‘s Conn Carroll, who believes the House GOP won’t coalesce around one plan or, as he calls it, “a villain to run against.”
This has been the GOP strategy since 2010, and don’t expect it to change, despite the assurances the leadership has given to Rep. Price.
Price’s bill has never been scored by the Congressional Budget Office (CBO). But a former Republican head of the CBO scored it independently and found that it saves trillions of dollars over 10 years and will reduce the uninsured population by 29 percent by 2016.
If this is true, why haven’t Republicans even put it up for a vote?
A quick look at H.R. 2300, the current version of Price’s bill, shows you why the GOP likely won’t propose an alternative to Obamacare — ever.
The bill starts off with Republicans’ favorite health care distractions — tort reform and selling across state lines.
If you eliminated every malpractice claim in America, that would only reduce the costs of our health care system by 1 to 1.5 percent – far less than implementing a public option.
Selling insurance over state lines would just give insurers the chance to sell plans from the state with the fewest regulations. The Washington Post‘s Ezra Klein looked at a CBO report on a bill from 2005 that would have made national sales of state insurance plans possible and found “the legislation would not change the number of insured Americans or save much money, but it would make insurance more expensive for the sick and cheaper for the healthy, and lead to more healthy people with insurance and fewer sick people with insurance.”
The real goal of Price’s bill and just about every Republican reform of the health care system is to end the employer-provided health insurance dynamic that most Americans rely upon. Employers get a generous tax break for providing health coverage that Price would then extend to individuals. The 2009 version of his bill did this in a way that would actually have resulted in a huge tax increase.
But the bigger problem with Price’s plan to sever the employer-employee health insurance relationship and create plans that stay with an individual for life is that it would end up in cancelations of current plans — tens of millions of cancelations.
Republicans could argue that these new plans would be better than the existing plans for various reasons — but that’s an argument they know doesn’t work, because they crushed it when Democrats used it to defend the cancelations that happened after the implementation Obamacare.
Price says his plan would cover people with pre-existing conditions, though it doesn’t include an individual mandate or any incentive to prevent insurers from cherry-picking the healthiest consumers.
“In other words, this looks much like the reforms that collapsed in Texas, and in California,” Klein noted. ”Price isn’t learning from past policy mistakes, and so he means to repeat them.”
The biggest problem with Price’s bill is how it reforms existing public health care programs.
If H.R. 2300 became law, anyone could opt out of Medicare or Medicaid and receive a voucher to purchase private insurance.
We have no idea how many people would opt out of Medicare given the fact that few private insurers see people over 65 as the path to prosperity for their business. But when the growth of Medicare costs is far below that of private insurers, all that voucher would end up being is a ticket to pay far more for health care at the time of your life when it will cost you the most.
And if too many beneficiaries opted out, the entire system of dictating costs to providers in exchange for volume could collapse with devastating effects to our deficit and debt.
The worst part for Republicans is the facet of the law that allows Democrats to make a pretty simple case against the GOP’s Obamacare alternative: It ends Medicare as we know it. The GOP could rebut that assertion by saying that Medicare will still exist for those who want it, but a party that has been shedding senior support all year doesn’t want to have that argument.
Any alternative the GOP proposes to replace Obamacare is going to spark negative headlines — even if the GOP manages to evade the tax increases, cancelations and potential problems for Medicare that exist in Price’s bill.
If the Republican leadership makes the mistake of offering an alternative, they’ll dull the sting of their attacks on Obamacare by having to defend some version of a plan they were wise enough to sit on for years.
By: Jason Sattler, The National Memo, December 16, 2013
“Trapped In A Conservative Box”: The Cost Of The GOP’s Redistricting Wins Presents A Real Problem
Sometimes in politics you can lose by winning. Witness the problems the Republican Party is experiencing trying to govern with a majority that is widely believed to be unshakeable in the near future thanks to the redistricting job GOP state legislators did after the 2010 census.
Politico’s Alex Isenstadt has a report today suggesting that the party’s success has trapped Republicans in a conservative box, “narrowing the party’s appeal at a time when some GOP leaders say its future rests on the opposite happening.”
This isn’t necessarily a new thought. As I wrote back in early March:
In a sense the GOP’s success in the last round of redistricting – creating what the Cook Political Report sees as over 200 safe GOP districts – is proving Pyrrhic. If you’re a Republican member of Congress your greatest existential threat comes from primary challenges, so that’s what shapes your agenda, even if it comes at the cost of national political viability.
I was writing then about the GOP’s doubling down on the same policy agenda that voters rejected last November. That hasn’t changed in the intervening months. In fact, if you watched most House Republicans (and more than a few senators and other elected officials) you would not know that the party lost last year on multiple fronts: The presidential race wasn’t close and Obama became the first candidate since Dwight Eisenhower to crack 51 percent two elections in a row; Democrats picked up seats in both chambers of Congress and won more House votes than did the GOP, though Republicans held the lower chamber because, in large part, of their redistricting success. Meanwhile, the national GOP brand remains terrible.
Isenstadt is writing about “recurring drama within the House Republican Conference – from the surprise meltdown on the farm bill to the looming showdown over immigration reform,” but it’s the same basic problem: Conservatives unchecked by practical considerations such as what will help the party nationally.
The Politico piece has a couple of telling nuggets:
Of the 234 House Republicans, just four now represent districts that favor Democrats, according to data compiled by The Cook Political Report. That’s down from the 22 Republicans who resided in Democratic-friendly seats following the 2010 midterms, prior to the line-drawing.
They’re also serving districts that are increasingly white. After redistricting and the 2012 election, according to The Cook Political Report, the average Republican congressional district went from 73 percent white to 75 percent white. And even as Hispanics have emerged as America’s fastest-growing demographic group, only about one-tenth of Republicans represent districts where the Latino population is 25 percent or higher.
The piece also has the obligatory conservative quote about how what the party really needs is not to broaden its appeal but more starkly state its case. But this proceeds from an incorrect assumption of conservatism’s nationwide appeal. I am always reminded of this passage from Ryan Lizza’s Eric Cantor profile a few months ago. Lizza spoke with Georgia Republican Rep. Tom Price, a conservative leader:
He explained how surprised he was when one of his colleagues from a Northern state told him that he favored a tax increase on millionaires. “It hit me that what he was hearing when he’s going home to a Republican district in a blue state is completely different than what I’m hearing when I go home to a Republican district in a red state,” he said. “My folks are livid about this stuff. His folks clearly weren’t. And so we weren’t even starting from the same premise.”
Price is no tea party freshman just finding his way around the Congress. He’s the vice chairman of the House Budget Committee and has been in Congress for eight years. And yet it only just recently occurred to him that not every district holds the same political beliefs as his. That’s a real problem for Republicans and it’s one their redistricting success is only exacerbating.
By: Robert Schlesinger, U. S. News and World Report, July 1, 2013
“America’s Scariest Doctors”: Meet The GOP Doctors Caucus Where Fetal Masturbation Is Just The Tip Of The Iceberg
The phrase “fetal masturbation” made an unlikely appearance in the political discourse Wednesday, thanks to a Republican congressman who said the country needs a 20-week abortion ban because he’s seen sonograms that show male fetuses “feel pleasure” when they “have their hand between their legs.”
The science on whether fetuses can feel pain (let alone masturbate) is pretty dubious, which is something one might expect the congressman, Texas Rep. Michael Burgess, to know, considering the fact that he’s an OB-GYN and a proud member of the GOP Doctors Caucus. But a look at the caucus’s roster reveals he has plenty of company from other lawmakers with controversial thoughts on science and women’s health.
Caucus chairman Rep. Phil Gingrey, also an OB-GYN, defended Rep. Todd Akin’s infamous comments about rape and abortion last year. Saying that Akin was “partly right” that a women’s body can shut down an unwanted pregnancy due to rape, Gingrey added that a 15-year-old girl who gets pregnant might accuse her boyfriend of rape because she’s embarrassed, so “that’s what he meant when he said legitimate rape versus nonlegitimate rape.”
Then there’s Rep. Tom Price, who, when asked what women who can’t afford birth control should do in the absence of insurance coverage, replied “there’s not one woman” who lacks access. “Bring me one woman who has been left behind,” he said, “There’s not one.” A Hart Research survey found that about one in three female voters have struggled to afford the medicine at some point, including 55 percent of young women.
Virtually all of the caucus’s members support defunding Planned Parenthood, even though doing so would be devastating for women’s health issues that have nothing to do with abortion. Co-chair Rep. Diane Black pledged, “I will not rest until we put a stop to Planned Parenthood’s blatant abuse of taxpayer dollars.”
Others have profound respect for science. Co-chairman Rep. Phil Roe thinks there are “many questions surrounding the science” of climate change. While Rep. Paul Broun, who still makes house calls, thinks evolution and the Big Bang are “lies straight from the pit of Hell.”
Then there’s Rep. Scott DesJarlais, a pro-life conservative who “had an affair with a patient and later pressured her to get an abortion.” Later, the Tennessee Board of Medical Examiners found DesJarlais had slept with two female patients in violation of a state law that prohibits “unprofessional conduct.” He was forced to pay a small fine. (He also slept with three co-workers.)
Or Rep. Charles Boustany, who was “has been the defendant in at least three malpractice suits over his two decade career,” according to Politico. (He maintains a medical license in Louisiana under no restrictions and his staff said the suits are common.)
Rep. Ron Paul was a member of the caucus as well before leaving the Congress. And while his son, Sen. Rand Paul, is not a member of the caucus because he’s in the upper chamber, some have raise questions about his war on board certification for his ophthalmology practice.
The GOP Doctors Caucus helped lead the fight against Obamacare, so voters should rest assured that if they had their way to repeal the law, they’d be in good hands.
By: Alex Seitz-Wald, Salon, June 20, 2013
“A Finger In The Eye Of Hispanic Voters”: House GOP Dream Act Deferral Vote Is Political Insanity
Honestly, when I saw that House Republicans had passed an amendment today which would defund President Obama’s limited, executive-order-driven Dream Act, my first thought was to wonder what the GOP is thinking. Does this party have a death wish?
This isn’t the political equivalent of rocket science. Hispanics voted overwhelmingly to support Obama last year. And given demographic trends regarding the share of the electorate they’re going to make up in coming years, neither party can afford to become noncompetitive with these voters. It’s a matter of political survival. And many Republicans know this – see the Republican National Committee’s 2012 post-mortem, for example, or the College Republicans’ recent version.
Immigration is not the number one issue for Hispanic voters, but it is a gateway issue and one that gets to tone and outlook. If voters think a party is hostile to and/or distrustful of them, they’re going to tune that party out. So rational Republicans (not to mention a whole lot of their corporate backers) want to get immigration reform done.
But today’s GOP – especially its House denizens – aren’t about rationality. So they cast the vote they did today. And it’s not an isolated occurrence. The Atlantic’s Garance Franke-Ruta looks at how the GOP is trying to blow its 2016 chances:
House Republicans walking away from comprehensive immigration reform. Tying a path to citizenship to continued second-class standing on access to health insurance. Voting to resume deporting undocumented immigrants brought here as children, a year after President Obama issued an executive order instructing the Department of Homeland Security to use discretion and make such deportations a low priority.
And this isn’t simply bad policy or stumbling into bad politics. This is going out of their way to charge into bad politics. It’s not like there’s any chance this amendment becomes law. So why make a point of voting for it?
I was at a press breakfast yesterday with Rep. Tom Price, the Georgia Republican who is vice chairman of the House Budget Committee, and he was asked about whether the GOP would suffer politically if it is blamed for killing immigration reform this year. Price, who favors the House GOP’s official approach of going piecemeal on immigration reform rather than trying to tackle it comprehensively, made a couple of enlightening comments.
First, he said that “I think what the American people want is to see individuals working to solve challenges.” I tend to think that what the American people actually want is to see their elected representatives actually solving challenges rather than simply trying – this isn’t kindergarten: You don’t get points for trying really hard; you get points for getting stuff done.
The second thing he said was that legislation with a path to citizenship or a path to legal status wouldn’t pass the House with a majority of Republican votes because the GOP doesn’t trust “the administration to enforce the current laws that are on the books as they relate to much of immigration.” But he then went on to conflate the views of his party and its base with the broader electorate: “The American people don’t trust Washington in this area because the promise that was made in 1986 has been broken,” he said, referring to the deal President Ronald Reagan signed which provided amnesty for illegal immigrants back then in exchange for promises of border security. “There’s no trust at all. The first step in regaining that trust is living up to the promise that was made to the nation back in 1986 and that is controlling and securing the border.”
Two points. First, the border is far more secure than it has been. Second, if mistrust of Washington was as widespread as Price seems to suppose, polls would show deep opposition to both comprehensive immigration reform and a way for currently illegal immigrants to gain citizenship, but poll after poll shows otherwise. A recent poll conducted for Bloomberg showed that 74 percent of adults favor “Allowing immigrants living in the country illegally to become citizens, provided they don’t have criminal records, they pay fines and back taxes, and they wait more than 10 years.” That’s hardly angry mistrust of Washington regarding immigration.
The problem is that House Republicans either confuse their base’s wishes or simply don’t want to cross them. Either way, they’re voting themselves a path to oblivion.
By: Robert Schlesinger, U. S. News and World Report, June 7, 2013
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