“Rand Paul’s Crazy Word Salad On Obamacare”: A Symbol Of GOP’s Larger Mess
Sen. Rand Paul made national news this weekend when he refused to say precisely whether he wanted to repeal Kentucky’s version of the Affordable Care Act, Kynect, along with the federal act itself. He bobbed and weaved like his boy Mitch McConnell, and most people have left it at that: another scared Republican afraid to tell the voters what he really thinks about a program that’s helped many of them. Reporters are used to that. Nobody except liberals even criticize it anymore, sadly.
But I want to look at Paul’s entire ludicrous soliloquy on Obamacare, Kynect and healthcare generally, because it shows how fundamentally unserious he is about domestic policy. Or if he is serious, he’s seriously delusional. It was every bit the nonsensical word salad we are used to being served by Sarah Palin, but maybe it’s sexism: Paul is never called out on it or mocked the way the former Alaska governor was. He ought to be.
I’ve written before that “Paul is what you get when traditional and corrosive American nepotism meets the 21st century GOP echo chamber: a pampered princeling whose dumb ideas have never been challenged by reality.” Ron Paul’s son has a tendency to look proud of himself whenever he shows a passing familiarity with facts and figures and ideas, even if he’s conflating or distorting them beyond any resemblance to reality. It’s on display in this interview with Kentucky reporters.
The junior senator from Kentucky starts out by acknowledging that Kynect gets a lot of praise, locally and nationally.
I think the real question that we have in Kentucky is people seem to be very much complimenting our exchange because of the functionality of it, but there are still the unknown questions or what’s going to happen with so many new people.
OK. Let’s take a look at “what’s going to happen with so many new people.” Here Paul rolls out some brand-new GOP anti-ACA scare tactics. First: The rapid expansion of Medicaid, he claims, is costing jobs.
I mean it’s basically about a 50 percent increase in Medicaid in one year. That’s a dramatic shot to a system. And my question is what will happen to local hospitals. If you look at [Glasgow, Kentucky, hospital] TJ Samson laid off 50 people and they’re saying they can’t afford the huge burden of Medicaid.
Oops, stop right there. While the hospital’s CEO did in fact link the layoff of 49 staffers to Obamacare in April, days later the Kentucky Cabinet for Health and Family Services disputed that account. It said the hospital would take in hundreds of thousands of dollars more in Medicaid funding annually, because it’s now being reimbursed for uninsured patients it used to treat without payment. Asked about the discrepancy, Paul just pointed to earlier reporting about the Samson CEO’s remarks and said: “All I know is what I read in the papers.”
So for President Rand Paul, the buck would presumably stop with the papers.
Then Paul raised the specter of folks getting their private health insurance subsidized under the Affordable Care Act, but with such high deductibles that they ultimately won’t be able to pay.
That’s gonna mean … you’re still just a non-payer, probably. And hospitals are going to have to figure out, we won’t know this for six months to a year, how many people who show up with subsidized insurance will actually be able to pay [their] deductible.
This could conceivably be a problem – actually, it was a big problem before the ACA – but Paul has no evidence the ACA made the problem worse. More likely it has helped some, because even with a high deductible plan, many preventive services are now provided without a co-pay. The point is, there’s no evidence of such a problem yet; Paul is just throwing trash at Obamacare to see what will stick. And there’s more:
How many of the new people on Medicaid, how many of those people may have actually had insurance before? Did they go from being a non-payer to being a government payer? Or did they maybe have insurance, but now they’re on Medicaid because it’s easier than having insurance?
Paul could probably find out the answers to these questions, with staff work and a little consultation with the Kentucky Cabinet for Health and Family Services, but he would never bother. After hearing all of this bad news, much of it invented, a local reporter asked the senator the obvious question:
With all those unknowns, do you think Kynect should be dismantled?
And here Paul joins McConnell and punts. Or lies, since it’s pretty sure from his answer he thinks Kynect should be dismantled.
You know I’m not sure — there’s going to be … how we unravel or how we change things. I would rather —I always tell people there’s a fork in the road.
Oh, that fork in the road. Paul turns to boilerplate conservative rhetoric:
We could have gone one of two directions. One was towards more competition and more marketplace and one was toward more government control. The people who think that the government can efficiently distribute medicine need to explain why the VA’s been struggling for decade after decade in a much smaller system.
Points for working in the VA, the Obama scandal du jour. Let’s leave that alone, it’s a story in itself. Continue, Sen. Paul:
And they also need to explain, even though I think we all want Medicare to work better, why Medicare is $35 trillion short.
Huh? First of all, Paul doesn’t “want Medicare to work better,” he wants to repeal it. That’s something you don’t hear much about, but he sponsored a bill with Utah Tea Party Sen. Mike Lee to replace Medicare with the Congressional Health Care Plan members of Congress buy in to, essentially privatizing it. The bill would also raise the age of eligibility from 65 to 70. That ought to go over well with the GOP’s rapidly aging white base. That’s why Paul is forced to lie about his own Medicare position.
And the allegation that Medicare is “$35 trillion short”? I could find no documentation for it besides a Heritage Foundation blog post, and a ton of YouTube videos where Rand Paul makes the claim on Fox News. It seems to refer to a 2011 estimate by Medicare trustees that the Part A Trust Fund would face a shortfall by 2026 unless payroll taxes were raised or program costs were trimmed – and the Affordable Care Act has been trimming them. It’s bunk.
Then Paul turns briefly to the question of Kynect:
There’s a lot of questions that are big questions that are beyond the exchange and the Kynect and things like that. It’s whether or not how we’re going to fund these things.
But then he detours again, to take us back to the already debunked example of TJ Samson hospital’s Medicaid-induced “layoffs.”
If they lose 50 good paying jobs in the hospital, is that good? Then we’ve got more people in the wagon, and less people pulling the wagon.
With that profound Kentucky take on Paul Ryan’s “makers vs. takers” narrative, he walks away. And we’re back to Mitt Romney’s deriding the “47 percent.” In Paul’s more colorful telling, the problem is that some of us pull the wagon, while freeloaders and layabouts just lounge in it. For 50 years, Republicans have tried to tell voters the folks “in the wagon” are minorities. But in Kentucky, which is 88 percent white, they’re mainly white. So Rand Paul, the great 2016 hope, is really a prisoner of the elitist 2012 narrative that cost the GOP the White House.
Even though there’s so much to explore in Paul’s Kynect two-step – delusion, ideology, outright lies – the media mostly ignored it. Those who’ve paid attention simply covered the admittedly newsworthy Obamacare evasion. But I think Paul’s entire stand-up act, his performance art — Being a Very Serious Senator, or at least playing one on TV — deserves more attention. It’s only the soft bigotry of the media’s low expectations for Republicans, and maybe a little of society’s sexism, that makes Rand Paul someone to contend with in 2016, when Sarah Palin is widely just a punch line.
By: Joan Walsh, Editor at Large, Salon, June 2, 2014
“McConnell’s Obamacare Policy”: Repeal It, Then Immediately Reinstate The Whole Damn Thing
I think there’s one way, and only one way, to interpret Mitch McConnell’s position on the Medicaid expansion in Kentucky, and last night the Washington Post’s fact checker confirmed it. McConnell wants to repeal the Medicaid expansion (along with the rest of Obamacare) and then let the people who run the state of Kentucky (i.e. people other than him) decide whether to reinstate it, and pay for it out of state coffers.
That’s a difficult position to support, which explains why his campaign obscures it behind a bunch of rambling designed to convince people (including very politically savvy people) that McConnell has come around to supporting the Medicaid expansion.
But it’s actually identical to his position on Kynect—the state’s health insurance exchange—and perhaps he’ll apply it to other integral parts of Obamacare as well. As a general matter it amounts to arguing that Obamacare should be repealed, and then reinstated in full at the state level. But that’s a total fantasy.
When Obamacare is repealed, the funding Kynect relies upon, as well as the health plans and rules that make it a popular and widely used portal, will disappear as well. No biggie, says McConnell. Once they’re gone, the state can decide whether it wants to reinstitute those things on its own.
But of course, as with Medicaid expansion, it’s almost impossible to imagine states riding to the rescue of those harmed by Obamacare’s repeal. Running the exchange is fairly expensive on its own, but its costs would dwarfed by the resources required to recreate the actual market Obamacare has created in Kentucky. Remember, Kentucky flirted with creating Obamacare’s coverage guarantee without creating any incentives for everyone to purchase insurance. No mandate, no subsidies. And the system predictably collapsed. But it’s unlikely that Kentucky could afford to reinstate ACA-style subsidies on its own. And without them, the plans will be too expensive to justify a mandate. And so under McConnell’s policy, Kentucky’s newly insured would be left with nothing.
The idea that ACA politics are gruesome for Democrats is so deeply ingrained in the national media’s belief system that it won’t be shaken loose by McConnell’s dissembling alone. But if it were true, why would Republicans across the country be hiding their true views about Obamacare behind the word “fix”? Why would any Republicans, let alone the Senate GOP leader, be saying they want to get rid of everything Obamacare does except the things it does in their own states?
By: Brian Beutler, The New Republic, May 30, 2014
“Repurposing Of A Failed Website”: The Republicans’ Subtle Retreat From ‘Obamacare’
House Republicans held a press conference on Capitol Hill this week, at which the New York Times’ Jonathan Weisman tweeted a fascinating image – of the podium.
If you look closely, you’ll notice the sign on the podium not only refers people to a website run by the House Republican Conference, but also to a specific part of the site – gop.gov/yourstory – followed by a tagline that reads in all caps, “Our veterans deserve better.”
At first blush, that wouldn’t seem especially noteworthy, except up until very recently the gop.gov/yourstory website served a very different purpose: it was set up to collect scary stories from people who didn’t like the Affordable Care Act. Republicans launched a months-long campaign to collect anecdotal evidence from “Obamacare victims” and this website was intended to be the go-to destination for those adversely affected by the health care reform law.
But the political winds have changed direction. The crusade to find “Obamacare victims” has run its course – the evidence never materialized – and House Republicans are ready to give up on the campaign and start collecting other horror stories the party can try to exploit for partisan gain.
The repurposing of a failed website is, however, just a piece of a larger puzzle. As Juliet Eilperin and Robert Costa reported this morning, Republicans suddenly find themselves in “retreat” on health care.
Republican candidates have begun to retreat in recent weeks from their all-out assault on the Affordable Care Act in favor of a more piecemeal approach, suggesting they would preserve some aspects of the law while jettisoning others.
The changing tactics signal that the health-care law – while still unpopular with voters overall – may no longer be the lone rallying cry for Republicans seeking to defeat Democrats in this year’s midterm elections…. On the campaign trail, some Republicans and their outside allies have started talking about the health-care law in more nuanced terms than they have in the past.
Imagine that. Running on a platform of taking health care benefits from millions of people isn’t the winning strategy far-right lawmakers thought it’d be.
“The sentiment toward the Affordable Care Act is still strongly negative, but people are saying, ‘Don’t throw the baby out” with the bathwater, Glen Bolger, a partner with the GOP polling firm Public Opinion Strategies, told the Washington Post.
Remember when Republicans assumed they could simply ride a “Repeal Obamacare!” wave to electoral fortunes? That plan has been thrown out the window.
And what about the House GOP’s vaunted alternative, years in the making?
[S]enior House Republicans have decided to postpone a floor vote on their own health-reform proposal – making it less likely that a GOP alternative will be on offer before the November elections, according to lawmakers familiar with the deliberations. The delay will give them more time to work on the bill and weigh the consequences of putting a detailed policy before the voters in the fall, lawmakers said.
I suspect this isn’t more widely considered a humiliating fiasco for Republicans because most political observers simply assumed they’d fail to present their own plan, but this new “postponement” only makes the GOP’s debacle look worse.
Remember, it was exactly four months ago today that House Majority Leader Eric Cantor (R-VA.) publicly vowed, “This year, we will rally around an alternative to Obamacare and pass it on the floor of the House.”
That was Jan. 30. On May 30, Cantor’s new message is apparently, “Check back after the elections.”
Americans have only been waiting five years for the Republican alternative to the Affordable Care Act. What’s another seven months?
We know, of course, why GOP officials are struggling. As we talked about in February, Republicans could present an alternative policy that they love, but it’ll quickly be torn to shreds, make the party look foolish, and make clear that the GOP is not to be trusted with health care policy. Indeed, it would very likely scare the American mainstream to be reminded what Republicans would do if the power over the system were in their hands.
On other hand, Republicans could present a half-way credible policy, but it would have to require some regulations and public investments, which necessarily means the party’s base would find it abhorrent.
As a Republican Hill staffer recently told Sahil Kapur, every attempt to come up with a serious proposal leads to a plan that “looks a hell of a lot like the Affordable Care Act.” And so we get … nothing.
Nothing, that is, except the Democratic law, which is working quite well, Republican assurances to the contrary and repeated attempts at sabotage notwithstanding.
By: Steve Benen, The Maddow Blog, May 30, 2014
“Content-Free Carping”: From VA To Obamacare To Medicare
At the moment most Republicans are looking at the VA scandal that broke out in Phoenix as a sheer political bonanza without any long-term significance: a federal agency responsible for an especially valued constituency (veterans) has screwed up fatally on Barack Obama’s “watch.” That’s enough to powerfully reinforce a number of important conservative memes about Obama (and indirectly, Democrats): he and his people are incompetent, they don’t have the normal patriotic impulse to take care of veterans, and when held accountable they stonewall and lie.
But a few voices are beginning to figure out how to link the VA mess not only to the overriding issues of Obamacare, but to the “socialized medicine” treatment of Obamacare that would be applied to Medicare, too, if the political climate was right.
Here’s the Cleveland Plan Dealer‘s Kevin O’Brien spelling it all out:
Putting a government bureaucracy in charge of one’s health is a gamble likely to end badly.
And yet, if Obamacare stands, that is precisely the gamble each and every American eventually will take.
There is no better predictor of the course of a single-payer medical system in the United States than the VA system, because it is a single-payer system….
Americans who watch this story play out and fail to make the clear and obvious connection to Obamacare will be guilty of willful ignorance. The systemic flaw is identical. It’s just magnified on a massive scale. Rather than making a false promise to treat all of the ills of a relatively few sick and injured military veterans, Obamacare has put the federal government on the path to taking responsibility for the medical needs — and the attendant costs — of the entire U.S. population.
Like most conservative attacks on “bureaucracy,” O’Brien’s ignores the powerful bureaucracies that operate in the private sector with even less accountability. As TNR’s Jonathan Cohn puts it:
It’s worth remembering that some of the problems veterans are having right now have very little to do with the VA and a whole lot to do with American health care. As Phil Longman, author of Best Care Anywhere, noted in his own congressional testimony last week, long waits for services are actually pretty common in the U.S.—even for people with serious medical conditions—because the demand for services exceeds the supply of physicians. (“It took me two-and-a-half years to find a primary care physician in Northwest Washington who was still taking patients,” he noted.) The difference is that the VA actually set guidelines for waiting times and monitors compliance, however poorly. That doesn’t happen in the private sector. The victims of those waits suffer, too. They just don’t get the same attention.
But nonetheless, the longer the VA scandal stays in the public eye, the more we will hear arguments the VA should be broken up and its services privatized with federal regulations and subsidies replacing federal bureaucracies–creating a system much like the one contemplated by Obamacare, as it happens. But at the same time, we’ll be told Obamacare itself is a failure because it involves the government in guarteeing heath care. And where conservatives speak to each other quietly, it will be understood that Medicare is subject to the same complaints and deserves the same fate.
No wonder most GOP pols confine themselves to content-free carping about Obama being responsible for the VA scandal.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal. May 22, 2014
“The Big Dis-Kynect “: Mitch McConnell’s Big Obamacare-Kynect Lie
Here’s why all the super-smart insidery people privately say they think that in the end, Alison Lundergan Grimes will not beat Mitch McConnell in Kentucky. Her strategy, they say, is to keep it close, keep her distance from Obama, hold her own in debates, try to match him attack ad for attack ad, and just hope McConnell makes a mistake. And the super-smart people agree: You may admire or loathe McConnell, but if he’s proven one thing in umpteen elections, it’s that he doesn’t make mistakes.
That’s what the insiders say. There’s just one problem with it. McConnell has made about a mistake a week so far! He’s run an awful campaign. And he’s given anybody no reason at all to think he won’t just keep making them.
The latest is maybe the biggest howler yet, bigger than even the ad that mistook Duke basketball players for UK Wildcats. He said last week that while he will certainly still pursue repeal of Obamacare, he thinks Kentucky should be able to and will keep its celebrated Kynect health-care exchange, set up by Democratic Governor Steve Beshear under the Affordable Care Act. Here’s how LEO Weekly, out of Louisville, reported the moment:
McConnell took three questions on the Affordable Care Act and how its repeal would affect the 413,000 Kentuckians who now have insurance through the state exchange, Kynect. The first question asked how he would respond to those who say repeal would take away the health care of 413,000 Kentuckians, to which McConnell launched into his standard answer that Obamacare was raising premiums, raising deductibles, and killing jobs, concluding, “It was a big mistake, we ought to pull it out root and branch and start over.”
WHAS’ Joe Arnold followed up that answer by asking, “But if you repeal it, won’t all of the state exchanges be dismantled? How does that work?” McConnell then launched into his standard “solution” of sorts, calling for an “international market” of insurance companies that aren’t limited by state lines, in addition to “malpractice reform.”
The LEO writer, Joe Sonka, whom McConnell’s muscle men once threw out of a press conference because he has the temerity to write, like, facts and stuff, went on to slice and dice McConnell’s argument: “Kynect could not have existed without the Affordable Care Act, and it would cease to exist if the Affordable Care Act ceased to exist. There would be no people eligible for the expanded Medicaid—the large majority of those who signed up through Kynect—and there would be no exchange for people to sign up for affordable private insurance with federal subsidies. Saying that Kynect is unconnected with the ACA or its repeal is just mind-numbingly false. The ACA and Kynect are one in the same.”
This is obvious to anyone with a brain. The category of humans with a brain includes McConnell. He’s not that stupid. That leaves only one other choice: hypocritical. Well, two other choices: hypocritical and lying. That is, he knows Kynect can’t exist without the ACA, but he just said it anyway, without any concern for the truth. And the hypocrisy part comes in, of course, because, well, how can he have stood up there for years saying that, no, Americans should not be permitted to get health care the Obama way, and he’s going to strike it down the second he can—but Kentuckians, they’re different?
This gives Grimes an opening she didn’t have. More than 430,000 Kentuckians have health care now through Kynect. Mitch wants to take it away. No, wait, he doesn’t! Well, he wants to take Obamacare away, and Kynect came through Obamacare, but somehow he’s going to keep Kynect. And he’s going to go buy a new Oldsmobile, even though Olds is out of business, and he’s gonna campaign with Colonel Sanders, even though he’s been dead since 1980, and once he’s reelected he’s going to privatize Medicare—except in Kentucky, because Kentucky is different. Grimes’s media team, a talented bunch in my experience, should be able to have quite a lot of fun with this.
The Lexington Herald-Leader sure did, raking McConnell over the coals Wednesday. It wrote:
Asked specifically if Kynect should be dismantled, McConnell said: “I think that’s unconnected to my comments about the overall question.”
Huh?
That’s a quote that should live forever, or at least until Election Day. The super-smart insiders may be right, though, about one thing. McConnell won’t make “a mistake.” He’ll make several.
By: Michael Tomasky, The Daily Beast, May 29, 2014
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