“The Real Cost Of Republican Cruelty”: Voters Should Know Who’s Holding Up Their Health Care
With one week remaining before the March 31 deadline for health coverage this year, a Republican filing a lawsuit against the Affordable Care Act has become a familiar, if tiresome, sight.
But Republicans filing a lawsuit against the law on the grounds of copyright infringement? That’s something new.
Yet that is effectively what happened this month in Louisiana. On March 14, the state’s lieutenant governor sued the progressive group MoveOn.org over a billboard criticizing Gov. Bobby Jindal’s refusal to expand Medicaid in the state. The billboard uses Louisiana’s tourism slogan — “Pick Your Passion!” — and adds: “But hope you don’t lose your health. Gov. Jindal’s denying Medicaid to 242,000 people.” The lawsuit claims that the MoveOn ad will “result in substantial and irreparable harm, injury, and damages” to the Louisiana tourism office — as if denying health insurance to the neediest will not cause the state “substantial and irreparable harm.”
Legal experts say Jindal’s ploy has no chance of succeeding, thanks to the First Amendment. (This would be the same First Amendment that the governor passionately invoked in defense of “Duck Dynasty” patriarch Phil Robertson’s right to spew racist and homophobic vitriol.)
Jindal’s reason for refusing to expand Medicaid is as specious as his reason for suing MoveOn. He claims, falsely, that the expansion would divert funds that now go to disabled individuals under traditional Medicaid. In reality, the health-care law doesn’t harm the existing program. It creates several programs to improve care for the disabled receiving Medicaid; Jindal enrolled Louisiana in three of them. But this hasn’t stopped him from blaming the ACA for his own bad policies, including cuts he made to state Medicaid funding for pregnant women.
Louisiana isn’t the only state where Republicans are preventing thousands of low-income Americans from receiving health care. In Virginia, where state lawmakers refuse to expand Medicaid, hospitals will face higher costs and reduced services as a result. One million Texans will be denied access to coverage if the state continues to reject the Medicaid expansion. Meanwhile, Mississippi Gov. Phil Bryant is willing to leave 300,000 of his neediest citizens uninsured. His reasoning? He’s afraid that the law might be repealed, leaving his state no way to meet its commitments — an ironic stance for a Republican to take, since they’re the ones trying to repeal it!
The 19 states that are refusing to expand Medicaid aren’t just leaving low-income Americans out to dry — they’re also leaving billions of health-care dollars on the table. While Bobby Jindal busies himself over a billboard, his state’s internal analysis found that Medicaid expansion would save Louisiana as much as $134 million in 2015 alone.
The real cost of Republican cruelty, however, cannot be measured in dollars and cents, but in people’s lives. Researchers at Harvard and the City University of New York concluded that without the Medicaid expansion, individuals will go without checkups, cancer screenings and treatment for diseases such as diabetes and depression — leading to thousands of premature and preventable deaths.
So much for compassionate or fiscal conservatism.
Amid the misinformation and fear-mongering, however, lies a real opportunity for Democrats to increase support for the ACA and win more races in November.
Consider the recent special election in Florida’s 13th Congressional District, where Republican David Jolly’s victory is being widely interpreted as a rebuke of the Affordable Care Act. Polls suggest that it wasn’t Obamacare that hurt Democrat Alex Sink but the same factor that often hurts Democrats in midterm elections: low turnout.
To combat this, what if Democrats organized a clear, concerted effort to demonstrate how Republicans are denying millions of Americans access to health insurance?
There are already signs that raising awareness is working. The Moral Monday movement, which favors expanding Medicaid, has been getting attention for its protests at public meetings in several southern states. Other states are considering following the lead of New Hampshire, where the state Senate voted, with Republican support, for a modified expansion.
At the same time, progressives should back MoveOn’s brilliant billboard campaign parodying the tourism slogans of not just Louisiana but also Texas, Florida, Nebraska, Virginia and Wisconsin — which are all blocking the Medicaid expansion.
The campaign might consider going to South Dakota, Alaska, Georgia, North Carolina, Mississippi and Maine, which have Republican governors, contested Senate races and huge numbers of residents who are being denied access to health care. They need to know who is at fault.
High-profile Democrats running for federal office this cycle should be similarly bold. Voters, especially low-income voters who are most hurt by the GOP’s cruel stance on health care, need to understand just what’s at stake. It’s time for Democrats to run on health-care reform, not away from it — and Medicaid expansion is a worthy place to start. If they need to know how far Republicans have gone to prevent it, there’s a billboard along Interstate 10 in Louisiana that’s a pretty good guide.
By: Katrina vanden Heuvel, Opinion Writer, The Washington Post, March 25, 2014
“John Boehner’s Hypocritical Griping About The Obamacare Deadline Delay”: Conservatives’ Real Beef, That People Want To Sign Up
The Obama Administration has made another adjustment to the Affordable Care Act and the critics are making another fuss.
The adjustment, first reported (I think) by Amy Lotven for Inside Health Policy, is an extension of the open enrollment period for buying private insurance through the new Obamacare marketplaces. Officially, most people have until March 31 to sign up for a plan. (The exception are people who lose a job or have some other, similar life-altering experience. They can sign up throughout the year.) But on Wednesday, the administration announced that it will be offering some extra time to consumers who don’t finish their applications in time. They’ll be able to use the websites, just like they can now, only they’ll have to check a box attesting to the fact that they started the application process before April 1.
Exactly how many extra days will these folks get? And what’s to prevent somebody from lying—effectively taking advantage of the grace period to get insurance after the official deadline? On a predictably painful and frustrating conference call Wednesday, officials from the Department of Health and Human Services wouldn’t answer these questions directly. Obamacare critics, meanwhile, were quick to express their displeasure.”What the hell is this? A joke?” House Speaker John Boehner said at a press conference. “Another deadline made meaningless. If he hasn’t put enough loopholes in the law already, the administration is now resorting to an honor system to enforce it.”
Boehner appears to be right about the lack of enforcement. Nothing can stop people from gaming this new system. And establishing some kind of fixed date might be a good idea, as Philip Klein points out at the Washington Examiner, although in practice the insurers will basically do that on their own. (If they don’t get applications by the middle of the month, they won’t start coverage on May 1.) But even insurers are shrugging at this and it’s not clear why Boehner or anybody else should react differently.
There’s genuine reason to think that people who waited until the last minute to sign up really might have problems completing the process in time. Traffic to the online marketplaces has been increasing rapidly, with levels now rivaling the surge that took place in late December. On Tuesday, 1.2 million people visited healthcare.gov, according to officials. At some point, the congestion could trigger a built-in queuing system—making it difficult for last-minute applicants to finish enrollment by midnight on March 31. As administration officials pointed out, you don’t stop people from voting because they were standing in line when the polls closed. Or, to borrow a phrase I saw on twitter, you don’t kick somebody out of a restaurant because their dish wasn’t ready before closing time.
As for people gaming the system to buy themselves extra time, sure, it’s going to happen. But it’s unlikely to happen that frequently, certainly not enough to upset the actuarial balance of insurance plans. And it’s not like this is unprecedented. As Igor Volskly explained in an item for ThinkProgress, the Bush Administration did pretty much the same thing with Medicare Part D:
In May of 2006, just days before the end of open enrollment, President Bush took administrative action to waive “penalty fees for very low-income seniors and people with disabilities who sign up late” and allowed “the same impoverished beneficiaries to sign up for Medicare drug coverage until Dec. 31.” …
Like Obamacare, the launch of President George W. Bush’s prescription benefit plan was hampered by technical glitches, setbacks, and mass confusion. As the May 15 deadline for enrollment loomed, a bipartisan group of lawmakers advocacy organizations, and a surprising number of newspaper editorials, urged the administration to extend the enrollment period and protect seniors from the penalties associated with late enrollment.
Of course, the real issue here for conservatives isn’t this one delay. It’s all of the delays, plus all of the exceptions and waivers. And it’s totally reasonable to ask hard questions about these, particularly when it comes to the limits of presidential authority and the precedent it sets for the future. (I’m still waiting to hear from more lawyers on the constitutional issues.) But, for what it’s worth, the Affordable Care Act really did give HHS a huge amount of leeway over how to implement the law—and it did so for a very good reason. Given the inherent complexity of health care, there’s no way Congress could have figured out all of the details. It made sense to delegate that authority—to put in place new systems, but leave the nitty-gritty of regulations and transitions to the administration.
For each one of these extensions or delays, the ultimate question is whether they change the law’s ability to realize its basic goals—which, in this case, means encouraging people to buy new private health plans while maintaining a stable insurance market. Giving people a little extra time to enroll wouldn’t seem to impede this kind of progress. If anything, it would seem to enhance it. And maybe that’s what really bothers some of the law’s fiercer critics.
By: Jonathan Cohn, The New Republic, March 26, 2014
“The Real Truth About ObamaCare”: Conservatives Need To Help Fix It, Or Face Their Worst Nightmare!
Despite the worst roll-out conceivable, the Affordable Care Act seems to be working. With less than two weeks remaining before the March 31 deadline for coverage this year, five million people have already signed up. After decades of rising percentages of Americans’ lacking health insurance, the uninsured rate has dropped to its lowest levels since 2008.
Meanwhile, the rise in health care costs has slowed drastically. No one knows exactly why, but the new law may well be contributing to this slowdown by reducing Medicare overpayments to medical providers and private insurers, and creating incentives for hospitals and doctors to improve quality of care.
But a lot about the Affordable Care Act needs fixing — especially the widespread misinformation that continues to surround it. For example, a majority of business owners with fewer than 50 workers still think they’re required to offer insurance or pay a penalty. In fact, the law applies only to businesses with 50 or more employees who work more than 30 hours a week. And many companies with fewer than 25 workers still don’t realize that if they offer plans they can qualify for subsidies in the form of tax credits.
Many individuals remain confused and frightened. Forty-one percent of Americans who are still uninsured say they plan to remain that way. They believe it will be cheaper to pay a penalty than buy insurance. Many of these people are unaware of the subsidies available to them. Sign-ups have been particularly disappointing among Hispanics.
Some of this confusion has been deliberately sown by outside groups that, in the wake of the Supreme Court’s “Citizens United” decision, have been free to spend large amounts of money to undermine the law. For example, Gov. Rick Scott, Republican of Florida, told Fox News that the Affordable Care Act was “the biggest job killer ever,” citing a Florida company with 20 employees that expected to go out of business because it couldn’t afford coverage.
None of this is beyond repair, though. As more Americans sign up and see the benefits, others will take note and do the same.
The biggest problem on the horizon that may be beyond repair — because it reflects a core feature of the law — is the public’s understandable reluctance to be forced to buy insurance from private, for-profit insurers that aren’t under enough competitive pressure to keep premiums low.
But even here, remedies could evolve. States might use their state-run exchanges to funnel so many applicants to a single, low-cost insurer that the insurer becomes, in effect, a single payer. Vermont is already moving in this direction. In this way, the Affordable Care Act could become a back door to a single-payer system — every conservative’s worst nightmare.
By: Robert Reich, The Robert Reich Blog, March 22, 2014
“Republicans Can’t Win By Attacking Health Care In 2014”: We will Turn The Corner If Progressives Do Not Sit On The Sidelines
For me, the fact that Republicans keep using the Affordable Care Act – Obamacare – as a political football is a tragedy. Sure, the law has problems, but it is already saving lives and improving the health of millions of Americans.
Thankfully, it seems that Republicans who are counting on attacking the health reform system to get them into the end zone will be stopped short of the goal line based on numbers coming out of a March special election for a Florida House seat
For me, the Affordable Care Act comes down to people’s lives and health. Consider the story of a young man I met who told me that this new avenue to becoming insured had saved his life.
He had some symptoms that made him worry about his health. But he, like many Americans without insurance, ignored them, as he couldn’t afford to see the doctor. After the Affordable Care Act became law, he got coverage through his parents’ health insurance plan, and on visiting a doctor, found out he had stage 4 — that’s advanced — cancer. Fortunately, he got to the doctor in time to save his life.
That young man is far from alone. As of the end of February, some 11 million Americans have health coverage under the new law. Repealing it, as Republicans continue to insist, would take away coverage from each and every one of them.
In the Florida election, Republican David Jolly said “I’m fighting to repeal Obamacare, right away.” His opponent, Democrat Alex Sink, countered, “We can’t go back to insurance companies doing whatever they want. Instead of repealing the health care law, we need to keep what’s right and fix what’s wrong.”
The key part of Sink’s message was to remind voters why people wanted health care reform in the first place. As one of Sink’s TV ads said, “Jolly would go back to letting insurance companies deny coverage.”
That’s an effective reminder of the huge problems Americans have had for decades, when insurance companies could deny care because of a pre-existing condition, charge people higher rates because they were sick, and even charge women higher rates than men. The ACA ended all that.
The candidates in Florida pushed especially hard for the votes of seniors, which is not surprising given both Florida’s high senior population and the fact that seniors vote more frequently than other age groups.
In its ads for Jolly, The Republican Congressional Campaign repeated the same misleading charge that Republicans used successfully in 2010 to scare seniors against the ACA, that it cut $716 billion from Medicare. But unlike 2010, when Democrats did not respond to attacks on the ACA, Sink pushed back.
She reminded seniors that the ACA actually provides important new Medicare benefits, including closing the infamous prescription drug “donut hole.” Sink’s ads accurately said, “His [Jolly’s] plan would even force seniors to pay thousands more for prescription drugs.”
By Election Day, voters had a clear contrast between the positions of the candidates on the ACA. It was a close election, with Jolly winning by a small margin (48.4 percent to 46.5 percent) in a district with an 11-point Republican advantage, one that has been represented by the GOP for nearly 60 years.
But polling found that independent voters in the district supported the “keep and fix” position over the “repeal” position by a margin of 57 percent to 31 percent. Sink actually gained ground over Jolly during the election on the question of which candidate had a better position on the ACA.
I am very much looking forward to the time when Congress can start having real debates on how, as Sink said, “we can keep what’s right and fix what’s wrong” with the Affordable Care Act. However, it looks like it will take at least one more election, in 2014, to get us to that point.
We will turn the corner if progressives do not sit on the sidelines, but instead welcome the debate that Republicans insist on having about repealing the ACA.
That debate is an opportunity for people to be reminded in concrete terms that the new health care program, for all its shortcomings, is about providing every American with the peace of mind that comes with having health coverage.
By: Richard Kirsch, Senior Fellow at The Roosevelt Institute; Published in The National Memo, March 20, 2014
“Stand By It, Support It, Argue For It”: Democrats Should Run On Obamacare, Not Run From It
Alex Sink should have won the special congressional election in Florida yesterday. She had more money, she had a better resume and profile, and she was certainly a good candidate.
Florida’s 13th congressional district is a very competitive district that President Obama carried in both 2008 and 2012. True, it had been in Republican hands for a long time, but it was a good chance for the Democrats to pick up an open seat.
So, what went wrong? Hard to tell, of course, from inside the beltway, but let me offer up one thought. Sink tried to straddle health care and got caught in the middle.
As we all know, the notion that “I was for it before I was sort-of against it” does not sit well with voters. Certainly one could argue that the “fix what is wrong” strategy could work in 2014 for Democrats. But my fear is that what the voters hear is “I don’t really like Obamacare much because it may be hurting me politically.”
It is my strong belief that Democrats need to argue vociferously for the benefits of Obamacare. They need to tout what it will do for the country, for average Americans, for those without health insurance, for the economy, for keeping health care costs under control. If candidates believe they can distance themselves politically, especially after they voted in favor of it, they are making a tragic mistake. Own it. Don’t shy away from the important impact it is having now and will have in the future.
Sure, each race is different, each race will have its own dynamics, each race will have its own issues and differences among candidates. But if Democrats are hopelessly divided on health care, even at odds with themselves, they will not be able to stop the Republicans from hammering them.
By emphasizing the “mend it, don’t end it” strategy rather than the “here’s what it will do for you” strategy, Democrats are playing defense. Sure, they can use the Bill Clinton line, “We’ll be fixing it this year, will fix it next year and we’ll fix it the year after that,” but stand by it, support it, argue for it. This is the way Social Security worked and Medicare too — they were constantly amended and changed — but the end result is that they are among the most effective and popular programs ever enacted.
Gov. Mitt Romney tried to straddle the auto bailout, Republicans try obfuscating on women’s issues and Kerry tried to argue both sides of his Iraq vote. It’s hard to make those plays work.
On Obamacare, Democrats should argue strongly for it. Over the next eight months, Democrats should point to the number of people signing up, the care that people are receiving, the improvements in delivery and cost, and, most importantly, what it will accomplish in the future. Once Obamacare is fully operational, fewer people will be bankrupted by health care expenses, our populace will be healthier and the overall impact on the nation will be similar to Social Security and Medicare.
In short, if Democrats start now and double down on the issue, they will fare better in November than if they run and hide.
By: Peter Fenn, U. S. News and World Report, March 12, 2014
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