“We Got ‘Em Now”: No, Healthcare.gov’s Problems Will Not Offer The GOP Political Deliverance
Today marks the beginning of what will surely be a series of hearings in Congress at which members will fulminate and shake their fists at various people who had responsibility for creating Healthcare.gov. It’s quite something to see some congressman who’s still struggling to figure out how to work the Blackberry his staff gave him asking questions about beta testing and error logs and a bunch of other stuff he doesn’t begin to understand. But maybe the weirdest thing is the feeling one gets from the GOP over the last few days, which can be summarized as, “We got ’em now!” They seem to believe that the website problems are going to provide the deliverance they’ve been waiting for after the political disaster of the government shutdown.
Here’s a little prediction: Feigned Republican outrage over the ACA web site is going to be just as effective in reversing the GOP’s current fortunes as feigned Republican outrage over Benghazi was in undoing Barack Obama’s re-election bid.
Nevertheless, they’ve got a new spring in their step, as The New York Times reports today. “If the Web site glitches are just the tip of the iceberg,” says Representative Greg Walden, who as chair of the National Republican Congressional Committee is responsible for making sure his party holds the House in 2014, “it’s only a matter of time before the law sinks and takes with it those Democrats who wrote it, voted for it and are proud of it.” All they have to do is sit back and wait for Obamacare to implode, then reap the political benefits.
I wouldn’t get too excited if I were them. First of all, if you’re arguing about why the website isn’t working, you’ve implicitly accepted the premise that the website ought to work, so people can use it and get insurance. Which is quite different from arguing, as some Republicans have, that people who are now uninsured just shouldn’t bother getting insurance at all. When you stand before the cameras to shout, “I will not rest until these problems are fixed and Obamacare works properly!” and you then turn around and say, “I will not rest until Obamacare is destroyed!”, you’re not exactly convincing the voting public that you’re the one they want running things.
Furthermore, as Greg Sargent reminds us, “when it comes to supplying genuine oversight, previous House GOP probes — into Benghazi and the IRS scandal – devolved into circus stunts. Those investigations got knocked off kilter by lurid and fanciful charges that seemed directed at a hard right audience that remains firmly in the grip of the conservative closed information feedback loop.” In today’s Republican party, efforts at embarrassing the Obama administration quickly get taken over by the the party’s tin foil hat brigade, and even the sane ones end up playing to Sean Hannity’s audience instead of to the country as a whole.
If you’re a Republican member of Congress, this is coming at a critical time, because it’s around now when your potential primary opponents are deciding whether they want to run against you in next year’s election. That gives you an incentive to prove to the folks back home that you’re as conservative as the nuttiest Tea Partier. It isn’t hard to do, really—all that’s necessary is to go on television and tell the Fox News host that you’re deeply concerned that Healthcare.gov was intentionally made to work improperly as a pretext for the socialist Obama administration to collect all our DNA to facilitate herding us into FEMA concentration camps (or something like that). Which helps make your primary challenge less likely, but doesn’t serve the party’s larger purpose of convincing the American public that the GOP is not, in fact, a party of extremists who don’t care about governing.
Hearings like these seldom produce any useful information, but if they increase the pressure on the administration to get things fixed quickly, then that’s all to the good. But if I were a Republican, I wouldn’t get too excited about what they’re going to do for my party.
By: Paul Waldman, Contributing Editro, The American Prospect, October 24, 2013
“GOP Crocodile Tears On Obamacare”: Their Entire Strategy Is To Create Noise, Not Solutions
One of the strange things about politics is that it is considered “smart” to make every conceivable argument against your foes, even when your arguments are contradictory or reveal you to be indifferent to people leading desperate lives. But rarely is this “throw the kitchen sink” tactic pursued with such hypocritical gusto as with the GOP’s primal scream over the Obamacare Web site’s rollout.
To listen to Republican laments about Healthcare.gov’s terrible launch, you’d think the GOP was deeply concerned that people who need affordable health insurance are being denied this essential protection thanks to the administration’s incompetence.
But of course nothing could be further from the truth. What conservative officials, pundits and advocates are screaming is closer to the following:
How dare you totally screw up something that we think shouldn’t exist!
How dare you make it hard for poor, uninsured workers to get health coverage we don’t want to subsidize them to purchase!
What did Kathleen Sebelius know and when did she know it, when it comes to the wreck of a train we’ve prayed would be a train wreck all along?
This is what the “logic” of a party of “no” sounds like — where the entire strategy is to create noise, not solutions.
I get that a chunk of the GOP thinks discrediting government’s competence is a political winner (many of these critics are themselves lifers in elected office, but nevermind). But please spare us the fallacious leap to the idea that these Web site snafus reveal that the left’s “technocratic hubris” in “taking over a sixth of the American economy” was bound to fail.
There’s a reason everything about Obamacare is unduly complex, but it has nothing to do with a federal takeover. It’s precisely the opposite. Obamacare is complicated because it seeks to expand coverage largely by relying on private insurers, and also by honoring our tradition of federalism.
The need to check an applicant’s eligibility and income, and to use this information in light of locally offered private health plans to compute associated levels of potential subsidy — all of which requires tying together a bunch of huge databases that weren’t designed to communicate instantly with each other — comes from the need to subsidize the purchase of private coverage in a tailored way.
If we just gave every American a wallet-sized card like they do in single-payer nations — or even an identical universal voucher folks could use to help pay for private health coverage (as diverse voices from Zeke Emanuel and Victor Fuchs to Pete Peterson have championed) — the system, along with its technology backbone, would be far simpler.
This isn’t an excuse; it’s a piece of an explanation.
Meanwhile, when Republicans argue that the Web site’s initial failure means we shouldn’t go forward with extending affordable coverage to the uninsured, it’s like saying that the other high-profile tech failure this month — of the Web-based Common Application used by hundreds of colleges — means we should tell this year’s high school seniors to put off college. I mean, if that nonprofit can’t get the application technology right, what other reasonable choice is there?
The phoniest tears come from conservative analysts who “fear” that the Web site meltdown will trigger an adverse selection problem. The meme of the month is that only the sickest people will be desperate enough to persist in getting coverage, leaving the whole system subject to actuarial implosion.
As my daughter and her friends might say, “Chill, people.” Let’s see how the next few months go. There’s something sad and misguided about talented right-wing wonks devoting immense energy to criticism, yet seeming unable to spare a brain cell for actual public problem-solving. Even a conservative mind is a terrible thing to waste.
The problem, as always, is that once the GOP turns to health-care solutions, they’ll be forced to fess up that Romney-Obamacare was theirs. And it works. That’s something Republican voters are now finding out beyond just Massachusetts.
Like Butch Matthews, 61, a former small-business owner and lifelong Republican from Little Rock. Matthews and his wife, too young for Medicare, had been paying over $1,000 a month in the individual market for a Blue Cross Blue Shield policy with a $10,000 deductible.
“I did not think that Obamacare was going to be a good plan,” he told the (highly functional) Web site ThinkProgress. “I did not think that it was going to help me at all.”
He thought wrong. The policy Matthews just bought from the Arkansas Obamacare marketplace will cost him nothing after income-based subsidies and has a deductible of $750. Doctor visits will cost him $8 instead of nearly $150. He stands to save at least $13,000 a year
“I still am a very strong Republican, but . . . I am so happy this came along,” Matthews said.
If enough Republican voters have happy endings like this, it won’t be long before the GOP’s crocodile tears turn real.
By: Matt Miller, Opinion Writer, The Washington Post, October 23, 2013
“Lousy Medicaid Arguments”: Deeply Revealing, More Evidence Of The Right’s Intellectual Decline
For now, the big news about Obamacare is the debacle of HealthCare.gov, the Web portal through which Americans are supposed to buy insurance on the new health care exchanges. For now, at least, HealthCare.gov isn’t working for many users.
It’s important to realize, however, that this botch has nothing to do with the law’s substance, and will get fixed. After all, a number of states have successfully opened their own exchanges, doing for their residents exactly what the federal system is supposed to do everywhere else. Connecticut’s exchange is working fine, as is Kentucky’s. New York, after some early problems, seems to be getting there. So, a bit more slowly, does California.
In other words, the technical problems, while infuriating — heads should roll — will not, in the end, be the big story. The real threat remains the effort of conservative groups to sabotage reform, especially by blocking the expansion of Medicaid. This effort relies heavily on lobbying, lavishly bankrolled by the usual suspects, including the omnipresent Koch brothers. But it’s not just money: the right has also rolled out some really lousy arguments.
And I don’t just mean lousy as in “bad”; I also mean it in the original sense, “infested with lice.”
Before I get there, a word about something that, as far as we can tell, isn’t happening. Remember “rate shock”? A few months ago it was all the rage in right-wing circles, with supposed experts claiming that Americans were about to face huge premium increases.
It quickly became clear, however, that what these alleged experts were doing was comparing apples and oranges — and as Ezra Klein of The Washington Post pointed out, oranges that, in many cases, you can’t even buy. Specifically, they were comparing the premiums young, healthy men were paying before reform with the premiums everyone — including those who previously couldn’t get insurance because of pre-existing conditions — will pay under the new system. Oh, and they also weren’t taking into account the subsidies many Americans will receive, reducing their costs.
Now people are signing up for policies on state exchanges and, to a limited extent, on the federal exchange. Where are the cries of rate shock? Anecdotal evidence, which is all we have so far, says that people are by and large happily surprised by the low cost of their insurance. It was telling that when Fox News eagerly interviewed some middle-class Americans who said they had been hurt by the Affordable Care Act, it turned out that none of their guests had actually checked out their new options — they just knew health reform was terrible because Fox News told them so.
Now, about those lousy Medicaid arguments: Last year’s Supreme Court decision upholding the Affordable Care Act did strike down one provision, the one that would have forced all states to accept an expansion of Medicaid, the already-existing program of health insurance for the poor. States are now free to reject that expansion. Yet how can states justify turning down a federal offer to insure thousands of their citizens, one that would cost them nothing in the first year and only trivial amounts later? Sheer spite — the desire to sabotage anything with President Obama’s name on it — is the real reason, but doesn’t sound too good. So they need intellectual cover.
Enter the same experts, more or less, who warned about rate shock, to declare that Medicaid actually hurts its recipients. Their evidence? Medicaid patients tend to be sicker than the uninsured, and slower to recover from surgery.
O.K., you know what to do: Google “spurious correlation health.” You are immediately led to the tale of certain Pacific Islanders who long believed that having lice made you healthy, because they observed that people with lice were, typically, healthier than those without. They were, of course, mixing up cause and effect: lice tend to infest the healthy, so they were a consequence, not a cause, of good health.
The application to Medicaid should be obvious. Sick people are likely to have low incomes; more generally, low-income Americans who qualify for Medicaid just tend in general to have poor health. So pointing to a correlation between Medicaid and poor health as evidence that Medicaid actually hurts its recipients is as foolish as claiming that lice make you healthy. It is, as I said, a lousy argument.
And the reliance on such arguments is itself deeply revealing, because it illustrates the right’s intellectual decline. I mean, this is the best argument their so-called experts can come up with for their policy priorities?
Meanwhile, many states are still planning to reject the Medicaid expansion, denying essential health care to millions of needy Americans. And they have no good excuse for this act of cruelty.
By: Paul Krugman, Op-Ed Columnist, The New York Times, October 20, 2013
“Hey, Obamacare Complainers”: You Hypocrites, Regular Insurance Has Tons of Glitches Everyday
The nation’s new health-insurance exchanges, the online marketplaces for medical coverage that are an integral part of Obamacare, opened for business last week. Immediately the trouble began. Web pages went blank. Attempts to enroll in coverage were delayed, or altogether stymied, as sites crashed. Critics of the law pounced. “Too many unanswered questions and too many unsolved problems,” said U.S. Sen. Orrin Hatch, Republican of Utah.
Yet there’s another way to see these growing pains: as evidence not of change but of continuity for consumers of health insurance in America. With each misstep, government officials are simply catching up to the record of headache-inducing frustrations produced by the longstanding private medical insurance system.
Whether you’re one of the 50 percent or so of Americans who already have private health insurance (mostly through an employer, as I do) or one of those who may now turn to the exchanges to buy coverage, the bureaucracy is often maddening. Sure, the Affordable Care Act may seem opaque and unwieldy, but make no mistake: Employer-provided healthcare—which offers plans by the very same companies now on the exchanges—is equally Byzantine. No wonder that only 22 percent of American consumers reported themselves as satisfied with the health care system in a 2012 survey from the Deloitte Center for Health Solutions.
A few weeks ago I had an all-too-typical experience. My insurance company, Anthem Blue Cross, sent me a letter saying, “It has come to our attention that we have been paying for certain . . . drugs that are not covered under your existing benefit plan.” Going forward, the letter added, my doctor would need to prescribe something different or I’d have to start paying for these particular medications myself.
And when would this kick in? According to one part of the letter, January 1, 2014. According to a different part of the letter, right away.
It concluded with the sentence I’ve come to dread most: “If you have any questions or concerns, please call the customer service number on your ID card.”
Bravely, I did. Forty-five minutes later, I had yet to talk to an actual human being. Finally, at the 50-minute mark, a customer-service representative showed up on the line. She was cheerful and peppy. I was not.
The Anthem representative was unable to clarify anything in the letter and asked if she could put me on hold while she did a little research. I said OK, but I made a special plea: to call me back if we somehow got disconnected. Just a week before, on another Anthem call—concerning a paid claim that Anthem said was unpaid—I’d gotten cut off after an hour or so on the phone. She assured me that she’d call me back, if need be.
Ten minutes later, the representative returned to tell me that the answer to when Anthem would stop covering my prescriptions was neither January 1 nor immediately. It was December 1.
Where did this new date suddenly come from? She couldn’t explain. I asked to speak to her supervisor directly. She countered with a classic chess move: I was put on hold for another 15 minutes. Then: “Thank you for calling Anthem Blue Cross. Good-bye.” The line went dead. Checkmate.
Despite my plea and the representative’s promise, no one from the company called me back. I have yet to find the stomach to phone Anthem again.
Sure, the implementation of the Affordable Care Act is hitting some bumps, especially in its early days. But before critics falsely brand these as the inevitable consequence of a “government takeover” of our healthcare system, let’s remember that when it comes to medical coverage, bureaucratic snafus are hardly the province of Obamacare alone.
By: Randye Hoder, Contributor, Time Magazine, October 9, 2013
“The GOP’s White Southern Republican Problem”: Following Similar Path Of “Massive Resistance” Taken After Brown V. Board Decision
In 1956, segregationist Southern Democrats outlined a policy of “massive resistance” in response to the Supreme Court’s Brown v. Board of Education ruling desegregating public schools.
Today, the Republican Party, particularly in the South, is following a similar path of massive resistance when it comes to Obamacare and any other major policy initiative proposed by President Obama. According to The New York Times, twenty-six states—all-but-three controlled by the GOP—have declined the Medicaid expansion under Obamacare, thereby denying health insurance coverage to 8 million Americans. “Every state in the Deep South, with the exception of Arkansas, has rejected the expansion,” writes the Times.
The GOP’s obsession with defunding Obamacare has caused them to shut down the government despite the public outcry. Many factors play into the shutdown, but a leading cause is the fact the Republican Party is whiter, more Southern and more conservative than ever before.
Writes Charlie Cook:
Between 2000 and 2010, the non-Hispanic white share of the population fell from 69 percent to 64 percent, closely tracking the 5-point drop in the white share of the electorate measured by exit polls between 2004 and 2012. But after the post-census redistricting and the 2012 elections, the non-Hispanic white share of the average Republican House district jumped from 73 percent to 75 percent, and the average Democratic House district declined from 52 percent white to 51 percent white. In other words, while the country continues to grow more racially diverse, the average Republican district continues to get even whiter.
As Congress has become more polarized along party lines, it’s become more racially polarized, too. In 2000, House Republicans represented 59 percent of all white U.S. residents and 40 percent of all nonwhite residents. But today, they represent 63 percent of all whites and just 38 percent of all nonwhites.
Even though House Republicans do not represent the changing face of the country, they have a huge structural advantage when it comes to the makeup of Congress, especially following the 2010 redistricting cycle, when the GOP controlled the process in twenty states compared to seven for Democrats. Writes Cook:
The number of strongly Democratic districts—those with a score of D+5 or greater at the presidential level—decreased from 144 before redistricting to 136 afterward. The number of strongly Republican districts—those with a score of R+5 or greater—increased from 175 to 183. When one party starts out with 47 more very strong districts than the other, the numbers suggest that the fix is in for any election featuring a fairly neutral environment. Republicans would need to mess up pretty badly to lose their House majority in the near future.
This phenomenon is most acute in the South, where the GOP systematically packed as many Democratic voters, particularly African-Americans, into as few districts as possible in order to ensure huge Republicans majorities across the region (see my story “How the GOP Is Resegregating the South”). Here’s the gist:
In virtually every state in the South, at the Congressional and state level, Republicans—to protect and expand their gains in 2010—have increased the number of minority voters in majority-minority districts represented overwhelmingly by black Democrats while diluting the minority vote in swing or crossover districts held by white Democrats. “What’s uniform across the South is that Republicans are using race as a central basis in drawing districts for partisan advantage,” says Anita Earls, a prominent civil rights lawyer and executive director of the Durham-based Southern Coalition for Social Justice. “The bigger picture is to ultimately make the Democratic Party in the South be represented only by people of color.” The GOP’s long-term goal is to enshrine a system of racially polarized voting that will make it harder for Democrats to win races on local, state, federal and presidential levels. Four years after the election of Barack Obama, which offered the promise of a new day of postracial politics in states like North Carolina, Republicans are once again employing a Southern Strategy that would make Richard Nixon and Lee Atwater proud.
After the 1994 elections, white Southern Republicans accounted for sixty-two members of the 230-member House GOP majority. Today, white Southern Republicans account for ninety-seven members out of the 233-member House GOP majority. That’s a pretty remarkable shift and one that is not likely to end any time soon. “In all but one election since 1976, the proportion of Southerners in the House Republican caucus has gone up,” says Dave Wasserman of the Cook Political Report.
Of the fifty-four members of the congressional Tea Party Caucus—which is most vociferously telling John Boehner not to compromise—33 are from Southern states. Of the eighty members of the so-called House GOP “suicide caucus” who urged Boehner to defund Obamacare, “half of these districts are concentrated in the South,” writes Ryan Lizza of The New Yorker. As long as ultraconservative Southerners from lily-white districts hold the balance of power in the Congress, we shouldn’t be surprised that obstruction and dysfunction is the result.
By: Ari Berman, The Nation, October 4, 2013
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