“Boehner Struggles With His Failed ACA Predictions”: He Should At Least Try To Discuss The Substance Of The Issue Honestly
House Speaker John Boehner sat down with NBC’s Chuck Todd on “Meet the Press” yesterday, and the host asked a good question about the Republican leader’s failed predictions about the Affordable Care Act. Regrettably, the Speaker couldn’t respond with an equally good answer.
TODD: You made some dire predictions about health care. 2014 you said fewer people would have health insurance. According to plenty of surveys, more people have health insurance today than they did before it went down from – the uninsured rate went down 17 percent to just under 12 percent. You said it would destroy jobs. The first year it was implemented, the country added 3 million jobs. Why…
BOEHNER: Obamacare made it harder for employers to hire people. The economy expands and as a result, you are going to have more employees because businesses have to. But if you can ask any employer in America, and ask them whether Obamacare has made it harder for them to hire employees, they’ll tell you yes. Because it’s a fact.
When you look at – you know why there are more people insured? Because a lot more people are on Medicaid. And giving – you know, we expanded Medicaid in a big way. And giving people Medicaid insurance is almost like giving them nothing. Because there aren’t – you can’t find a doctor that will see Medicaid patients.
The Speaker soon added that, as far as he’s concerned, the Affordable Care Act is “not working.”
Boehner might have a credible argument, if we abandoned the agreed upon meaning of “working.”
Look, I realize that health care policy has never been the Ohio Republican’s strong suit, and the Speaker isn’t a wonk deeply engaged in policy details. I can also appreciate why he’s a little embarrassed about making all kinds of ACA predictions, each of which turned out to be wrong. It’s just not realistic to think Boehner will fess up on national television to getting the entire fight over health care backwards.
There’s just no avoiding the fact, however, that Boehner’s comments on “Meet the Press” were woefully incorrect.
According to the Speaker, “it’s a fact” that the Affordable Care Act has “made it harder for employers to hire people.” There’s simply no evidence to support this. None. The U.S. economy saw a jobs boom coincide with the implementation of the ACA. Indeed, the reform law has actually created plenty of jobs within the health care industry by spurring “unprecedented” levels of “entrepreneurial activity.”
At the same time, Boehner believes the drop in the uninsured rate is the result of Medicaid expansion, but that’s wrong, too – millions of consumers have gained private coverage by way of exchange marketplaces. This is even true of the Speaker’s home state of Ohio, which is prepared to create its own exchange if the Supreme Court makes it necessary.
As for the benefits of Medicaid, coverage through the program is not the practical equivalent of “nothing.” Many Americans who’ve gained health security through Medicaid have benefited greatly from affordable care.
Boehner’s conclusion – that “Obamacare” is “not working” – is only true if one closes their eyes, sticks their fingers in their ears, and refuses to consider the evidence. The law is pushing the uninsured rate to new lows; it’s succeeding in satisfying consumers; the law’s price tag is lower than expected; it’s producing impressive results on premiums and enrollment totals; we’re seeing the lowest increase in health care spending in 50 years; the number of insurers who want to participate in exchange marketplaces keeps growing; there’s reduced financial stress on families, the efficacy of Medicaid expansion is obvious, as is the efficacy of the medical-loss ratio and efforts to reduce medical errors system-wide.
The maligned law is even becoming more popular.
Boehner doesn’t have to like the law. He doesn’t even have to admit he was wrong. But he should at least try to discuss the substance of the issue honestly.
By: Steve Benen, The Maddow Blog, May 4, 2015
“Florida’s Rick Scott Files Bizarre New ACA Lawsuit”: Scott Only Wants A Check ‘That Doesn’t Have Obamacare Cooties’
It was just last week when Florida Gov. Rick Scott (R) completed a rarely seen flip-flop-flip, denouncing Medicaid expansion, then embracing it, and then condemning it. The consequences matter: 800,000 low-income Floridians were poised to have access to medical care, but they’ll now go without.
And while the governor’s decision seemed like the end of the story, it was actually the start of a more ridiculous turn of events.
Republican Gov. Rick Scott announced Thursday that he will sue the federal government for allegedly coercing Florida to expand Medicaid.
“It is appalling that President Obama would cut off federal healthcare dollars to Florida in an effort to force our state further into Obamacare,” Scott said in a statement.
By late yesterday, the far-right governor was reduced to comparing the White House to the mafia. “This is the Sopranos,” Scott said. “[Administration officials] are using bullying tactics to attack our state. It’s wrong. It’s outrageous they are doing this.”
This is actually one of the more amazing political fights in the country right now, and it’s worth appreciating why.
Back in 2006, the Bush/Cheney administration created a Medicaid pilot project intended to provide funds to help hospitals treat the uninsured. The policy was called “Low Income Pools” (LIP) and Florida received some money through the initiative.
Not surprisingly, the Affordable Care Act made the LIP project unnecessary, and began phasing out the policy.
In Florida, Scott seized on this in the most bizarre way possible – if federal officials are willing to scrap LIP funding, the governor said, then maybe they won’t fund Medicaid. The Republican found a convenient excuse to reject billions in federal funds and a lifeline to 800,000 of his struggling constituents.
Yesterday, the governor took this one step further, announcing a lawsuit to force Washington to give Florida federal funds for a program that will no longer exist. Scott wants money from the Obama administration to help Floridians (through LIP), but at the same time, he also doesn’t want money from the Obama administration to help Floridians (through the ACA).
Joan McCarter joked that Scott only wants a check “that doesn’t have Obamacare cooties.” Greg Sargent added that the governor could very easily clean up this mess by re-embracing Medicaid expansion through the ACA and simply claiming “it isn’t Obamacare.”
Even the Republican president of the Florida state Senate acknowledged yesterday that Scott’s lawsuit doesn’t make any sense
The bottom line in this little farce is that Rick Scott is going to extraordinary lengths – embracing and rejecting money, pitting the GOP-led state House against the GOP-led state Senate, dividing his allies, ignoring the needs of hundreds of thousands of his constituents, undermining his own state budget, even turning down tax cuts – because he finds it necessary to be against “Obamacare.” There’s no real substance to any of this, so much as there’s a partisan principle that the Republican governor is choosing to put at the top of his priority list.
The consequences are predictably absurd.
Brian Beutler’s take on this is exactly right: Scott is “suing the federal government to bail him out of a self-made crisis.”
By: Steve Benen, The Maddow Blog, April 17, 2015
“This Did Not Go According To Plan”: McMorris Rogers Gets An Earful On ACA
For much of 2013 and 2014, Republicans were on a quest to discover “Obamacare victims.” GOP officials were convinced the Affordable Care Act was wreaking havoc on families’ lives, and Republicans everywhere were hunting for horror stories.
In nearly every instance, those stories fell apart in the face of routine scrutiny, and most of the “victims” were actually far better off with the ACA than without it. One of the more notable examples arose early last year when Rep. Cathy McMorris Rodgers (R-Wash.), the House Republican Conference chair, used her party’s official response to the State of the Union to introduce America to “Bette in Spokane.”
Predictably, the story unraveled and McMorris Rodgers was pressed for an apology after pushing a misleading story. A year later, the Republican congresswoman hasn’t given up.
Cathy McMorris Rodgers, chair of the House GOP conference, took to Facebook to commemorate the fifth anniversary of the Affordable Care Act by asking to hear real-life horror stories from real people.
This did not go according to plan. McMorris Rodgers generated plenty of responses, most of which were from people who see the ACA as a lifesaver for their families.
I’m not altogether sure what the point of the endeavor was supposed to be. What exactly did the Republican congresswoman hope to accomplish?
But even putting that aside, this little incident should be a reminder to GOP lawmakers that their assumptions about “Obamacare” may not be in line with Americans’ reactions in the real world. In fact, if Republicans on the Supreme Court gut the law, consumers will be looking to folks like McMorris Rodgers to prevent systemic chaos.
Postscript: Wonkette joked, “[O]bviously, the takeaway here is that Obamacare is such a huge failure that the government is paying people to troll Facebook and lie about how much they like the ACA, because liberals are congenital liars, and poor Cathy McMorris Rodgers is a victim of cyberbullying, the end.”
Wonkette was kidding, but I wouldn’t be too surprised if this line took root in conservative media fairly soon, if it hasn’t already.
By: Steven Benen, The Maddow Blog, March 27, 2015
“Can’t Stop, Won’t Stop”: GOP Will Never Stop Coming For Obamacare
Obamacare turned 5 on Monday, a birthday achieved despite sustained and repeated efforts to smother the law in its cradle.
The law has taken some hits, including a 2012 Supreme Court decision that buckled the knees of the bill’s backers but seemed to make the Affordable Care Act the settled law of the land.
Now the Supreme Court has again taken up another challenge to the law.
King v. Burwell hinges on whether or not four words buried deep in the text of the law contain the seeds of Obamacare’s destruction by eliminating tax subsidies for people living in states that declined to set up their own insurance exchanges.
But even if they lose again at the court, conservatives say that they will continue to try to undo the law through the courts.
Michael Cannon, a health-policy expert at the Cato Institute, said the most promising challenge to the ACA comes from the state of Maine, which, after the Roberts court ruled in 2012 that the federal government was limited in how much it could compel states to expand Medicaid, sued to roll back its existing Medicaid coverage.
Last year, a federal appeals court ruled against the state, but Gov. Paul LePage has appealed to the Supreme Court, even as Maine’s attorney general has refused to represent the state in its challenge of the law.
Other remaining challenges include Sissel v. U.S. Department of Health and Human Services, which argues the ACA is unconstitutional because it violated the Constitution’s origination clause that states spending bills must originate in the House, not the Senate.
“They are both kind of long shots,” acknowledged Cannon, noting that “the Supreme Court has never struck anything down on origination grounds” and that the House likely lacks standing in its lawsuit against the administration.
If the administration loses King v. Burwell, most health-policy experts predict that it will create a “death spiral” as low-income beneficiaries lose their subsidies in states that did not set up their own exchanges, and insurers are forced to raise rates. But conservatives say they will not delay in kneeing the law into the grave by filing lawsuits in states that set up their own exchanges.
Because many states rushed to do so, conservatives say they expect that governors and their health departments may have violated their state constitutions, and so even residents of those states that believed they were immune from the Burwell decision could face a loss of subsidies as well.
If the Supreme Court decides in favor of the government in King, conservative legal scholars said that what they decide to do in the future to tear down the law depends upon precisely the way in which the judgment is rendered. Halbig v. Burwell mirrors the King case in many respects, but other cases could still go forward, in particular one in Indiana in which several dozen school districts have argued that the employer mandate to provide health insurance puts too much of a burden on state and local governments.
Smaller challenges to the law, meanwhile, continue to mount. Little Sisters of the Poor sued to exempt themselves from the contraceptive mandate. If successful, the suit would allow more organizations to opt out than the Hobby Lobby decision did.
Another challenge, brought by the Goldwater Institute of Arizona, takes aim at the Independent Payment Advisory Board, which was designed to permit the Executive Branch to limit Medicare payments. Even some of the law’s liberal supporters, like former Vermont Gov. Howard Dean, have said that the board should be eliminated or rethought.
Meanwhile, conservative legal scholars say they continue to pore over the text of the law in the hopes that they will find some other legal weaknesses that were not readily apparent. The King case, after all, hinges on four words in the text that were discovered by a legal scholar months after the law was passed.
“This law is so complicated that even those who have read it don’t understand the depths of it,” said John R. Graham, a senior fellow at the conservative National Center for Policy Analysis. “Every time we look at it, we find something else to take to a judge.”
And such lawsuits, he added, help galvanize opposition to the bill years after it has passed.
“They keep the energy up, keep Obamacare on the front pages, keep hope alive.”
Which is necessary, because many conservatives still hope that the law will collapse under its own weight.
“They have really reached the limit of sign-ups. Enrollment is flattening as people see more and more how expensive the coverage is, how high the deductibles are, all the hoops they have to jump through, and they realize it is just not very attractive insurance,” said Grace-Marie Turner of the Galen Institute. She said that many states would be able to opt out of some of the law’s provisions in 2017, and find their own alternatives.
“There is going to be huge momentum going forward to make changes to this law,” Turner said. “I could go on forever about how damaging this law has been to people’s lives. It has to be changed.”
By: David Freedlander, The Daily Beast, March 25, 2015
“It’s Better To Let Your Constituents Lose Their Coverage”: Paul Ryan To States; Help Us Sabotage Health Care
On the fifth anniversary of the Affordable Care Act becoming law, there’s value in reflecting on the systemic advances, which we did earlier. But it’s also a good time to look ahead and consider where the policy fight is headed.
Congressional Republicans, for example, who’ve already voted literally several dozen times to repeal the law, released budget plans last week that would – you guessed it – uproot the American health care system, replacing it with an alternative that Republicans can neither explain nor identify.
As if that weren’t quite enough, the GOP budget plans would likely double the uninsured rate, while eliminating $1 trillion in tax revenue that pays for the ACA. Because the Republican budget blueprint relies on bizarre gimmicks and fraudulent arithmetic, the plan offers no explanation for how it would cover the $1 trillion loss and no details about how Congress would help the millions of families that would lose access to affordable medical care after Republicans take their benefits away.
The GOP budget also makes no effort to address the possibility that Republican justices on the Supreme Court may soon scrap subsidies to consumers in two-thirds of the country in the ridiculous King v. Burwell case. House Ways & Means Committee Chairman Paul Ryan (R-Wis.), however, is on the case – he doesn’t have a policy solution, but Ryan has a plan to persuade state policymakers to help congressional Republicans’ broader game plan.
Rep. Paul Ryan urged state lawmakers to resist setting up state insurance exchanges if the Supreme Court rules that key parts of the Affordable Care Act can only continue if they do so.
“Oh God, no… The last thing anybody in my opinion would want to do, even if you are not a conservative, is consign your state to this law,” the Wisconsin Republican told state legislators Thursday during a conference call organized by the Foundation for Government Accountability, a conservative think-tank.
Ryan reportedly went on to say, “If people blink and if people say, ‘This political pressure is too great, I’m just going to sign up for a state-based exchange and put my constituents in Obamacare,’ then this opportunity will slip through your fingers.”
The right-wing Wisconsinite is known for some pretty extreme postures, but this is a brazen move, even for Paul Ryan.
If the Republican justices gut the Affordable Care Act, it’s likely Americans would see a bifurcated system: consumers in states run by Democrats would continue to receive subsidies to afford quality medical coverage, while millions of consumers in Republican-run states would go without. Or put another way, if your state created its own exchange marketplace, very little will change. If your state has referred consumers to healthcare.gov to enroll, you and your neighbors may be in big trouble.
If the high court’s ruling sides with the right, it’s quite likely that some Republican-led states would scramble to create their own exchange in order to help their citizens. Indeed, leading GOP officials in states like Michigan and Ohio have already indicated an intention to do exactly that in order to prevent their constituents from suffering.
That’s what Paul Ryan is responding to – he’s effectively telling these state officials, “No, wait, it’s better to let your constituents lose their coverage. Helping families keep their coverage is what the White House wants, so don’t do it.”
And what about the “opportunity” Ryan mentioned on Friday? As the congressman sees it, if the Supreme Court sides with Republicans, and if states agree to let their citizens go without, then they’ll be able to take advantage of the new GOP alternative to the Affordable Care Act. What’s in it? Paul Ryan doesn’t know. What will it cost? Paul Ryan doesn’t know. How many people will it cover? Paul Ryan doesn’t know. When can we see it? Paul Ryan doesn’t know.
Why in the world would state officials listen to such ridiculous advice, putting their own constituents in jeopardy? Paul Ryan doesn’t know – and neither does anyone else.
By: Steve Benen, The Maddow Blog, March 23, 2015
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