Republican Failures On Health Care Raise Calls For Single-Payer Health Plan

The failure of  the Republican attempt to repeal Obamacare is a tremendous defeat for Donald Trump, along with Paul Ryan, which may hinder their ability to pass other parts of the Republican agenda, such as rewriting the tax code. The inability of Republicans to come up with a reasonable solution for our health care problems highlights the inability to solve the problem by relying on the market, and has revived calls for a single-payer health care plan.

The Week has this argument for Why Democrats should push ‘Medicare for all’ now even before it the Republicans gave up on their plan:

The AHCA is a monstrous bill that would leave at least 24 million more people uninsured by 2026. But whether or not it fails, the Democrats shouldn’t sit idly by and wait for Republicans to slowly bleed ObamaCare to death by other means. They need a counter-offer, one that’s more compelling than the creaky status quo. They need a single-payer, Medicare for all plan. Here’s why.

The first reason is that single-payer is quite clearly the best universal health-care policy option for the United States. As Dr. Adam Gaffney explains, the U.S. model of multi-tiered health insurance has generally lousy and highly unequal outcomes, both here and in European countries with similar structures like the Netherlands. Complicated public-private hybrid systems mean much larger administrative costs, and the fact that markets are extraordinarily ill-suited to deliver health care means tons of difficult regulation.

Indeed, the distance in uninsured people between ObamaCare and single-payer is actually greater than that between ObamaCare and the Republican plan. Complicated, janky programs tend to let people fall through the cracks.

..The AHCA is extraordinarily unpopular because it takes coverage and subsidies away from people, and a majority believe that it should be the government’s responsibility to make sure everyone is covered. Fundamentally, Medicare is very popular, a fact only partially covered up by generations of red-baiting and duplicitous austerian propaganda. If Democrats had simply bulled ahead with a single payer-esque plan in 2009, instead of the complicated and heavily means-tested ObamaCare, they almost certainly would have done better than they actually did in the 2010 election.

And even for people who are skeptical of going full-bore all at once on single-payer, it still makes an excellent opening bid. Start with single-payer for all during the next bite at the health-care apple, and you could end up with a plan of combining Medicare and Medicaid, enrolling all people under 26 and over 55, and putting a Medicare buy-in on the ObamaCare exchanges. (That might begin chipping away at the employer-based system and be a somewhat more gradual route to single-payer.) Just witness the original opening bid for ObamaCare, which was far more generous before it got badly whittled down by conservative Democrats…

It also makes an excellent organizing signpost. Medicare for all is simple, easy to understand, and hard to argue against or distort. Most people know someone on Medicare who can testify to the generally good care, or who is counting the days until they can enroll and have the peace of mind that comes with quality coverage. Fabricated agitprop like the mythical ObamaCare “death panels” will be a much harder sell.

Erica Etelson is one of those writing op-eds promoting a single-payer plan, and taking the Democratic Party to task for failing to do so:

With Trumpcare dead on arrival in Congress, Democrats have an opening to propose what they should have pushed for in the first place: single-payer health care for all. Fifty-eight percent of Americans, including 41 percent of Republicans, favor a federally funded health care system that provides universal coverage. Only 48 percent want to keep Obamacare as is.

Though Democrats are loathe to admit it, Obamacare is far from perfect. Some people pay higher premiums and out-of-pocket costs than they can afford. In some areas of the country, choices of doctors are limited. Compared to nations with single-payer systems, health outcomes are poor. And a small but vocal minority of Americans are troubled by Obamacare’s individual mandate which, they believe, infringes on their liberty…

Bernie Sanders ran with remarkable success on a Medicare for All proposal that generated enormous excitement among the progressive wing of the party and sent shivers down the spine of the Democratic corporate establishment. Hillary Clinton, a one-time champion of single-payer, pounced on Sanders with alarmist, counterfactual claims that Sanders’ proposal would increase costs and make people worse off.

While the GOP is still cringing over the humiliating defeat of its seven-year promise to repeal Obamacare, Democrats should kick them while they’re down by introducing single-payer legislation. Even Trump-collaborator, Sen. Joe Manchin, D-WV, is starting to wise up, thanks to his constituents; at a recent town meeting, Manchin praised Canada’s health care system and said he was taking a look at single-payer as an alternative to Obamacare…

We watched the Democratic National Committee undercut Sanders’ candidacy. And we’ve watched the Democrats disappear the single-payer option by refusing to support Rep. John Conyers’, D-MI, single-payer bill (HR 676). Enough.

The Democrats’ lackluster opposition to Trumpism does not match the fierce and relentless resistance of their base. They can and must stop doubling down on the centrist “pragmatism” that has alienated growing numbers of voters and start acting like a party more committed to the health and well-being of the 99 percent than protecting the power and profits of oligarchs.

This populist moment in American politics is the Democrats’ to seize. With a strong majority supporting single payer, the Democrat have a golden opportunity to give their dwindling base a reason to come home. As Trump said moments after conceding defeat, “Here’s the good news: Health care is now totally the property of the Democrats.” Good news indeed, if the Democrats know what to make of it.

Donald Trump now has the opportunity to work with Democrats, and any Republicans who are willing, to fulfill his campaign promises of giving us a great health care plan which will cover everybody. Of course he will not do so, and will probably continue to work to undermine the Affordable Care Act.

Obamacare Repeal Fails

Donald Trump and Paul Ryan are both losers.

In a spectacular political defeat for Donald Trump and Paul Ryan, the legislation to repeal Obamacare has been pulled as it was clear it was going down to defeat. It was far easier for Republicans to vote to repeal the Affordable Care Act over fifty times in the past when they knew it would be vetoed if it made it through both houses of Congress than it is now that they would be held accountable for a replacement. The New York Times reports:

House Republican leaders, facing a revolt among conservatives and moderates in their ranks, pulled legislation to repeal the Affordable Care Act from consideration on the House floor Friday in a major defeat for President Trump on the first legislative showdown of his presidency.

“We’re going to be living with Obamacare for the foreseeable future,” the House speaker, Paul D. Ryan, conceded.

The failure of the Republicans’ three-month blitz to repeal President Barack Obama’s signature domestic achievement exposed deep divisions in the Republican Party that the election of a Republican president could not mask. It cast a long shadow over the ambitious agenda that Mr. Trump and Republican leaders had promised to enact once their party assumed power at both ends of Pennsylvania Avenue.

Paul Ryan apparently was  surprised to find that it is complicated to sell Americans on health care plan which will cost them more and provide less.

CBO Issues Devastating Report On Effects Of GOP Obamacare Replacement

The nonpartisan Congressional Budget Office has projected that twenty-four million more Americans will wind up uninsured under the Republican health care plan (which calls into question whether this should be called a health care plan at all). The plan would provide inadequate funding for Medicaid, and risks destabilizing the individual market–unless you believe Republican predictions that the free market would respond with better products. This is rather hard to believe considering the failure of the market to handle insurance for those not receiving it through employer or government programs prior to the Affordable Care Act.

To put this in perspective, studies have projected that the loss of insurance by twenty million people (which is less than is predicted under the Republican plan) will result in 24,000 more deaths per year. This backs up the statement from Bernie Sanders that “thousands of Americans will die” if the Republican plan becomes law

Remarkably, a White House analysis projected that the plan will result in an even higher number losing insurance–26 million over the next decade. This is hardly consistent with what Donald Trump promised on the campaign trail. The plan also contradicts Trump’s promises that he would not cut Medicaid and would expand payment for treatment of opiate dependence.

The Center on Budget and Priorities notes how millions would be paying more for less coverage, along with facing higher out of pocket expenses. Aaron Blake points out:

According to the CBO, 64-year olds making $26,500 per year would see their premiums increase by an estimated 750 percent by 2026. While they are on track to pay $1,700 under the current law, the CBO projects the American Health Care Act would force them to pay $14,600. Even if you grant that inflation will allow them to make slightly more money by 2026, that’s still about half of their income going to health care.

There is additional information of significance. Despite Republican claims of a death spiral, the CBO report showed that the ACA is not “imploding.” As other studies have also found, it is stabilizing as more people obtain coverage:

Under current law, most subsidized enrollees purchasing health insurance coverage in the nongroup market are largely insulated from increases in premiums because their out-of-pocket payments for premiums are based on a percentage of their income; the government pays the difference. The subsidies to purchase coverage combined with the penalties paid by uninsured people stemming from the individual mandate are anticipated to cause sufficient demand for insurance by people with low health care expenditures for the market to be stable.

The Washington Post has fact checked White House press secretary Sean Spicer’s spin regarding the CBO report.

Quote of the Day: Conan On Trump’s Muslim Travel Ban & Health Care Plan

Disney has announced that its upcoming live-action “Aladdin” movie is going to feature Middle Eastern actors. Filming will begin in May, or whenever the actors are no longer detained at the airport.

Bonus Quotes

New research says that Neanderthals used to relieve pain by chewing on a plant containing the main ingredient in aspirin. Or as that’s now being called, “the Republican healthcare plan.”

Hawaii is suing President Trump over his latest travel ban. In response, President Trump is suing Hawaii for “being hard to spell.”

The Republican Health Care Plan Screws Many To Help Very Few

It looks like Republicans think that America has been demanding a new health care plan which will greatly reduce the number of people who are insured, increase costs for poor and older Americans, destabilize the individual insurance market, and cut taxes for the wealthy. While waiting for the CBO scoring, the Brookings Institute has made their calculations as to how terrible the Republican health care bill is, predicting that at least 15 million people will lose health care coverage:

There is significant uncertainty about exactly how CBO will model these provisions and how it will expect the various provisions to interact with one another. Nonetheless, we conclude that CBO’s analysis will likely estimate that at least 15 million people will lose coverage under the American Health Care Act (AHCA) by the end of the ten-year scoring window. Estimates could be higher, but it’s is unlikely they will be significantly lower.

 

Many will suffer from the cuts to Medicaid. Many of those who purchase private coverage on the exchanges will suffer because of how the subsidies are restructured, based on age as opposed to income and the actual costs of insurance. The Kaiser Family Foundation has posted projections regarding this.

Medical organizations and those representing the elderly including AARP, the American Medical Association and the American Hospital Association have objected to the Republican plan. AARP issued a statement opposing the “House plan that would make changes to our current health care system, such as shortening the life of Medicare, hiking costs for those who can least afford higher insurance premiums, risking seniors’ ability to live independently, and giving tax breaks to big drug companies and health insurance companies.”

The less affluent voters who backed Trump will be hurt by the changes. Of course some people do benefit. “Nearly everyone in the Top 1%, who earn more than $774,000 a year, would enjoy a hefty tax cut, averaging $33,000, according to the non-partisan Tax Policy Center. Those in the Top 0.1% would get an average tax cut of about $197,000.” Insurance companies also benefit:

Obamacare allowed insurance companies to deduct only $500,000 of their executives’ pay as a business expense. The GOP bill would repeal that limitation, starting in 2018.

Top insurers pay their leaders millions in compensation every year so this provision could mean a nice tax savings for the companies.

One excuse given by Republicans for repealing Obamacare is the increased cost of premiums. However, most people receive health care coverage through either government programs or employer programs, which have not had major increases in premiums. The individual market had frequent jumps in premiums, and that has continued, except under Obamacare most people receive subsidies to help cover this. As a consequence, only about three percent of the country is actually facing the increases in premiums which Republicans are using to justify their plan. In return, we receive more comprehensive coverage which cannot be denied based upon medical problems.

As one of the three percent who purchases health insurance without qualifying for subsidies, I certainly do not see the Republicans as doing me any favors. My premiums will be higher under the Republican plan than they are now, and the even bigger problem is that the plan may “threaten the stability of the individual market” per the Brookings report, possibly making it impossible to obtain coverage.

 

Discussing Obamacare Replacement With A Republican Congressman

House Republicans have finally released their plan to replace Obamacare. I have a lot of concerns about the plan, such as whether the tax credits will be sufficient for low income families to afford health insurance, and their attack on Planned Parenthood.

I am going to wait until I have a chance to look at the details of the plan to discuss it in depth, but for other reasons I have found it a good day to blog about health care. Hours prior to the release of the plan, I met with my conservative Republican Congressman, Bill Huizenga, along with a few colleagues, to discuss health care. I figured it would be futile to change the mindset of a conservative Republican, but when I received the invitation I also thought I should make the attempt to try to explain how health care really works. After all, there is zero chance of changing anyone’s mind if no attempt is made to persuade them. I was also appreciative that he was willing to meet with a group which strongly disagreed with him on the issue, while many Republicans around the country are reportedly hiding from their constituents.

The first time I spoke today I made a point of explaining how I am self-employed and have purchased health care on the individual market for my entire life. Therefore I could definitely state that high premiums and high out of pocket expenses, often cited as a failing of the Affordable Care Act by Republican, have always been a characteristic of the individual market–and are not something created by Obamacare.

Discussion got bogged down for quite a while over philosophical issues, especially when someone referred to health care as a right. Congressman Huizenga disagreed. While I managed to get out most of what I wanted to say today, in a conversation with multiple people present, sometimes the topic changed before I got a chance to speak. I didn’t get a chance until after the meeting while speaking to a colleague that I can understand a Republican’s position in not seeing health care as a Constitutional right in the same way as civil liberties specifically expressed in the First Amendment. After all, the Founding Fathers would have never conceived of health care being as expansive, and expensive, as it is now. However, regardless of whether you want to call it a right, access to affordable health care is both highly desirable, and something which is expected in a modern, advanced, industrialized society such as the United States. We should do it regardless of whether you want to label it a right.

The limited nature of assured coverage in the United States, compared to the rest of the world, was an underlying thought in many of our comments. It did come up that 1) the sick can show up to the Emergency Room and will not be turned away and 2) a significant portion of the Medicare population consists of the disabled. In typical Republican dodging of the issue, the Congressman at one point tried to claim that this does provide some form of basic health care as people can go to the Emergency Room. I pointed out that it is one thing to receive coverage in the Emergency Room, but this does not mean that people will receive necessary follow up medical care, especially for the types of chronic medical conditions I typically treat, such as diabetes, heart failure, and emphysema. Initial stabilization in an Emergency Room is both costly and not adequate health care. Plus an Emergency Room physician present pointed out that being seen does not mean patients do not receive large bills, which could be well beyond their ability to pay.

Congressman Huizenga responded that the disabled can receive coverage on Medicare, but I pointed out that people with chronic medical problems are not necessarily disabled, especially if they receive adequate medical treatment. Someone with diabetes, for example, can live and work for many years with the condition. However, without adequate care, twenty years down the road they are far more likely to develop problems such as heart attacks, strokes, and renal failure.

The Congressman’s philosophy on limited government (which, like most Republicans, is terribly selective, ignoring everything from infringements on reproductive rights to today’s revised anti-Muslim travel ban), also influenced his responses. Before his arrival I had discussed with others how market solutions have not worked well, with insurance companies having developed a business strategy based upon collecting premiums and then finding ways to deny care. Congressman Huizenga brought up irrelevant matters such as restrictions on choice present in Canada and other countries which Americans might not tolerate. The typical Republican scare stories. My response was simply that we do not have to adopt the restrictions which he mentioned, regardless of what other countries have done. One point I did not manage to get in was that in the United States, private insurance plans are often far more restrictive on the choices which patients and physicians can make than the government Medicare program is.

The physicians present generally saw Obamacare as an improvement over the previous system, but not going far enough, with Medicare for All being seen as a preferable solution. As a couple of us discussed afterwards, this is a far easier sell for physicians, who see first hand the amount of time and money wasted in having to deal with multiple different insurance companies, with  multiple different sets of rules. Plus this has the huge advantage of taking the astronomical profits received by the insurance industry, and using that money to actually provide health care. (Medicare for All was promoted by Bernie Sanders in the 2016 nomination battle, leading to politically-based opposition from Hillary Clinton.)

If Medicare for All is too hard a sell immediately, I, and others, suggested phasing it in. I also mentioned ideas such as the public option and the Medicare buy-in which were considered when the ACA was being written, but died when the two most conservative Senators voting with the Democrats (Joe Lieberman and Ben Nelson) opposed the ideas. Either would help with the high costs on the individual market.

The  higher cost for caring for older individuals, with some of that cost spread to the premiums of younger purchasers, is a major problem in health care coverage.  I doubt insurance companies even want to cover their older customers, who are responsible for the bulk of their costs. Either outright lower the Medicare age (even if gradually, such as initially to 50 or 55, and ultimately to around 40) or allow a Medicare buy-in.

After the Congressman left, his Legislative Director remained for a brief time and suggested that Americans would not go for expanding a government program such as Medicare. While a typical Republican thought, it does not hold up. I pointed out that we all do wind up on a government program, with most people going on Medicare at age 65. Not only are Americans failing to rebel at the though of going on Medicare at age 65, many look forward to the opportunity. Remember all those tea party protests with signs like “Keep Government Out Of My Medicare.”

My parting comment to Congressman Huizenga before he left was that Republicans must move beyond their anti-Obama rhetoric and actually address the problem. I related how for the past eight years I have often heard patients blame Obama for anything wrong with the health care system, even if it was over matters not even related to the Affordable Care Act. However, in early January, before Donald Trump even took office, I started to hear patients blame Trump for their healthcare problems. Republicans now “own” healthcare and must deliver.

I have my doubts as to whether the plan released today does deliver, but I do want to take a look at the details beyond what is in the initial news stories I have read.

Opposition To Trump Could Cost Republicans Control Of Congress

I have said many times that the party winning the 2016 presidential election would very likely suffer for it, considering how flawed and unpopular both candidates were. If Hillary Clinton had won, most likely we would see Democrats lose further seats in Congress and the state legislatures in 2018 and 2020. Opposition to Donald Trump should help the Democrats, especially with Hillary Clinton not on the ballot. The elections will largely be a referendum on Donald Trump. Will Jordan recently showed that historically a president with an approval rating as low as Trump’s typically  loses thirty-nine House seats, with the Democrats needing twenty-four votes to retake the House. Larry Sabato had similar findings:

History is on the Democrats’ side: The president’s party has lost ground in the House in 36 of 39 midterms since the Civil War. The average loss is 33 seats, a shift in seats that would flip the House next year. Unpopular presidents can galvanize the opposition — and Democrats already seem highly engaged in battling Trump — and President Trump’s approval rating is already underwater in some polls, meaning he hasn’t had much of a honeymoon. Of course, there’s plenty of time for that to change, both positively and negatively for the president.

While it is far too early to be certain that Trump’s approval rating will remain at its currently low levels, there is considerable cause for concern among Republican House members. This is exacerbated by the complaints many are seeing from their constituents. CNN has reported on the anger at Republican town halls and  The Washington Post reports that Swarming crowds and hostile questions are the new normal at GOP town halls:

Republicans in deep-red congressional districts spent the week navigating massive crowds and hostile questions at their town hall meetings — an early indication of how progressive opposition movements are mobilizing against the agenda of the GOP and President Trump.

Angry constituents swarmed events held by Reps. Jason Chaffetz (Utah), Diane Black (Tenn.), Justin Amash (Mich.) and Tom McClintock (Calif.). They filled the rooms that had been reserved for them; in Utah and Tennessee, scores of activists were locked out. Voters pressed members of Congress on their plans to repeal the Affordable Care Act, on the still-controversial confirmation of Education Secretary Betsy DeVos and even on a low-profile vote to disband an election commission created after 2000.

House Republicans had watched footage earlier this week of McClintock’s raucous town hall in northern California and his police-assisted exit — a warning of what might come. And with Congress scheduled for a week-long recess and a raft of additional town halls starting Feb. 18, the warning may have been warranted…

Remembering how voter anger and heated town halls helped end Democratic control of Congress in 2010, Republicans have begun taking security precautions. Some have avoided in-person town halls, holding forums on Facebook or by telephone instead. Many were briefed on security recommendations for public events and their district offices at a closed-door meeting led by Rep. Dave Reichert (R-Wash.), a former county sheriff.

If the Democrats are to retake Congress, it will depend on Trump’s popularity remaining low. Pollsters such as Mark Blumenthal are looking at both whether it is likely to remain low, and how low it can go:

One striking characteristic of Trump’s initial job rating is the relative intensity of disapproval. In our most recent full week of tracking, for example, far more Americans strongly disapprove of the way Trump is handling his job (41 percent) than strongly approve (29 percent). That gap means that Trump’s overall 46 percent approval rating includes 17 percent who only “somewhat approve” of his performance…

One of the themes of new administration, as the NBC News Politics team recently noted, is how “Trump picks fights with, well, almost anyone.” Those stories help reinforce the perception of his toughness and outspokenness.

The downside of these “sprays of attack,” as CNN’s Jake Tapper called them, are the “sprays of falsehoods coming from the White House” that accompany them. These controversies help further reinforce negative perceptions about Trump’s honesty forged during the campaign.

A second theme has been the flurry of initial executive actions that helped drive the sense, especially among Republicans, that Trump can get things done. But note that relative softness in perceptions of effectiveness among Trump’s least committed supporters. As the NBC Politics team points out, executive actions aside, the Trump team has made little progress so far on his “big ticket agenda items (Obamacare repeal and replace, tax relief, paying for that border wall).”

Again, it is very early in the Trump presidency and the long term trends in his approval rating will be influenced by the direction of economy and by war, peace and scandal, or the lack thereof. However, if the initial flurry of executive action gives way to gridlock and legislative stagnation, perceptions of Trump’s ability to “get things done” may atrophy, and with it, his overall approval rating.

We don’t know where Trump’s approval rating will be in 2018 and 2020. There are many factors beyond the actual actions of the president, and if the country is doing well despite Trump’s actions, the Republicans will benefit. However, the first three weeks of Trump’s presidency give Republicans a lot to worry about.

Country Now Evenly Divided On Impeachment Of Donald Trump

Donald Trump’s first three weeks in office have been a disaster, with Trump learning that being president is a hard job which he is not prepared for. Public Policy Polling shows that his support has dropped further from last week, with 46% both favoring and opposing impeachment:

PPP’s new national poll finds that Donald Trump’s popularity as President has declined precipitously just over the last two weeks. On our first poll of his Presidency voters were evenly divided on Trump, with 44% approving of him and 44% also disapproving. Now his approval rating is 43%, while his disapproval has gone all the way up to 53%. If voters could choose they’d rather have both Barack Obama (52/44) or Hillary Clinton (49/45) instead of Trump.

Just three weeks into his administration, voters are already evenly divided on the issue of impeaching Trump with 46% in favor and 46% opposed. Support for impeaching Trump has crept up from 35% 2 weeks ago, to 40% last week, to its 46% standing this week. While Clinton voters initially only supported Trump’s impeachment 65/14, after seeing him in office over the last few weeks that’s gone up already to 83/6.

While I don’t actually see impeachment as anything imminent, Common Dreams reports that, “On Thursday, Congressman Jerrold Nadler (D-NY) filed a ‘resolution of inquiry’ that amounts to the first legislative step toward impeachment.”

The poll looked at several issues where support for Trump is falling. This includes Obamacare:

47% of voters now say they support the Affordable Care Act to only 39% who are opposed. It just keeps getting more popular. And only 32% think the best course of action to take on health care is repealing the ACA, while 65% would like Congress to keep it and just fix parts that need fixing.

More now oppose Trump’s executive order on immigration than back it. Among those in support, a strong majority see the Bowling Green Massacre as a reason for why it is needed.

Voters think he’s over reaching to make a country safe…that they already consider to be safe. 66% of Americans consider the United States to be a safe country, to only 23% who consider it unsafe. Perhaps as an outgrowth of that sentiment only 45% of voters support Trump’s Executive Order on immigration, to 49% who are opposed to it. Among those who do support it you have to wonder how well thought out their position is- by a 51/23 margin Trump voters say that the Bowling Green Massacre shows why Trump’s immigration policy is needed.

By a 48/43 spread, voters do think that the intent of the Executive Order is to be a Muslim ban. And just 22% support a Muslim ban, to 65% who are opposed. The order has also increasingly raised issues about Trump’s competence in voters’ eyes- only 27% think the Executive Order was well executed, to 66% who think it was poorly executed. The spread on that question was 39/55 when we asked last week.

Another aspect of voters already feeling safe is that they don’t want to pay for the wall with Mexico. Just 32% support a 20% tax on items imported to the United States from Mexico, to 55% who are opposed to that concept. And in general only 37% of voters want the wall if US taxpayers have to front the cost for it, to 56% who are against that.

Betsy DeVos is also unpopular. Protesters were trying to prevent Betsy DeVos from entering a public school. While I totally sympathize with their view of her, I’m not sure this is a good idea. I don’t know if she has ever even seen the inside of a public school before. It might be a good idea for her to see what a public school is like, and that they are not threatened by grizzly bears. If they did want to keep her out they might have dressed up as grizzly bears in burkas. What could be scarier to her? (For those not familiar with her record, see this post.)

The Nation Begins To Unite In Opposition To Donald Trump–Growing Number Support Impeachment

Thanks to the incompetence of Donald Trump, opposition to his administration is far beyond what I might have hoped for a month ago. While it took five years to have massive opposition to George W. Bush, we are seeing it in the first two weeks under Trump. We are seeing demonstrations as big as, or in the case of the first weekend,  larger than, were seen during the Vietnam war. The number of people who want to see Trump impeached has reached 40 percent, up from 35 percent a week ago. Public Policy Polling provides these results:

Less than 2 weeks into Donald Trump’s tenure as President, 40% of voters already want to impeach him. That’s up from 35% of voters who wanted to impeach him a week ago. Only 48% of voters say that they would be opposed to Trump’s impeachment.

Beyond a significant percentage of voters already thinking that Trump should be removed from office, it hasn’t taken long for voters to miss the good old days of Barack Obama…52% say they’d rather Obama was President, to only 43% who are glad Trump is.

Why so much unhappiness with Trump? Voters think basically everything he’s doing is wrong:

-Overall voters are pretty evenly split on Trump’s executive order on immigration from last week, with 47% supporting it to 49% who are opposed. But when you get beyond the overall package, the pieces of the executive order become more clearly unpopular. 52% of voters think that the order was intended to be a Muslim ban, to only 41% who don’t think that was the intent. And the idea of a Muslim ban is extremely unpopular with the American people- only 26% are in favor of it, to 65% who are against it. When it comes to barring people from certain countries from entering the United States, even when those people have already secured a Visa, just 39% of voters are supportive to 53% who are against it. And just 43% of voters support the United States indefinitely suspending accepting Syrian refugees, with 48% opposed to that. Finally voters see a basic competence issue with Trump’s handling of the executive order- only 39% of voters think it was well executed, to 55% who believe it was poorly executed…

In addition, Steve Bannon is highly unpopular: “19% of voters see Bannon favorably, to 40% who have a negative opinion of him.” Few believe his claims of vote fraud. A majority opposes the wall, which was the centerpiece of his campaign: “Only 40% of voters are in support of building the wall if American taxpayers have to front the cost for it, to 54% who are opposed.”

Even his campaign promise to repeal Obamacare has become unpopular: “46% of voters now say they support it to just 41% who are opposed. And only 33% of voters think the best course of action is for Congress to repeal the Affordable Care Act and start over, to 62% who think it would be better to keep it and fix the parts that need fixing.” Congressional Republicans are also finding it to be difficult to abolish the Affordable Care Act, and are now talking about fixing Obamacare rather than repealing it.

Trump is also losing his battles, including with the media. Despite his attacks on CNN, “By a 50/42 spread voters say CNN has more credibility than Trump.” Similarly, The Washington Post and The New York Times have more credibility than Trump in this poll.

While Donald Trump is highly unpopular and his policies are failing, he may have unintentionally succeeded at one thing. He has brought the country together, even if in opposition to him, as is seen in the highly publicized photo above.

Trump Screws Up Obamacare So He Can Falsely Call It A Failure

The White House has pulled ads to promote signing up for coverage under Obamacare, including ads already paid for. If the goal is to provide more affordable coverage, this is counterproductive. Younger, healthier people tend to put off signing up, and are among the last to enroll each year. Having more healthy people sign up for coverage leads to lower insurance premiums.

Of course if the goal is to call Obamacare a failure, then this was a smart move by Trump. The higher premiums are, the easier it is to criticize the plan.

What Donald Trump might not even understand is that the Affordable Care Act did not bring about insurance with high premiums, along with high deductibles and copays. Insurance on the individual market has always been like this for those of use who purchase our own insurance, as opposed to receiving insurance through employers or government plans. The difference is that, prior to Obamacare, people could purchase expensive, high deductible plans and then lose their coverage if they got sick. If they already had preexisting medical conditions, they would often be denied coverage, or have the reasons they need health care coverage be excluded from the plan. These problems no longer exist under the Affordable Care Act.

Republicans are meeting to discuss health care, with a goal of introducing legislation by late March for an alternative program. While President Trump and Republican Congressional leaders are talking about a quick repeal of Obamacare, The Washington Post reports that, behind closed doors, many Republicans are expressing concerns:

Republican lawmakers aired sharp concerns about their party’s quick push to repeal the Affordable Care Act inside a closed-door meeting Thursday, according to a recording of the session obtained by The Washington Post.

The recording reveals a GOP that appears to be filled with doubts about how to make good on a long-standing promise to get rid of Obamacare without explicit guidance from President Trump or his administration.

Senators and House members expressed a range of concerns about the task ahead: how to prepare a replacement plan that can be ready to launch at the time of repeal; how to avoid deep damage to the health insurance market; how to keep premiums affordable for middle-class families; even how to avoid the political consequences of defunding Planned Parenthood, the women’s health-care organization, as many Republicans hope to do with the repeal of the ACA.

In a survey conducted by The New England Journal of Medicine, most primary care physicians preferred making improvements to the Affordable Care Act and opposed repeal. Improvements supported by physicians included creating a public option similar to Medicare to compete with private plans, providing tax credits to people eligible for Medicaid to purchase private plans, and increasing the use of health savings accounts. There was less support for some good ideas such as expanding Medicare coverage to those 55 to 64 years of age. There was also less support for two of the ideas promoted by Republicans, shifting even more costs to consumers and reducing regulations on insurance companies by allowing them to sell insurance over state lines. (From or dealings with insurance companies, doctors know that they cannot be trusted, and regulation is needed.) From the report:

We found that in response to the question, “What would you like to see the federal policy makers do with the Affordable Care Act?,” 15.1% of PCPs indicated that they wanted the ACA to be repealed in its entirety. Responses varied according to the physicians’ self-reported political party affiliation; no Democrats wanted to see the ACA repealed, whereas 32.4% of Republicans did. Among physicians who reported voting for Trump, only 37.9% wanted the ACA repealed in its entirety. PCPs were less likely than the general public to want the law repealed. A Kaiser Family Foundation poll conducted after the election that used a question and response options similar to those in our survey showed that 26% of the general public wants the law repealed in its entirety

When asked about aspects of the ACA as it currently exists, the physicians we surveyed almost universally supported the insurance-market regulations that prohibit insurance companies from denying coverage or charging higher prices on the basis of preexisting conditions (95.1% stated that the prohibition was “very important” or “somewhat important” for improving the health of the U.S. population). There was also strong support for other key provisions of the law, including allowing young adults to remain on their parents’ insurance plan until 26 years of age (87.6%), providing tax credits to small businesses (90.8%) and tax subsidies to individuals (75.2%), and expanding Medicaid (72.9%). A lower proportion — just under half — favored the tax penalty for individuals who do not purchase insurance (49.5%)…

Although only 15% of PCPs want the ACA repealed, nearly three quarters (73.8%) favor making changes to the law. Physicians responded most favorably to policy proposals that might increase choice for consumers, such as creating a public option resembling Medicare to compete with private plans, providing tax credits to allow people who are eligible for Medicaid to purchase private health insurance, and increasing the use of health savings accounts. PCP Survey Responses Regarding Potential Health Reform.). Physicians responded most negatively to policies that would shift more costs to consumers through high-deductible health plans. Less than half were in favor of proposals to decrease insurance-market regulations (by allowing insurance companies to sell across state lines), require states to expand Medicaid, or expand Medicare to adults 55 to 64 years of age.