Why Conservatives Hate Obamacare

Jonathan Chait writes that the Republicans have finally admitted why they oppose Obamacare. The bulk of his article is a useful recap of many of the Republican claims which have turned out to be untrue.

Republicans claimed that Obamacare is mainly signing up people who already had insurance, but actually 57 percent of those who enrolled on the exchanges previously lacked insurance. He went on to debunk conservative claims that the Affordable Care Act isn’t reducing the number of uninsured, along with false claims about insurance premiums first for this year and then projections for next year.

Finally he got to the current conservative argument:

And so conservative objections to Obamacare are finally turning from the practical to the philosophical. In response to reports that Obamacare insurance turns out to be affordable, Roy, who has spent months warning of rate shock, mocks that “other people’s money will pay for it.” Conservative columnist Byron York likewise argues “Obamacare’s ‘good news’ applies only to the poor.”

It is true that Obamacare is far more helpful to people lower down the income scale. The poorest people get Medicaid, which is free. Those higher up the income ladder get tax credits, which phase out at $45,000 a year for an individual, and $94,000 a year for a family of four. (I wouldn’t call people earning under those levels “poor.”) Of course, people who get employer-sponsored insurance also get their coverage paid for with “other peoples’ money.” The difference is that employer-sponsored insurance uses a tax deduction, which gives the largest benefits to those who earn the most money, as opposed to Obamacare’s sliding scale tax credit, which gives the most to those who earn the least.

But at least conservatives are now representing their true bedrock position on Obamacare. It is largely a transfer program benefitting people who either don’t have enough money, or pose too high a health risk, to bear the cost of their own medical care. Conservatives don’t like transfer programs because they require helping the less fortunate with other peoples’ money.

Of course even those of us who do not receive any tax credits and pay the full cost still benefit from Obamacare. While I am paying a higher premium than last year, the insurance plan I purchased is far more comprehensive and cannot be cancelled regardless of changes in medical condition. It covers preventative care with no out of pocket costs, and allows me to keep my daughter on my plan while she is in college. Obamacare does help the less fortunate. That is what we do in a civilized nation. It also helps the rest of us.

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Peter Beinart Says It All: Hillary does learn from her mistakes. But only after the damage is done.

Bush Clinton

Peter Beinart has an article on A Unified Theory of Hillary in today’s issue of National Journal.The entire article is worth reading but one line really sums up the article and my overall opinion of Hillary Clinton: “Hillary does learn from her mistakes. But only after the damage is done.” He also pointed out how her tunnel vision “might produce a presidency more stylistically akin to that of George W. Bush.”

Beinart does have also have some praise for Hillary Clinton as being tough-minded, and does feel she might have a better chance of dealing with Congress than other recent Democratic presidents. Looking back to the  years when Bill was in the White House, and even earlier, he had this to say:

From their days in Arkansas, Hillary took the lead in combating the scandalmongers who threatened Bill’s career. Her default position was single-minded and relentless. She repeatedly urged her husband’s advisers to meet attacks on Bill’s character by going after the character of his opponents. (According to Bernstein, in 1992 she urged the campaign to fan rumors about George H.W. Bush’s infidelity.) It was Hillary who called in Dick Morris when Bill was losing his bid for reelection as governor in 1980, and who became Morris’s point of contact when the Clintons entered the White House. According to Jeff Gerth and Don Van Natta Jr.’s biography Her Way, when a liberal Arkansas staffer objected to Morris’s presence, Hillary responded, “If you want to be in this kind of business, this is the kind of person you have to deal with.”

Tough-minded, but also showing the lack of principle she is known for.

Clinton has a history of making big mistakes on the big issues, such as her handling of health care reform:

Hillary’s failure to see that her model, which she had developed in Arkansas, was not working and needed to be altered midstream. As in Arkansas, Hillary—now aided by Magaziner—kept tight control of the process. At task force meetings, Bernstein notes, participants were forbidden from copying draft documents or, in many cases, even taking notes. The secrecy alienated not only members of Congress, health care activists, and the press, but key figures in the Clinton administration as well. Hillary and Magaziner both knew a great deal about health care policy. But neither knew as much about health care politics as Treasury Secretary Lloyd Bentsen, Health and Human Services Secretary Donna Shalala, or Office of Management and Budget Director Leon Panetta. Yet because of the task force’s secrecy, and because they feared directly confronting the president’s wife, Bentsen, Panetta, Shalala, and others in the administration often felt marginalized. As Haynes Johnson and David Broder document in The System—their indispensable book on the health care battle—Clinton officials angered by their lack of influence repeatedly leaked damaging information to a press corps angered by its lack of access.

Her biggest mistake was in getting her husband to agree to promise to veto anything other than what Hillary wanted, despite the fact that the Republican counter-proposal was extremely similar to the Affordable Care Act passed under Barack Obama, and would have served as a point to negotiate from at the time rather than having to wait until just recently to achieve health care reform. Some Clinton staffers recommended considering more modest proposals from moderate Democrats when it became clear that her entire package could not pass in Congress.

But Hillary resisted switching course, and she and Magaziner won the day. In his State of the Union address the following January—at Hillary’s urging and over Gergen’s opposition—Bill pledged to veto any health care bill that did not provide universal health coverage, even though key figures in his own party already believed that was the only kind of health care bill Congress would pass.

Hillary proceeded to move to the right to counter the false impression spread by the right that she was a left-wing radical.

IF HILLARY’S FAILURE to improvise contributed to the demise of health care reform, it also contributed to her greatest foreign policy blunder—her support for the Iraq War—and her subsequent loss to Barack Obama in 2008.

As with health care reform, Hillary’s transition from first lady to elected official relied on a clear plan, a key component of which was: Disprove the caricature of herself as a left-wing radical (an effort made easier by the fact that the caricature had never been remotely true). In her New York Senate race, Tomasky notes, Hillary ran to Rudy Giuliani’s right on abortion: She supported parental-notification laws; he did not. In the Senate, she cosponsored legislation with former impeachment champion Sam Brownback to study the effects of mass media on children and hired a staffer to reach out to abortion foes.

Clinton has also come under criticism recently for not supporting marriage equality until 2013, long after this became the politically safe position to take. She has most recently received unfavorable criticism for her handling of an interview with Terry Gross on this subject, although after listening to the interview I did not feel she did as badly as many others have written.

For the right to call Hillary Clinton a left-wing radical is even more absurd than their current claims that Barack Obama is a socialist. How would they respond if an actual leftist were to become president?

Beinart went on to describe how, after 9/11, Clinton joined Joe Lieberman on the far right of the Democratic Party, going as far as to claim 9/11 as justification for the war in Iraq and failing to recognize her mistake until virtually everyone else had abandoned her original view:

Almost as soon as the twin towers fell, Hillary began staking out positions on the right edge of her party. On Sept. 12, from the floor of the Senate, she warned—in language similar to George W. Bush’s—that regimes that “in any way aid or comfort [terrorists] whatsoever will now face the wrath of our country.” As Gerth and Van Natta detailed, Hillary did not just vote to authorize war with Iraq—something most other nationally ambitious Democrats did as well—she justified her vote by citing Saddam Hussein’s ties to al-Qaida, a claim echoed by only one other Senate Democrat, Joe Lieberman.

Even once it became clear that governing postwar Iraq would be far harder than the Bush administration had predicted, Hillary gave little ground. In a December 2003 speech to the Council on Foreign Relations, she called her Iraq decision “the right vote” and insisted that “failure is not an option.” As late as February 2005, when Iraq was already in civil war, she drew attention to the “many parts of Iraq that are functioning quite well” and warned that it “would be a mistake” to set a timetable for withdrawing U.S. troops.

In bucking her party’s liberal base, Hillary almost certainly believed she was doing the right thing. She was “cursed,” she declared, when explaining her refusal to join John Edwards’s 2007 call for an immediate withdrawal of U.S. troops, “with the responsibility gene.” Hillary’s intellectual failure lay in her inability to recognize that the definition of “responsibility” she had developed during the 1990s, with its emphasis on American freedom of action and the utility of military force, was being abused and misapplied in Iraq. Her political failure lay in her inability to see how dramatically the center of gravity in her party was shifting away from her point of view.

As the situation in Iraq went south, liberal activists—enraged at the Democratic Party’s ideologically hawkish, politically submissive leaders—launched an intraparty rebellion. The first sign came in 2003, when blogs like Daily Kos and activist groups like MoveOn.org powered Howard Dean’s stunning insurgency against a field of Washington Democrats who had backed the war. Yet during that period, Hillary and her top advisers were remarkably slow to recognize that the ground was shifting underneath their feet, and that the centrist strategy they had laid out at the beginning of her Senate career was now dangerously outdated.

Clinton’s failure to recognize how the Democratic party was changing could be seen in her choice of Mark Penn to be chief strategist for her campaign: “Hillary put her fate in the hands of a consultant who not only discounted their influence but loathed them.” Her presidential campaign only reinforced suspicion of her among many liberals:

But while she may have had no good way to discuss her Iraq vote, Hillary could have at least signaled to angry liberals that she would act differently on Iran. Instead, she picked a fight over Obama’s willingness to meet Tehran’s leaders without preconditions, a fight that to many liberals confirmed that Obama would change Bush foreign policy while Hillary represented more of the same.

More broadly, Hillary’s campaign failed to adequately recognize that her Iraq vote had convinced many liberals that she lacked the courage of her convictions. As an actress playing Hillary quipped on Saturday Night Live in January 2007, “I think most Democrats know me. They understand that my support for the war was always insincere.” In that environment, Hillary’s unwillingness to embrace controversial liberal causes for fear that they’d be used against her in the general election became a character issue. Arguably, the key moment in Hillary’s demise came at a Drexel University debate on Oct. 30, when she refused to forthrightly endorse New York state’s plan to issue driver’s licenses to undocumented immigrants and was slammed by her opponents and the press for trying to have it both ways. Eleven days later, in perhaps his most important speech of the primary campaign, Obama wowed a Jefferson-Jackson Day Dinner in Iowa, declaring that “not answering questions because we are afraid our answers won’t be popular just won’t do.” At a time when Democratic primary voters were hungry for authenticity and backbone, Penn’s efforts to inoculate Hillary against right-wing attack convinced many liberals that she lacked both.

Beinart concluded (emphasis mine):

NONE OF THIS is to suggest that Hillary would be an ineffective president—only that her successes and failures would look different from Bill Clinton’s and Barack Obama’s. Bill’s failures often owed to indiscipline. Obama’s have stemmed in part from aloofness. If past is prologue, Hillary’s would stem in significant measure from unwillingness to change course. Hillary does learn from her mistakes. But only after the damage is done.

Her successes as president, on the other hand, would likely result from the kind of hands-on, methodical, unyielding drive that both Bill Clinton and Obama struggled to sustain. In her wonkishness and her moderate liberalism, Hillary has much in common with Obama and her husband. But her “tunnel vision”—in the words of a close friend quoted in Sally Bedell Smith’s For Love of Politicsmight produce a presidency more stylistically akin to that of George W. Bush. For years now, Democrats have yearned for a leader who champions their causes with the same single-minded, supremely confident, unwavering intensity that they believe Republican leaders bring to theirs. For better and worse, they may soon get their wish.

For better and worse. While undoubtedly far better than a presidency in the hands of any imaginable Republican opponent at present, I also feel that Democrats who are now so willing to hand her the nomination will also see the worse aspects.

Other controversies also surround Clinton at present. Matthew Contenetti has raised criticism this week of Clinton’s early defense of child rapist. See Doug Mataconis and Steve M for responses.

Even a simple question from The New York Times Book Review has created controversy as it reinforced views of Clinton as being calculating and dishonest:

If you had to name one book that made you who you are today, what would it be?

At the risk of appearing predictable, the Bible was and remains the biggest influence on my thinking. I was raised reading it, memorizing passages from it and being guided by it. I still find it a source of wisdom, comfort and encouragement.

Gawker’s reaction was that, “Some people like Hillary Clinton. Other people dislike Hillary Clinton. However you feel about Hillary Clinton, it is difficult to deny that she is one of the most cold and calculating political figures in all the land.” This led to a link to a 2013 article on Clinton’s Cowardice As a Political Philosophy, which looked at her views on Iraq and gay marriage.

The Daily Banter responded:

But does Clinton calling the Bible her most influential book tantamount to a political calculation?

Yes it does.

It would be one thing if Clinton meant that the Bible has been the most influential on her because it’s had a profound impact on the course of human history for more than 2,000 years. However, she wasn’t talking about the book’s cultural and political impact, but rather the influence it’s had on her personally as a reader of it.

Because if the book with the biggest influence on Hillary Clinton were truly the Bible, she would never have gotten to where she is. The Bible, however beloved it may be, is not a book conducive to thinking. Rather, the Bible deals in revealed wisdom written by men of antiquity who probably knew less about the natural world than a contemporary American fifth grader. Without question there are passages in the Bible that may very well have given her a modicum of wisdom, comfort, and encouragement, but for every such excerpt there is one or more that couldn’t be more disturbing and anathema to what we today call common decency.

There is no time to air all the dirty laundry of the Bible here. Besides, most Americans are familiar with its horrors, yet many seem to accept it as a sort of general guide on how to live by focusing on passages they find agreeable while discarding the rest.

The “rest” would include the multiple instances of mass killing in the Old Testament, including the great flood started by god that wiped out nearly all of humanity. Homosexuals, witches, and Sabbath-breakers are ordered killed. The Ten Commandments say that one must only worship Yahweh, who judges people merely for what they think. Interestingly enough, rape is not mentioned in the commandments.

In the New Testament, we come to learn that those who do not accept that Jesus was brutally tortured and killed for their sins will suffer in hell in anguish for all eternity simply for not believing. This is founding principle of Christianity.

And yet this is the text that Hillary Clinton — a Yale Law School-educated former U.S. Senator and Secretary of State — says is the book that’s had the biggest impact on her life.

You can believe it if you like. And if you do, there’s a bridge near me I’d like to sell you.

While hardly the biggest campaign issue, this also underscores Hillary Clinton’s lack of self-awareness, failing to understand how a dishonest and calculating answer such as this does nothing to appease the right while reinforcing reservations about her from the left.

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Survey: Most Buying On Insurance Exchanges Weren’t Previously Covered

Reprinted with permission from Kaiser Health News

Nearly six in 10 Americans who bought insurance for this year through the health law’s online marketplaces were previously uninsured—most for at least two years, according to a new survey that looks at the experiences of those most affected by the law.

That finding is higher than some earlier estimates, and counters arguments made by critics of the law that most of those who purchased the new policies were previously insured.

The survey also found that consumers who purchase their own coverage because they can’t get it at work are more likely to have a favorable view of the Affordable Care Act than the general public. Still, they are nearly evenly divided, with 47 percent holding a favorable view of the law and 43 percent an unfavorable one, according to the survey by the Henry J. Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)

That compares with 46 percent of adults nationally who are sour on the law, and 38 percent who hold favorable views.

Consumers who received a government subsidy to help them purchase a plan were most likely to say they benefited from the law, according to the Kaiser survey. Those most likely to say they were negatively affected were those who had prior coverage but had to switch because their plans were discontinued for not meeting the law’s standards or for other reasons.

The report is likely to provide fodder for all sides in the debate about the law’s effect on health care costs and reducing the number of uninsured, which remains sharply partisan.

The findings suggest the new market for those who buy their own insurance “is working far better than critics say it is, but probably not as well as advocates hoped it would be,” said Drew Altman, president and CEO of the nonpartisan foundation.

Aside from data about premium costs, there has been little information so far about the experiences and perceptions of those who buy their own coverage. Are they healthier or sicker than those who get coverage through their jobs? Did people who lose their former coverage end up paying more or less for new plans? Do they like their coverage?

The Kaiser survey provides additional details based on a telephone survey of a nationally representative sample of 742 adults who purchased their own coverage. Many of the health law’s provisions were aimed at them, from the subsidies to help low- and middle-income residents buy coverage, to rules barring insurers from rejecting people with medical conditions, or charging women more than men.

The report shows sharp contrasts between those who say the law benefited them and their families and those who felt it hurt them:

– 34 percent of enrollees say they have benefited from the law, often citing lower costs or better access to care, while 29 percent said they were negatively affected, generally as a result of increased costs.

– 71 percent of those who enrolled in a plan that took effect after Jan. 1 rate their coverage as excellent or good, with 55 percent saying it is an excellent or good value for what they pay, but 39 percent rate it as an “only fair” or “poor” value.

– 43 percent say it is difficult to afford their monthly premiums and nearly half, 46 percent, are not confident they would be able to afford their share of the cost of a major illness or injury. About one third of those with new plans say they are dissatisfied with their deductibles.

Overall, about half of those who purchased a plan that met the health law’s rules said they got help in enrolling, from family members, assisters, brokers or others.

The survey was taken in April and early May, which means some respondents had held their policies since January, while others didn’t finish enrolling until mid-April, so had little or no experience using the new plans.

“It’s still fairly early so I’m not sure how much weight to give these responses,” said Sabrina Corlette, project director at the Health Policy Institute at Georgetown University. “How many are satisfied but haven’t used their plan yet?”

Altman acknowledged that it will be several years before the full picture is known, but said the survey offers insights into several important policy questions, from the percent of enrollees who were previously uninsured to their health status when they signed up.

The relative health of new enrollees is important because insurers base their premiums partly on estimates of how much they may have to pay out in claims. Under new rules, they can no longer bar the sick or charge them more.

The survey found that people enrolling in new coverage were more likely to report being in “fair” or “poor” health (17 percent) than those who hung onto older plans purchased before the law went into effect (6 percent), suggesting they may be sicker and costlier to cover. Insurers built such projections into their rates for this year and as people start to use their coverage, are only starting to find out if they projected correctly.

One section of the survey examines the experiences of those whose policies were canceled, or who switched from previous coverage to something new for other reasons.

While the law’s critics have argued those consumers ended up paying more and getting less, the report found that 46 percent of those who switched plans paid less for their coverage, often because of subsidies, while 39 percent paid more. Annual deductibles – the amount enrollees pay before insurance picks up most of the tab – are similar to what they paid before. More than half described their choice of medical providers as “about the same.”

Even so, the survey found that those who switched are less satisfied with the cost of their plans than those who were previously uninsured and less likely to believe their coverage is a good value.

Those reactions should not be seen as “a call to arms to beef up this coverage” since such efforts could boost premiums and government spending on subsidies, said Joe Antos of the American Enterprise Institute.

The federal government is expected to spend about $12 billion on insurance subsidies this fiscal year, which ends in September, according to the latest report from the Congressional Budget Office. People earning between 100 percent and 400 percent of the federal poverty level – about $11,500 to $46,000 a year — can qualify for subsidies on a sliding scale.

“There are resource limits,” Antos said. “Going back to taxpayers and saying we want you to cough up more money probably won’t be a big seller.”

The survey’s margin of error is plus or minus 4 percentage points for results based on the full sample, 5 percentage points for those who bought plans on or after Jan. 1 and 6 percentage points for those in plans purchased through the marketplace.

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Insurance Exchanges Providing Coverage At Reasonable Price With Choices Expanding

Now that health care coverage through the exchanges has been up and running for a several months we are getting more data on the favorable results. A major benefit has been to not only replace policies on the individual market which often had limited coverage with comprehensive coverage that cannot be canceled for development of medical problems, but to also make such care more affordable. A report from the Department of Health and Human Services found wide variation from state to state but found that on average those who receive subsidies are paying $82 a month in premiums, about one-fourth of what they would have paid without the subsidies.

The government has previously reported that 87 percent of the 5.4 million Americans who chose a health plan through the federal health exchange qualified for some financial help.

The health officials said they have not yet analyzed the incomes of people who qualified for the subsidies. But overall, the report shows, the average monthly tax credit this year is $264. Without the federal help, the average premium chosen by people eligible for a tax credit would have been $346 per month, and the subsidy lowered the consumers’ premiums, on average, by 76 percent. The result is that four out of five people with subsidies are paying premiums of no more than $100 a month — although that does not include money they might need to spend for insurance deductibles and other out-of-pocket costs.

An erroneous report in The Los Angels Times claimed that the cost of subsidies was running above current projections received a lot of coverage in conservative blogs this morning but the article has since been corrected to indicate that the cost of subsidies is consistent with projections from the Congressional Budget office.

McClatchy added additional information from the HSS report on choices available on the exchanges:

On average, federal marketplace users can choose from 5 insurers and 47 marketplace plans across all the metal tiers; bronze, which cover 60 percent of health care costs, silver plans, gold plans that cover 80 percent of costs and platinum plans that cover 90 percent.

The report found competition between plan providers lowers premiums. That bodes well for plan prices in 2015 when more plans are expected to enter the marketplace.

McKinsey & Company also looked at choices available in their own study, finding that consumers typically had a choice of both more expensive plans with larger provider networks and less expensive plans with more restrictive networks. They also note that, “There is no meaningful performance difference between broad and narrowed exchange networks based on Centers for Medicare and Medicaid Services (CMS) hospital metrics…” Of course there are reasons beyond quality metrics which might cause people to be willing to pay more for a plan which offers more choice. They also report that 46 percent of those responding to their survey indicated they knew what type of plan they had enrolled in and 26 percent were unaware of the network type they had selected.

The Hill reported on a growing number of insurance companies desiring to offer policies through the exchanges, which will both help lower costs and provide increased choice. As Jonathan Chait points out, this is evidence that Obamacare has been a success, doing what the program was designed to do. The actual news is also quite different from what is being posted at many conservative sites.

While insurance prices through the exchanges are expensive before subsidies are included (and remain expensive for those of us who do not qualify for subsidies), the premiums look much more reasonable when compared to insurance prices prior to the Affordable Care Act, and when the frequent double digit increases in rates were considered. The Commonwealth Club has looked at insurance prices on the individual market prior to Obamacare.

USA Today, in reporting on the HHS report and the increased number of insurance companies planning to offer coverage, points out that “new state filings for the 2015 plan year show more insurance companies are moving onto health care exchanges in some competition-deprived states and requesting rate increases that are largely in line with pre-Obamacare years.”

Choice in physicians is increasing in plans in the exchanges, but United Health Care continues to reduce choice by dropping still more physicians from their Medicare Advantage networks (which is unrelated to Obamacare).

The Los Angeles Times and The Boston Globe are among newspapers reporting on a study from The Journal Of The American Medical Association showing that the Affordable Care Act has resulted in better health care and lower costs for young adults.

Read more here: http://www.mcclatchydc.com/2014/06/18/230648/new-hhs-report-touts-federal-marketplace.html?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=13220140&_hsenc=p2ANqtz-9LEiMRY8tbEZ1g2JFk4Z-JO7Rf4BCeYZyOvcOmYTGlzNq5IKvCPlgMTZIg2Py07w_QMVoT4v6g8-NzQZYh0u7h_Lue2Q&_hsmi=13220140#storylink=cpy
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Republican Extremism And The Weakness Of Republican Leadership

The victory of David Brat over Eric Cantor was momentarily a cause for celebration, but the long term results might not be so favorable. Norm Ornstein warns that this will lead to further radicalization of the Republican Party:

First, it is clear that this moves the Republican Party even further to the right, in approach, attitude and rhetoric. Even if the overwhelming majority of incumbents, including establishment ones, have won renomination, even if broader Republican public opinion is more establishment conservative than Tea Party radical, all it takes is an example or two of the opposite to get all politicians jumping at their shadows and muttering to themselves, “That could happen to me.”

…American political parties always face a tension between their establishment and ideological wings. On the Republican side, going back more than a hundred years to the Teddy Roosevelt era, that was a struggle between moderate progressives and conservatives.

Now it is different. There are no moderates or progressives in today’s GOP; the fight is between hard-line conservatives who believe in smaller government and radical nihilists who want to blow up the whole thing, who have as much disdain for Republican traditional conservatives as they do for liberals.

In our 2012 book, “It’s Even Worse Than It Looks,” Tom Mann and I described the Republican Party as an “insurgent outlier.” That is even more true today. The energy and driving force in the party, in its House membership, media dominance, caucus and primary electorates and financial backers, is not its conservative wing but its radical side.

Ornstein is probably right that this will pull the Republicans even further to the right, but how far right can they go before even safe Republican districts are at risk? Will Republicans in these districts support any lunatic with an R after his name, or is there a limit? At the moment it appears that Brat should win, but the narrative would certainly change if the victory by such an extremists were to cause the Republicans to lose a safe Republican district.

Yesterday I noted Brat’s views on slashing spending on Medicare, Social Security, and education.  His plan to replace Obmamacare is just as absurd: “We need to also scrap employer-based health insurance, and give those incentives to individuals to carry their own portable health insurance. If we did that, the issue of pre-existing conditions largely goes away.” This makes absolutely no sense as the individual market has been dominated by insurance plans which have been the most abusive at denying coverage to the sick.

Brat’s campaign manager, Zachery Werrell, scrubbed his Facebook page after the victory but Yahoo News took screen shots while the page was still available:

From comparing George Zimmerman’s shooting of unarmed black teenager Trayvon Martin to abortion to calling for the abolition of the Food and Drug Administration and encouraging the adoption of the silver monetary standard, Zachary Werrell – one of just two paid staffers for the upstart campaign of Randolph-Macon College economics professor David Brat – sought in 2012 and 2013 to build a public profile as a socially conservative libertarian voice…

“Can someone who was outraged that George Zimmerman was found not guilty of ‘SOMETHING ANYTHING’ and who is simultaneously pro-choice explain the logical dissonance there? Ie. Why its not ok to kill someone who is banging your head into concrete but its ok to kill someone for simply existing who, through your conscious actions, you brought into the world?” Werrell had written in an Oct. 24, 2013, posting.

The month before, the campaign manager for the likely next congressman for Virginia’s 7th District – since no Democrat has represented that district since 1971 – questioned whether existing state lines were defensible. “Should sections of States be allowed to secede from a State if they feel they are un/underrepresented in the State Government?” Werrell asked. “I say yes. I derive that opinion from our first foundational document – the Declaration of Independence. What say you?”

On Oct. 25, 2013, he called for an end to the regulation of prescription drugs, citing a story from the Ludwig von Mises Institute. “Abolish the FDA!” he wrote.

On Oct. 29 of that year, it was a piece by Fred Reed from Lew Rockwell’s website on the wussification of boys that set him off. “There is a war on boys!” Werrell wrote. “Rough housing, playing soldier, etc, are all punished or medicated away. And we wonder why there is gender inequality in the classroom and in college/attendance/graduation rates.”

The Reed piece called for the end of women teachers in coed or boys’ schools. “It is time to get women out of the schooling of boys,” wrote Fred Reed. “It is way past time. Women in our feminized classrooms are consigning generations of our sons to years of misery and diminished futures.” The piece further argued that “women should not be allowed within fifty feet of a school where boys are taught” and that “Women are totalitarian. Men are happy to let boys be boys and girls be girls. Women want all children to be girls.”

Brat is far more likely than Cantor to make a major gaffe. It will be interesting to see his take on the views of his campaign manager.

If we can fantasize about a Democratic upset in this Congressional district, we might also fantasize about another upset in the general election. Peter Beinart looked at the weakness of the Republican leadership:

Cantor’s boss, John Boehner is, according to Nancy Pelosi, “the weakest speaker in history.” Less than 50 percent of Republicans approve of his performance. Over the last two years, he has repeatedly retreated in the face of opposition from rank-and-file conservatives who treat him with barely disguised disdain. Until the defeat of Cantor, his most likely heir apparent, it was widely assumed that he would soon either step—or be pushed—aside soon.

In the Senate, Minority Leader Mitch McConnell only avoided Cantor’s fate by attaching himself to his Kentucky colleague Rand Paul, whose upstart Senate candidacy McConnell had opposed. Like Boehner, McConnell is treated with striking disrespect in his own caucus.

David Frum wonders whether the Republican leadership will ever fight back:

At some point, Republican leaders must recognize that they have a fight on their hands whether they like it or not. If they refuse to join that fight, they will be devoured anyway. If they surrender, they condemn the whole conservative project in America to the destructive leadership of fanatics (and the cynics who make their living by duping fanatics).

I never thought there was much of a chance of Grimes to beat Mitch McConnell despite being close in the polls but today Political Wire reported that “A new Magellan Strategies (R) poll in Kentucky finds Allison Lundergran Grimes (D) leading Sen. Mitch McConnell (R) by three points in the U.S. Senate race, 49% to 46%.” Perhaps a major reason that Cantor was defeated is general bipartisan disgust with the Republican leadership, and if so this just might extend to knocking out McConnell.

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Medicaid Coverage Varies From One Side Of Town To Another In Some Border Cities

As Annie Lowrey described, which side of town one lives on can determine whether a poor person receives Medicaid benefits if the town is on a border between a state which participates in the expanded Medicaid program and one which does not. The Affordable Care Act provides for expanding Medicaid benefits with the federal government paying most of the cost, but many Republican-controlled states have chosen not to participate in the program:

Arkansas accepted the Medicaid expansion in the Affordable Care Act. Texas did not.

That makes Texarkana perhaps the starkest example of how President Obama’s health care law is altering the economic geography of the country. The poor living in the Arkansas half of town won access to a government benefit worth thousands of dollars annually, yet nothing changed for those on the Texas side of the state line.

After the Supreme Court decided in 2012 that states could not be compelled to expand Medicaid to cover more of their low-income residents, many politicians voiced fears that the poor in states that opted out of the expansion might flood into states that opted in.

Thus far, 26 states and the District of Columbia have chosen to extend Medicaid, encouraged by the promise that the federal government will shoulder 90 percent of the cost indefinitely. The others — including Texas — have so far declined.

But none of the low-income Texarkana residents interviewed realized that moving to the other side of town might mean a Medicaid card. In fact, health researchers and those who work with the poor expect very few Americans to move between states to take advantage of the law.

“It’s impossible to understand what it is to move when you have nothing,” said Jennifer Laurent, the executive director of Randy Sams’ Outreach Shelter, where Ms. Marks is staying until she puts together enough savings from her two low-wage jobs to find her own place. “To risk everything — losing your bed, your sense of community — for an uncertain benefit? There’s no way you want to risk that.”

Research on other expansions of government benefits has borne that out: A study in the journal Health Affairs looked at the “welfare magnet hypothesis” and found no evidence that it exists…

The disparities among states have left about eight million low-income adults ineligible for Medicaid and have widened the difference in what federal safety-net benefits are available to similar families in different states. There are a number of border communities where one state is expanding Medicaid and the other is not: West Memphis, Ark., and Memphis; Chicago and Gary, Ind.; Washington’s Maryland suburbs and those in Northern Virginia; and Spokane, Wash., and Coeur d’Alene, Idaho.

There is currently a battle in Virginia over whether to accept the program. In order to prevent this, the Republicans are attempting to flip the state Senate by offering a Democratic member what might be an illegal bribe to step down.

The expanded Medicaid program is both providing many people with needed health are coverage, and is also improving profits for hospitals which no longer have to provided reimbursed care.

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Koch Brothers Donate $25 Million To The United Negro College Fund

David Koch

I think it was a smart move by the Koch Brothers to give a $25 million grant to the United Negro College Fund. If their goal is to improve their public reputation in response to the campaign by the Democratic Party to vilify them, such a move is likely to be far more effective than Charles Koch’s whiny and misleading op-ed in The Wall Street Journal. Maybe they hope that this will help counter some of the harm done by their financing of the Tea Party which, while containing a variety of views, far too often looks like the KKK without the white sheets. The willingness and ability of the Koch Brothers to receive this form of favorable publicity also gives an example of why it is foolish for the Democrats to spend so much effort in their campaign against the Koch Brothers personally as opposed to actually learning how to promote a coherent message.

There are many reasons to vote for the Democrats over the Republicans with the Republicans adopting an extremist agenda, acting to undermine the foundations of our Democratic system, and failing to engage in any rational thought as they pursue policies in contradiction of economics, science, and the very principles of individual liberty which this nation was founded upon. There are so many issues for the Democrats to concentrate on, yet Harry Reid wants to concentrate on a pair of brothers who most people have never heard about. Sure attacking the Koch Brothers might be good for fund raising emails, but this is no substitute for coming up with a real message.

The fact of the matter is that the Koch Brothers are not the worst enemy faced by the Democrats and supporters of liberty (true liberty, not the plutocracy and religious authoritarianism promoted by the right wing under this label). There is certainly quite a bit of hypocrisy  in the economic views of the Koch Brothers, who made their fortune taking advantage of government programs while selectively arguing for economic libertarianism as a means to escape regulation. However in some ways the Koch Brothers are preferable to the standard Republican line, from opposing the Iraq War to being more libertarian on social issues. David Koch also has a long history of philanthropy. They could even be a force for moderation of some of the extreme views of the Republican Party.

Of course this is not meant to excuse all their behavior, including suspected illegal activity and funding of efforts to deny climate change (which on at least one occasion has blown up in their faces). The most reprehensible has been the funding of dishonest advertisements against the Affordable Care Act.  Everyone is entitled to their opinion, but when they spread false information which contributes to mistrust of a law which has resulted in improvements in the lives of millions, they risk doing serious harm to those who remain uninsured based upon misinformation. The Affordable Care Act is also a good thing for the economy, helping to reduce the deficit, reduce unemployment, and enable people to leave jobs they remain in for insurance coverage to work for or form small businesses of their own. Those who truly support freedom, as opposed to giving it lip service as the right wing does, would prefer a system which gives more choice to individuals rather than leaving them at the mercy of an insurance industry which has existed without serious competition in most markets, and which found it to be more profitable to find ways to deny providing care. Support of Obamacare is the only rational position for those who support the rights of the individual over the rights of abusive monopolies. Unfortunately such a choice is beyond the thought process of those on the right who have been brainwashed to see our tradition of self-government as the source of tyranny.

I would find it far easier to ignore the Koch Brothers if they would cease spending their money on these dishonest ads and ideally use their influence to truly promote freedom. Regardless, we could show appreciation for contributions such as this and perhaps it is time for Harry Reed to find a new bogey man–or preferably to do a better job of actually promoting ideas.

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Drudge Starts Fake Rumor That Hillary Clinton Is Using A Walker

hillary clinton people

No, Matt Drudge, Hillary Clinton has her hands on a patio chair for the People cover story. She is not using a walker.

I imagine that the same conservatives who can’t tell the difference between a market based health care system in the Affordable Care Act and “socialized medicine” also wouldn’t be able to tell the difference between a patio chair and a walker.

Beyond the fake controversy over Clinton’s health being raised by people such as Matt Drudge and Karl Rove, the article does not clarify whether she is running for president, but does reveal that she binged on the first season of House of Cards.

Update: Clinton also stated that the problems she had after her concussion have all dissipated.

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Doctors No Longer Strong Republicans

JAMA Internal Medicine has some data which I would have predicted–doctors are less likely to support Republicans now than in the past. The data is based upon campaign contributions and therefore has no data regarding reasons for the change. This data would not include contributions under $200 and it is not known if those making smaller donations differ from the larger, reportable contributions.

The study found that since 1996 contributions to Republicans by physicians have decreased, dropping to under 50 percent leading up to the 2008 election. Many of the results suggest that doctors are contributing based upon factors comparable to the general population. This includes a significant gender gap with 57 percent of men and 31 percent of women contributing to Republicans over the entire study period. Leading up to the 2012 election, 52.3 percent of male physicians contributed to Republicans and 23.6 percent of female physicians contributed to Republicans.

I am apparently an exception to the trend that male physicians and physicians in solo or small practices are more likely to contribute to Republicans. Another trend mirrors the general population with those earning more being more likely to contribute to Republicans.

Overall the trend against support for Republicans is similar to the overall trend for more highly educated people to be less likely to support Republicans. The education in science might make many physicians more likely to reject Republicans in recent years as scientists have tended to oppose Republicans. Many people trained in science would have a difficult time supporting a party in which many believe in creationism, and most reject the view of 97 percent of climate scientists on global warming.

The study is unable to determine whether medically related issues have any bearing on the results. Democrats have been far more supportive of health care in recent years, but I also find that many of my colleagues get their news from Fox and have the same misconceptions about the Affordable Care Act and other issues as Republicans in general have. On the other hand, many physicians, along with many physician organizations, have been highly supportive of Obamacare after having seen the serious problems in health care delivery in this country. Republican policies would also be terrible for the future of Medicare, but I’m not sure how widespread this realization is among physicians.

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A Fact Checker Responds To Mitch McConnell’s Dishonesty On Obamacare

In response to the issue discussed yesterday where Mitch McConnell simultaneously opposed the Affordable Care Act and supported Kynect, the computer exchange set up in Kentucky as part of the Affordable Care Act, Glenn Kessler exchanged email with Jesse Benton, McConnell’s campaign manager. Benton made some absurd statements such as that,  “When Obamacare is repealed, Kentucky can choose to continue Kynect or alter it in a way that makes the best sense for Kentuckians.” As discussed yesterday, Kynect cannot exist without Obamacare.

Benton also tried to separate the benefits of the expanded Medicaid program from the Affordable Care Act:

Medicaid existed before Obamacare and will continue to exist after repeal. Kynect is not Medicaid. It is a state administered exchange that provides a marketplace for private insurance plans.  While some 300,000 Kentuckians discovered they were eligible for Medicaid through Kynect, they do not purchase private insurance through the exchange; they are enrolled in the state-administered program.

The expansion of Medicaid is another aspect of the Affordable Care Act, with the federal government paying the bulk of the cost of this expansion. If Obamacare is repealed, there would not be either Kynect or the expanded Medicaid program which many in Kentucky have benefited from.

Benton also claimed that people in Kentucky “would move back to HSA’s and other higher deductible plans they had pre-Obamacare to receive a higher quality of care.” However there were no previous plans for most of these people as 75 percent of the newly insured in both Medicaid and the exchange were previously uninsured. High deductible plans and HSA’s work well for upper income individuals, but they are not a good solution for those with lower incomes who cannot afford to pay high deductibles or place money in HSA’s.

Kessler concluded:

McConnell appears to have accepted the Medicaid expansion that has been so embraced by his state’s residents, while drawing a distinction with the Obamacare health plans sold on the statewide exchange. Given that three out of four of the newly insured in Kentucky ended up on Medicaid, that probably makes political sense—and also is newsworthy.

But the history of individual state exchanges shows it is not credible for McConnell to suggest that the state exchange would survive without the broad health-care system constructed by the Affordable Care Act, such as an individual mandate and subsidies to buy insurance. Given the popularity of the state exchange, McConnell appears to want to offer out hope it would continue even in the unlikely case the law was actually repealed. That’s likely not a tenable position, and we will pay close attention to McConnell’s phrasing on this issue in the future. The senator is clearly trying to straddle a political fence; when doing so, it’s easy to lose your balance.

I do find it strange that Kessler decided to review the exchange with the above conclusion “rather than a traditional fact check.” These statements from McConnell and his campaign manager are clearly dishonest. Kessler has declared statements which were far more ambiguous to be dishonest in the past. I do applaud his decision to concentrate on reviewing the facts as opposed to jumping to awarding Pinocchios, but hope that this new policy applies to both parties.

In related news, a new Wenzel Strategies poll (a Republican pollster with a reputation for a strong pro-Republican “house effect”) has Mitch McConnell leading Democratic challenger Alison Lundergan Grimes by 47 percent to 44 percent. The closeness of the race is encouraging but it is hard to see Kentucky voting in a Democratic senator.

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