Mitch McConnell Backs Kentucky State Exchange While Calling For Obamacare Repeal

McConnell

Now that people are experiencing the advantages of the Affordable Care Act it is becoming harder for Republicans to call for repeal. While people might tell pollsters they dislike Obamacare, they also oppose the consequences of repeal. In Kentucky, people might say they dislike Obamacare, but they certainly do like Kynect, their highly successful insurance exchange. This is resulting in problems for Mitch McConnell who has been calling for the repeal of Obamacare and is now up for reelection.

McConnell has been trying to express support for Kynect while continuing to oppose Obamacare. It is necessary for one to be either dishonest or quite ignorant about the Affordable Care Act to make claims such as the ones McConnell is making:

“If Obamacare is repealed, Kentucky should decide for itself whether to keep Kynect or set up a different marketplace,” McConnell campaign spokeswoman Allison Moore told WFPL.

“But Kentuckians shouldn’t have been forced to lose the plans they had and liked, shouldn’t have seen their premiums skyrocket, shouldn’t have had their Medicare cut, and shouldn’t have had their taxes raised because of President Obama and his friends in Washington forced it down their throats.”​

McConnell is being dishonest with his claims that premiums are skyrocking and Medicare is being cut. One reason people in Kentucky support Kynect is that it is allowing them to obtain health insurance at a lower cost. Republicans are resorting to scare tactics with claims of Medicare cuts.

The Kentucky Herald-Leader had this editorial criticizing McConnell for attempting this deception:

Nothing could be more connected — or should be more important to Kentucky’s senior senator — than the fates of the more than 400,000 Kentuckians who are getting health insurance, many for the first time, and the federal Affordable Care Act, which is making that possible.

Repeal the federal law, which McConnell calls “Obamacare,” and the state exchange would collapse.

Kynect could not survive without the ACA’s insurance reforms, including no longer allowing insurance companies to cancel policies when people get sick or deny them coverage because of pre-existing conditions, as well as the provision ending lifetime limits on benefit payments. (Kentucky tried to enact such reforms in the 1990s and found out we were too small a market to do it alone.)

Kentucky’s exchange also could not survive without the federal funding and tax credits that are helping 300,000 previously uninsured Kentuckians gain access to regular preventive medicine, including colonoscopies, mammograms and birth control without co-pays.

As a result of a law that McConnell wants to repeal, one in 10 of his constituents no longer have to worry that an illness or injury will drive them into personal bankruptcy or a premature grave.

Repealing the federal law would also end the Medicaid expansion that is enabling Kentucky to expand desperately needed drug treatment and mental health services.

Kynect is the Affordable Care Act is Obamacare — even if Kentuckians are confused about which is which.

The Louisville Eccentric Observer also responded to McConnell:

Just for the record, McConnell saying that Kynect can survive the repeal of Obamacare is like saying that the Oklahoma City Thunder can trade Kevin Durant, but keep his jump shot.

The Kynect website and call center was paid for with federal money from the ACA, specifically $252 million in federal grants. Without the ACA, Kentucky foots the bill for a website that is worthless.

Over 300,000 Kentuckians gained Medicaid coverage because the ACA expanded Medicaid eligibility and Kentucky did not opt out, and that coverage is 100 percent paid for by federal money under the ACA, until it becomes 90 percent after a few years. Without the ACA they are no longer eligible, unless Kentucky changes their state law and pays through nose to cover these new people (that is not happening).

Most of the 82,795 Kentuckians who bought private insurance through Kynect were able to do so with the help of federal subsidies only made possible by the ACA. Without the ACA, those plans that have strong consumer protections on preexisting conditions, not being dropped from coverage for getting sick, and spending caps are no longer mandatory, so they’re gone. Gone as well is the requirement that children must be covered under their parents plans through the age of 25. Without the ACA many of these people won’t find someone to insure them, and many are forced to go back to junk plans that are worthless when you have a medical emergency or plans that are unaffordable without federal ACA subsidies.

Without the ACA, Kynect is nothing but a worthless website that would soon go dark, and roughly 400,000 Kentuckians will lose their coverage and the consumer protections it provides, and will therefore be thrown back into the old healthcare system that had failed them beforehand.

What McConnell is hoping to do with this strategy is deceive Kentucky voters who like what Kynect is doing but have a negative perception of the Affordable Care Act, and hope that the media here will do lazy “He said, She said” reporting that does not explicitly point out that what McConnell is saying is flatly false. He might turn out to be successful on that front, but this might also be a good opportunity for Alison Lundergan Grimes to get off of the sidelines and actually talk about health care with the media and voters so they know exactly what McConnell is trying to do, and have an honest conversation about what she would do. Or, she can continue staying out of this fight, and just hope for the best. Your call, Alison.

This should make it easier for McConnell’s opponent, Alison Lundergan Grimes, to defend Obamacare. Instead it looks like she is trying to play it safe. Greg Sargent discussed how Grimes is talking about the Affordable Care Act:

Now the Grimes campaign is finally hitting McConnell over his gyrations on the issue, accusing him of “voting to destroy Kynect.” From Grimes senior adviser Jonathan Hurst:

Mitch McConnell has been in the fantasyland that is Washington for so long that he cannot tell the difference between fact and fiction. McConnell has voted to destroy Kynect — and he has said he will do it again. In the U.S. Senate, Alison Lundergan Grimes will fix the law to ensure it is working for all Kentuckians.

This seems somewhat defensive. It again leans heavily on a vow to “fix” the law, and doesn’t state flatly that Kynect is a policy success. Some Dems, such as Rep. John Yarmuth and pollster Celinda Lake, have suggested Grimes go further. Lake told me the other day that her polling has showed that Kynect polls positively in Kentucky, even as the law known as “Obamacare” or the “Affordable Care Act” remains under water.

Lake suggests this to Grimes:  “She could say, `In Kentucky, we got it right. I’ll take Kentucky values to Washington.”

The idea would be to focus people on something they like — the state exchange — separating it from the hated Obummercare, localizing the contrast between the two candidates’ positions. Her statement today does not mention Obamacare, signaling again that Kynect is far more popular in the state, and that it’s now somewhat safe to make an issue at least out of the state exchange. Indeed, elsewhere Grimes has said: “I am not and will not be for taking away insurance that 400,000 Kentuckians just recently got access to.”

Still, given the tentativeness of Grimes’ statement, clearly she is still not prepared to cross over into seriously making an issue out of that contrast, and it just won’t be a central point she makes. As noted here before, I understand all the reasons for Grimes’ reluctance.

While it is understandable that Democrats would show some reluctance to being associated with Obamacare, failure to speak out probably guarantees their defeat. Democrats need to go on the offensive and take credit for the benefits of the law their party passed. Trying to distance themselves will not work. Everyone knows that this is a policy passed by the Democrats. Acting scared only reinforces the negative views and makes Democrats look weak. As long as Democrats remain afraid to forcibly speak out about the benefits of Obamacare and explain its benefits, voters will fall for the type of deception Mitch McConnell is practicing. Voters do want the benefits of Obamacare, and the popularity of Kynect gives Grimes the perfect opportunity to speak out in its defense.

Update: Glenn Kessler reviewed the facts regarding the above issue.

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Two Polls Give (Limited) Hope For A Democratic Upset In November

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There are two recent poll findings which you might think should help the Democrats in November but most likely will not. Gallup found that the Democratic Party had a favorable rating of 44 percent while the Republicans have a with 34 percent favorable rating.

Unfortunately this type of lead has not necessarily translated into election victories in the past. It also doesn’t help the Democrats that, while leading the Republicans, they are still under 50 percent.

Republicans also have an advantage in House elections due to gerrymandering, and due to the concentration of Democrats in urban areas, leading to a larger margin of victory in a smaller number of districts. Democrats are defending several Senate seats in red states where they would not enjoy this lead over Republicans.

Brendan Nyhan looked at a recent Washington Post-ABC News poll which showed that more people agree with the Democrats on the issues:

More Americans say they trust Democrats than Republicans on the “main problems the nation faces over the next few years” as well as a number of key policy issues, including the economy, health care and immigration. Members of the public also typically indicate that Democrats are closer to their opinion than Republicans on specific issues like abortion, same-sex marriage and raising the minimum wage.

This apparent political advantage is less important than it might seem, however. For instance, Democrats had greater advantages on several major issues at comparable points in the 1994 and 2010 electoral cycles, which both resulted in Republican landslides…

Why haven’t these issue advantages translated into electoral success? First, the midterm electorate is not representative of the American public. The public’s preferences for Democrats on the issues may diminish or disappear once you look at registered voters or those who claim they are “absolutely certain” to vote, as Jaime Fuller of The Washington Post has noted. The Democrats’ edge on the issues is likely to dissipate further among the older, whiter group of Americans most likely to vote in November.

In addition, the importance of the issues in congressional elections is typically overstated. Structural factors like presidential approval, the state of the economy, the type of election (midterm or presidential year) and the composition of the seats that are up for election tend to matter more.

Most likely, based upon fundamentals in a midterm election the Republicans should do better than the Democrats. However, if the Democrats are seeking to significantly beat historical expectations, they sure have a better chance at the upset if they are the party which a majority support than if they did not have this support. How they do will depend a lot on whether the Democrats can get more of their supporters out to vote than is typical in midterm election years.

While the Democrats face a difficult task in holding onto Senate seats in the red states, there is an advantage to incumbency which should allow some to win. This might be enough to allow the Democrats to maintain control of the Senate until 2016 when the fundamentals are in their favor, including having an election year electorate and it is the Republicans who will be defending Senate seats in several blue states.

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The 2014 White House Correspondents’ Dinner–Full Video And Best Lines

Above is the video of Barack Obama at the White House Correspondents’ Dinner. Full transcript is here and excerpts follow:

I admit it — last year was rough.  Sheesh.  At one point things got so bad, the 47 percent called Mitt Romney to apologize.

Of course, we rolled out healthcare.gov.  That could have gone better.  In 2008 my slogan was, “Yes We Can.”  In 2013 my slogan was, “Control-Alt-Delete.”  On the plus side, they did turn the launch of healthcare.gov into one of the year’s biggest movies.  (Slide of “Frozen”)

But rather than dwell on the past, I would like to pivot to this dinner.  Let’s welcome our headliner this evening, Joel McHale.  On “Community,” Joel plays a preening, self-obsessed narcissist.  So this dinner must be a real change of pace for you.

I want to thank the White House Correspondents Association for hosting us here tonight.  I am happy to be here, even though I am a little jet-lagged from my trip to Malaysia.  The lengths we have to go to get CNN coverage these days.  I think they’re still searching for their table.

MSNBC is here.  They’re a little overwhelmed.  They’ve never seen an audience this big before.

Just last month, a wonderful story — an American won the Boston Marathon for first time in 30 years. Which was inspiring and only fair, since a Kenyan has been president for the last six.

We have some other athletes here tonight, including Olympic snowboarding gold medalist Jamie Anderson is here.  We’re proud of her.  Incredibly talented young lady.  Michelle and I watched the Olympics — we cannot believe what these folks do — death-defying feats — haven’t seen somebody pull a “180” that fast since Rand Paul disinvited that Nevada rancher from this dinner. As a general rule, things don’t like end well if the sentence starts, “Let me tell you something I know about the negro.”  You don’t really need to hear the rest of it. Just a tip for you — don’t start your sentence that way.

And speaking of conservative heroes, the Koch brothers bought a table here tonight.  But as usual, they used a shadowy right-wing organization as a front.  Hello, Fox News.

Let’s face it, Fox, you’ll miss me when I’m gone. It will be harder to convince the American people that Hillary was born in Kenya.

Of course, now that it’s 2014, Washington is obsessed on the midterms.  Folks are saying that with my sagging poll numbers, my fellow Democrats don’t really want me campaigning with them.  And I don’t think that’s true — although I did notice the other day that Sasha needed a speaker at career day, and she invited Bill Clinton.a, Bill Clinton, Bill O’Reilly, Captain America, Chris Christie, Community, Donald Trump, Facebook, Fox, George Bush, Health Care Reform, Hillary Clinton, House of Cards, Jeb Bush,

And I’m feeling sorry — believe it or not — for the Speaker of the House, as well.  These days, the House Republicans actually give John Boehner a harder time than they give me, which means orange really is the new black.

Look, I know, Washington seems more dysfunctional than ever.  Gridlock has gotten so bad in this town you have to wonder:  What did we do to piss off Chris Christie so bad?

One issue, for example, we haven’t been able to agree on is unemployment insurance.  Republicans continue to refuse to extend it.  And you know what, I am beginning to think they’ve got a point.  If you want to get paid while not working, you should have to run for Congress just like everybody else.

Of course, there is one thing that keeps Republicans busy.  They have tried more than 50 times to repeal Obamacare.  Despite that, 8 million people signed up for health care in the first open enrollment. Which does lead one to ask, how well does Obamacare have to work before you don’t want to repeal it?  What if everybody’s cholesterol drops to 120?  What if your yearly checkup came with tickets to a Clippers game? Not the old, Donald Sterling Clippers — the new Oprah Clippers.  Would that be good enough?  What if they gave Mitch McConnell a pulse?  What is it going to take?

Joel McHale, star of Community and The Soup, did an excellent job. #sixtimesashostandamovie. He has followed a long line of top comedians who have roasted politicians and the media and previous events. The all time best speakers was Stephen Colbert who roasted George Bush in 2006. The full transcript of his speech can be found here.

Following are some of Joel McHale’s best jokes, with video above and full transcript here.

Good evening, Mr. President — or as Paul Ryan refers to you, yet another inner-city minority relying on the federal government to feed and house your family.

I’m a big fan of President Obama. I think he’s one of the all- time great presidents — definitely in the top 50. Please explain that to Jessica Simpson. You’re right. That was low.

All right, how about the president’s performance tonight, everyone?  It is — it’s amazing that you can still bring it with fresh, hilarious material. And my favorite bit of yours was when you said you’d close the detention facility at Guantanamo Bay. That was a classic. That was hilarious, hilarious. Still going.

All right, look, I know it’s been a long night, but I promise that tonight will be both amusing and over quickly, just like Chris Christie’s presidential bid.

It’s a genuine thrill to be here in Washington, D.C., the city that started the whole crack-smoking-mayor craze.

The vice president isn’t here tonight, not for security reasons. He just thought this event was being held at the Dulles Airport Applebee’s. Yes, right now Joe is elbow-deep in jalapeno poppers and talking to a construction cone he thinks is John Boehner. Also true.

Hillary Clinton has a lot going for her as a candidate. She has experience. She’s a natural leader. And, as our first female president, we could pay her 30 percent less. That’s the savings this country could use.

Hillary’s daughter Chelsea is pregnant, which means in nine months we will officially have a sequel to “Bad Grandpa.” It also raises the question, when the baby is born, do you give Bill Clinton a cigar?

Jeb Bush says he’s thinking about running. Wow, another Bush might be in the White House. Is it already time for our every-10- years surprise party for Iraq? Yes.

As it stands right now, the Republican presidential nominee will either be Jeb Bush, Rand Paul, or a bag of flour with Ronald Reagan’s face drawn on it.  A bag of flour. All right.

People are asking, will Donald Trump run again? And the answer is, does that thing on his head crap in the woods?  I actually don’t know. I don’t know.I don’t know if that thing on his head has a digestive system.

Governor, do you want bridge jokes or size jokes? Because I’ve got a bunch of both. I could go half and half. I know you like a combo platter.  Now, I get that. I’m sorry for that joke, Governor Christie. I didn’t know I was going to tell it, but I take full responsibility for it. Whoever wrote it will be fired. But the buck stops here. So I will be a man and own up to it, just as soon as I get to the bottom of how it happened, because I was unaware it happened until just now.

I’m appointing a blue-ribbon commission of me to investigate the joke I just told. And if I find any wrongdoing on my part, I assure you I will be dealt with. I just looked into it. It turns out I’m not responsible for it. Justice has been served. He’s going to kill me.

Mr. President, you’re no stranger to criticism. Ted Nugent called you a subhuman mongrel. And it’s comments like that which really make me question whether we can take the guy who wrote “Wang Dang Sweet Poontang” seriously anymore.

Your approval rating has slipped. And even worse, you only got two stars on Yelp.

Mitch McConnell said his number one priority was to get the president out of office. So, Mitch, congrats on being just two years away from realizing your goal. You did it — kind of.

But thanks to “Obamacare,” or, as the president refers to it, “Mecare,” millions of newly insured young Americans can visit a doctor’s office and see what a print magazine actually looks like. That’s awesome.

Now over 8 million people have signed up for “Obamacare,” which sounds impressive until you realize Ashley Tisdale has 12 million Twitter followers. So that’s pretty good.

Sir, I do think you’re making a big mistake with Putin. You have to show a guy like that that you’re just as crazy as he is. He invades Crimea. You invade Cancun.  Russia takes back the Ukraine. America takes back Texas. Something to think about.

The director of national intelligence, James Clapper, is here. Finally I can put a face to the mysterious voice clearing its throat on the other end of the phone.  It was weird.

And CNN is desperately searching for something they’ve been missing for months — their dignity.  Totally. That was just that table. At this point, CNN is like the Radio Shack in a sad strip mall. You don’t know how it’s stayed in business this long. You don’t know anyone that shops there. And they just fired Piers Morgan.

Fox News is the highest-rated network in cable news.  Yeah. I can’t believe your table  — that far.  And it’s all thanks to their key demographic, the corpses of old people who tuned in to Fox News and haven’t yet been discovered.

Former “Inside Edition” host Bill O’Reilly is not here. He did host that. Bill’s got another book coming out soon, so he’s making his ghost writers work around the clock. Bill O’Reilly, Megyn Kelly and Sean Hannity are the Mount Rushmore of keeping old people angry.

This event brings together both Washington and Hollywood. The relationship between Washington and Hollywood has been a long and fruitful one. You give us tax credits for film and television production, and in return, we bring much-needed jobs to hard-working American cities like Vancouver, Toronto, and Vancouver again.

Hollywood helps America by projecting a heroic image to the rest of the world. We just released another movie about Captain America, or, as he’s known in China, Captain Who Owes Us $1.1 Trillion.

There’s a lot of celebrities here tonight. They’re the ones that don’t look like ghouls. Look around. The cast of “Veep” is here. That’s a series about what would happen if a Seinfeld star actually landed on another good show. I like “The New Adventures of Old Christine,” I swear.

I’m not going to spoil the shocking twist on “House of Cards,” but just know that it was so surprising that Nancy Pelosi’s face almost changed expression. Did you like that one, Nancy? I can’t tell.

Biz Stone, the founder of Twitter, is here. So if any of you congressmen want to cut out the middleman, just show him your penis. Not now! Are you nuts?

And here’s why America is the best country in the world. A guy like me can stand before the president, the press and Patrick Duffy — and tell jokes without severe repercussions. And instead of being shipped off to a gulag, I’m going to the Vanity Fair after-party. That’s right. This is America, where everyone can be a Pussy Riot.

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Not Ready To Settle For Hillary

Not Ready Hillary

Tim Kaine is getting some publicity for saying he is ready for Hillary. I wonder if it is an early application for the vice presidential spot.

I’m not ready for Hillary, first because we have a major election coming up this November. Democrats need to concentrate on that, not 2016.

I’m also not ready to settle for Hillary. Sure, her nomination looks inevitable, but 2016 is still a long time away. She is unlikely to make the same mistakes which allowed Obama to beat her in 2008, but there is the possibility that she will make new mistakes. At the moment there doesn’t seem anyone credible to challenge her, but new Democratic leaders just might emerge while campaigning this fall. While the attacks are pure partisan nonsense, it is also possible that the Republican witch hunt on Benghazi might make her decide it just isn’t worth it to run.

I’m still hoping that the Democrats could do better and find a candidate who stands for something beyond inevitability and being the first woman president. If we want a woman candidate, I’d certainly consider Elizabeth Warren before Hillary Clinton. I’d have to take a closer look before endorsing her (and that would be premature to consider when she denies plans to run). She has received favorable publicity for a variety of reasons. Perhaps what interests me the most about her is that she once said “I was a Republican because I thought that those were the people who best supported markets.” She now is a Democrat because of realizing that is not true. It is impossible to truly be a supporter of a free market economy and vote for Republicans, whose agenda is to destroy the market economy, along with the middle class, in order to transfer the nation’s wealth to a tiny plutocracy.

At very least, can’t the Democrats come up with a candidate who wasn’t a cheerleader for the Iraq war, one of the biggest mistakes in our history?

There is no doubt, considering how extreme the Republican Party is, and how disastrous their policies are for individual liberty, economic prosperity, and our national security, that if Hillary is the candidate I will hold my nose and vote for her as the clear lesser evil. On the other hand, amusing that Republican defeat is otherwise assured, should our two party system only give us a choice between a Clinton and a Bush, I just might take a look at the Green Party.

Update: Rand Paul Could Shake Up An Election Against Hillary Clinton

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Republican Extremism Gives Democrats The Edge

Jonathan Chait looked at demographic and political trends to consider whether the trend towards the Democratic Party is likely to continue. Much of what he wrote is a recap of the conventional wisdom these days, with some disagreeing. He considered multiple factors including the tendency of the young and minorities to vote Democratic. To some degree this could be offset by an increased trend for white voters to vote Republican out of a backlash against the increase in minorities. While Democrats are expected to dominate in presidential elections, there certainly can be exceptions if there is a major occurrence favoring Republicans as the party out of power. Plus Republicans should continue to maintain a sizable portion of Congress due to the higher turnout among Republicans in off year elections as well as structural advantages in each House. Republicans have an advantage in the House of Representatives due to gerrymandering and the greater concentration of Democrats in urban areas, giving Democrats victories by larger margins in a smaller number of states. Republicans have an advantage in the Senate due to smaller Republican states having the same number of Senators as the larger Democratic states. Republicans therefore have a reasonable chance of controlling each House, or come close as is now the case in the Senate, despite a larger number of people voting for Democrats to represent them.

The key point which gives us our status quo, and gives the Democrats the edge, is that the Republican Party is now firmly in the hands of a radical fringe which will always have difficulty winning a national election, but which is unlikely to change in the foreseeable future:

My belief, of which I obviously can’t be certain, is that conservatism as we know it is doomed. I believe this because the virulent opposition to the welfare state we see here is almost completely unique among major conservative parties across the world. In no other advanced country do leading figures of governing parties propose the denial of medical care to their citizens or take their ideological inspiration from crackpots like Ayn Rand. America’s unique brand of ideological anti-statism is historically inseparable (as I recently argued) from the legacy of slavery. Whatever form America’s polyglot majority ultimately takes, it is hard to see the basis for its attraction to an ideology sociologically rooted in white supremacy.

Jonathan Bernstein sees the United States as remaining more of a 50:50 nation as in 2000, also citing George Bush’s victory over John Kerry in 2004. However the Democratic advantage in the electoral college has increased tremendously since 2000 when George W. Bush was able to come in a close enough second to take the presidency due to irregularities in Florida and a friendly Supreme Court. This victory in 2000, along with the 9/11 attack, gave Bush, as an incumbent during time of war, an edge which future Republican candidates are unlikely to enjoy.

The current political divisions won’t last in their current form forever. At sometime there is likely to be a major event which shakes up the current divisions. Chait noted that this might have been the 9/11 attack if the Republicans hadn’t squandered their political advantages by their disastrous invasion of Iraq. I would add to that being on the wrong side of far too many other issues prevented the Republicans from becoming a long-term majority party.

Most likely at some point in the future the far right will lose their grasp on the Republican Party as those who actually want to be able to win an election eventually regain control. Perhaps this will come as a newer generation rejects the most extreme ideas of the current conservative movement. If the Republicans don’t change, eventually a third party might challenge them, as difficult as it is for third parties to compete in our current political system. We might also see the Republicans persisting in their current form as a southern regional party as others battle for political control in the rest of the country.

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Republicans Will Soon Regret Being The Party Of Repealing Obamacare

The Affordable Care Act has exceeded expectations where ever we have measurements, such as in people signing up, despite the Congressional Budget Office reducing their prediction after the computer problems in October. The Republican horror stories have been debunked whenever the facts have been examined. There are no death panels, and the Republican predictions of doctors refusing to see Obamacare patients or long waits have turned out to be false. Health insurance companies desire to increase participation in the exchanges, and premium increases are projected to be far less than Republicans have predicted. However, despite the success, the debate over Obamacare is unlikely to end soon. Far too many Republicans suffer from Obamacare Derangement Syndrome.

This includes a degree of short term memory loss. The individual mandate, selling insurance through exchanges, and high deductible plans to discourage spending are all conservative ideas which most Republicans supported up until the Affordable Care Act was nearing passage in Congress. This year Republicans will continue the attacks on Obamacare because of the intensity of opposition among Republican voters. Elections, especially off-year elections, have become far more about motivating the base to get out to vote as opposed to convincing undecided people to vote for your party. Repeating the same lies about the Affordable Care Act will motivate their voters to get out to vote. If Democrats, who at times are almost as inept at campaigning as Republicans are at governing (and predicting the effects of Obamacare), continue to cower in fear over their own accomplishments, there will be little to motivate as many Democrats to get out and vote.

However the realities will change over time, as First Read explained:

It’s easy to explain why the GOP doesn’t want to move on. Health care is the issue that fires up the base; it unites a party that’s divided on other issues; and the law remains mostly unpopular in most public-opinion polls. Obama even recognized this when he talked about possible bipartisan fixes to the health-care law during his news conference yesterday. “My suspicion is that probably will not happen until after November, because it seems as if this is the primary agenda item in the Republican political platform.”

That’s a short-term winner but a long-term problem

That political platform looks like a short-term winner in the upcoming midterm elections, with the GOP having an excellent opportunity of winning back the Senate. But it raises other long-term challenges. What do you do with the eight million Americans who now have insurance on the exchanges, and with the 24 million Americans who are projected to be on the exchanges by 2017 (the next time there’s the possibility of a GOP president)? What about the millions more who have insurance via expanded Medicaid or via their parents’ insurance? And how do you advocate repeal and replace when you don’t have a detailed legislative alternative (that’s scored by the Congressional Budget Office)? Come 2015 and 2016, Republican presidential candidates could very well find themselves in an unsustainable position — having to campaign on a repeal message in the primaries (because that’s what GOP voters want), but then having to face a general electorate that’s more hostile to the idea (because repeal doesn’t poll well outside the GOP).

Americans will not want to repeal Obamacare when they consider what this means. We cannot take away health insurance from millions, and place many more at risk of losing coverage should they become sick. In the near future, to argue to repeal Obamacare will sound as absurd as arguing to repeal Medicare. Of course those who think that Republicans have really moved beyond wanting to repeal Medicare haven’t paid enough attention to the Ryan budget which Republicans have repeatedly voted to support.

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Success Of Obamacare Might Translate Into Political Success

The number of people signing up for private insurance coverage under the Affordable Care Act has now reached eight million. While primarily symbolic, it does represent a victory after initial projections of seven million were reduced to six million due to the problems when the exchanges opened. We know that if they failed to meet these projections, Republicans would be making a big deal of them. In addition, late enrollees included a high percentage of young people.

Good news means more positive head lines, such as National Journal writing that Obamacare is on a Winning Streak. The political climate is changing, with some Democrats now being more willing to run on its success.  I think it is essential that they do this to reduce the risk of the loss of a large number of seats this November. The evidence shows that Obamacare is a success but if Democrats don’t defend it, voters will only hear Republican attacks. Hiding from Obamacare will only make Democrats look weaker, and will not protect them from voters who vote against Democrats based upon Republican misinformation.

Ezra Klein writes that the right suffers from Obamacare Derangement Syndrome, being unable to admit that it is working:

Republicans used to talk about Bush Derangement Syndrome. Washington Post columnist Charles Krauthammer defined it as “the acute onset of paranoia in otherwise normal people in reaction to the policies, the presidency — nay — the very existence of George W. Bush.” Republicans like Krauthammer understood that BDS helped the Bush administration in two ways: it fired up their supporters and it distracted liberals from more modest, but effective, critiques.

Today, the right struggles with Obamacare Derangement Syndrome: the acute inability to see Obamacare as anything but a catastrophic failure that the American people will soon reject. For those suffering from ODS, all bad Obamacare news is good news, and all good Obamacare news is spin. In this world, delays of minor provisions in the law prove that the entire structure is collapsing, while surges of millions of people enrolling in insurance don’t prove anything at all…

But it’s coming at a moment when Obamacare’s successes are getting tougher and tougher to deny. The law signed up more than 7.5 million people in the exchanges, more than 3.5 million people in Medicaid, and it led millions more to get health care through their employers or directly through insurers. Premiums are lower than the Congressional Budget Office predicted when the law passed, and insurers are already thinking about how to compete for applicants in 2015. The White House has a much better story to tell than anyone — including me — thought possible in December.

For Republican pundits it might not matter that Obamacare is a success. Republicans show more intensity in their views, and very little concern for the truth. Campaigning against Obamacare might still motivate Republicans to get out and vote.

Andrew Sullivan might be a bit overly optimistic about the political effects of the success of Obamacare, but I hope he is right:

There’s simply no denying that the law has been rescued by an impressive post-fiasco operation that did to ACA-opponents what the Obama campaign did to the Clintons in 2008 and to Romney in 2012. Obama out-muscled the nay-sayers on the ground. I have a feeling that this has yet to fully sink in with the public, and when it does, the politics of this might change. (Since the law was pummeled at the get-go as something beyond the skills of the federal government to implement, its subsequent successful implementation would seem to me to do a lot to reverse the damage.) There are some signs that this is happening. A new Reuters/Ipsos poll finds the following:

Nearly one-third of respondents in the online survey released on Tuesday said they prefer Democrats’ plan, policy or approach to healthcare, compared to just 18 percent for Republicans. This marks both an uptick in support for Democrats and a slide for Republicans since a similar poll in February.

That’s mainly because of renewed confidence and support from previously demoralized Democrats. But it’s also a reflection, it seems to me, of the political vulnerability of Republicans who have failed to present a viable alternative to the law, and indeed seem set, in the eyes of most voters, merely to repeal ACA provisions that are individually popular. And this bad position is very likely to endure because of the intensity of the loathing for Obama/Obamacare among the Medicare recipients in the GOP base. It seems to me that right now, the GOP cannot offer an alternative that keeps the more popular parts of Obamacare without the air fast leaking out of their mid-term election balloon. And so by the fall, the political dynamics of this may shift some more in Obama’s direction. By 2016, that could be even more dramatic. One party – the GOP – will be offering unnerving change back to the status quo ante, and the other will be proposing incremental reform of the ACA. The only thing more likely to propel Hillary Clinton’s candidacy would be a Republican House and Senate next January.

It’s that long game thing again, isn’t it? Like the civil rights revolution of the Obama years, it seemed a close-to-impossible effort to start with, and then was gradually, skillfully ground out. It also seems true to me that the non-event of the ACA for many, many people will likely undermine some of the hysteria on the right. The ACA-opponents may be in danger of seeming to cry wolf over something that isn’t that big a deal. Yes, they may have premium hikes to tout as evidence of the alleged disaster. And every single piece of bad news on the healthcare front will be attributed to the ACA, fairly or not. But the public will still want to know how premiums can go down without people with pre-existing conditions being kicked out of the system, or without kids being kicked off their parents’ plan, and so on. I think, in other words, that the GOP’s position made a lot of short-term political sense in 2010 and even 2012. But it’s a much tougher sell in 2014, let alone 2016. Once again, they have substituted tactics for strategy. Every time they have done that with Obama, they have failed.

Sullivan described how he has benefited from the Affordable Care Act and concluded, “Yes, I am just one tiny, and rare example. But for me, at least, Obamacare has over-delivered and over-performed. If my experience is replicated more widely, then I suspect the polling and politics will shift yet again.”

Cross posted at The Moderate Voice

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Coverage Of The Success of Obamacare And Debunking Republican Lies

Obamacare Winning

Reading liberal versus conservative columnists give entirely different views of the Affordable Care Act. Liberals have been writing about its success while conservatives continue to spread misinformation. Here’s a few examples of liberal views on the topic (which are the fact-based articles):

Tim Dickenson of Rolling Stone (source for the above graphic) writes that Obamacare is working. Instead of the fake conservative horror stories, he linked to stories which show how the Affordable Care Act is helping people. He described the successes, and pointed out that “Republican Party sabotage has also impeded enrollment.” Rather than back away  from calling a lie a lie as many journalists will, Dickenson directly addressed Republican lies as lies as he debunked them:

GOP LIE No. 1: THE NUMBERS DON’T MEAN ANYTHING
Over the course of the open-enrollment period, Republicans labored to argue that Obamacare did far less good than advertised because an estimated 4.7 million Americans received letters in the fall warning that their current policies could not be renewed, as they failed to comply with new coverage requirements. They point to these “cancellations” to argue that few of the folks being counted as ACA enrollees previously lacked insurance.

There are three glaring flaws to this argument. First: Many if not most of those whose plans were canceled were automatically transferred into similar policies that complied with the new law. One of the nation’s largest for-profit insurers told House investigators that it had issued fewer than 2,000 outright cancellations.

Second: Through executive orders, Obama gave roughly half of those who received a letter – 2.35 million – the chance to stay in their existing coverage. CBO estimates suggest that just 1.5 million actually continued in their grandfathered plans, as many could find cheaper and/or better coverage on a subsidized exchange or qualify for Medicaid. It’s telling that the Michigan leukemia patient featured in Koch-funded ads intended to convey the horror of these cancellations has found a compliant poicy on the exchange that still covers her oncologist and cut her monthly premium in half.

Giving the Republican argument every benefit of the doubt, this would leave a potential pool of about 3 million people who changed, rather than gained, insurance. This leads to the third flaw in the argument: Obamacare sign-ups were always going to include millions of people who already had insurance. In its latest estimate, the CBO showed just two-thirds (4 million of 6 million) of exchange enrollments coming from people who were previously uncovered. And the limited hard data available from the states suggests the CBO is closer to the mark than the GOP: In New York, nearly 60 percent of buyers were previously uninsured. In Kentucky, it’s even higher: 75 percent.

GOP LIE No. 2: THEY HAVEN’T PAID THEIR PREMIUMS YET
GOP critics point out that the administration hasn’t tracked how many enrollees are actually paying their insurance bills. The complaint about transparency is fair, but the concern is misplaced. Figures from state exchanges and insurers themselves show that between 80 and 95 percent of enrollees are paying their bills.

GOP LIE No. 3: OBAMACARE WILL COLLAPSE UNDER ITS OWN WEIGHT
One legitimate concern as Obamacare ramped up was that it could enter a “death spiral.” This would happen if the number of older, sicker people on the exchanges far outnumbered the young and the healthy. Premiums would spike, year over year, with each increase driving more healthy folks out of the pool – making the exchange unsustainable. While reaching 7 million enrollees is a huge win politically, it doesn’t ensure Obamacare’s viability as an insurance program. “I do think there’s too much focus on the overall number,” Karen Ignagni, a top insurance-industry lobbyist, told reporters. What matters far more, she said, is the insurance pools’ “distribution of healthy to unhealthy.”

The administration wanted 18- to 34-year-olds to make up nearly 40 percent of enrollees. By March, however, only 25 percent of the mix was under 35. That sounds dire. Yet even pools with just 25 percent of younger people would not create a tailspin, forcing premiums to rise by just 2.4 percent, according to the Kaiser Family Foundation.

Additionally, the convoluted structure of Obamacare eliminates systemic risk. Even the 27 states that relied entirely on the federal exchange will end up with state-specific insurance pools. What this means is that if a death spiral were to develop in, say, Ohio, that failure would not pull down neighboring states. What’s more, safeguards within the ACA mean states don’t have to get the mix right in Year One. For the first three years, ACA has shock absorbers to prevent premium spikes in states with problematic pools. Over that same period, the penalties for not buying insurance step up – which should drive younger, healthier people into the market, balancing the risk profile. We lack hard data to get a clear picture of all state pools. But private insurers are sending optimistic signals to investors that all is well. Case in point: Insurance giant WellPoint just raised its earnings forecast.

GOP LIE No. 4: “OBAMACARE IS THE NUMBER-ONE JOB KILLER IN AMERICA”
That’s what Texas Sen. Ted Cruz told a Tea Party convention in Dallas last summer. Since then, the GOP has been making two ACA-connected job-loss claims, both demonstrably false. First, they twisted a February CBO report to claim that Obamacare will cause 2.5 million Americans to lose their jobs. What the CBO actually found is that Americans will be able to work a little less thanks to lower health-care costs, voluntarily scaling back work hours between 1.5 and 2 percent through 2024, or the output of 2.5 million full-time workers. The other GOP lie is that Obamacare is causing employers – who will be responsible for insuring employees who work more than 30 hours a week – to either scale back the hours of full-time employees or hire only part-time workers. This, too, is hogwash. While the share of part-time employment remains historically high, it has actually been in decline since 2010, when Obama­care became law.

I have discussed many of the above points, with links to the evidence, in previous posts on health care reform.

I was also happy to see that he concluded with the same opinion I have expressed that Democrats must take the offensive on health care:

House Republicans have learned the hard way that even nibbling around the edges of Obamacare can backfire. In February, the GOP pushed a bill to tweak the mandate that businesses offer health care to all employees working more than 30 hours. Switching to the GOP’s preferred 40-hour standard, it turns out, would add $74 billion to the deficit by 2024 and cause nearly 1 million Americans to lose coverage. That’s the kind of move that would play right into Democratic hands. Says Greenberg, “Democrats do very well when they hit back at Republicans on what people lose.”

Until recently, Greenberg had been advising Democrats to move beyond Obamacare and turn to bread-and-butter issues like jobs and the minimum wage. “The strongest attack on Republicans,” he says, “is that they’re obsessed with Obamacare instead of critical issues like dealing with the economy.” But his new poll has Greenberg rethinking that counsel. “Until now, this is an issue where the intensity has been on the other side,” he says. But defending Obamacare, he adds, has emerged as “a values argument for our base.” Greenberg now believes Democrats “ought to lean much more strongly” to campaign on the virtues of Obamacare as a means of boosting progressive turnout. “Not apologizing for Obamacare and embracing it actually wins the argument nationally,” he says. “And it produces much more engagement of Democratic voters. That’s a critical thing in off-year elections.”

Eugene Robinson also wrote about the success of Obamacare:

A new report by the nonpartisan Congressional Budget Office estimates that, despite all the problems with the HealthCare.gov Web site launch, 12 million people who previously lacked insurance will obtain coverage this year. By 2017, the year Obama leaves office, the CBO predicts that an additional 14 million uninsured will have managed to get coverage .

Why was the Affordable Care Act so desperately needed? Because without it, 54 million Americans would currently have no health insurance. Within three years, according to the CBO, Obamacare will have slashed the problem nearly in half.

We should do better, and perhaps someday we will. Most industrialized countries have some kind of single-payer system offering truly universal coverage. But if you have to work within the framework of the existing U.S. health-care system — which involves private health insurance companies and fee-for-service care — the Affordable Care Act reforms are a tremendous advance.

Many Republican critics of Obamacare know, but refuse to acknowledge, that the reforms are here to stay. Does the GOP propose to let insurance companies deny coverage because of preexisting conditions, as they could before the ACA? Does the party want to reimpose lifetime caps on the amount an insurer will pay? Tell young adults they can no longer be covered under their parents’ policies?

He concluded by also recommending that Democratic candidates take advantage of the success of Obamacare:

To do well in the fall, Democrats have to infuse their most loyal voters with similar enthusiasm. The success of Obamacare will help. Already, polls are showing upticks in support for embattled Democratic incumbent senators in Louisiana, Arkansas and Alaska. Democrats control their own destiny in November: If they can get their voters to the polls, they’ll win.

In the long run, no matter what happens in the election, I’m more convinced than ever that the Affordable Care Act will be seen as landmark legislation. With minimal immediate impact, the ACA does two tremendously important things.

First, it shifts the incentive structure in the health-care industry in ways that promise to hold down rising costs. And second, it establishes the principle that health care should be considered a right, not a privilege.

Of course it’s not perfect. It’s a thing of beauty anyway. We have liftoff. It’s working.

Paul Krugman described Obamacare as the unknown ideal:

The current state of public opinion on health reform is really peculiar. If you’ve been following the issue at all closely, you know that the Affordable Care Act is one of the great comeback stories of public policy: after a terrible start, it has dramatically exceeded expectations. But hardly anyone seems to know that.

He blamed Fox and Rush Limbaugh for all the misinformation they have spread, the Obama administration for doing a “lackluster job so far in getting the word out,” and “a persistent anti-ACA tilt in news coverage.” He pointed out how factual stories on the success of Obamacare are often buried in the back pages of newspapers.

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Fact Checking Valuable, But Not Always Right

Pinoccio

The Moderate Voice has a post yesterday on the increase in fact-checking in journalism. Fact-checking is preferable to the standard media practice of quoting both sides as if they are equally valid, generally with an implied assumption that the truth is somewhere in the middle. This leads to erroneous reporting when one side is intentionally using misinformation and lying far more than the other. However labeling something fact checking doesn’t necessarily mean it is immune from journalistic problems. Paul Krugman pointed out one problem:

“The people at PolitiFact are terrified of being considered partisan if they acknowledge the clear fact that there’s a lot more lying on one side of the political divide than on the other,” Krugman wrote in 2011.

“So they’ve bent over backwards to appear ‘balanced’ — and in the process made themselves useless and irrelevant.”

As Krugman pointed out, there are fact checkers which label an equal number of statements from Democrats and Republicans as being wrong in order to give the appearance of being impartial. That typically means that outrageous lies from Republicans are called lies but to provide a sense of balance,  statements from Democrats which are generally true but in which there is an exception are also called lies.

The entire idea of calling something true or a lie is often a poor way to handle complex issues which are stated by politicians in brief statements. Sometimes politicians are trying to be truthful, but boiling down a complex issue into a brief statement, or commercial, will result in exceptions where the statement is false. Often it is preferable to look at what is true in what is being said and where it isn’t entirely true and explain the issue rather than just calling it truth or a lie.

While Republicans have been hit far more with big lies on health care, Democrats have been harmed by the problems in how some fact checkers declare something either true or a lie (being a lie if not 100% true in every case). There have been two big examples of this. The first is Democrats saying that the Medicare proposals in the Ryan budget would destroy Medicare. Technically this is untrue as Ryan would replace Medicare with something named Medicare. On the other hand, it is true because the Republican proposals would change Medicare into something fundamentally different with far less protection for seniors. Rather than just calling it a lie, fact checkers would have done more good by explaining why Democrats consider these changes to be destroying Medicare.

The other is the greatly exaggerated “lie of the year” when Obama said people could keep their own doctor under the Affordable Care Act. This was an absurd statement on one level because every year insurance companies and doctors make decisions which can affect this which the government has no  power over. On the other hand, Obama was right in the context where he was speaking, even if worded poorly. Republicans were lying when they claimed that Obamacare would make people join some sort of government run program which would tell them which doctors they can see. The Affordable Care Act actually makes it more likely that people could have insurance which would allow them to keep their doctor than had been the case in the past and does nothing to force people to lose their doctor. People have a better chance of keeping their doctor when protected from losing their insurance. Frequently people are forced to change doctors because of employers changing insurance plans. Employees have a better chance of keeping their own doctor when provided more choice in plans, as under the Affordable Care Act.  Where Obama got it wrong was that the same forces already present which lead to people having to change doctors, while diminished, would still exist. It would be far better to explain this complex issue, where Obama was mostly right, than to just declare it a lie because it is not true one hundred percent of the time.

Cross posted at The Moderate Voice

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Don’t Panic Because Nate Silver Predicts Republicans Will Take Senate

I was traveling yesterday and when I finally got on line saw a lot of panic over Nate Silver predicting that the Republicans were favored to take control of the Senate. I don’t find this terribly significant.

We already knew that there was a real possibility that the Republicans could take control of the Senate and Silver’s prediction does not provide any new information. Silver making the prediction does not mean it is any more likely to occur than it was last week. He was way off in predicting a 61 percent chance the Republicans would take control of the Senate in 2012. I hope he is wrong again.

As I noted recently, Nate Silver’s predictions in the 2012 presidential election were similar to those from other sources (ignoring the Republicans who made predictions contrary to polling results). His predictions for the Senate in 2012 were also comparable to predictions being made by others at that point. His prediction for the Senate in 2014 is comparable to predictions already made by others.

There is real reason to fear that the Republicans will take control of the Senate is year, but the news of Nate Silver predicting this does not alter what we knew before he made this prediction and does not mean that it is any more likely to occur.

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