Republican Attempts To End Obamacare May Have Died

As I’ve discussed previously, Republican plans to repeal Obamacare are not going well for them. Donald Trump is still talking about immediate repeal, while having no idea what is actually going on. Repeal might not be possible as more Senators, in addition to those mentioned in the previous post, are jumping ship.  Jonathan Chait writes that their plans to destroy Obamacare may have died, reporting that additional Republican Senators are now pushing to include a replacement plan with legislation to repeal Obamacare.

Over in the House, Paul Ryan is also talking vaguely about including portions of a new plan in the repeal legislation.

Including a replacement plan could very well kill off any Republican plans to repeal Obamacare. From a public relations stand point, they will have difficulty obtaining public support for a health plan which does not include popular components of the Affordable Care Act. Politico confirmed this in a new poll:

Voters want — and expect — President-elect Donald Trump and the GOP-controlled Congress to repeal the 2010 health care law, according to a new POLITICO/Morning Consult poll released Tuesday, but they are skeptical of repeal without a plan to replace Obamacare and some of its most popular elements…

Testing eight separate elements of the law, more voters want to keep each of the eight provisions than want to repeal them, in some cases by overwhelming margins.

Nearly two-thirds of voters, 66 percent, favor keeping a provision that prohibits insurance companies from denying coverage to patients with pre-existing conditions. Sixty-three percent of voters want to keep the requirement that insurance companies allow policyholders to keep their children on their plans until age 26. Fifty-six percent think subsidies for low-income Americans to buy insurance should stay, and the same percentage wants to keep federal funding for states to expand their Medicaid programs.

A 55-percent majority also wants to keep the requirement that businesses and companies with more than 50 full-time employees offer health insurance to those employees, while only 27 percent want that provision repealed. Many Republicans say that requirement has led businesses to slash jobs and hours to avoid hitting that threshold.

And 53 percent of voters want to keep requiring insurance companies to cover prescription birth control, while just three-in-10 want that requirement repealed. (The Supreme Court ruled in 2014 that employers may exclude contraceptive coverage for their employees if it violates the employers’ religious beliefs.)

Pluralities of voters also want to keep two other provisions of the law, though by narrower margins: 46 percent want to keep the elimination of lifetime and annual limits on health reimbursement to individuals, while 32 percent want that repealed. And 33 percent of voters want to repeal the long-derided medical-device tax, compared to 37 percent who want to keep it.

The most-popular elements of the law are also well-regarded by Republicans. Sixty-three percent of Republicans want Trump and Congress to keep the prohibition on denying coverage to those with pre-existing conditions, and 56 percent want to retain requiring insurance companies to allow the children of policyholders to stay on their plans until age 26.

In other words, as has been the case all along, the public opposes Obamacare by name but supports its components when asked.

Besides the public relations issues, the repeal of Obamacare might be dead due to Senate rules. The Senate can repeal Obamacare as part of a budget resolution with a simple majority, but a bill which repeals Obamacare and establishes a replacement program can be blocked with a filibuster if it lacks sixty votes. If Republicans cannot get a simple majority for repeal now, they could wind up with a choice of continuing Obamacare or only replacing it with a plan which can obtain bipartisan support. Such a plan will very likely be much like Obamacare, even if under a different name.

AMA Warns Of Risks Of Gutting Health Care Reform

With Republicans appearing to make abolishing Obamacare a top priority (following their failure to gut ethics oversight of Congress), the American Medical Association has weighed in with this letter (emphasis mine) stressing the importance of making coverage more affordable, providing greater choice, and increasing the number insured:

Dear Majority Leader McConnell, Leader Schumer, Speaker Ryan and Leader Pelosi:

On behalf of the physician and medical student members of the American Medical Association (AMA), I am writing regarding our ongoing commitment to reform of the health care system and potential legislative actions during the first months of the 115th Congress.

The AMA has long advocated for health insurance coverage for all Americans, as well as pluralism, freedom of choice, freedom of practice, and universal access for patients. These policy positions are guided by the actions of the AMA House of Delegates, composed of representatives of more than 190 state and national specialty medical associations, and they form the basis for AMA consideration of reforms to our health care system.

Health system reform is an ongoing quest for improvement. The AMA supported passage of the Affordable Care Act (ACA) because it was a significant improvement on the status quo at that time. We continue to embrace the primary goal of that law—to make high quality, affordable health care coverage accessible to all Americans. We also recognize that the ACA is imperfect and there a number of issues that need to be addressed. As such, we welcome proposals, consistent with the policies of our House of Delegates, to make coverage more affordable, provide greater choice, and increase the number of those insured.

In considering opportunities to make coverage more affordable and accessible to all Americans, it is essential that gains in the number of Americans with health insurance coverage be maintained.

Consistent with this core principle, we believe that before any action is taken through reconciliation or other means that would potentially alter coverage, policymakers should lay out for the American people, in reasonable detail, what will replace current policies. Patients and other stakeholders should be able to clearly compare current policy to new proposals so they can make informed decisions about whether it represents a step forward in the ongoing process of health reform.

We stand ready to work with you to continue the process of improving our health care system and ensuring that all Americans have access to high quality, affordable health care coverage.

Sincerely,
James L. Madara, MD

Medical groups and physicians have been conflicted regarding expected health care policy under Donald Trump. There was some early support for Tom Price to head Health and Human Services in the hope that he will work to reduce the regulatory burden, but many doctors have come out in opposition to him out of concern for reductions in coverage for many Americans.

While health care policy could likely a major impact of the all-Republican government, it received very little attention during the presidential campaign. This is partially due to the media’s preference to cover the horse race and scandal, Donald Trump making more noise on matters such as the Wall, and an extraordinarily poor campaign by Hillary Clinton which concentrated on stressing Trump’s negatives and avoiding issues. Democrats are now starting to speak out on health care. Chuck Schumer is trying to turn Trump’s slogan against him, warning that Republicans will “Make America Sick Again.” Hopefully they can provide a resistance beyond coming up with a slogan.

Democrats were successful in blocking George Bush when he attempted to partially privatize Social Security in his second term, and similarly have a chance of receiving public support in opposing Republican attempts to reduce health care coverage, including cuts in Medicare and Medicaid. Republicans are also getting jittery about health care legislation. They could safely please their constituents by voting to abolish Obamacare when Barack Obama was in office and they knew he would veto their efforts if it made it past a filibuster. Many now realize they will be held accountable for what happens, including if people lose coverage, and insurance costs continue to rise rapidly. The Committee For A Responsible Federal Budget, typically conservative on government  spending,  has outline the costs of repealing Obamacare, giving further reasons for Republicans to be cautious.

Donald Trump remains a huge wild care, having both promised to abolish Obamacare and to provide a plan to cover all Americans. So far he has given no meaningful specifics, talking primarily about health savings accounts and allowing insurance companies to sell insurance over state lines. Neither is a real plan. One point to Trump’s credit is that, while his major appointees have been from a very narrow group (primarily wealthy conservatives), he has spoken to a wider range of people. Zeke Emanuel, the architect of the Affordable Care Act, came out of a meeting with Trump expressing optimism, as reported by NPR. He believes Trump might seek to have a bipartisan bill after Republicans have complained about how Obamacare was passed by only Democrats. He also pointed out that some conservatives are pushing for “repeal and replace” as opposed to the currently discussed tactic of “repeal and delay” and discussed how legislation might be handled after an initial resolution (even if along party lines) to abolish the ACA utilizing budget reconciliation:

And so that you really do need to repeal and replace, and you need to do it in one bill. Otherwise, you’re really going to disrupt the individual insurance market in a very bad way, and you’ll be responsible for millions of people losing their coverage but also health insurance premiums going up. And I think that is not a scenario that a lot of Republicans really want…

So one possibility is that they pass a resolution saying that they will then come back and pass a bill that will repeal parts of the Affordable Care Act and at the same time have a replacement for those parts of the Affordable Care Act…

The resolution can be party lines, but the bill would then have to construct both the repeal part but simultaneously the replacement part. And I think if you do it that way, you could begin to negotiate with Democrats. If you just have a repeal and we’ll be back in three years and tell you how we’re going to fix it, then the Democrats are simply going to walk away. Chuck Schumer has made that clear.

And they should walk away because then it’s all – it’s the old pottery barn principle that Colin Powell made famous, which is, you break it; you have to fix it, and you take responsibility. And the Democrats will not want their fingerprints anywhere near the breaking of Obamacare and the disruption of the insurance industry in the United States…

The question is, what is the shape of that bill? Is it just a repeal bill, or is it a repeal with replacement? And that negotiation about that bill could take several months. My own estimate is if both sides come with good faith, they could probably hammer this out in about six months. It’s not a small item. I mean health care reform is big.

The question is, what are the gives and takes? I do think – again, one of the reasons I’m optimistic is that when you look at conservative and liberal health policy experts, there’s about 70 or 80 percent overlap between the two groups about the shape of the future and what you would need. And I think that’s, again, why I’m optimistic – because there aren’t that many ways of doing health care reform. They’re really limited.

Of course counting on the sanity of Republicans is a very risky bet.

The Republicans Now Have A God Problem

If you listen to Republicans, they are running to uphold moral values based upon Christianity. Many Republican candidates in the past have even claimed that god wanted them to run, and have cited god to justify their policies. Suddenly it is no longer the case that the Republicans are running on god’s platform. Amy Davidson looked at God and the GOP at The New Yorker:

Indeed, other potential G.O.P. candidates are now having to recalculate how another religion figures into the equation. There has never been a Catholic Republican nominee for the White House (the Mormons, interestingly, got there first), although there may be one this year, with a field that includes Rick Santorum, Chris Christie, and Jeb Bush, who converted to Catholicism, his wife’s faith, some twenty years ago. For them, the issue is not one of religious bigotry, such as John F. Kennedy faced in his 1960 campaign, with insinuations of adherence to secret Papist instructions. In a way, it’s the opposite: the very public agenda of the all too authentic Pope Francis.

Early signs of trouble came in the summer of 2013, when the new Pope, speaking with reporters about gays in the Church, asked, “Who am I to judge?” The conservative wing of the Party had relied on his predecessors to do just that. Then he proved much less reticent about issuing a verdict on capitalism. In an apostolic exhortation issued at the end of 2013, he labelled trickle-down economic theories “crude and naïve.” The problems of the poor, he said, had to be “radically resolved by rejecting the absolute autonomy of markets and financial speculation and by attacking the structural causes of inequality.” That went quite a ways beyond the sort of tepid proposals for job creation and “family formation” that Romney made on the Midway, and the response from Republicans has involved a certain amount of rationalization. “The guy is from Argentina—they haven’t had real capitalism,” Paul Ryan, Romney’s former running mate, and a Catholic, said.

“It’s sometimes very difficult to listen to the Pope,” Santorum noted last month, after Francis, in remarks about “responsible parenting”—widely interpreted as an opening for a discussion on family planning—said that there was no need for Catholics to be “like rabbits.” Santorum echoed Ryan’s suggestion that Argentine exceptionalism might be at work: “I don’t know what the Pope was referring to there. Maybe he’s speaking to people in the Third World.” On that front, when it emerged that Francis had been instrumental in the diplomatic breakthrough with Cuba, Jeb Bush criticized the deal, and Senator Marco Rubio, also a Catholic, said that he’d like the Pope to “take up the cause of freedom and democracy.”

As if all that weren’t enough, His Holiness is preparing an encyclical on climate change, to be released in advance of his visit to the United States later this year. In January, he said of global warming, “For the most part, it is man who continuously slaps down nature.” Stephen Moore, of the Heritage Foundation, has written, “On the environment, the pope has allied himself with the far left.” Actually, Francis is very much in the center in terms of scientific opinion, but the leading potential G.O.P. contenders, with the possible exception of Christie, sit somewhere on the climate-change-denial-passivity spectrum—Jeb Bush has said that he is a “skeptic” as to whether the problem is man-made.

In recent decades, liberal Catholic politicians were the ones with a papal problem; both Mario Cuomo and John Kerry had to reckon with the prospect of excommunication for their support of abortion-rights laws. John Paul II, meanwhile, was a favorite of conservatives; despite his often subtle views, he became at times little more than a symbol of anti-Communism and a certain set of social strictures. He cemented an alliance, in the political realm, between conservative Catholics and evangelicals. (Rubio also attends an evangelical church.) Abortion was a significant part of that story. By contrast, the Franciscan moment will push some Republican candidates to make decisions and to have conversations that they would rather avoid.

It will also offer a chance to address the knotty American idea that faith is an incontrovertible component of political authenticity. (Why is the Romney who thinks about God the “real” one?) The corollary should be that nothing is as inauthentic as faith that is only opportunistically professed, something that this Pope, who has extended a hand to atheists, seems to know. Still, the campaign will be defined not by theological questions but by political ones, prominent among them inequality and climate change. Both can have spiritual dimensions and speak to moral issues, such as our obligations to one another. But neither can be solved by faith alone.

For those who buy the false claims which have come from some Republicans in the past that the United States was founded as a Christian nation, it might conceivably cause some problems to see Republican candidates at odds with the Pope’s views on religion. While this could be amusing, most likely it won’t matter. The Republican base, which never allows facts to get in the way of their beliefs, sure aren’t going to alter their view based upon what the Pope says. We have seen how willing they are to ignore science when it conflicts with their views on evolution, climate change, or abortion. Republicans also don’t allow economic data which shows that their beliefs (essentially held as a religion) on economics are total hogwash interfere with this religion, no matter how often the economy performs better under Democrats than Republicans. Still, Republicans who could never justify their policies based upon facts, might lose even more legitimacy when they also lose religious justification for their policies.

While most people, or at least those who respect the desire of the founding fathers to establish a secular state, would not use religious views as justification for public policy decisions, there will at least be a bit of satisfaction in seeing Republicans lose even this basis to justify their absurd positions.

Why The Republicans Won Despite Being Wrong On All The Issues

Paul Krugman points out that the Republicans, despite winning the midterm elections on Tuesday, were wrong on everything:

First, there’s economic policy. According to conservative dogma, which denounces any regulation of the sacred pursuit of profit, the financial crisis of 2008 — brought on by runaway financial institutions — shouldn’t have been possible. But Republicans chose not to rethink their views even slightly. They invented an imaginary history in which the government was somehow responsible for the irresponsibility of private lenders, while fighting any and all policies that might limit the damage. In 2009, when an ailing economy desperately needed aid, John Boehner, soon to become the speaker of the House, declared: “It’s time for government to tighten their belts.”

So here we are, with years of experience to examine, and the lessons of that experience couldn’t be clearer. Predictions that deficit spending would lead to soaring interest rates, that easy money would lead to runaway inflation and debase the dollar, have been wrong again and again. Governments that did what Mr. Boehner urged, slashing spending in the face of depressed economies, have presided over Depression-level economic slumps. And the attempts of Republican governors to prove that cutting taxes on the wealthy is a magic growth elixir have failed with flying colors.

In short, the story of conservative economics these past six years and more has been one of intellectual debacle — made worse by the striking inability of many on the right to admit error under any circumstances.

Then there’s health reform, where Republicans were very clear about what was supposed to happen: minimal enrollments, more people losing insurance than gaining it, soaring costs. Reality, so far, has begged to differ, delivering above-predicted sign-ups, a sharp drop in the number of Americans without health insurance, premiums well below expectations, and a sharp slowdown in overall health spending.

And we shouldn’t forget the most important wrongness of all, on climate change. As late as 2008, some Republicans were willing to admit that the problem is real, and even advocate serious policies to limit emissions — Senator John McCain proposed a cap-and-trade system similar to Democratic proposals. But these days the party is dominated by climate denialists, and to some extent by conspiracy theorists who insist that the whole issue is a hoax concocted by a cabal of left-wing scientists. Now these people will be in a position to block action for years to come, quite possibly pushing us past the point of no return.

He then went on to look at why they won, expressing views similar to what I had written about the election earlier in the week:

Part of the answer is that leading Republicans managed to mask their true positions. Perhaps most notably, Senator Mitch McConnell, the incoming majority leader, managed to convey the completely false impression that Kentucky could retain its impressive gains in health coverage even if Obamacare were repealed.

But the biggest secret of the Republican triumph surely lies in the discovery that obstructionism bordering on sabotage is a winning political strategy. From Day 1 of the Obama administration, Mr. McConnell and his colleagues have done everything they could to undermine effective policy, in particular blocking every effort to do the obvious thing — boost infrastructure spending — in a time of low interest rates and high unemployment.

This was, it turned out, bad for America but good for Republicans. Most voters don’t know much about policy details, nor do they understand the legislative process. So all they saw was that the man in the White House wasn’t delivering prosperity — and they punished his party.

This was their strategy, literally beginning on Day 1, if not earlier. A Frontline documentary described what the Republicans planned:

On the night of Barack Obama’s inauguration, a group of top GOP luminaries quietly gathered in a Washington steakhouse to lick their wounds and ultimately create the outline of a plan for how to deal with the incoming administration.

“The room was filled. It was a who’s who of ranking members who had at one point been committee chairmen, or in the majority, who now wondered out loud whether they were in the permanent minority,” Frank Luntz, who organized the event, told FRONTLINE.

Among them were Senate power brokers Jim DeMint, Jon Kyl and Tom Coburn, and conservative congressmen Eric Cantor, Kevin McCarthy and Paul Ryan.

After three hours of strategizing, they decided they needed to fight Obama on everything. The new president had no idea what the Republicans were planning.

Of course we cannot just criticize the Republicans. The Democrats were at fault when six years later they still had no effective response to this Republican strategy, and were afraid to stand up for their accomplishments. Being right doesn’t do any good politically if they were afraid to explain this to the voters. Democratic candidates ran away from Obama and his policies and then were shocked when the Obama voters didn’t come out to vote for them. As Peter Beinhart wrote, the Democrats cannot keep playing not to lose:

This fall, Democrats ran like they were afraid of losing. Consider the issues that most Democrats think really matter: Climate change, which a United Nations report just warned will have “severe, pervasive and irreversible impacts” across the globe. The expansion of Medicaid, so millions of poor families have health coverage. Our immoral and incoherent immigration system. Our epidemic of gun violence, which produces a mini-Sandy Hook every few weeks. The rigging of America’s political and economic system by the 1 percent.

For the most part, Democratic candidates shied away from these issues because they were too controversial. Instead they stuck to topics that were safe, familiar, and broadly popular: the minimum wage, outsourcing, and the “war on women.” The result, for the most part, was homogenized, inauthentic, forgettable campaigns. Think about the Democrats who ran in contested seats Tuesday night: Grimes, Nunn, Hagan, Pryor, Hagan, Shaheen, Landrieu, Braley, Udall, Begich, Warner. During the entire campaign, did a single one of them have what Joe Klein once called a “Turnip Day moment”—a bold, spontaneous outbreak of genuine conviction? Did a single one unfetter himself or herself from the consultants and take a political risk to support something he or she passionately believed was right?

…We saw the consequences on Tuesday. According to exit polls, voters under 30 constituted only 13 percent of the electorate, down from 19 percent in 2012. In Florida, the Latino share of the electorate dropped from 17 to 13 percent. In North Carolina, the African-American share dropped from 23 to 21 percent.

By positioning himself as a moderate, he may have missed a chance to gin up more enthusiasm within the state’s expanding Democratic base, earning fewer votes in such deep-blue communities as Arlington County and Alexandria than left-of-Warner Gov. Terry McAuliffe (D) did a year ago.

All of it has left some to wonder whether Warner would have won bigger if he had eschewed the middle and embraced the left, and whether the winning path for moderates that Warner forged during his own bid for governor 13 years ago is becoming extinct.

“I think if you look at the returns around the country . . . it raises questions about just how successful the bipartisanship brand really is,” Rep. Gerald E. Connolly (D-Va.) said Tuesday after easily winning a fourth term in Northern Virginia’s 11th Congressional District by talking about women’s rights, immigration reform and climate change — and less about working with Republicans.

Here’s a similar take on what the Democrats did wrong: “They were so focused on independents that they forgot they had a base. They left their base behind. They became Republican-lite.”

That opinion came from Rob Collins, the executive director of the National Republican Senatorial Committee. He also said Democrats “sidelined their best messenger” by running away from Obama, and for not talking about the economy. Republicans might be wrong virtually all the time lately when it comes to governing, but quite often they are smarter than Democrats with regards to politics.

Left and Right Join Together To Oppose Militarization Of Police

Police Missouri

The militarization of the police force seen with the shooting in Ferguson, Missouri has led to another case of portions of the left and right joining together. This includes a push for legislation in Congress with the backing of both the American Civil Liberties Union and Gun Owners of America.:

Groups on the left and right are uniting behind calls to end what they say is the rise of a “militarized” police force in the United States.

They say the controversial police tactics seen this week in Ferguson, Mo., are not isolated to the St. Louis County Police Department and warn the rise of heavily armed law enforcement agencies has become an imminent threat to civil liberties.

“What we’re seeing today in Ferguson is a reflection of the excessive militarization of police that has been happening in towns across America for decades,” said Kara Dansky, senior counsel for the American Civil Liberties Union (ACLU).

The ACLU is aligned with Sen. Rand Paul (R-Ky.) and groups on the right who are calling for an end to a controversial Defense Department program that supplies local police departments with surplus military equipment, such as armored tanks, machine guns and tear gas.

According to the Defense Logistics Agency, more than $4 billion in discounted military equipment has been sold to local police departments since the 1990s.

“Why are those guns available to the police?” asked Erich Pratt, spokesman for the conservative Gun Owners of America. “We don’t technically have the military operating within our borders, but they’re being given the gear to basically operate in that capacity.”

Gun Owners of America and the ACLU are both backing a forthcoming bill from Rep. Hank Johnson (D-Ga.) that would curtail the sale of DOD weapons to local police departments.

More libertarian factions of the Republican Party are speaking out on this issue:

The killing of 18-year-old Michael Brown by a police officer in Ferguson, Mo., has produced a rare and surprisingly unified response across the ideological spectrum, with Republicans and Democrats joining to decry the tactics of the city’s police force in the face of escalating protests.

Most notably, the reactions reflect a shift away from the usual support and sympathy conservatives typically show for law enforcement in such situations. Although possibly unique to the circumstances of the events in Missouri this week, the changing reaction on the right is clear evidence of a rising and more vocal libertarian wing within the Republican Party.

No better sign of that came Thursday than in an article by Sen. Rand Paul (R-Ky.) published on Time’s Web site.

“If I had been told to get out of the street as a teenager, there would have been a distinct possibility that I might have smarted off,” he wrote. “But, I wouldn’t have expected to be shot.”

In his piece, Paul criticized what he called the growing militarization of local police forces. “There is a legitimate role for the police to keep the peace,” he wrote, “but there should be a difference between a police response and a military response.”

This comes as a change from what we generally expect from Republicans:

Since Richard M. Nixon made cracking down on crime a central issue of his 1968 presidential campaign, Republicans have held themselves up as the alternative to a Democratic Party they have derided as soft on issues of law and order. But an appetite for changes in the criminal justice system has been building among Republicans, many of whom believe the tough-justice approach has run its course.

Mr. Paul, Senator Rob Portman of Ohio and Representative Paul D. Ryan of Wisconsin are among those who say that the federal and state governments need to rethink the way convicts are sentenced and imprisoned, arguing that the current system is inhumane and too costly.

Mr. Paul’s remarks on Thursday were similar to those of other leading conservatives who have weighed in on the events in Ferguson.

“Reporters should never be detained — a free press is too important — simply for doing their jobs,” Senator Ted Cruz, Republican of Texas, wrote on his Facebook page on Thursday, reacting to news that journalists from The Washington Post and The Huffington Post had been held by the police. “Civil liberties must be protected, but violence is not the answer.”

Erick Erickson, a conservative writer, took to Twitter to question why the police needed to display so much firepower. “It is pretty damn insane that people who spend all day writing speeding tickets,” he wrote, “hop in tanks with AR-15s at night.”

But not all conservatives are as concerned about the civil liberties aspects:

Other conservatives have focused on instances in which chaos has broken out in the streets. Images and headlines on The Drudge Report and Breitbart.com have singled out acts of violence among demonstrators and shown looters breaking store windows…

In much of the conservative news media, the protesters in Ferguson are being portrayed as “outside agitators,” in the words of Sean Hannity, the Fox News host.

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.

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.

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

Quote of the Day: Bill Maher on The Ryan Budget And Obamacare

“Game of Thrones returns this weekend on HBO. I’m sure you know it as a magical fantasy where you’re never quite sure who’s going to live or die. Or maybe I’m thinking of Paul Ryan’s budget.” –Bill Maher

Bonus Quote:

“Obamacare hit its numbers. Despite all the initial problems, Healthcare.gov surpassed the enrollment goal, over 7 million. Now the Republicans are saying that they’re going to repeal the Internet.” –Bill Maher

Paul Ryan Admits Consequences Of Replacing Obamacare With Republican Alternative

Republicans who have been attacking the Affordable Care Act have been unable to provide a specific alternative to replace it with. One problem they face is that, while polls show large numbers of people say they oppose Obamacare, a majority also supports many of the individual components of the law. Paul Ryan admitted what repeal of Obamacare and replacing it with a Republican alternative would mean:

House Budget Committee Chairman Paul Ryan (R-Wis.) says in a new interview that it would be too costly for Republicans to reinstate some of the more popular provisions of Obamacare if and when the law is repealed, but that Republicans should look for alternatives.

The former GOP vice presidential nominee was asked on Bloomberg’s “Political Capital with Al Hunt” about whether Republicans would keep provisions like requiring coverage for pre-existing conditions, keeping kids on their parents’ insurance until they are 26 years old and barring insurance companies from having different rates for those whose jobs include physical labor.

The first two provisions are among the most popular parts of Obamacare, which as a whole is not popular. But Ryan says such provisions would also drive up the cost of insurance too much.

“If you look at these kinds of reforms, where they’ve been tried before — say the state of Kentucky, for example — you basically make it impossible to underwrite insurance,” Ryan said, according to an advance transcript. “You dramatically crank up the cost. And you make it hard for people to get affordable health care.”

Returning to underwriting insurance would mean that insurance companies could once again issue policies based upon who they find the most profitable to cover, denying coverage to those with pre-existing medical conditions and based upon age.

It is less expensive for health insurance companies to sell insurance only to young, healthy people and to revoke coverage when people get sick. However this is not what we need from health insurance, which to be meaningful must be available to everyone and cover people when they become sick. As I’ve pointed out many times in the past, most people going into bankruptcy from medical expenses were insured at the time they first got sick or injured.

Cross posted at The Moderate Voice