Republicans Plan To Impose Huge Tax Increase On Middle Class In Opposing Obamacare Fix

Republicans are increasingly seeing King v. Burwell as a way to do what they couldn’t accomplish in over fifty votes–repeal the Affordable Care Act. While it defies logic, the Supreme Court could conceivably rule that the Affordable Care Act only provides subsidies for plans purchased on state exchanges but not on the federal exchange.

A majority of people want Congress to pass a simple legislative fix should this occur, guaranteeing a continuation of the subsidies for those who purchase plans over the federal exchange. The health care and insurance industries also support such a fix.

This does not mean that the Republican Party will take the rational path. The Wall Street Journal reports:

Congressional Republicans say they won’t move to preserve consumers’ health insurance tax credits if the Supreme Court strikes them down, raising the stakes in the latest legal challenge to the Affordable Care Act…

Leaders in the GOP-controlled House and Senate see the court challenge as their best hope for tearing apart a law they have long opposed. If the court strikes down the subsidies, Democrats are expected to clamor for lawmakers to pass a measure correcting the language in the law to revive them. Congressional Republicans say there is no possibility they would allow that.

“No, no, no, no,” said Sen. Dan Coats (R., Indiana). “Even Democrats have acknowledged that this needs fixing.”

That position would force lawmakers to confront people in as many as 37 states where the federal government is currently running some or all of the exchange where consumers buy plans and tap the tax credits. There are 6.1 million people in those states who have the credits for 2015, according to federal data released this week. The average tax credit this year is $4,330, the Congressional Budget Office said this week.

Eleven of the states where the federal government has a hand in running the insurance exchange – including seven with Republican governors – signed onto a brief submitted late Wednesday asking the Supreme Court to uphold their tax credits. The brief said the loss of the credits “would deprive millions of low-and moderate-income Americans of billions of dollars in federal premium assistance essential to buy health insurance, thereby disrupting state insurance markets throughout the United States.”

The brief was filed by a group of mostly Democratic attorneys general. The lone Republican, North Dakota’s Wayne Stenehjem, declined to comment…

Nobody in the Senate Republican caucus has said the party should tweak the law so it can continue as it is, particularly since such a move would preserve the unpopular requirement for people to buy coverage or pay a fine, said Don Stewart, a spokesman for Senate Majority Leader Mitch McConnell of Kentucky.

Republicans are also increasingly preparing to use the budget procedural tactic known as reconciliation to repeal large parts of the law and potentially enact alternative provisions after the court ruling, whatever the outcome. The reconciliation process allows party leaders to pass changes with a simple majority, rather than the 60 votes most bills need to clear procedural hurdles in the Senate.

A loss of the subsidies would amount to a tax increase on the middle class. Republicans tend to concentrate on lowering taxes for the wealthy, at the expense of the middle class, and therefore see no problem in this. They mistakenly believe this will not affect their more affluent supporters, who do not qualify for the subsidies. What they fail to realize is that reducing the number of people in the risk pool will result in higher premiums for everyone.

Republicans are again talking about proposing their own plan, but they have repeatedly failed at doing so. The last time the Republicans did propose a plan it was remarkably similar to Obamacare, except then it was proposed as the conservative alternative to Hillarycare.

Any Republican plan which avoids harming millions of people will not only have to provide a mechanism for assisting those who cannot afford insurance coverage. Any plan must also ensure that insurance companies could not return to denying coverage to those who have medical problems. Republicans will find that this is not so simple, and will require the type of compromises seen in the Affordable Care Act.

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Kaiser Health Tracking Poll Shows Most Support Fix For Subsidies Under Affordable Care Act

While you can never be certain as to what the Supreme Court would do, I’ve always felt that it is most likely that they would ultimately find that King v. Burwell is a frivolous case. (In other words, the most conservative justices might accept it, but John Roberts will cast the deciding vote against it if needed). This case is the latest Republican attempt to overturn the Affordable Care Act in the courts because of some language in the law, contradicting other portions, which could be taken to mean that subsidies are only available to those who obtain coverage through state exchanges, and not the federal exchange.

As I’ve pointed out in the past, it would politically be bad for Republicans if the court ruled against the Obama administration in this case. If the Supreme Court does accept the absurd argument that subsidies should only be available under the law for policies purchased on state exchanges, the simplest solution would be for Congress to revise a few words in the law to fix the problem. It is rather common for Congress to pass laws after major legislation to fix minor problems, except in this case Republicans in Congress are more interested in repeated, futile efforts to repeal ObamaCare as opposed to making such fixes–with yet another repeal vote now planned.

The Kaiser Health Tracking Poll for January finds that relatively few people are now aware of King v. Burwell, but most people do think that Congress should fix the problem. Among total voters, passing a law to fix this is supported 64 percent to 27 percent. There is similar support among independents, greater support among Democrats, and even a substantial number of Republicans (40 percent) would support such a fix:

King v Burell

If this is not fixed by Congress passing such a law, the second solution would be for states to start their own exchanges. A majority would also support this in affected states. Even Republicans support this, although at lower levels than Democrats and independents:

King v Burell2

I suspect that Republican leaders would much prefer to see the Supreme Court not put them in a position to have to take such action, either in Congress or at a state level. Failure to take such action would make displease the majority of voters, while taking such action would displease their base, who might take revenge in primaries where they dominate.

Update: Hospitals and insurance companies also lose if the subsidies are not continued, and are therefore also defending the subsidies before the Supreme Court.

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CBO Shows ObamaCare Costing Less Than Projected–Ignore Conservative Attempts To Distort The Data

There was more good news from the Congressional Budget Office today regarding the Affordable Care Act. The latest’s estimates significantly reduce the costs of expanding medical care under the law:

 The Congressional Budget Office on Monday significantly lowered its estimate of the cost of providing health insurance coverage to millions of Americans under the Affordable Care Act.

Douglas W. Elmendorf, the director of the budget office, said the changes resulted from many factors, including a general “slowdown in the growth of health care costs” and lower projections of insurance premiums that are subsidized by the federal government.

In March 2010, when President Obama signed the health care law, the Congressional Budget Office estimated that the expansion of coverage would cost the federal government $710 billion in the fiscal years 2015 through 2019, Mr. Elmendorf said.

“The newest projections indicate that those provisions will cost $571 billion over that same period, a reduction of 20 percent,” he said. The Affordable Care Act not only subsidized the purchase of private insurance, but also authorized a major expansion of Medicaid, the federal-state program for low-income people.

As usual, conservatives are cherry picking and distorting the numbers to portray this as a negative. Among other distortions of the facts, they fail to take into account the fact that having a substantial portion of the country be uninsured results in higher costs for both government programs, as well as costs which are passed on to those who do pay for insurance. The bottom line is that, even before these more favorable numbers, the CBO found that the Affordable Care Act results in a reduction in the deficit. Strange that conservatives who place such a high priority on reducing the deficit (which was run up by Republicans during the Bush years) oppose a program which will help reduce the deficit.

Of course if conservatives are unhappy with the cost of the Affordable Care Act, they should keep in mind the fact that costs are much higher due than they otherwise might be due to providing coverage through private insurance companies rather than through a single-payer system modeled on Medicare. Somehow I doubt many conservatives would go for the far more cost effective single-payer model.

Conservatives are also attacking the law because, while reducing the number of uninsured by 27 million people, there will still be 31 million uninsured in 2025. However, when looking at who will remain uninsured, I wonder which group conservatives are complaining about. Of this 31 million, 30 percent are illegal aliens and conservatives would sure protest if health care coverage were extended to them. Another 1o percent are ineligible for coverage because of living in states which did not expand Medicaid–a decision which conservatives support. The remainder are people who will qualify for coverage but choose not to purchase it.

The number of uninsured might fall as more red states go along with the expanded Medicaid program. It was just announced that Indiana is the latest to offer the expanded Medicaid program.

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Conservative Argues That It Is Not A Bad Thing If People Die Due To Repealing Obamacare

If the Affordable Care Act were to be repealed, as most Republicans are calling for, we would see millions of Americans lose their insurance. We would return to past problems, including people being denied insurance when they have medical problems, people once again being forced to declare bankruptcy due to medical costs, and we would see many more deaths than we will otherwise see.  Michael R. Strain of the American Enterprise Institute has an op-ed in The Washington Post under the headline, End Obamacare, and people could die. That’s okay.

Note again that the author is from the American Enterprise Institute and this is published in The Washington Post. This is not just some isolated blogger or conservative shouting out their personal opinion.

Strain’s logic is that “We make such trade-offs all the time.” For example, “Consider, for example, speed limits. By allowing people to drive their cars at speeds at which collisions result in death, our government has decided that the socially optimal number of traffic fatalities is not zero.”

He has other such examples, but they do not apply to the type of trade-off he is advocating. There are good reasons for having a society in which people can drive, and it is an unavoidable fact that this will lead to a certain number of traffic fatalities. The types of trade offs he discussed are not analogous to taking away health care coverage.

While there are reasons for having a society in which people can drive, despite traffic fatalities,  there is no good reason for either having people uninsured or for a system in which insurance companies are allowed to profit by denying coverage to those who become sick.

Strain argues that, “In a world of scarce resources, a slightly higher mortality rate is an acceptable price to pay for certain goals.” This falsely assumes that health care coverage is something which we cannot afford to provide. However every other industrialized nation on the planet, existing in the same “world of scarce resources,” is able to provide health care coverage to its citizens. The Affordable Care Act is a valuable step in the right direction, but it is an incremental step which still falls short of what is provided in the rest of the industrialized world.

There is no good reason why the United States cannot provide the same level of health care coverage as is seen in the rest of the industrialized world. One reason why we have been unable to do this is the unnecessary middleman–private insurance companies making huge profits while making health care more expensive than elsewhere. Perhaps the answer is that in a world of scarce resources, a system of private insurance is an unacceptable price to pay, and we should be thinking in terms of conversion to a far more cost-effective single payer system.

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Senate Republicans Agree Climate Change Is Real But Continue To Deny Cause

Climate-vote

With Republicans controlling the Senate, Democrats are largely limited to symbolic votes. Democrats wanted to attach an amendment to the Keystone XL Pipeline bill which would get Republicans on record with regards to climate change. There was little difficulty in passing an amendment agreeing that climate change is real, and not a hoax. Only one Republican, Roger Wicker of Mississippi, voted no. The catch is that, while they agreed that the climate is changing (a fact which some conservatives do deny), they do not accept the view of 97 percent of climate scientists that human action is the cause.

Senator Brian Schatz introduced a stronger amendment: “To express the sense of the Senate that climate change is real; and human activity significantly contributes to climate change.” Under the rules of the Senate, this amendment failed with a 50-49 majority. Most Republicans voted against it, but there were a handful of exceptions–full list here.

I’m not sure what all this proved, but next could we have a vote to determine which Republicans don’t believe in evolution, or that the earth is not flat?

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Will The State Of The Union Address Matter After This Week?

Obama SOTU

I certainly liked Obama’s State of the Union Address while listening to it. In a room dominated by Republicans, Obama was once again the adult in the room–the sensible one interested in governing and not bogged down in extremist ideology. His economic numbers provided real evidence of success, despite Republican obstructionism, and Obama was right in addressing the need to extend the benefits of economic recovery to more in the middle class.

The question is whether the speech, and Obama’s aggressiveness on policy matters, will make a difference matters beyond this week. David Corn summed up some of my concerns:

Barack Obama is very good at getting elected president (two for two!) and pretty darn good at policy (Obamacare; the stimulus; the auto industry rescue; Wall Street reform; ending Don’t Ask, Don’t Tell; Cuba; immigration reform executive action; dumping DOMA; middle-class tax cuts; new EPA limits on emissions that cause climate change; banning torture; downsizing the wars in Iraq and Afghanistan, and killing Osama bin Laden). But there’s one key piece of the job description where he’s fallen short: shaping the ongoing political narrative of the nation.

The president is the country’s storyteller in chief. And despite his inspiring powers of oratory (see Campaign 2008) and his savvy understanding of the importance of values in political salesmanship (see Campaign 2012), Obama, as his aides concede, has not effectively sold the nation on his own accomplishments, and, simultaneously, he has failed to establish an overarching public plot line that explains the gridlock in Washington as the result of GOP obstructionists blocking him on important issues where public opinion is in his favor. With his State of the Union speech Tuesday night, Obama had one last chance to take a swing at forging this narrative. Though he did adopt a muscular stance in presenting a forceful and vigorous vision—going on offense in the fourth quarter of his presidency, as his advisers have put it—the president let the Republicans off easy.

Throughout his presidency, as the GOP has consistently sought to block him, Obama has responded inconsistently. He often has pleaded for reason and looked to craft a deal—frequently (and justifiably) to prevent a hit to the economy. (This was the adult-in-the-room strategy.) At times, he has praised House Speaker John Boehner, while pointing to Boehner’s tea party wing as the cause of the partisan paralysis. And then he has occasionally—but not too often—flashed anger and slammed Republicans for being irresponsible and reckless (the debt ceiling scuffle, the assorted government shutdown showdowns). He has not presented a steady and stark tale in which he stars as the fighter for the middle- and lower-income Americans who are stymied repeatedly by always-say-no Republicans aligned with plutocrats, the gun lobby, corporate polluters, and other foes of progress. Consequently, he has often borne blame for the sluggish economy and the mess in Washington, with the Democratic Party paying the price for the dips in his approval rating.

For this to have meaning, Obama must stick to pushing his views, and the Democratic Party must be there behind him. The reaction of the Democratic Party has been even more inconsistent than Obama’s. Here’s what I thought during the speech:

Of course the general election is an entirely different ballgame than the midterms, and Democrats who thought there was benefit in running as Republican-lite in a midterm election where the big contests were in the red states might act more boldly. Or maybe not.

On the other hand, maybe we should just be happy that Obama had a good speech, the positive results from his policies are real, and that the speech was well accepted. Beyond that, I’m not sure that a State of the Union address ever really matters all that much.

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Republican Women Revolting Against GOP Rape Ban But For Wrong Reasons

National Journal reports that the some Republicans oppose their party’s planned legislation to attempt to restrict abortion rights, or as Think Progress puts it,Republicans Introduce An Anti-Abortion Bill So Extreme That GOP Women In Congress Are Revolting.

Republican lawmakers are raising concerns that the party will alienate young voters and women by voting for an antiabortion bill coming to the House floor next week, on the 42nd anniversary of the Roe v. Wade Supreme Court decision.

In a closed-door open-mic session of House Republicans, Rep. Renee Ellmers spoke out against bringing up the Pain Capable Unborn Child Protection Act, which would ban abortion after 20 weeks, telling the conference that she believes the bill will cost the party support among millennials, according to several sources in the room.

“I have urged leadership to reconsider bringing it up next week.… We got into trouble last year, and I think we need to be careful again; we need to be smart about how we’re moving forward,” Ellmers said in an interview. “The first vote we take, or the second vote, or the fifth vote, shouldn’t be on an issue where we know that millennials—social issues just aren’t as important [to them].”

I have previously discussed how the twenty-week ban, in addition to being an unacceptable act of government intrusion in the rights of women to control their own body, is based upon conservative pseudo-science. They base it on false claims that the fetus can feel pain at twenty weeks despite this being scientifically impossible prior to the development of the cerebral cortex. This objection from some Republicans, based upon political expediency as opposed to principle, also demonstrates the hypocrisy of Republicans. If something really was morally wrong, as Republicans claim abortion is at twenty weeks, then it would not be justifiable to oppose the ban because of fear of losing votes.

If conservatives really had a case that abortion is morally wrong, then why should such an act be justifiable based upon who the father is? It would not be the fault of the fetus that the mother was raped. The abortion exclusion also shows just some of the difficulties in enforcing any laws against abortion rights. The proposed legislation would only apply if a woman reports the rape to the police, but this imposes unfair obstacles considering how women who report rape are often treated. Are we getting back to the Todd Akin idea of “legitimate rape” with such requirements? On the other hand, if reporting a rape to the police is the requirement for a legal abortion, this would potentially give motivation for women to falsely claim rape, along with causing increased skepticism among some people when women do report rape, further worsening problems for women who are raped.

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Potential Conservative Attacks On Obama If He Had Attended Paris March

I recently discussed why the right wingers attacking Obama regarding the recent rally in France are wrong as it was both impractical and noted why it would have been inappropriate for Obama to have attended. If he had gone there is no doubt he would have been attacked by the right for multiple reasons, including:

  • The cost of the trip
  • The security risks in appearing at such an event with inadequate time to prepare
  • Hogging the limelight, making the trip about him
  • The disruption his security measures would have caused in Paris if he attended
  • Ignoring the request of the French government that he not attend because of the disruption it would have caused
  • Wearing the wrong color suit
  • Having the wrong skin color (more implied than said out loud)
  • Not being in Washington at a time when there would have been a greater risk of terrorist attacks
  • Just for going to France, because conservatives usually hate France
  • For allowing his kids to remain home without parental supervision where they might listen to Beyoncé (and they would be even madder when this led to Jimmy Carter defending him)

On the other hand, if a Republican president had not attended, they would have had no complaints and would have praised him for not going to France.

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Gallup Finds Increase In Self-Described Liberals

Gallup Liberals

In a poll of limited significance, Gallup has found an increase in the number of self-described liberals:

Conservatives continued to outnumber moderates and liberals in the U.S. population in 2014, as they have since 2009. However, their 14-percentage-point edge over liberals last year, 38% vs. 24%, is the smallest in Gallup’s trends since 1992. The percentage of U.S. adults identifying themselves as politically conservative in 2014 was unchanged from 2013, as was the percentage of moderates, at 34%, while the percentage considering themselves liberal rose a percentage point for the third straight year.

While not a huge number, this might contradict the idea that the Republican midterm victory was a sign of greater support for conservative views.

I find this to be of limited significance as people tend to take more liberal positions on polls than would be expected if self-described labels had a real bearing on political positions. I have generally seen this poll to be more a measure of the demonization of the word liberal by the right wing noise machine than a measure of ideological beliefs, and perhaps this trend shows that conservatives are having less success in demonizing liberals.

Besides polling on issues, I find the recent Pew survey on religious affiliation to be more meaningful than this poll. Among their findings which might be of significance in speculating on political trends, Pew found that “Among Americans ages 18-29, one-in-four say they are not currently affiliated with any particular religion.”

Another finding of interest is that, while 70 percent of Republicans label themselves conservative, only 44 percent of Democrats label themselves liberal. Is this due to a majority of Democrats not being liberal, or again due to people simply avoiding the term liberal? I suspect it is a combination of each, with the Democratic Party being a more centrist party, but also with many Democrats supporting liberal positions without using the liberal label.

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Goals Of The New Republican Congress: Repeal Obamacare Despite Success In Lowering Uninsured, Declare War On Math, Promote Pseudoscience To Restrict Abortion

Uninsured 2015

While Republicans are probably on the verge of voting yet again to repeal the Affordable Care Act, and will continue to make false claims that it has been a failure, Gallup shows once again how successful the law has been. The uninsured rate has fallen to 12.9 percent, down from 17.1 percent a year ago. The open enrollment period for 2015 remains open making it likely that the uninsured will fall further, especially if there is a last minute surge in people enrolling as last year. The number will further increase if more states go ahead and accept the expanded Medicaid program, and more people are also likely to receive insurance from employers with the trend towards decreased unemployment. Gallup also found that most who have obtained insurance plan to continue coverage, either through the same or a different insurance company.

Even before the inevitable vote to repeal Obamacare, the new Republican controlled Congress has declared war on math, as Jonathan Chait described it, and have introduced a national ban on abortions after twenty weeks. I recently discussed the pseudo-science used by Republicans to justify this, and there is more at Think Progress.

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