Wednesday, July 04, 2012 4:34:44 AM
Orszag: Even If They Win, Republicans Can't Kill Obamacare
The president's former budget director is skeptical of GOP plans to repeal or subvert the Affordable Care Act in the wake of the Supreme Court decision.
By Molly Ball
Jul 2 2012, 3:00 PM ET
The Supreme Court decision upholding President Obama's health-care legislation last week has renewed Republicans' zeal to kill the Affordable Care Act in the only way they still can -- by repealing it in Congress. But the president's former budget director, Peter Orszag, doesn't think it will be possible.
"If the Senate does not flip Republican [in November] and/or if President Obama is reelected, you're not going to see repeal writ large," Orszag told me in an interview at the Aspen Ideas Festival. "Even in the configuration where Romney wins and there's a Republican Seante and the House is Republican also, it is much more difficult to do than many people anticipate."
That's because the reconciliation process that would allow the GOP to get repeal through the Senate with just 51 votes has technical requirements that could pose arguments, Orszag said.
"Reconciliation is intended to be used only for deficit reduction, and the provisions all have to be budget related," he said. "The official scoring shows that the ACA reduces the deficit, which means that repealing it increases the deficit, so you'll have to come up with some other something" to make up the difference.
Nor does Orszag believe many states will end up staying out of the ACA's Medicaid expansion, something the Supreme Court ruled they be allowed to do. Numerous GOP governors now are making noises about taking advantage of this ruling to buck Obamacare, but Orszag believes the funds that come with the expansion will eventually be an offer they can't refuse.
"On the one hand you have some governors who are clearly saying, 'We're not going to apply it,'" he said. "On the other hand, the subsidies are very deep. You have 100 percent federal financing for a few years, and then, even out over time, you have 90 percent of the cost of the initial enrollees being covered by the federal government."
For the same reason states accepted and built upon Medicaid to begin with -- a desire to help the poor -- they will get on board with the new funding in the long run, he predicted.
"Over time, I suspect whatever the initial reaction is, it will become, maybe not impossible, but difficult to resist a 90 percent subsidy rate," Orszag said. "That is a really, really significant subsidy for people who can benefit from health-care coverage."
Orszag, who has sometimes been critical of the Obama Administration since he departed and took a position with Citigroup, agreed with those who have faulted the White House's PR effort on the ACA.
"I would agree with those who have raised some questions about the effectiveness of the communications strategy around the health-care push," he said. "I don't think anyone could go out and credibly claim that the communications around the health bill has been an A-plus effort."
The administration, he said, allowed the legislation's opponents to define it by failing to put enough focus on all the benefits of the law.
"There's been a very successful effort to brand Obamacare as something that's actually inconsistent with what's in the legislation, in part because what's in the legislation is never explained," he said. "It's 'death panels' and 'government takeover of health care' and all these things that are actually not accurate."
And Orszag called on the administration to propose bolder measures to improve the economy through a combination of short-term stimulus spending and long-term deficit reduction.
"That's basically the structure that the administration has adopted, but it's kind of half-hearted on both sides, and without a lot of detail, frankly, on the long-term deficit reduction," he said. "I think the risk in that half-hearted version is you're not doing enough to spur the economy in the short run, and you're also, on the long-term deficit stuff, allowing Rep. [Paul] Ryan and others to take the deficits in Medicare and Medicaid and use them as an excuse to destroy the village in order to save it."
Ryan, the Republican chair of the House Budget Committee whose proposed budget would dramatically restructure Medicare, has been allowed to take control of the debate, Orszag said.
"We do not need to go down as radical a path as Mr. Ryan has proposed with either Medicare or Medicaid to shore them up," he said. "And by not having as many specifics as might be desirable, I think it's harder to challenge Mr. Ryan. The response is always, 'That's great, but what's your plan?'"
Copyright © 2012 by The Atlantic Monthly Group
http://www.theatlantic.com/politics/archive/2012/07/orszag-even-if-they-win-republicans-cant-kill-obamacare/259328/ [with comments]
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Mitch McConnell: Odds Are Against Health Care Law Repeal
07/02/12
http://www.huffingtonpost.com/2012/07/02/mitch-mcconnell-health-care-law_n_1644466.html [with embedded video, and comments]
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House Democrats' Fundraising Sets Record After Health Care Ruling
07/03/2012
http://www.huffingtonpost.com/2012/07/03/house-democrats-fundraising-health-care_n_1644974.html [with embedded video, and comments]
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Massachusetts Health Care Law, Staple Of Mitt Romney Legacy, May Hold Good Signs For Obamacare
07/03/12
http://www.huffingtonpost.com/2012/07/03/massachusetts-health-care-law_n_1645691.html [with comments]
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Obama And Health Care: White House Turns To Scott Brown For Relief
by Sam Stein
Posted: 07/03/2012 1:00 pm
WASHINGTON -- With the debate over the Affordable Care Act law morphing from a constitutional matter before the Supreme Court to an implementation matter before state houses, President Barack Obama and allied Democrats are refiguring their sales pitch.
In response to criticisms that the law hamstrings governors, defenders of the president's health care law will be championing a states-rights amendment that already enjoys Republican support.
Under current law, states are allowed to opt out of various requirements of the Affordable Care Act by 2017, provided that they meet minimal standards for coverage. The Empowering States to Innovate Act would move that date to 2014.
For the Obama White House, the amendment has a number of politically appealing aspects. The most obvious is that it provides an avenue to the type of federalist approach that the Republican Party, and its standard-bearer Mitt Romney, has argued should have been adopted in the first place. More bluntly, the co-sponsor of the amendment, along with Sen. Ron Wyden (D-Ore.), is Sen. Scott Brown, a Massachusetts Republican who happens to share a senior adviser with Romney.
When top Obama administration officials were asked how they would go about selling the law in the immediate aftermath of the court's ruling, one of the three provisions they cited was the opt-out amendment. It was equally telling that the president made a point of emphasizing the idea in his post-SCOTUS remarks.
"Each state will take the lead in designing their own menu of options, and if states can come up with even better ways of covering more people at the same quality and cost, this law allows them to do that, too," Obama said. "And I’ve asked Congress to help speed up that process, and give states this flexibility in year one."
Perhaps the most obvious signal that the White House sees the amendment as a campaign instrument came in February 2011, when the president declared [ http://www.whitehouse.gov/the-press-office/2011/02/28/remarks-president-and-vice-president-national-governors-association ] -- in a bit of prescience with respect to the GOP primary -- that he "agree[d] with Mitt Romney" that states should be given "the power to determine their own health care solutions."
But as the Obama administration moves to embrace the Empowering States to Innovate Act, Republicans have gone silent. The Huffington Post reached out on multiple occasions to both Brown's Senate office and his re-election campaign to confirm that he still supports the amendment; to the Romney campaign to ask if the candidate backed the provision; and to the office of Senate Minority Leader Mitch McConnell (R-Ky.), asking if he supported it. None of the requests for comment were returned.
The silence may be owed to political caution more than anything else. Even after the Supreme Court affirmed the constitutionality of the Affordable Care Act, the de-facto position of the GOP has been to act as if the law will never come to be. Romney has pledged to repeal it upon taking office. And several Republican governors have said, in recent days, that they won't implement several of its components.
Under less charged circumstances, these governors and Romney may be more inclined to embrace the Wyden-Brown amendment. But to do so would be an implicit recognition that the Affordable Care Act will exist in the foreseeable future.
"I think it is very powerful," Wyden said of his proposal. "I think you start with a few propositions. It is a big and diverse country. There will be differences of opinions with respect to health care reform. This gives all side the opportunity to show their approach is attractive for their region to the country. But there is a bar, and that is you have to meet the coverage requirements of the Affordable Care Act."
"The White House has already endorsed it," Wyden added. "There are plenty of others, including conservative folks who would like to go with some of their ideas. The concept is baked into the law."
So far, the most notable example of a state gearing up to take advantage of the opt-out amendment is Vermont, which is set to adopt a single-payer, state-wide health care system. Other states may soon follow. But under the Wyden-Brown amendment, they would have to meet certain criteria.
A state must first pass a law to provide health insurance to its citizens. The Secretary of Health and Human Services and the Secretary of the Treasury must then review the legislation and determine whether it provides individuals with coverage as comprehensive and affordable as the Affordable Care Act does. They also must make sure it wouldn't increase the federal deficit.
Should they meet that criteria, the Affordable Care Act provisions states can avoid include the individual mandate, the health insurance exchanges and certain coverage rules. According to Wydens' office, a state could still collect federal money under the ACA for, among other things, "the subsidies for premiums, the subsidies for co-pays, and the tax credits for small businesses," even after opting out for their own distinct reforms.
The money earmarked for Medicaid expansion -- which the Supreme Court ruled states could decline and which several Republican governors have signaled they will reject -- is unrelated to the amendment.
Democrats allied with the White House see the Wyden-Brown amendment as a helpful way to disarm criticisms that the Affordable Care Act is overly burdensome on those very same Republican governors. But the expectation remains that they will end up implementing the law rather than opting out. As The Huffington Post's Jeff Young reported [ http://www.huffingtonpost.com/2012/07/02/health-care-reform-republican-governors_n_1644393.html ], the lobbying pressure for them to do so will be severe. The political realities will also change over time, as some reforms are implemented, public opinions shift and elections take place.
"We have heard from a number of states that once the Supreme Court rules they would start moving to implement the bill," said Neera Tanden, president of the Center for American Progress, in an interview after the decision came down.
"They face a stark choice: if they don’t implement the exchanges, they face a federal exchange," she said. "So I think the effect of the litigation was to call into question the whole apparatus of the law, to make people confused by it. I think you will see some more moderate Republican governors start to implement the law now."
Copyright © 2012 TheHuffingtonPost.com, Inc.
http://www.huffingtonpost.com/2012/07/03/obama-health-care-scott-brown_n_1646538.html [with comments]
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GOP Lawmakers Divided On Keeping Obamacare's Young Adult Insurance Provision
Rep. Paul Ryan (R-Wis.) opposes mandating that insurance companies allow young people to stay on their parents' health care plans.
07/03/2012
http://www.huffingtonpost.com/2012/07/03/gop-obamacare-young-adult-insurance_n_1643517.html [with comments]
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Paul Ryan: Medicare Cuts Keep Money For Medicare (VIDEO)
07/01/2012
http://www.huffingtonpost.com/2012/07/01/paul-ryan-medicare_n_1640990.html [with embedded video, and comments]
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How Liberals Win
President Franklin D. Roosevelt signing the National Recovery Act.
Bettmann/Corbis
By BILL SCHER
Published: June 30, 2012
PRESIDENT OBAMA has endured much criticism of his legislative skills from his fellow progressives. His conciliatory approach has been compared unfavorably with Franklin D. Roosevelt’s gleeful pugnacity and Lyndon B. Johnson’s relentless arm-twisting. His willingness to strike deals with corporations has been tagged “business as usual.” Many progressives, frustrated over the past three years, have concluded that the political system is fundamentally broken because corporate power has been allowed to suffocate popular liberal policies.
But the Supreme Court’s upholding of Mr. Obama’s health care law reminds us that the president’s approach has achieved significant results. If his liberal critics paused to assess how he achieved such results, they would not see a system paralyzed by corporations; they would see that the most liberal reforms in more than 40 years have been brought about because Mr. Obama views corporate power as a force to bargain with, not an enemy to vanquish.
The necessity of corporate support for, or at least acquiescence to, liberal policies is not a new development in the history of American liberalism. Indeed it has been one of its hallmarks.
Roosevelt may be remembered for his combativeness toward corporations; he famously said, “I welcome their hatred.” But he said that in 1936, only after key New Deal legislation had passed with the help of the United States Chamber of Commerce and the American Bankers Association.
Early on, Roosevelt was quite adept at bargaining with corporations. In his first 100 days, to attract corporate support for the National Industrial Recovery Act, he won collective bargaining, minimum wages and maximum hours in exchange for a temporary suspension of antitrust law, so businesses could fix prices. To establish the Securities and Exchange Commission in 1934, he made concessions to Wall Street that scrapped statutory requirements in favor of regulatory flexibility. The following year, to allow the Federal Reserve to better conduct monetary policy, he gave bankers representation on the policy committee.
Johnson also found little value in warring with corporations. He won a Keynesian tax cut in early 1964, defeating budget-conscious conservatives, thanks to a broad coalition that included corporations. He attracted business support to back his first antipoverty bill by junking plans to promote family farming and push businesses to hire long-term unemployed people. He created the Transportation Department, in 1966, only after exempting resistant shipping interests from its jurisdiction. He incited a new era of environmental protection, increasing federal responsibility for cleaning air and water, while defusing corporate opposition by trading away federal pollution standards.
Democratic presidents typically pay dearly when they choose to fight corporations instead of deal with them. Jimmy Carter sapped his political capital in the first two years of his presidency by trying to pass, with belligerent anticorporate rhetoric, a National Energy Act that would reduce our dependence on oil. He gave two major national addresses intended to rally the public and fend off critics’ attacks. At a town hall, he lashed out at oil companies for enjoying “a position of privilege in our country for too long” and having undue influence in Congress. But these confrontational tactics failed to rouse enough public ire to trump that influence, and Mr. Carter settled for a far smaller energy bill than he originally demanded.
Or consider President Bill Clinton. In 1993, his health care task force largely resisted meeting with insurance lobbyists as it drafted legislation. In turn, the insurers didn’t wait for the legislation to be finalized before embarking on a vicious advertising campaign. When the first lady, Hillary Rodham Clinton, tried to belittle that effort, fund-raising for the insurance lobby skyrocketed and its advertising budget quintupled. Mr. Clinton, his bully pulpit diminished, couldn’t get Congress to vote on his bill. He suffered such a humiliating defeat that his ability to enact any other progressive reform was severely crippled.
The realities of corporate power cannot be wished away by any president, no matter how tough the talk, because corporations can and will spend freely during the legislative process. And when they are unified, they have the resources to dominate debate. Even the progressive holy grail — a constitutional amendment banning corporate campaign donations — would not stop that.
BUT when corporations are divided or mollified, reformers can breathe. The president can be heard. Business owners can be convinced that they will remain profitable. The dim prospect of perpetual gridlock can be trumped by the allure of regulatory certainty.
Just look at how Mr. Obama handled the health care law. Recently released e-mail exchanges between the White House and the pharmaceutical lobby, which detail a path of compromises that won the drug industry’s support for the Affordable Care Act, certainly look more like “business as usual” than “change.” The e-mails include a White House promise of a “direct line of communication” to lobbyists, along with a suggestion to “stay quiet” about an agreement that buried a proposal for cheap drug imports.
But the e-mail trove is a case study in how liberal change becomes reality. The key to President Obama’s success was enlisting drug companies to pay for pro-reform advertisements. He also persuaded health insurers to forgo a major opposition campaign — by accepting the industry’s proposal for the individual mandate to buy private insurance and dropping plans for a competing public insurance option. As the final vote neared, the United States Chamber of Commerce and other organizations spent millions of dollars on advertisements attacking “Obamacare.” But the pharmaceutical industry effectively matched the chamber’s money in supportive advertisements, blunting the impact of the criticism.
Health care was not an anomaly for Mr. Obama. His original stimulus package never faced well-financed conservative opposition in part because the United States Chamber of Commerce backed the business tax cuts in the package. We got a Consumer Financial Protection Bureau after Mr. Obama put Wall Street at ease by resisting proposals to cap the size of banks. New standards lifting average fuel-efficiency goals were set once the White House accepted the automakers’ demand for a review in 2021 and flexibility regarding light trucks. The food safety bill empowered the Food and Drug Administration to recall tainted items but won industry support by dropping a ban on bisphenol A, or BPA, a chemical used in food and beverage containers.
The necessity of forging coalitions with corporations is understandably difficult for progressives to accept. Every time it happens, corporations seem to quickly go back to their usual tricks. They lobby to weaken enforcement. They litigate to have rules overturned. They abandon politicians who risked compromise for them. Corporations are exasperating, irritating and untrustworthy partners.
But most of the time politics is exasperating and irritating, not euphoric and cathartic. As Roosevelt himself told a group of dissatisfied youth activists in 1940, “if you ever sit here you will learn that you cannot, just by shouting from the housetops, get what you want all the time.”
As much as Roosevelt enjoyed pugnacity, he also understood its limits. Because Mr. Obama heeded this lesson of liberal history, there was a health care law for the Supreme Court to uphold.
Bill Scher is the executive editor of LiberalOasis.com [ http://liberaloasis.com/ ] and host of the LiberalOasis Radio Show podcast.
© 2012 The New York Times Company
http://www.nytimes.com/2012/07/01/opinion/sunday/how-liberals-win.html [ http://www.nytimes.com/2012/07/01/opinion/sunday/how-liberals-win.html?pagewanted=all ]
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The president's former budget director is skeptical of GOP plans to repeal or subvert the Affordable Care Act in the wake of the Supreme Court decision.
By Molly Ball
Jul 2 2012, 3:00 PM ET
The Supreme Court decision upholding President Obama's health-care legislation last week has renewed Republicans' zeal to kill the Affordable Care Act in the only way they still can -- by repealing it in Congress. But the president's former budget director, Peter Orszag, doesn't think it will be possible.
"If the Senate does not flip Republican [in November] and/or if President Obama is reelected, you're not going to see repeal writ large," Orszag told me in an interview at the Aspen Ideas Festival. "Even in the configuration where Romney wins and there's a Republican Seante and the House is Republican also, it is much more difficult to do than many people anticipate."
That's because the reconciliation process that would allow the GOP to get repeal through the Senate with just 51 votes has technical requirements that could pose arguments, Orszag said.
"Reconciliation is intended to be used only for deficit reduction, and the provisions all have to be budget related," he said. "The official scoring shows that the ACA reduces the deficit, which means that repealing it increases the deficit, so you'll have to come up with some other something" to make up the difference.
Nor does Orszag believe many states will end up staying out of the ACA's Medicaid expansion, something the Supreme Court ruled they be allowed to do. Numerous GOP governors now are making noises about taking advantage of this ruling to buck Obamacare, but Orszag believes the funds that come with the expansion will eventually be an offer they can't refuse.
"On the one hand you have some governors who are clearly saying, 'We're not going to apply it,'" he said. "On the other hand, the subsidies are very deep. You have 100 percent federal financing for a few years, and then, even out over time, you have 90 percent of the cost of the initial enrollees being covered by the federal government."
For the same reason states accepted and built upon Medicaid to begin with -- a desire to help the poor -- they will get on board with the new funding in the long run, he predicted.
"Over time, I suspect whatever the initial reaction is, it will become, maybe not impossible, but difficult to resist a 90 percent subsidy rate," Orszag said. "That is a really, really significant subsidy for people who can benefit from health-care coverage."
Orszag, who has sometimes been critical of the Obama Administration since he departed and took a position with Citigroup, agreed with those who have faulted the White House's PR effort on the ACA.
"I would agree with those who have raised some questions about the effectiveness of the communications strategy around the health-care push," he said. "I don't think anyone could go out and credibly claim that the communications around the health bill has been an A-plus effort."
The administration, he said, allowed the legislation's opponents to define it by failing to put enough focus on all the benefits of the law.
"There's been a very successful effort to brand Obamacare as something that's actually inconsistent with what's in the legislation, in part because what's in the legislation is never explained," he said. "It's 'death panels' and 'government takeover of health care' and all these things that are actually not accurate."
And Orszag called on the administration to propose bolder measures to improve the economy through a combination of short-term stimulus spending and long-term deficit reduction.
"That's basically the structure that the administration has adopted, but it's kind of half-hearted on both sides, and without a lot of detail, frankly, on the long-term deficit reduction," he said. "I think the risk in that half-hearted version is you're not doing enough to spur the economy in the short run, and you're also, on the long-term deficit stuff, allowing Rep. [Paul] Ryan and others to take the deficits in Medicare and Medicaid and use them as an excuse to destroy the village in order to save it."
Ryan, the Republican chair of the House Budget Committee whose proposed budget would dramatically restructure Medicare, has been allowed to take control of the debate, Orszag said.
"We do not need to go down as radical a path as Mr. Ryan has proposed with either Medicare or Medicaid to shore them up," he said. "And by not having as many specifics as might be desirable, I think it's harder to challenge Mr. Ryan. The response is always, 'That's great, but what's your plan?'"
Copyright © 2012 by The Atlantic Monthly Group
http://www.theatlantic.com/politics/archive/2012/07/orszag-even-if-they-win-republicans-cant-kill-obamacare/259328/ [with comments]
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Mitch McConnell: Odds Are Against Health Care Law Repeal
07/02/12
http://www.huffingtonpost.com/2012/07/02/mitch-mcconnell-health-care-law_n_1644466.html [with embedded video, and comments]
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House Democrats' Fundraising Sets Record After Health Care Ruling
07/03/2012
http://www.huffingtonpost.com/2012/07/03/house-democrats-fundraising-health-care_n_1644974.html [with embedded video, and comments]
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Massachusetts Health Care Law, Staple Of Mitt Romney Legacy, May Hold Good Signs For Obamacare
07/03/12
http://www.huffingtonpost.com/2012/07/03/massachusetts-health-care-law_n_1645691.html [with comments]
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Obama And Health Care: White House Turns To Scott Brown For Relief
by Sam Stein
Posted: 07/03/2012 1:00 pm
WASHINGTON -- With the debate over the Affordable Care Act law morphing from a constitutional matter before the Supreme Court to an implementation matter before state houses, President Barack Obama and allied Democrats are refiguring their sales pitch.
In response to criticisms that the law hamstrings governors, defenders of the president's health care law will be championing a states-rights amendment that already enjoys Republican support.
Under current law, states are allowed to opt out of various requirements of the Affordable Care Act by 2017, provided that they meet minimal standards for coverage. The Empowering States to Innovate Act would move that date to 2014.
For the Obama White House, the amendment has a number of politically appealing aspects. The most obvious is that it provides an avenue to the type of federalist approach that the Republican Party, and its standard-bearer Mitt Romney, has argued should have been adopted in the first place. More bluntly, the co-sponsor of the amendment, along with Sen. Ron Wyden (D-Ore.), is Sen. Scott Brown, a Massachusetts Republican who happens to share a senior adviser with Romney.
When top Obama administration officials were asked how they would go about selling the law in the immediate aftermath of the court's ruling, one of the three provisions they cited was the opt-out amendment. It was equally telling that the president made a point of emphasizing the idea in his post-SCOTUS remarks.
"Each state will take the lead in designing their own menu of options, and if states can come up with even better ways of covering more people at the same quality and cost, this law allows them to do that, too," Obama said. "And I’ve asked Congress to help speed up that process, and give states this flexibility in year one."
Perhaps the most obvious signal that the White House sees the amendment as a campaign instrument came in February 2011, when the president declared [ http://www.whitehouse.gov/the-press-office/2011/02/28/remarks-president-and-vice-president-national-governors-association ] -- in a bit of prescience with respect to the GOP primary -- that he "agree[d] with Mitt Romney" that states should be given "the power to determine their own health care solutions."
But as the Obama administration moves to embrace the Empowering States to Innovate Act, Republicans have gone silent. The Huffington Post reached out on multiple occasions to both Brown's Senate office and his re-election campaign to confirm that he still supports the amendment; to the Romney campaign to ask if the candidate backed the provision; and to the office of Senate Minority Leader Mitch McConnell (R-Ky.), asking if he supported it. None of the requests for comment were returned.
The silence may be owed to political caution more than anything else. Even after the Supreme Court affirmed the constitutionality of the Affordable Care Act, the de-facto position of the GOP has been to act as if the law will never come to be. Romney has pledged to repeal it upon taking office. And several Republican governors have said, in recent days, that they won't implement several of its components.
Under less charged circumstances, these governors and Romney may be more inclined to embrace the Wyden-Brown amendment. But to do so would be an implicit recognition that the Affordable Care Act will exist in the foreseeable future.
"I think it is very powerful," Wyden said of his proposal. "I think you start with a few propositions. It is a big and diverse country. There will be differences of opinions with respect to health care reform. This gives all side the opportunity to show their approach is attractive for their region to the country. But there is a bar, and that is you have to meet the coverage requirements of the Affordable Care Act."
"The White House has already endorsed it," Wyden added. "There are plenty of others, including conservative folks who would like to go with some of their ideas. The concept is baked into the law."
So far, the most notable example of a state gearing up to take advantage of the opt-out amendment is Vermont, which is set to adopt a single-payer, state-wide health care system. Other states may soon follow. But under the Wyden-Brown amendment, they would have to meet certain criteria.
A state must first pass a law to provide health insurance to its citizens. The Secretary of Health and Human Services and the Secretary of the Treasury must then review the legislation and determine whether it provides individuals with coverage as comprehensive and affordable as the Affordable Care Act does. They also must make sure it wouldn't increase the federal deficit.
Should they meet that criteria, the Affordable Care Act provisions states can avoid include the individual mandate, the health insurance exchanges and certain coverage rules. According to Wydens' office, a state could still collect federal money under the ACA for, among other things, "the subsidies for premiums, the subsidies for co-pays, and the tax credits for small businesses," even after opting out for their own distinct reforms.
The money earmarked for Medicaid expansion -- which the Supreme Court ruled states could decline and which several Republican governors have signaled they will reject -- is unrelated to the amendment.
Democrats allied with the White House see the Wyden-Brown amendment as a helpful way to disarm criticisms that the Affordable Care Act is overly burdensome on those very same Republican governors. But the expectation remains that they will end up implementing the law rather than opting out. As The Huffington Post's Jeff Young reported [ http://www.huffingtonpost.com/2012/07/02/health-care-reform-republican-governors_n_1644393.html ], the lobbying pressure for them to do so will be severe. The political realities will also change over time, as some reforms are implemented, public opinions shift and elections take place.
"We have heard from a number of states that once the Supreme Court rules they would start moving to implement the bill," said Neera Tanden, president of the Center for American Progress, in an interview after the decision came down.
"They face a stark choice: if they don’t implement the exchanges, they face a federal exchange," she said. "So I think the effect of the litigation was to call into question the whole apparatus of the law, to make people confused by it. I think you will see some more moderate Republican governors start to implement the law now."
Copyright © 2012 TheHuffingtonPost.com, Inc.
http://www.huffingtonpost.com/2012/07/03/obama-health-care-scott-brown_n_1646538.html [with comments]
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GOP Lawmakers Divided On Keeping Obamacare's Young Adult Insurance Provision
Rep. Paul Ryan (R-Wis.) opposes mandating that insurance companies allow young people to stay on their parents' health care plans.
07/03/2012
http://www.huffingtonpost.com/2012/07/03/gop-obamacare-young-adult-insurance_n_1643517.html [with comments]
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Paul Ryan: Medicare Cuts Keep Money For Medicare (VIDEO)
07/01/2012
http://www.huffingtonpost.com/2012/07/01/paul-ryan-medicare_n_1640990.html [with embedded video, and comments]
===
How Liberals Win
President Franklin D. Roosevelt signing the National Recovery Act.
Bettmann/Corbis
By BILL SCHER
Published: June 30, 2012
PRESIDENT OBAMA has endured much criticism of his legislative skills from his fellow progressives. His conciliatory approach has been compared unfavorably with Franklin D. Roosevelt’s gleeful pugnacity and Lyndon B. Johnson’s relentless arm-twisting. His willingness to strike deals with corporations has been tagged “business as usual.” Many progressives, frustrated over the past three years, have concluded that the political system is fundamentally broken because corporate power has been allowed to suffocate popular liberal policies.
But the Supreme Court’s upholding of Mr. Obama’s health care law reminds us that the president’s approach has achieved significant results. If his liberal critics paused to assess how he achieved such results, they would not see a system paralyzed by corporations; they would see that the most liberal reforms in more than 40 years have been brought about because Mr. Obama views corporate power as a force to bargain with, not an enemy to vanquish.
The necessity of corporate support for, or at least acquiescence to, liberal policies is not a new development in the history of American liberalism. Indeed it has been one of its hallmarks.
Roosevelt may be remembered for his combativeness toward corporations; he famously said, “I welcome their hatred.” But he said that in 1936, only after key New Deal legislation had passed with the help of the United States Chamber of Commerce and the American Bankers Association.
Early on, Roosevelt was quite adept at bargaining with corporations. In his first 100 days, to attract corporate support for the National Industrial Recovery Act, he won collective bargaining, minimum wages and maximum hours in exchange for a temporary suspension of antitrust law, so businesses could fix prices. To establish the Securities and Exchange Commission in 1934, he made concessions to Wall Street that scrapped statutory requirements in favor of regulatory flexibility. The following year, to allow the Federal Reserve to better conduct monetary policy, he gave bankers representation on the policy committee.
Johnson also found little value in warring with corporations. He won a Keynesian tax cut in early 1964, defeating budget-conscious conservatives, thanks to a broad coalition that included corporations. He attracted business support to back his first antipoverty bill by junking plans to promote family farming and push businesses to hire long-term unemployed people. He created the Transportation Department, in 1966, only after exempting resistant shipping interests from its jurisdiction. He incited a new era of environmental protection, increasing federal responsibility for cleaning air and water, while defusing corporate opposition by trading away federal pollution standards.
Democratic presidents typically pay dearly when they choose to fight corporations instead of deal with them. Jimmy Carter sapped his political capital in the first two years of his presidency by trying to pass, with belligerent anticorporate rhetoric, a National Energy Act that would reduce our dependence on oil. He gave two major national addresses intended to rally the public and fend off critics’ attacks. At a town hall, he lashed out at oil companies for enjoying “a position of privilege in our country for too long” and having undue influence in Congress. But these confrontational tactics failed to rouse enough public ire to trump that influence, and Mr. Carter settled for a far smaller energy bill than he originally demanded.
Or consider President Bill Clinton. In 1993, his health care task force largely resisted meeting with insurance lobbyists as it drafted legislation. In turn, the insurers didn’t wait for the legislation to be finalized before embarking on a vicious advertising campaign. When the first lady, Hillary Rodham Clinton, tried to belittle that effort, fund-raising for the insurance lobby skyrocketed and its advertising budget quintupled. Mr. Clinton, his bully pulpit diminished, couldn’t get Congress to vote on his bill. He suffered such a humiliating defeat that his ability to enact any other progressive reform was severely crippled.
The realities of corporate power cannot be wished away by any president, no matter how tough the talk, because corporations can and will spend freely during the legislative process. And when they are unified, they have the resources to dominate debate. Even the progressive holy grail — a constitutional amendment banning corporate campaign donations — would not stop that.
BUT when corporations are divided or mollified, reformers can breathe. The president can be heard. Business owners can be convinced that they will remain profitable. The dim prospect of perpetual gridlock can be trumped by the allure of regulatory certainty.
Just look at how Mr. Obama handled the health care law. Recently released e-mail exchanges between the White House and the pharmaceutical lobby, which detail a path of compromises that won the drug industry’s support for the Affordable Care Act, certainly look more like “business as usual” than “change.” The e-mails include a White House promise of a “direct line of communication” to lobbyists, along with a suggestion to “stay quiet” about an agreement that buried a proposal for cheap drug imports.
But the e-mail trove is a case study in how liberal change becomes reality. The key to President Obama’s success was enlisting drug companies to pay for pro-reform advertisements. He also persuaded health insurers to forgo a major opposition campaign — by accepting the industry’s proposal for the individual mandate to buy private insurance and dropping plans for a competing public insurance option. As the final vote neared, the United States Chamber of Commerce and other organizations spent millions of dollars on advertisements attacking “Obamacare.” But the pharmaceutical industry effectively matched the chamber’s money in supportive advertisements, blunting the impact of the criticism.
Health care was not an anomaly for Mr. Obama. His original stimulus package never faced well-financed conservative opposition in part because the United States Chamber of Commerce backed the business tax cuts in the package. We got a Consumer Financial Protection Bureau after Mr. Obama put Wall Street at ease by resisting proposals to cap the size of banks. New standards lifting average fuel-efficiency goals were set once the White House accepted the automakers’ demand for a review in 2021 and flexibility regarding light trucks. The food safety bill empowered the Food and Drug Administration to recall tainted items but won industry support by dropping a ban on bisphenol A, or BPA, a chemical used in food and beverage containers.
The necessity of forging coalitions with corporations is understandably difficult for progressives to accept. Every time it happens, corporations seem to quickly go back to their usual tricks. They lobby to weaken enforcement. They litigate to have rules overturned. They abandon politicians who risked compromise for them. Corporations are exasperating, irritating and untrustworthy partners.
But most of the time politics is exasperating and irritating, not euphoric and cathartic. As Roosevelt himself told a group of dissatisfied youth activists in 1940, “if you ever sit here you will learn that you cannot, just by shouting from the housetops, get what you want all the time.”
As much as Roosevelt enjoyed pugnacity, he also understood its limits. Because Mr. Obama heeded this lesson of liberal history, there was a health care law for the Supreme Court to uphold.
Bill Scher is the executive editor of LiberalOasis.com [ http://liberaloasis.com/ ] and host of the LiberalOasis Radio Show podcast.
© 2012 The New York Times Company
http://www.nytimes.com/2012/07/01/opinion/sunday/how-liberals-win.html [ http://www.nytimes.com/2012/07/01/opinion/sunday/how-liberals-win.html?pagewanted=all ]
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Greensburg, KS - 5/4/07
"Eternal vigilance is the price of Liberty."
from John Philpot Curran, Speech
upon the Right of Election, 1790
F6
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