Brian Dickerson: From obstruction to destruction - How the GOP is sabotaging Obamacare
12:22 AM, June 2, 2013 | 92 Comments
In this March 15, 2013, photo the Senate Minority Leader, Republican Mitch McConnell of Kentucky, points to a 7-foot stack of Affordable Health Care Act regulations during an event in National Harbor, Md. / Manuel Balce Ceneta/AP Photo
By Brian Dickerson Detroit Free Press Columnist
Prominent Republicans from Jeb Bush to Louisiana Gov. Bobby Jindal agree: To regain its mojo by 2016, their party must articulate not just what it is against, but what it is for.
Yet, when it comes to health care, Michigan’s GOP lawmakers are doing exactly the opposite. More than three years after President Barack Obama signed the Affordable Care Act into law, Republicans in Congress and the Michigan Legislature are working full-time to sabotage the two objectives that the ACA was designed to achieve: expanded health insurance coverage and lower health care costs.
Last month, Michigan’s nine Republican members of Congress joined the GOP majority in the House in yet another meaningless vote to repeal the legislation popularly known as Obamacare. This is the 37th time that the House has cast such a vote — and the 37th time that the Democratic-controlled Senate has declined to take any notice whatsoever.
Meanwhile, Republican state legislators in Lansing continue to withhold approval for an expansion of Medicaid that Michigan’s Republican governor says is the most cost-effective way to extend health care coverage to hundreds of thousands of uninsured residents. Without expanded Medicaid coverage, virtually all of those uninsured residents will continue to rely on taxpayer-subsidized emergency room care — the costliest care available — to address even their most pedestrian medical problems.
Rotten to the core?
U.S. Senate Minority Leader Mitch McConnell of Kentucky articulated his party’s position succinctly last week when he explained that Obamacare was so thoroughly rotten that it would be whittled to nothing if he and his GOP colleagues began cutting away its most objectionable features.
“Everything is connected — 2,700 pages of statute, 20,000 pages of regulations so far,” McConnell explained. “The only solution is to repeal it, root and branch.”
This is, of course, exactly the sort of thing suicide bombers say just before detonating their vests in a marketplace crowded with Pakistani peasants. (“Don’t you see? It’s all connected!”)
But my point is not to suggest that McConnell is a terrorist. My point is that he: a) probably hasn’t read the legislation he’s critiquing; b) lost interest in solutions about the same time Republicans lost control of the Senate, and c) couldn’t care less about the health care crisis that Obamacare was conceived to address.
That goes double for Michigan’s Republican legislators, who live to serve an “I-got-mine” constituency that already enjoys health insurance coverage and aren’t really interested in Michiganders who don’t.
Let me repeat that: If you don’t have health insurance now, Michigan’s Republican representatives in Washington and Lansing do not care about your medical concerns, especially if they are of the chronic sort that can’t be effectively addressed in a single emergency room visit.
Everything else — all that happy horse poop about deficits and death panels and socialists who want to take away your freedom — is calculated to distract public attention from that ugly truth.
Fixing the beta version
None of this would matter if Obamacare 1.0 were a work of legislative genius whose authors got everything exactly right in their initial attempt at comprehensive health care reform. After all, the chances that House Republicans will succeed in repealing the ACA anytime before 2017 are negligible; barring a net gain of 22 Republican seats in the Senate, it ain’t happening.
But Obamacare isn’t perfect — not by a long shot. Major legislative initiatives never are, which is why every significant federal program enacted in the past 100 years has been quickly followed by significant alterations and technical fixes designed to improve it.
Social Security, Medicare, Ronald Reagan’s immigration initiative, the Children’s Health Insurance Program: All were bedeviled by unforeseen (or, in some instances, widely forecast) glitches that triggered quick, remedial action by Congress.
Obamacare is no different. With full implementation still seven months away, even advocates acknowledge the program needs significant tweaking. Consumer groups think the government needs to provide more navigational help for uninsured people seeking to enroll in a reconfigured health insurance marketplace. Employers, especially in the restaurant and retail industries, are threatening to cut the hours of part-time employees unless Congress loosens coverage mandates for those who work 30-40 hours a week.
In short, there’s a great deal that can be done to strengthen the ACA — and to increase the likelihood that it will facilitate the wider, more efficient medical coverage its drafters sought — before all its provisions take effect Jan. 1.
But none of these improvements is likely to be made as long as Republicans who control the U.S. House and Michigan Legislature will entertain nothing less than total repeal. We should expect more of people who were hired not to drown government in the bathtub, but to make it work for its customers.
Contact Brian Dickerson at bdickerson@freepress.com.
For months now a number of conservatives have led me to believe that President Obama bought his re-election by showering gifts from the Treasury on growing liberal constituencies. So you can imagine my surprise when I noticed that many of those same conservatives are helping Ben Smith blow up his article .. http://www.buzzfeed.com/bensmith/obama-healthcare-young-people .. about how Obamacare will actually screw over young people.
Now there’s no sense pretending a bunch of young, healthy taxpayers won’t be confronted with insurance premiums larger than their insurance subsidies, and thus be on the losing side of one of the ACA’s many reforms. It’s true. They will. If only somebody had pointed that out before the election!
But, of course, people have been writing about this “screwing” forever.
As Ben notes in his own article, this is how social insurance works. We all pay for each other’s stuff, and when it comes to benefits like medical care that old people rely upon more than young people, then young people end up paying for a bunch of stuff they don’t use … until they get old.
By the same logic, Democrats have been “screwing” young people for almost 50 years, by requiring workers to finance Medicare spending. Likewise, on closer inspection, the ACA is an even more devastating blow to young men than to young women, because it ends gender rating and thus represents an enormous transfer of wealth from men to women.
And yet young people, like almost all people, are huge fans of Medicare, and I predict they’ll be big fans of the ACA, too.
If the ACA were all downside for young people then I think it would be fair to ask why they remained so enthusiastic about Obama and Democrats in 2012. But of course it’s not. And presumably Obama’s supporters appreciate both the immediate and future benefits the law will provide them, along with the broader social good of reducing the ranks of the uninsured — even if they don’t like paying their premiums now, while they’re healthy. They realize that “youth” isn’t a fixed demographic, and that they’ll eventually age out of it.
But if you zoom in from the big picture of social insurance and take a more fine-grained look at the ACA specifically, you find that its authors took a lot of steps to mitigate the cross-subsidy effects for young people: They will be able to buy bare-bones insurance; older beneficiaries will pay up to three times as much for any given policy as young people; and young adults will be more generously subsidized than the elderly overall.
That last feature comes thanks in part to the wealthy - the one constituency that actually sort of does get “screwed” by the law. Unlike Medicare and Social Security, which are financed by a regressive tax on workers, the ACA will be financed largely by taxes on wealthy individuals and companies, and the benefits divvied up among low-and-middle income people who currently lack insurance. I strongly suspect that this redistributive effect is what’s really animating the conservatives promoting Ben’s article.
The irony is that if the ACA had been written to ensure more people had skin in the game, then the right’s problems with the law’s progressive nature wouldn’t exist. Yet only then would it have possibly merited a headline like “Obama Prepares To Screw His Base.”
Once again the dumb people that populate the Tea Party groups get it wrong, which means they are batting close to 100%. What's worse they want to stick it to themselves and true Americans by getting rid of the 80/20 rule. Something most of them have no clue about.
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