Stealthcare

Republicans claim they have a “health” care plan. Oddly, though, nobody but Republicans can see any health in it. And even some of them are having trouble with their eyes.

My go-to person when it comes to analyzing these kinds of things for amateurs like me is Sarah Kliff, who now works for Vox. She wrote:

I have spent the bulk of 2017 writing about the different Republican plans to repeal the Affordable Care Act.

Graham-Cassidy, in my view, is the most radical of them all.

While other Republican plans essentially create a poorly funded version of the Affordable Care Act, Graham-Cassidy blows it up.

Kliff features the most cynical part of the proposed legislation, cynicism so breathtaking that even in the age of Tr-mp it stuns:

The bill offered by Republican Sens. Lindsey Graham and Bill Cassidy takes money from states that did a good job getting residents covered under Obamacare and gives it to states that did not. It eliminates an expansion of the Medicaid program that covers millions of Americans in favor of block grants. States aren’t required to use the money to get people covered or to help subsidize low- and middle-income earners, as Obamacare does now.

Now, that first part—that the bill steals money from states that expanded Medicaid and gives it to those that refused to do so—hasn’t received enough attention on the cable news shows I have watched. It is goddamned disgusting that Republican Senators, like Ron Johnson of Wisconsin (a co-sponsor of the monstrosity and one of the biggest creeps in the U.S. Senate), are willing to go on TV or write editorials telling people that his red state has been getting ripped off by Obamacare while other states, blue states, have been making off with the loot. In USA Today, Johnson wrote:

Under Obamacare, three states with 20% of our population — California, New York and Massachusetts — get 36% of the funding. Our bill fixes that.

Johnson was on MSNBC this morning and said the same thing—without being challenged. In fact, I have yet to hear a cable news host or interviewer confront any Republican senator, who tries to sell such bullshit to voters, with this simple question: “If you feel that way, if you believe your state has been on the short end of the Obamacare stick, why haven’t you demanded that your Republican governor expand Medicaid under Obamacare and take care of more of your people?”

The reason red states don’t generally benefit as much from the ACA is because 20 Republican-controlled states have refused to expand Medicaid coverage to their citizens, the funding of which is almost all paid for by the federal government. And now the block-granting scheme in this new legislation will essentially reward those worthless Republican governors and legislatures by giving them money, in amounts that won’t do the job ultimately, that doesn’t have Obama’s name on it—and excising the “Obama” from Obamacare means more than anything to these cynical schmucks.

And speaking of those cynical schmucks, possibly 50 of them in the U.S. Senate are willing to vote for a scheme that not only is bent on damaging or destroying Medicaid, but its stinginess will have to be reauthorized in 2026, else there will be no Image result for poor people on medicaidfederal money, not a dollar, spent on health insurance for those who need it. I have heard Senator Cassidy, a physician who forgot his oath, essentially say, “Ah shucks. Don’t worry. Nobody’s gonna get hurt. Congress will keep the spending coming after ten years. Trust us.”

No thanks. There’s too much at stake, as the chart above demonstrates.

In any case Sarah Kliff goes on to discuss more of the GOP deathcare bill:

Insurers in the private marketplace would be allowed to discriminate against people with preexisting conditions, for example. And it would eliminate the individual mandate as other bills would have, but this time there is no replacement. Most analysts agree that would inject chaos into the individual market.

Taken together, these components add up to a sweeping proposal sure to upend the American health care system. Because the Senate hasn’t seen an independent analysis yet from the Congressional Budget Office, I can’t even say for sure how sweeping, and neither can any of the Republicans who have come out in support of it.

Of course they can’t say how “sweeping” this bill will be. And they don’t want to know any of the details. The CBO is the last body they want to hear from. Besides that, they have ignored it in the past and there is no reason they will pay any attention to the CBO now. After all, Republicans don’t give a damn what the American Medical Association, the American Academy of Pediatrics, the American Nurses Association, the American Hospital Association, the National Rural Health Association, the Children’s Hospital Association, the American Cancer Society, the American Lung Association, the American Diabetes Association, the American Public Health Association, and other groups have to say about it (h/t to Rep. Don Beyer).

Nor do they even care what insurance groups have to say. America’s Health Insurance Plans is a political advocacy association representing 1300 health insurance companies. They don’t like this plan, even though I suspect that’s mostly because they fear it will lead to a single payer system. Blue Cross—bleeping Blue Cross, for God’s sake—released a statement full of “significant concerns” about Graham-Cassidy, saying it “would increase uncertainty in the marketplace, making coverage more expensive and jeopardizing Americans’ choice of health plans.” But more important, Blue Cross said:

The bill contains provisions that would allow states to waive key consumer protections, as well as undermine safeguards for those with pre-existing medical conditions.

Planned Parenthood and the AARP and advocates for the disabled and advocates for veterans (“A vote for #GrahamCassidy is a vote to take healthcare from veterans.”) and NARAL (“If #GrahamCassidyBill passes, ~13 mil women will lose access to maternity care. THIRTEEN MILLION.”) are all opposed to the bill. In fact, it is hard to find anyone outside of Republicans in Congress, and Tr-mp’s base of cultists (who will get hurt by this bill), who is in favor of it. But that doesn’t seem to matter.

The Sisters of Mercy, the Catholic group who advocates for the “poor, sick and uneducated,” said, “Time to Oppose Graham-Cassidy Healthcare Bill.” No, it is past time. Way past time. We can’t just blame this on Tr-mp. This is the fault of a GOP that will do anything—do anything to anyone outside its big-donor base—in order to rid the country of any traces of the Scary Negro who once sat in the White’s House. And nothing bothered them more than when he dared to put his uppity black hands on our healthcare system. They promised years and years ago they would lynch Obamacare. They meant it, even if they are having trouble finding the right rope.

Here is the number to the U.S. Capitol Switchboard, which can get you connected to the Senator of your choice:  (202) 224-3121. Besides what I included above from Sarah Kliff, there are other crappy provisions in this bill. Here is a link to a short summary of the biggest outrages and a “Sample Call Script” that you can use to help you talk to anyone who will listen.

Republicans: Have Bill, Will Kill

It’s time we all face it. The Republican Party is morally bankrupt.

If the party wanted to cash a check of compassion, the Bank of Morality would return it marked “insufficient funds.”

If there were a Bank of Health, the Republican Party would be the guy with a gun in his hand at the teller window, wearing no disguise and demanding all the goods.

Pick your metaphor. Or make one of your own. It’s easy.

You can go to many sites to see analyses of the two GOP “healthcare” plans (which as Senator Al Franken said yesterday, really are tax plans), but now that the Congressional Budget Office has weighed in on both, there is no escaping the reality that any member of Congress who has voted for or will vote for any iteration of the overall plan, and anyone outside of Congress who thinks that the plan is good for the country, is a moral failure as a human being.

It’s just that simple.

And speaking of simple, as for an analysis of what is going on, here is the bottom line:

GOP will kill bill.jpg

____________________________________________

[images from MSNBC]

In Praise Of Experience In The Democratic Party’s Fight Against Tr-mpcare

There is a lot of talk among Democrats and left-leaners that the leadership in the Democratic Party is too old and what is needed is new blood. Well, not so fast.

Sure, any political party needs new and younger folks coming into it to supply both energy and fresh ideas. But a healthy party is one in which a combination of experience and youthful exuberance and idealism prevails. After the devastating Congressional Budget Office report on the Republicans’ replacement for Obamacare came out on Monday, what we needed was competence and experience to explain just how devastating it was and how much harm the plan would do to Americans, the poor, the sick, and the old. Nancy Pelosi and Chuck Schumer provided that experience.

The video below is the press conference they held. Pay attention to how they marshalled the arguments supplied by the CBO’s analysis of the proposed legislation, and pay attention to how they represented institutional memory—as congressional veterans of past fights with Republicans over health reform—that highlighted Republican hypocrisy and duplicity. Oh. If you don’t watch the entire 16 minutes, at least go to the discussion (starting around 13:40) in which the point is made that it will be rural red state folks who will get hurt and blue state wealthier people who will actually benefit from the heartless GOP plan. Yet, two prominent Democrats are standing there in defense of the red state Republicans. Nothing represents better the differences between the two parties. Watch:

You Can Learn A Lot From The Headlines

His ratings are up. His employer is defending his obvious falsehoods about his career. Thus:

“Fox News Doesn’t Care If Bill O’Reilly Is A Liar”

Who thought they would? He has made them all rich. And speaking of Billo, here is some typical Billo logic:

“O’Reilly: Amanpour Is Wrong About Netanyahu Because She Was Raised In Iran”

And speaking of twisted logic, this is how conservatives are courting Hispanics:

“Mark Levin Mocks Rep. Luis Gutiérrez’s Accent, Calls Him The ‘Self Appointed Martin Luther King Of Latinos'”

This is how Republicans are courting black folks:

“GOP Leaders To Skip Selma Event”

And speaking of the anniversary of Selma, this man remembers:

“’I shouldn’t have to feel bad about being white’: N.J. deli owner serves racism with sandwiches, calls for White History Month”

Bon appétit!

Oh, get this. Republicans have finally come up with a solution, a final solution, to homelessness:

“GOP Lawmaker Suggests Wolves Could Help Get Rid Of Homeless People”

I suppose that is one way to do it. And speaking of ravenous wolves, yes, West Virginia, there is a War on Women:

“West Virginia Legislature Upholds 20-Week Abortion Ban Over Governor’s Veto”

And a domestic Holy War:

“Fox News Pundit: Muslim Holidays Discriminate Against Christians”

And a war on working people:

“Walker Wins Another War With Unions”

Nah, that is just a battle. The war has yet to be decided.

To end this little post, let’s play a game of “guess which political party.” I’ll start with an easy one. What political party is this guy from:

“Ben Carson Apologizes For Saying Prison Makes People Gay”

Okay, okay. That one was easy. Here’s a slightly harder one:

“Senator Who Used Snowball To ‘Disprove’ Climate Change Cites Scripture As Backup”

I know. Too easy. Try this one:

“Kris Kobach: ‘Not A Huge Jump’ To Think Obama Could Ban Criminal Prosecution Of Black People”

No use trying to stump you. It’s just not that hard to figure out. The conservative crezzies aren’t very subtle.

And speaking of the crezzies, there is always the founder and editor of the popular right-wing website WorldNetDaily:

“Joseph Farah Is ‘Just Asking’: Will Obama Actually Leave Office In January 2017?”

And I’m just asking, “Why should he?”

Here’s an insightful and Christianly column written by a conservative think tanker:

“End Obamacare, and people could die. That’s okay.”

Sure, that’s okay. Praise God.

In any case, speaking of ObamaCare, I do want to give credit to right-wingers for their bold predictions over the years. They said an America-hating President Obama would destroy the economy and jobs with, among other things, his ObamaCare fiasco. Except:

“Obamacare: Medicaid sign-ups rise, uninsured rate lower”

“U.S. Economy Adds 295,000 jobs, Unemployment falls to 5.5 %”

You gotta love it.

To end, this is what destroying the economy and jobs looks like:
obama and march jobs report

 

It’s Cheap To Be Rich

Nate Silver’s new FiveThirtyEight blog posted a piece by Ben Casselman this morning with the title,

Inflation May Hit the Poor Hardest

Yeah, well, Mr. Casselman, everything hits the poor hardest. A bad economy. A good economy. Everything. You know why? Because they’re bleeping poor, that’s why. But to be fair to the author, he was making a point about the fact that not everyone experiences the same rate of inflation. He begins his piece with this:

It’s getting more expensive to be poor.

He says that “families earning less than $20,000,” because they spend a disproportionate amount of their money on things like rent and utilities,

are experiencing a higher rate of inflation than the public at large even as their wages have stagnated…

The poor experience a double whammy: stagnating wages and a higher rate of inflation that eats away a disproportionate share of their purchasing power. And it is even worse than that. Just watch last night’s 60 Minutes segment on the working poor in Virginia’s part of Appalachia. Those folks are not only victims of a faltering local economy, but they are victims of the Republican Party in Virginia, a party that refuses to allow those poor working people to get the health insurance they are entitled to under the Affordable Care Act’s Medicaid expansion provision.

So, you’re damned right it is expensive to be poor in America.

But it is damned cheap to be rich.

Sheldon Adelson, from whom God sometimes has to borrow money till payday, is looking to buy himself a Republican presidential candidate for the 2016 race. Last time he spent almost $100 million in a losing effort. But don’t feel sorry for him. He made almost that much in two special hours last week. In any case, he told Forbes that this time he will “spend whatever it takes” to win. And whatever it takes will still be cheap for him.Republican Billionaire Sheldon Adelson

Unfortunately there are plenty of Republicans who want to be bought by Sheldon Adelson, including presidential hopefuls like Jeb Bush, Scott Walker, John Kasich, and the groveling Chris Christie, who if Adelson buys him will be getting a bargain, somewhere around $250,000 a pound—and that’s if Adelson only gives another paltry $100 million. Very cheap for a commander-in-chief who could blow up your enemies.

The Supreme Court, staffed by five conservative Republicans who believe that rich people should have a megaphone that matches their money, have now made it easier for Adelson and other moneyed folks to buy up what is left of American democracy. And although there ain’t much left to buy, thanks to Citizens United, what is left won’t cost those wealthy folks all that much. Last year Sheldon Adelson made about $22,000 a minute. In eleven short minutes he made enough to buy a pound of Chris Christie or a half-pound of Jeb! No problem! Cheap, cheap, cheap.

In the mean time, it remains very expensive to be poor, especially in western Virginia where, because of Republicans, folks have to rely on the occasional visits of two saintly nurses driving a raggedy 13-year-old Winnebago-turned-“Health Wagon” in order to stay alive.

health wagon2

An Erstwhile Conservative Exclusive: The Devil On ObamaCare

Tonight, of course, is the soft deadline for getting health insurance under the Affordable Care Act. I have been trying for months to get an interview with Satan himself so that I could get his take on all the controversy surrounding the new health care law. Finally, after a lot of effort, I was able to get the old devil to sit down for what I hope is only one of many interviews to come:

THE ERSTWHILE CONSERVATIVE: Thank you for your time. I know you’re busy on this important day for America, so I will make this quick. I guess my first question is: How hard have you been working to make sure the Affordable Care Act fails?

SATAN: Well, I’m glad you ask me that. Obviously it is in my interest that this plan fail and fail miserably. And because of that, I assigned several divisions of demons the task of destroying what we in hell sarcastically refer to as “ObamaCare”—a term your president, in what some thought was a moment of tactical brilliance, adopted in order to dull the force of the point, even though I think we have still succeeded, as the polls show, in dirtying the thing with his name.

I have put so many of my demonic assets into this massive and massively negative effort that we are a little short-staffed in other areas, like helping to deny people unemployment benefits and food stamps or making sure they don’t vote this fall in the mid-term elections. But I think we’ve done such a good job in the House the last few years that we’ll be okay. I just had to be sure that we were doing all we could to make sure people don’t sign up for affordable health care. The sicker and more fearful people are the better, as far as I’m concerned.

TEC: I see, I see. Just what do these anti-ObamaCare demons do?

SATAN: Well, the largest number of them get people to do things like lie about the law in print and on the Internet and on television. I think you know where I’m going here—

TEC:—Yes, yes, I do know where you’re going and I wanted to ask you about that—

SATAN—Oh, I’m happy to tell you about it. Journalism, or what passes for journalism these days, is very important in my business. We specialize, as you know, in using the trade to spread false information about a lot of things, from Obama’s birth certificate to Benghazi to phony vaccination controversies. The latter disinformation campaign has allowed us to gain back valuable ground we RougeoleDP.jpglost to those damned scientists who have found ways of combating many of the wonderful diseases I’ve been spreading around. Thanks to all the disinformation work we do, measles is making a comeback!  

TEC: Yes, you have done a great job in terms of spreading harmful lies, I must say.

SATAN: Yes, I have. And I’m damned proud of it. Jesus called me the Father of Lies, you know. 

TEC: Yes, I know that. He also said you were “a murderer from the beginning.”

SATAN: I know, I know. He is too kind sometimes! I’m very proud of the work I do and it feels great when you get recognized for doing a good job. Thank you, Jesus!

TEC: Besides spreading lies and misinformation about ObamaCare, what else are you doing to kill health reform?

SATAN: Well, obviously, merely lying about what the law is supposed to do and is actually doing isn’t enough because the other side has those awful truth-tellers out there who are always working against us. For that reason I assigned some Special Forces units—Rulers of Darkness we call them at home—to take the good news about ObamaCare out there and, like magic, turn it into bad news! Those Rulers of Darkness are amazing little devils!

TEC: Can you give us an example of how these Rulers of Darkness work? That sounds fascinating.

SATAN: Of course I can. Just the other day on Fox and Friends—God, how I love that show!—we had the co-hosts suggest that Obama is signing up Mexicans to get the enrollment numbers up! 

TEC: Mexicans?

SATAN: Yes! Mexicans! Isn’t that awesome? The fiendish discussion was an attempt to turn the positive fact that more than 6 million have signed up into a negative fact that the only reason the number is so high is because “illegals” are signing up at Mexican Consulates. Amazing isn’t it?

TEC: That is amazing.

SATAN: One of the co-hosts even mentioned some work I did back in 2009!

TEC: What was that?

SATAN: Don’t you remember when congressman Joe Wilson shouted out “You lie!” during Obama’s 2009 address to Congress? It was during the part where Obama said that the new law “would not apply to those who are here illegally.” Come on, I got personally involved in that one. You have to remember. Next to getting Sarah Palin to use the term “death panel,” that whole Joe Wilson thing was the best political work I did that year. You have to remember—

TEC: Of course I remember. Who could forget that?

SATAN: Well, the Fox host said that maybe Joe Wilson “had a point” when he shouted “You lie!” at the President. I tell you those Rulers of Darkness demons know how to put on a show! And you know what effect this kind of stuff is having? Let me give you an important example. There are families out there where either the husband or wife are not U.S. citizens, but their children are. And these folks are scared that if they sign their kids up for health insurance coverage that the government will move in and destroy their family through deportation. Thus, Latino enrollment in ObamaCare is far behind their population numbers and, as a hellish bonus, the kids are going to go without health care! Isn’t that awesome! I mean, trying to kill ObamaCare has featured some of hell’s finest work! People may actually die!

TEC: Speaking of that, how were you able to get all those Republican governors and legislatures to not expand Medicaid? I mean it makes good economic sense to expand insurance coverage and it certainly makes good Christian morals sense to do so, and since Republicans consider themselves to be economic and moral savants, it must have been hard to get, so far, 24 states controlled by Republicans to shut the door on the poorest of Americans and deny them health insurance, right?

SATAN: Wrong. It was pretty damn easy to tell you the truth (which I rarely do). All we had to do was make sure people connected the whole thing with that Scary Negro in the White’s House, and then talk radio and Fox, where some of our top-notch lying spirits are employed, took it from there. The result is that Republican politicians in all those states would not now dare expand Medicaid and make health insurance available to those who need it. And, again, more people will die! But I don’t want talk radio and Fox to get all the credit for the whole Medicaid expansion thing. I want to give a shout out to the demons we have assigned to the Supreme Court.

TEC: Huh?

SATAN: Yes, I know. Most people forgot what happened in 2012 when the Court unfortunately found ObamaCare constitutional. Under the original law, states were required to expand Medicaid or else lose Medicaid funding. But our guys, having failed to get Justice Roberts to strike down the damned law, made a nice recovery—I was about to come down hard on them— in getting him to agree to give states a choice in participating in the Medicaid expansion. And that opt-out has worked much better than we could have imagined.

TEC: How so?

SATAN: Well, I brought with me something that I’d like to read to you, if you don’t mind. It’s from the website Health Affairs, which was started by a bunch of worthless liberal do-gooders with the disgusting name of Project HOPE—damn how I hate that name! Anyway, I usually get all goose-pimply reading this, so bare with me, but it explains the effects of the failure to expand Medicaid:

Based on recent data from the Oregon Health Insurance Experiment, we predict that many low-income women will forego recommended breast and cervical cancer screening; diabetics will forego medications, and all low-income adults will face a greater likelihood of depression, catastrophic medical expenses, and death. 

Isn’t that juicy? Isn’t that wonderful? I am so proud of that and of our guys at the Supreme Court.

TEC: I can see it in your face. Look, I know you have to go, and again I thank you for your time on this important day, but I want to ask you one more question: What do you think is your biggest achievement related to the Affordable Care Act?

SATAN: Man, that’s a hard one. There are so many. Let me see. Some would say that getting the Republican Party to cheer for the failure of the law would be a big accomplishment. Others might say that getting the news media to ignore how much effort Republicans have put into seeing to it that the law fails is a big deal. But I would have to say it comes back to those deaths I mentioned. We’re all about suffering and death where I come from and I admit I’m a bit prejudiced, but the probable fact that thousands of people suffer and die each year, at least partly because they don’t have health insurance, is something those of us on our side celebrate daily. I don’t much care if the number is 45,000 a year or something lower—obviously I want that number to be as high as possible—but as long as people are suffering and dying unnecessarily I am as happy as any devil has a right to be.

TEC: Thank you. I hope we can talk again real soon.

SATAN: I’ll be looking forward to it.

Lucifer

“When It Is In Your Power To Act”

“Do not withhold good from those to whom it is due,
when it is in your power to act.
Do not say to your neighbor,
‘Come back tomorrow and I’ll give it to you’—
when you already have it with you.”

—Proverbs 3:27-28

medicaid expansion is not yet a reality here in Missouri, if it ever will be. But it is also struggling in Virginia and Arkansas (which already has a privatized version of it that needs reauthorized in order to continue). Expansion is struggling in those states even though both, like Missouri, have Democratic governors and even though a majority of people in both states favor expanding the program:56 to 38 in Virginia, including 55% support among Republicans, and 47.5 to 32.5 in Arkansas. (And there is good evidence that Missourians favor expansion too).

The Washington Post editorial page a couple of days ago featured this explanation of what is going on in Virginia, part of which I highlight for your contemplation:

In Richmond, House GOP lawmakers have made it clear they are not interested in compromise, nor do they wish to be bothered much with the facts. Mr. McAuliffe (D), in office barely a month, has tried schmoozing and executive mansion hospitality; he is nothing if not a deal-maker. The Republicans have responded with derision and fighting words. For them, it is enough to demonize Medicaid expansion as a function of Obamacare, and hope the resulting slogans carry the day — no matter what the cost to hundreds of thousands of struggling state residents who have no health insurance.

Demonizing Obamacare, the only thing Republicans can do effectively these days, has become, of course, a way of demonizing Obama. And it works in some places. In fact, it is working very well in Arkansas, as Seth Millstein points out (which I also highlight for your contemplation):

Arkansas residents strongly support expanding Medicaid under Obamcare — that is, until you tell them the expansion is part of Obamacare. Then they don’t support it anymore. In yet another indication of how successfully Republicans have tarnished the nickname for the Affordable Care Act, a new poll of Arkansans showed that net support for the state’s private Medicaid expansion drops by 19 points when you include the word “Obamacare” in the polling questionsArkansas residents, it seems, just don’t want to like Obamacare, regardless of what’s in it.

Sad, no? And what is sadder is the fact that the only clear demonstration of competence on the part of Republican officeholders and their mouthpieces on talk radio and Fox TV is their skill in transforming Obama into Satan in so many supposedly God-fearing places.

And speaking of God-fearing places, look at this graphic based on polling done by the left-leaning Joint Center for Political and Economic Studies:

medicaid expansion in the south

Hell, where the Bible says eternal torment awaits “all liars,” will freeze over before Republican politicians in the Jesus-loving states listed above pay any attention to such polling. Because lying about President Obama, in the strange and dark religion of conservative politics, covers a multitude of sins, especially the sin of ignoring the basic needs of so many disadvantaged Americans.

Roy Blunt’s Moocher Talk And What’s Wrong With It

Not only has the Affordable Care Act been attacked by Republicans for being a government takeover of the healthcare system or for creating death panels that will kill your grandparents in their sleep or for busting the federal budget and your own or for limiting your choice of policies and doctors, now the GOP has a new line of attack: ObamaCare is creating more moochers!

Even though that whole moocher thing didn’t work so well in the 2012 presidential election, it is so much a part of the right-wing’s dogma about Democrats and Democratic constituencies that they simply can’t let it go.

Roy Blunt, my own senator, appeared on this week’s Fox “News” Sunday. And, of course, he followed the newest ObamaCare’s-a-moocher-maker script on what Republicans should say in response to the release of the CBO’s analysis of some of the effects of the Affordable Care Act on the nation’s labor supply.blunt on fox

Before we get to what Blunt said, let’s look at the question Chris Wallace asked him and the way that question was set up for him and the way the reactionaries want us all to understand the issue. Wallace played a cherry-picked clip of Congressional Budget Office Director Doug Elmendorf’s testimony before the House Budget Committee last Wednesday. Here’s a transcript of the clip Wallace played:

DOUG ELMENDORF, CBO DIRECTOR: By providing heavily subsidized health insurance to people with very low income and then withdrawing those subsidies as income rises, the act creates a disincentive for people to work, relative to what would have been the case in the absence of that act.

Wallace stopped the clip there. What Fox viewers (and Roy Blunt) didn’t hear was what Elmendorf said next:

Now these subsidies, of course, makes those lower income people better off.

Yes. He said that. Right after he talked about the disincentive to work. He said that these folks would be better off. And he continued to explain:

This is an implicit tax, not the sort of tax we normally think about where if the government raises our taxes, we are worse off and face the disincentive to work more. Providing a subsidy, people are better off but they do have less of an incentive to work and I think they would respond to that by working somewhat less.

As you can see, the whole idea that folks would stop working or reduce the time they spend working is essentially based on what economists “think they would respond to” in terms of being better off because of the ACA. And it turns out that the CBO’s number-crunchers were influenced by the work of a conservative economist, as Jonathan Chait (“How Obamacare Became the New Welfare”) notes:

The Congressional Budget Office’s budget update last week surprisingly adapted an analysis, advocated by conservative economist Casey Mulligan, that Obamacare would induce the equivalent of two million full-time jobs in reduced labor. Now, in addition to its previously recited horrors, Obamacare was taking money from hard-working Americans to finance indolence.

Mr. Mulligan has been an outspoken critic of the Affordable Care Act from the start. Last October he criticized it for—sound familiar?—creating “a reduction in the reward for working” and suggested that its full implementation this year might cause “a recessionary double-dip.” So, he’s not a fan of the law, and it is unclear why the CBO embraced some of his thinking as to the effects it will have on the labor supply.

politics 1984 IS HEREBut such thinking is part of the long-time conservative critique of Democrats and their fondness for safety-net programs. On Sunday, Chris Wallace asked former-intellectual-turned-Fox-commentator George Will: “is giving people a cheaper way to get health insurance without working so much — is that a good thing or a bad thing?” As he always does, as he is no doubt required to do to get his big paycheck from Fox, Will took aim at liberals:

People forget Social Security was advocated, Chris, in the 1930s, as a way of getting people to quit working, because they thought we were confined to a permanent scarcity of jobs in this country. Second, it is the point of progressivism to put in front of the American people an increasingly rich menu of temptation to dependency on government. In order to change social norms and eventually national character, the president said, “I want to fundamentally change America,” and these disincentives to work are part of it.

Of course! President Obama and the Democratic Party want people to be dependent on government. They want people to stay in what Paul Ryan called the “poverty trap.” They want all Americans to quit working and become moochers. Makes perfect sense, right? That idea, which Rush Limbaugh and other right-wing radio personalities have aggressively pushed for more than two decades now, is what Republicans want voters to now specifically associate with “ObamaCare.”

But what about that idea? What about that poverty trap? You might be surprised. Jonathan Chait writes:

What’s more, as Jared Bernstein and Edwin Park point out, by lifting the threshold for who gets subsidized insurance, Obamacare actually reduces this poverty trap. Before Obamacare expanded it, Medicaid had extremely low income thresholds. It varies state by state, but the average state cut off Medicaid to people earning just 61 percent of the poverty line, a pitifully low sum. If you’re a single parent in Texas, you lose your Mediciad if you earn more than $3,600 a year. A family of two in Alabama loses its Medicaid once its income, after deductions, hits the lofty sum of $2,832 a year. That’s a severe incentive to keep poor people from obtaining full-time work.

Of course, Texas is boycotting Obamcare’s Medcaid expansion, and is thus keeping in place this strong incentive for its poorest citizens to stay out of the workforce. (If conservatives are worried about fostering a culture of dependency in these Obamacare-boycotting red states, they are keeping their fears very, very quiet.) The states choosing to expand Medicaid are correspondingly increasing the incentive for the very poor to enter the workforce.

As the above-cited economist Jared Bernstein makes clear:

During a hearing today on the latest CBO report, Rep. Paul Ryan declared the health care law to be “a poverty trap.”  He’s way off base.  In fact, he’s got it backwards…

None of this is to deny the CBO’s point that some people with incomes above the poverty level will choose to work less to avoid reductions in their premium subsidy.  But those choices are not the ones faced by the poor who live in states where the ACA is the law of the land.  In those states, the law has thoroughly reversed the poverty trap.  Rep. Ryan should know that and correct the misimpression he’s created.

Of course Paul Ryan, Roy Blunt, or any Republican for that matter, will not correct any of the misimpressions, not to say lies, they have created. And many mainstream journalists will continue to promote a false equivalence by reporting Republican misinformation and Democratic attempts to correct it as if both are morally equal and just part of the game of politics. Thus, if Democratic politicians want to keep their jobs and keep health insurance reform alive, it is up to them to get very aggressive in their defense of the ACA, especially with people like Roy Blunt running around and making mischief on television.

Which leads me finally to Blunt’s appearance on Fox yesterday. Chris Wallace, after playing the partial Elmendorf clip, asked Blunt this question:

WALLACE: Now, Republicans say this proves that ObamaCare is a job killer. Democrats say it means that fewer people will be locked into jobs. Senator Blunt, what is wrong with that, the idea of fewer people locked into jobs?

Now, of course Wallace knows that ObamaCare is not “a job killer.” The CBO report made clear and Elmendorf testified that the law would actually create jobs not kill them. But Wallace chose to set the question up by contrasting a Republican “job-killer” lie with a Democratic truth, to wit: the law allows some people to opt out of jobs they are locked into because of their need for employer-provided health insurance. And Blunt took the bait and further muddied the waters:

SEN. ROY BLUNT, R-MO.: Well, I think any law you pass that discourages people from working can’t be a good idea. Why would we want to do that? Why would we think that was a good thing? How does that allow people to prepare for the time when they don’t work?

This number is about three times as big as the number that was on the table when people that voted for the president’s health care bill voted for it in 2009 and ’10 when the estimate was it would cost the equivalent of 800,000 full time jobs. Now, they’re saying 2.3 million, and the best face can you put on that is that means people that don’t want to work don’t have to work. Surely, that’s not what we want to encourage. And that’s what this law does encourage.

Let’s start with his first declaration: “I think any law you pass that discourages people from working can’t be a good idea.” Oh, yeah? The Social Security law discourages people from working. Lots and lots of them. And lots of them are Republicans. Is Social Security a bad idea, Senator Blunt? Is Medicare a bad idea because it also discourages people from working? Apparently, Blunt thinks that making it possible for people who have worked all their lives and simply want to exit the labor force into retirement is a bad thing. No wonder he supported the infamous Paul Ryan Medicare-mutilating budget plan. I guess people should just work until their dead.

But more than that, notice how Blunt, like all Republicans are now doing and will continue to do until election day this November, focuses on those alleged 2.3 million” people who “don’t want to work” or “don’t have to work.” That is essentially the argument that was made more generally during the 2012 election. Paul Ryan said the following at a fundraiser in June of that election year:

Do you want the American idea of an opportunity society with a safety net where you can take a risk, start a business, make a difference, succeed and be honored for being successful? Or do we go down the path the president is proposing — a social welfare state, a cradle-to-the-grave society where we have more takers than makers?

The only difference now, in this election year, is that Republicans are targeting a specific effort by Democrats, embodied in the Affordable Care Act, to help low-income folks get affordable health insurance. And they think they have the CBO on their side this time.

elmendorfBut what about that CBO report and Director Elmendorf’s seemingly common-sense claim “that by providing a somewhat smaller incentive to work, somewhat fewer people would work”? Nobody argues that there won’t be some number of people who will do exactly what Elmendorf suggests they will do. As Jonathan Chait makes clear:

It is true that any means-tested government benefit will discourage some class of people from working. If a subsidy is available only for people below a certain income level, then people whose income approaches that income level will lose some incentive to earn more.

By its very nature, the concept of means-testing—which Republicans themselves have always embraced—involves people calculating whether working more actually makes them better off. People do that all the time when, for instance, they reach retirement age. The issue here is how many people will do what Elmendorf suggests. And relative to that issue Suzy Khimm (who used to be with the Washington Post’s Wonkblog) makes an excellent point:

It’s also worth taking the CBO’s findings with a grain of salt. The office had previously forecast that Obamacare would reduce the total hours worked by the equivalent of 800,000 workers, then updated its forecast based on more recent research. But one new study that CBO cited in its report actually “found no significant effect of Medicaid on employment or earnings” when Oregon expanded the program in 2008.

Austin Nichols, a researcher at the Urban Institute, says such evidence makes him skeptical that Obamacare’s effect on the labor market will be as large as the CBO predicts. “I don’t think we’re going to see the kinds of reductions in labor supply that Elmendorf is talking bout today,” says Nichols. “We have also evidence from Massachusetts that doesn’t show a large impact.”

Paul Krugman wrote that the “reduced labor supply” noted by the CBO and exploited by dishonest Republicans does in fact add to “the true cost of health reform.” But he demonstrates, through what he calls “some pretty prosaic economics,” that the effects are fairly modest. He ends:

Should you care how much other people work? Yes, a little – but not so much that it should change anyone’s views about health reform.

The truth is that at this point nobody really knows, with any degree of legitimate certainty, what direct and indirect effects the Affordable Care Act will have not only on the labor supply, but on other areas of the economy. As I have said many times, the ACA is an experiment. Much more time and evidence is needed to figure out whether the law will work as designed, whether it will need significant changes, or whether it should be scrapped altogether. But we have one political party that does not want it to work, will not lift a finger to fix any problems with it, and wants only to kill it before it has had a chance to prove or disprove itself.

Unfortunately for Missourians—especially for those Missourians who could get health insurance were it not for Republicans blocking Medicaid expansion—Roy Blunt is part of that one political party.

ObamaCare May Work!

When I retired five years ago, I did not “lose” my job. Nobody fired me or laid me off or put me on furlough. I simply stopped working because I wanted to. I withdrew my contribution to the total supply of labor in the country.

However, in the minds of Republicans and other right-wingers exploiting the latest Congressional Budget Office report that discusses the effects of the Affordable Care Act on the labor market, my decision not to work is actually a job loss. Hooey.

Although there is plenty of lying—yes, lying—and misinforming going on in terms of what the CBO report said, I chose this headline from a Fox “News” article on the matter to represent the lies and misinformation:

ObamaCare could lead to loss of nearly 2.3 million US jobs, report says

More hooey. That CBO report, which is titled, “The Budget and Economic Outlook: 2014 to 2024,” did not—I repeat: did not—say that the ACA could lead to “nearly 2.3 million” job losses. And although it is nice to see that conservatives, after years of bashing the CBO’s reports, are now embracing the nerds’ number-crunching skills, those cherry-picking right-wingers should actually read the report.

First of all, it should be noted that the portion of the CBO’s budget analysis that deals with the future labor effects of the ACA is, like the rest of the projections in the document, an “estimate.” And it is not just an estimate, it is an estimate essentially (but certainly not entirely) of what real people, including many low-income people or people approaching retirement age, will do in the face of getting help from the government to purchase health insurance. Thus, that CBO estimate is based on suppositions about human psychology. Keep that in mind when you hear the hysteria coming from Republicans (or when you hear the good news below).

Secondly, we are not talking about a reduction in the demand for labor, but a reduction in the supply of labor. You know, sort of like when I reduced the supply of labor by retiring five years ago. There elmendorfwas still a demand for my (excellent) services, but I chose not to supply them. As I said, that’s not the same thing as a job loss. By the way, I just heard Douglas Elmendorf, Director of the CBO, say the same thing in testimony before the House Budget Committee.*

There are already a lot of great articles out there that explain what is going on (here and here and here and here, for instance). The following is an excerpt from an excellent report on the subject from the Los Angeles Times:

The CBO projects that the act will reduce the supply of labor, not the availability of jobs. There’s a big difference. In fact, it suggests that aggregate demand for labor (that is, the number of jobs) will increase, not decrease; but that many workers or would-be workers will be prompted by the ACA to leave the labor force, many of them voluntarily.

As economist Dean Baker points out, this is, in fact, a beneficial effect of the law, and a sign that it will achieve an important goal. It helps “older workers with serious health conditions who are working now because this is the only way to get health insurance. And (one for the family-values crowd) many young mothers who return to work earlier than they would like because they need health insurance. This is a huge plus.”

Democrats should continue to aggressively counter the right-wing messaging on this latest CBO report (we can’t count on journalists to get the story straight, what with their “they said, they said” reporting in which telling a lie is on an equal footing with telling the truth). And Democrats, following economist Dean Baker, should enthusiastically embrace the fact that what may happen (remember: it is an estimate) is that the ACA will actually do what it was designed to do. Just before President Obama signed the ACA into law in March of 2010, he said,

And we have now just enshrined, as soon as I sign this bill, the core principle that everybody should have some basic security when it comes to their health care.

Basic security. Yes! The kind that may allow Dean Baker’s “older worker”—who has a serious health condition and needs health insurance provided by an employer—to opt out of the work force, or Baker’s “young mother” to stay at home and take care of her children. What family-values-hawking Republican could be against that?

Judging by their hatred of the Affordable Care Act, apparently every one of them.

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* UPDATE: Here is what Elmendorf said:

If someone comes up to you and says, ‘Well, the boss said I’m being laid off because we don’t have enough business to pay me,’ that person feels bad about that and we sympathize with them for having lost their job. If someone comes to you and says, ‘I’ve decided to retire,’ or ‘I’ve decided to stay home and spend more time with my family,’ or ‘I’ve decided to spend more time doing my hobby’ –- they don’t feel bad about it, they feel good about it. And we don’t sympathize, we say congratulations. And we don’t say they’ve lost their job, we say they’ve chosen to leave their job.

Do Businesses Have A Moral Obligation To Their Workers? A Missouri Businessman Says They Do

As the ObamaCare experiment continues, critics are still wishing for, or in some cases trying to engineer, its absolute failure.

Obviously, if you have been following politics closely since 2008, you know that right-wingers want to undermine the Affordable Care Act largely because they believe that doing so would destroy the Obama presidency, a goal they sketched out at the beginning of his first term. These folks did not—and still do not—want this president to be transformative, to go down in history as someone who mattered. And if the ACA turns out to be successful, if the experiment works, it will mean that its presidential champion, and the political party that supported him, will matter a great deal.

Peter Wehner, a very conservative columnist, used to work for George W. Bush. But in Ayn Randish, Tea Party circles, he is considered a “neo-liberal” and a “statist” and one who promotes “wealth distribution.” That’s how far right the right-wing has drifted. In the real world, the world of facts, Wehner is an anti-Obama right-winger who thinks the failure of healthcare reform will not only “indict” the Obama administration, but will “hurt liberalism,” too. Why? Because such a failure would mean that the attempt to achieve “universal health care coverage,” something that liberals “have been aiming for for half a century,” will be politically dead, along with the Obama legacy.

A few days ago, Wehner wrote a piece titled “A Scenario for the Repeal of ObamaCare,” in which he quotes fellow right-winger Avik Roy as saying that if Republicans take over the White’s House and Senate in 2017, and if the number of “newly insured could be dwarfed by the political constituency of those harmed by the law,” then “President Obama’s signature legislation may not be long for this world.” To which Wehner responds:

If so, it would sink the Obama presidency, both in real time and in the eyes of history. Which is precisely what ought to occur.

So, there you have it. They want Obama’s graying scalp, even if it means hurting millions upon millions of uninsured and otherwise uninsurable folks. This stuff is personal.

And speaking of personal, a column that appeared recently in the Joplin Globe was also personal. Except in a good way. A local businessman, who holds a degree in chemistry and physics, wrote a piece (“The impact of ACA isn’t really ‘devastating’ at all”) that blew me away (thanks to blogger Jim Wheeler for the tip).

Kelly Meares, who co-founded and operates a business in Webb City, Mo., was inspired by Senator Roy Blunt’s invitation “to share horror stories and devastation brought upon fellow Missourians by the implementation of Obamacare.” Well, I’m sure Ol’ Roy didn’t expect this ironic reply from someone here in Southwest Missouri:

Thanks for the invitation to share the devastating impacts of Obamacare on our family. If you don’t mind, I will refer to it as the ACA instead of a hate-based euphemism. Yes, Obama has adopted the term hoping to neutralize it, but the Affordable Care Act was created by Congress and built on a hodgepodge of Republican ideas in the hope of bipartisanship while still (regrettably) mollycoddling insurance companies.

Because of the ACA, our business is suffering through lower insurance costs for the first time ever. In spite of staff aging up, our provider has lowered our premium costs. We were accustomed to double-digit increases for most of the last decade. 

Wow! Good ACA news for a change. And from a businessman! Meares goes on to note that an often overlooked provision in the ACA—the requirement that insurance companies in the individual and small group market have to spend at least 80% of premiums (85% for the large group market) Kelly Meares, founderon actual health care or else refund the difference to policyholders—resulted in 588,000 Missourians getting checks from their insurance companies in 2012.

Meares also notes that thanks to the ACA his young adult daughter “has had the security of insurance as a dependent on our policy since leaving college” and “will be able to transition to a plan on the exchange regardless of pre-existing conditions.” That is really “devastating stuff,” he mockingly tells Senator Blunt.

But what is really devastating, in terms of countering enemies of the ACA like Roy Blunt, is the following sweet sarcasm:

I fear that the ACA will allow hospitals and medical practitioners to spend less time chasing debtors and foreclosing on the homes of the unfortunate people who happen to have some assets but insufficient or no insurance coverage for whatever reason. The medicos will be liberated to practice medicine and will have less deadbeat debt to pass on to the paying customers.

And now mom-and-pop businesses that make the sacrifice to provide insurance for their employees will have a more level playing field against those businesses that neglect their moral obligation to their workers. Consider this — if your business model depends on a paying a non-living wage and pushing your workers into the safety net (provided by others), then you are not an entrepreneur; you are an exploiter. To borrow a popular hate phrase: You are not a producer; you are a parasite.

Dang! How refreshing to see reflected on the local paper’s opinion page, a page usually filled with anti-Obama and anti-ACA nonsense, the point of view of a businessman who believes that businesses ought not “neglect their moral obligation to their workers.” Heck, who around these parts even knew that businesses actually have a moral obligation to their workers? Fantastic stuff.

Mr. Meares urged “the Missouri GOP controlled statehouse” to “do the right thing” by expanding Medicaid in the state, which would affect 193,000 Missourians. Then he candidly admitted that the ACA is not the perfect solution, that “single payer” would be preferable. “But the doomsayers shot that down,” he says. Yes, they did. From the start there was very little consideration of a single-payer system, which is why, as this principled businessman said earlier, that the ACA was constructed with “a hodgepodge of Republican ideas in the hope of bipartisanship while still (regrettably) mollycoddling insurance companies.”

Meares then looked Roy Blunt in the eyes and told him,

Enough of the mock outrage and straw man arguments, please.

And he finished his remarkable column with this:

Of course, it’s human nature not to like the ACA simply because nobody actually wants insurance. Nobody wants hospitals or doctors. Everybody wants to live a healthy, non-medically entwined existence. But unless the GOP can deliver the latter, then you must do more to support the former instead of making political capital on our denial and obstructing the flawed solution.

I request that you serve the people of Missouri and reject the politics of GOP obstruction at all costs.

Bravo!

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[photo from the website of Kelly Meares’ business]