Showing posts with label ACA. Show all posts
Showing posts with label ACA. Show all posts

Tuesday, November 3, 2020

Saving the Republic From Trump

 


I warned four years ago in this space that Trump and Trumpism needed to be rejected at the ballot box, at the time confident he would lose. And he we are four years later and well it's the same pitch as last time.

And obviously just as last time, this is NOT a normal election. This isn't a spirited debate about taxes and regulations or like in say 2004 where the top issue was which was the best way to fight Islamic terrorism. No, this is a fight for the future of our country to remain a democratic republic or do we begin the slow slide into autocracy?

It wasn't really a campaign of policy ideas four years ago. And it's been even less so this time. You can't really even have a debate on policies with Trump and Biden because the former is living in some alternate universe where everything under him is great and everyone is lying about everything all the time, except him. People could vote for Biden just to get rid of Trump, which is fine. But also he has put forth detailed plans on health care, fighting climate change, reducing student loan debt, raising the minimum wage, etc. 

What exactly is Trump even running to accomplish if he is re-elected? As best as I can tell it is mainly to just own the libs and troll the elites. He claims to have already built the wall (he hasn't) and made big beautiful trade deals (they are mostly the same as before). And those were his main areas of focus in 2016. What's left - even crueler immigration and refugee policy? Firing every non-loyalist at the FBI and DOJ? Pardoning everyone connected with his administration or campaign who has been indicted? His agenda is full of "wins" for him personally or for his bank account, touted as wins for the country. And then his cult gets on board. 

He's running a scare campaign that if Biden wins we'll have chaos with riots and protests, a mismanaged pandemic/vaccine, and massive unemployment. We already have that now! Or he's saying Biden never denounced riots/looting (a lie, he did) or that he will end the suburbs, god, and guns. OK, sure, like that would even be possible if it was on the to-do list, which it isn't, because the accusation is insane. Meanwhile for four years Trump has failed at handling every crisis and made things worse. The pandemic - failure, North Korea missile development - failure, Hurricane Maria response in Puerto Rico - failure, the trade war he started with China - a complete and utter failure. 

It's impossible to keep track of the scandals. A weekly list for Trump would have been a career ending list for any other politician a few years ago. It's a campaign detached from reality, where in this bubble Trump is doing a great job, is super popular, has made American great, and will win a re-election landslide unless there is massive voter fraud. Meanwhile, he is the least popular President ever, never once having a 50%+ average approval rating at any time and averaging 43/54 approve/disapprove over his first four years in spite of a good economy for three of them. Reality breaking into the MAGA cult bubble will be jarring for them this week.

Meanwhile, outside the MAGA bubble, we're living through a pandemic that will likely have killed well over 300,000 people by the time the next president is sworn in. The economy is still in bad shape with thousands of businesses closed permanently, and the unemployment rate dropped in September and October mainly because people were no longer eligible in their states. And we're probably looking at having to do another lockdown soon, as Europe is about to do. The health care system was already inefficient, sometimes cruel, and with resources overtaxed before the pandemic and it may get worse if SCOTUS strikes down the ACA. Trump has no plans to attempt to solve any of these problems. He doesn't even pretend to care about most of them. Imagine running for re-election and barely even talking about any of the top issues facing the country, based on polls, other than "law and order" the only response he has to protests and riots. And yet he still has a 10% chance to win according to 538.com.

The fact that Joe Biden is likely to win the national popular vote by 7+ points and Trump is presiding over this pandemic, faltering economy, and massive corruption, and we still have to sweat out the returns in a handful of swing states is a systemic failure. This should be a blowout. We are super polarized now and political scientists equate a 9-12 point popular vote win now as similar to what a Nixon or Reagan level landslide was at that time. But people are so siloed now in how they consume news. And in the Trump Media Universe he is doing a great job. Herbert Hoover never had Rush Limbaugh and Fox News telling their audiences that the sky was actually red, not blue, or else he may have had a fighting chance vs FDR in 1932. Hoover still got 40% of the vote in that election. So maybe we were always polarized. Now it's just that we are both polarized and almost perfectly sorted along racial, education, and rural/urban lines that it allows for incredibly unpopular candidates to still have a chance in the Electoral College. This is all because the biggest slice of the less popular candidate's base is white, rural, no-college voters and they have disproportionate power in our system.

It is just exhausting thinking about it. Shortly into his term, Jon Stewart noted that the presidency is supposed to age him, yet it's aging us. And this Andrew Sullivan essay was so on the nose:

With someone like this barging into your consciousness every hour of every day, you begin to get a glimpse of what it must be like to live in an autocracy of some kind. Every day in countries unfortunate enough to be ruled by a lone dictator, people are constantly subjected to the Supreme Leader’s presence, in their homes, in their workplaces, as they walk down the street. Big Brother never leaves you alone. His face bears down on you on every flickering screen. He begins to permeate your psyche and soul; he dominates every news cycle and issues pronouncements — each one shocking and destabilizing — round the clock. He delights in constantly provoking and surprising you, so that his monstrous ego can be perennially fed. And because he is also mentally unstable, forever lashing out in manic spasms of pain and anger, you live each day with some measure of trepidation. What will he come out with next? Somehow, he is never in control of himself and yet he is always in control of you. 
One of the great achievements of free society in a stable democracy is that many people, for much of the time, need not think about politics at all. The president of a free country may dominate the news cycle many days — but he is not omnipresent — and because we live under the rule of law, we can afford to turn the news off at times. A free society means being free of those who rule over you — to do the things you care about, your passions, your pastimes, your loves — to exult in that blessed space where politics doesn’t intervene. In that sense, it seems to me, we already live in a country with markedly less freedom than we did a month ago. It’s less like living in a democracy than being a child trapped in a house where there is an abusive and unpredictable father, who will brook no reason, respect no counter-argument, admit no error, and always, always up the ante until catastrophe inevitably strikes. This is what I mean by the idea that we are living through an emergency.


Anyway, today or in a few days we can end the emergency. And then we do not really have to care about what Trump does or says ever again. And won't that be glorious? Of course we still have to worry about what could be an insane lame duck session until Biden is sworn in, while Trump potentially metaphorically burns down the government on the way out the door. But yes, after 5+ years of Donald Trump dominating the news, we will hopefully earn a much-needed break. 

There really isn't a choice here. Joe Biden is an experienced leader, a decent caring human being with decades of service. Trump, on the other hand, as David Frum pointed out in 2017, is literally the worst human being we have ever elected President. And that included slaveholders and Andrew Jackson.

Biden is not perfect and has some Senate votes he wishes he could have back. But he's a normal consensus Democratic candidate, touting endorsements from all across the political spectrum, some of whom were part of the Bush and Trump administrations. He has dozens of policy prescriptions, some big and some small, that are aimed at addressing the country's major problems. He'll listen to the experts. All of these problems won't mysteriously vanish in January when he is sworn in, or probably not even by November 2024, but it would be a step in the right direction. This is a vote for sanity and decency to save the republic. 





Friday, September 7, 2012

Did Clinton's Response to the Medicare Attacks Win the Election for Obama?

(CBSNews)

We still won't really know what kind of post-Convention bounce Obama will get until early next week. But one essential goal in this convention was for the Democrats to clear up any confusion over the Medicare issue. Since the 2010 Midterm elections the Republicans have hammered the Dems over the "cuts" to Medicare in the Affordable Care Act (ACA) and in the process drove up support among voters 50 and over. When your base is old white people, this issue was teed up for them.

Of course President Obama was never going to win a majority of voters in this demographic, but he had to close the gap that opened up 2 years ago. Let's face it, older white voters typically lean Republican anyway. And when you add the race factor, it was always going to be an uphill climb for Obama with these voters. They were preconditioned to believe the distortions about the "Medicare "cuts" with Obama, more so than they'd be with President Clinton for the same reason that a lot of older white women put both hands on their pocketbooks when they see a black guy walking down the street.

But much like Republicans always have a built-in edge with voters on matters of the military and foreign policy, Democrats have always enjoyed a historical "trust" edge with voters on health care, particularly Medicare. This is for good reason, since the Democrats created the Medicare beneficiary program and have defended it from Republican attempts at cuts and privatization for over 40 years.

Some voters may not remember, but President Clinton "cut" Medicare in the 1990's. In exchange for slight benefit cuts (i.e. higher premiums for seniors, most of which were directed at the more well-to-do seniors), Clinton reduced the rate of growth and plowed the savings back into the Medicare trust fund to extend the life of the program.

The ACA essentially did the same thing. It reduced the rate of growth and cut payments to providers and insurance companies, which was estimated to save $716B over 10 years. And then it used that money to close the Medicare prescription drug donut hole (created by a bill Paul Ryan voted for, by the way) and extend the life of the program. Providers and insurance companies agreed to the Medicare payment cuts in exchange for the millions of new customers they will now be getting as a result of what the ACA does to provide access to insurance for people who are under the Medicare eligibility age. You have to look at the ACA in its entirety and not just the Medicare portion to understand how it all works.

Anyway, Clinton explains it better here:
Now, there were two other attacks on the president in Tampa I think deserve an answer. First, both Governor Romney and Congressman Ryan attacked the president for allegedly “robbing Medicare” of $716 billion. That’s the same attack they leveled against the Congress in 2010, and they got a lot of votes on it. But it’s not true.

Look, here’s what really happened. You be the judge. Here’s what really happened. There were no cuts to benefits at all, none.

What the president did was to save money by taking the recommendations of a commission of professionals to cut unwarranted subsidies to providers and insurance companies that were not making people healthier and were not necessary to get the providers to provide the service.

(APPLAUSE)
And instead of raiding Medicare, he used the savings to close the donut hole in the Medicare drug program.
(APPLAUSE)
And -- you all got to listen carefully to this. This is really important -- and to add eight years to the life of the Medicare trust fund so it is solvent until 2024. So...
(APPLAUSE)
So President Obama and the Democrats didn’t weaken Medicare. They strengthened Medicare.
(APPLAUSE)
Now, when Congressman Ryan looked into that TV camera and attacked President Obama’s Medicare savings as, quote, “the biggest, coldest power play,” I didn’t know whether to laugh or cry...
(LAUGHTER)
... because that $716 billion is exactly to the dollar the same amount of Medicare savings that he has in his own budget!
(APPLAUSE)
You got to give one thing: It takes some brass to attack a guy for doing what you did.
(LAUGHTER) 
It’s important, because a lot of people believe this stuff. Now, at least on this issue, on this one issue, Governor Romney has been consistent. He...
(LAUGHTER)
He attacked President Obama, too, but he actually wants to repeal those savings and give the money back to the insurance company.
(BOOING)
He wants to go back to the old system, which means we’ll reopen the donut hole and force seniors to pay more for drugs, and we’ll reduce the life of the Medicare trust fund by eight full years.
(BOOING)
So if he’s elected, and if he does what he promised to do, Medicare will now go broke in 2016. Think about that. That means after all we won’t have to wait until their voucher program kicks in, in 2023, to see the end of Medicare as we know it. They’re going to do it to us sooner than we thought.
(APPLAUSE)
Now, folks, this is serious, because it gets worse. And you won’t be laughing when I finish telling you this. They also want to block grant Medicaid and cut it by a third over the coming 10 years. Of course, that’s going to really hurt a lot of poor kids.
But that’s not all. A lot of folks don’t know it, but nearly two-thirds of Medicaid is spent on nursing home care for Medicare seniors who are eligible for Medicaid.
(APPLAUSE)
It’s going to end Medicare as we know it. And a lot of that money is also spent to help people with disabilities, including...
(APPLAUSE)
... a lot of middle-class families whose kids have Down’s syndrome or autism or other severe conditions.
And, honestly, just think about it. If that happens, I don’t know what those families are going to do. So I know what I’m going to do: I’m going to do everything I can to see that it doesn’t happen. We can’t let it happen. We can’t.

And then he dropped the mic.

Not only did he set the facts straight on Medicare, he also reminded everyone that Medicaid isn't just a program for poor people (as noted by Alec MacGillis on Twitter), that seniors and people with disabilities depend on Medicaid too.


And the cuts Romney-Ryan want to make to that program would devastate many families.

Recall, even with a booming economy in 1996, Clinton only managed to get 49% of the vote. With Ross Perot running again, he was still able to win an easy re-election partially by convincing many seniors that Newt Gingrich, Bob Dole, and the Republicans in Congress would follow through on their long stated goals to "let Medicare wither on the vine and die." Voters trusted Clinton and Gore on Medicare even after the cuts because Dole was stuck defending a more radical plan. Most voters believed that Clinton really did want to strengthen Medicare because that is what Democrats have always done. And most voters believed that Republicans really wanted to dismantle the program because that's what they have always tried to do.

Sound familiar?

If the Obama campaign doesn't end up using snippets of Clinton's comments in campaign ads this fall, they are really missing out on a golden opportunity. With post-Presidential approval ratings hovering around 70%, Clinton is the closest thing we have in this divided country to a statesman who most people like and trust.

With a slow recovery and unpredictable job growth, Obama is going to need to emphasize Medicare, foreign policy, and tax code fairness, among other things, the next few months. And Clinton may have helped him enough with seniors in states like Florida and the swing states in the Rust Belt in November, to allow Obama to make the closing argument on protecting Medicare, Medicaid, and ultimately the ACA.

Friday, June 29, 2012

Random Thoughts on SCOTUS Ruling on ACA

 High five! 

(Source: Pete Souza/The White House/Getty Images, Obama and Roberts at his re-do swearing-in in Jan. 2009)



1. I'm pleased Chief Justice Roberts was able to see how far-reaching a ruling striking down a century of domestic policy precedents would have been. It appears to me that he wasn't quite ready to get on the bus to Crazy Town with the other 4 activist conservative justices yet, so he looked to compromise with the 4 liberal to moderate justices who were going to uphold the law. I'm sure we'll have dozens of books and behind-the-scenes features to read in the coming years on how this all went down.

I do hear some usual liberal panic over the fact that they may have won the battle, but will eventually lose the war, based on the more-limited interpretation of the Commerce Clause. We'll see. Ultimately, however, I can't see many more big expansions of social welfare programs being proposed in the next 20 years, so to my liberal friends, just enjoy the victory for now. Then get back to work asap. Remember, in the last 3.5 years the Dems have won a lot of legal and legislative battles to advance progressive causes, but haven't done so good at the voting booth. If you want to see these changes remain for many years, it's time to win some damn elections.


2. I'm tired of hearing the phrase "The America I used to know no longer exists" or something to that effect. Can we retire this phrase once and for all?  The "America we used to know" stops existing every day. And that's a good thing.

America looked quite different to slaves after 1863 (Emancipation Proclamation). It also looked quite different for women after 1920 (Nineteenth Amendment). It looked much different for unions after the victories of organized labor in the 1930's. It looked much different for middle class people after WW2, in that, a true middle class was actually created. It looked much different for black people living in the old Confederate states again after 1964 (Civil Rights). And it looked much different for Senior Citizens after 1935 (Social Security) and then again after 1965 (Medicare). All of those programs were really "rights" programs - freedom from slavery, voting rights, collective bargaining rights, safety nets for elderly, etc.

All of these victories changed America for the better. Accessible/affordable Health Care for all was the next domino to fall. It took decades of trying, but finally it's the law of the land.


3. I don't know if it means that much for 2012 election, but if anything it will force the Republicans and Romney to provide more specificity on what exactly they don't like about the ACA that has driven them to wage a three-year campaign to keep it from passing and now to try to repeal it. As recently as early 2009, almost everything in the law was supported by most mainstream Republican politicians. The only thing that changed is a Democratic president proposed it instead of Mitt Romney or John McCain.

From 2009-present, much of the objection was on the constitutionality of the law and complaints were wrapped in generic terms like "freedom", "liberty", with misinformation about "Death Panels" and so on. So now that the constitutionality issue has been resolved, they should be required to provide specifics on why they want to repeal it and what they want to replace it with. No more he said/she said free passes from the MSM.


4. In the coming months, Obama and the Dems need to do a better job re-selling this to the American people. Again, tell everyone what's in it. Maybe have a SuperPAC buy some ads in swing states to promote the good things in the law that will benefit all Americans. And make a distinction between this law and the missing GOP plan. The GOP wants to rescind the checks to Seniors that fill the Medicare doughnut hole - what are they replacing it with?  The GOP wants to get rid of regulations that end discrimination based on pre-existing conditions - what are they replacing it with? The GOP wants to end regulations that force insurance companies to spend more of their profits on actual health care or else have to reimburse policy-holders - fine, what are they replacing it with?


5. The often-criticized legal strategy of the Obama Administration was again vindicated. Just as it was with their decision to avoid an Executive Order to repeal Don't Ask Don't Tell, but instead to be patient and wait for Congress to pass a more lasting repeal. Just as it was with the Arizona SB1070 ruling, and the decision by the Dept of Justice to stop defending the Defense of Marriage Act, which eventually evolved into a full support of gay marriage.


6. This is the 3rd issue now in the last 2 months that Team Romney has seemed ill-prepared to address. The first 2 were legitimate surprises: Obama's public support for gay marriage and his announcement of an Executive Order to create the Dream Act. It seemed to take the Romney campaign several days in those instances to have a coherent response that sort of pleased the GOP base and swing voters. Romney couldn't thread that needle without contradicting a previous held position.

In the case of the ACA ruling, we've known the decision was coming for weeks now, and that it would be 1 of 4 or so possibilities, depending on what was upheld or struck down. Romney's press conference after the ruling just seemed like it could have been given a month ago, with no specifics, just typical red meat for the base.

You can make the argument that how decisive a candidate is during a campaign, reacting to daily news events, reflects on how decisive he'd be as President reacting to the same daily events. And in those cases, Romney is now 0-for-3.


7. And finally, no sorry Right-Wingers, freedom and liberty didn't die with this ruling. Freedom and liberty was expanded and granted to those who, through no fault of their own, got sick and happened to not be wealthy. They now have the freedom to receive affordable health insurance coverage for all their necessary medical treatment, without having to worry about either having to go without necessary care or bankrupting them and their families.

It's been said that slavery was America's Original Sin. And lack of health insurance reform and lack of universal care was an ongoing daily mortal sin. So again, freedom didn't die. And now many millions more Americans have the freedom to not die due to a lack of access to quality affordable Health Care. That, as Vice President Joe Biden said, is a big-fucking-deal.

Wednesday, June 27, 2012

The ACA Ruling Will Impact People More Than Politicians

No matter which way the Supreme Court rules this week in regards to the Affordable Care Act, it's important to remember the stakes for real people, whose lives will be vastly better with this law and worse without it. Sometimes that gets lost in academic arguments over the Commerce Clause and "severability" and the purposefully obtuse analogies about whether the government could force you to buy broccoli.

So most of the insta-analysis will be whether the ruling helps or hurts Obama's or Romney's election chances. There will be legal analysis over what this ruling means for the Supreme Court's respect of past precedents and whether that's predictive of how future cases will be decided. And that's all fine. People are employed to do that kind of analysis. But again, let's remember that the decision affects real people with real problems.

So, until tomorrow at 10am, remember this will be the plight of uninsured or under-insured people, who can't obtain or afford health insurance should the entire ACA law be struck down.


People getting treated, waiting at Free Health Clinic in Maynardville, TN in 2009 (Source: AP)




People waiting in line at Free Health Clinic in Wise County, VA in 2009 (Source: Reuters)



People waiting in line at a Free Health Clinic in Portland, OR in 2009 (Source: Courier-Journal)


The fate of these people will be in the hands of a majority of nine wealthy justices, enjoying taxpayer funded, government health insurance.