November 8, 2010
WHAT THEY'RE PROPOSING WHEN THEY PUSH REPEAL.... One of the key messages Republican officials have emphasized since the midterm elections is their intention to push, full steam ahead, with repealing the entire Affordable Care Act. We have some sense of the political difficulties of pulling that off with a Democratic White House and Democratic Senate, but as far as the GOP and its supporters are concerned, they'll do whatever it takes to gut the system.
While we know why the right wants to do this, and roughly how they'll go about trying, I continue to think there hasn't been enough discussion of what the consequences of this policy would mean in practical terms. Take the effects on Medicare , for example. Jonathan Cohn's piece on this today drove the point home nicely.
[Republicans have been] attacking the health overhaul for what it will do to Medicare. And instead of accusing Democrats of trying to dump more money into a government program, as Republicans would typically do, they've attacked Democrats for doing the very opposite -- noting that the Affordable Care Act will reduce spending on Medicare somewhere around $400 billion over the next ten years. Apparently government-run health care is awful, except, um, when it isn't. [...]
But here's where things could get complicated for the advocates of repeal. Consider what undoing the cuts in Medicare would entail. It would start, first of all, with restoring higher payments to the insurers that provide private coverage for people in Medicare, through what's known as the Medicare Advantage plans. There's a reason the health law reduces those payments: Repeated independent studies, including those by the well-respected Medicare Payment Advisory Commission, determined that the government was paying the insurers too much.
Restore those payments, and you're wasting taxpayer dollars. And a lot of those wasted dollars will go to hiring new people to work at insurance companies. They won't be government bureaucrats, obviously. They'll be insurance company bureaucrats. But is that really better? Is the Tea Party in favor of waste as long as its lines the pockets of insurance executives rather than Uncle Sam?
Meanwhile, restoring the other cuts to Medicare would mean rescinding payment reductions designed to make the program more efficient.
Right. GOP candidates, including radical libertarians like Sen.-elect Rand Paul, were elected after running attack ads going after Dems on Medicare. It worked -- seniors showed up and voted Republican.
But at the same time, these same GOP candidates want to repeal the Affordable Care Act, which would in turn undermine Medicare's long-term health, make it less efficient, more wasteful, all while reintroducing the prescription drug "doughnut" hole.
It's not a plan seniors are going to like.
Indeed, we can see a similar dynamic play out on a variety of fronts -- Republicans talk about satisfying the demands of deficit hawks, but repealing the health care law would increase the deficit. They talk about taxes, but repealing the health care law would increase taxes on small businesses. They talk about being "pro-family," but repealing the health care law would leave far fewer kids with coverage.
And they talk about Medicare and waste, but repealing the health care law would lead to more wasteful spending while undermining Medicare.
Talking about repealing the ACA is easy. If only Republicans had some sense of what it was they were talking about, we could have a far more compelling debate.
—Steve Benen 1:20 PM
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"Talking about repealing the ACA is easy. If only Republicans had some sense of what it was they were talking about, we could have a far more compelling debate."
Ergo, the President should welcome Republican improvements and insist they bring their good ideas to the fore ASAP so that these wonderful ideas could be implemented.
Posted by: MikeBoyScout on November 8, 2010 at 1:25 PM | PERMALINK
The Republicans lack the votes to repeal the ACA. They're just making noise to satisfy their base, and to (they hope) perpetuate the ACA as a campaign issue.
Democrats are likely going to kind of slither under the radar to avoid the bad politics. Instead, they should fight with everything they've got to defend the act, and to help people understand the benefits of it.
I heard a Republican over the weekend call the ACA "the worst piece of legislation ever passed in Congress." Worse, for example, than the Fugitive Slave Act or the Gulf of Tonkin Resolution, just to pick a couple that come quickly to mind.
That's going to be their line in the next election. Dems have to beat that back now, not duck under cover and hope the veto still works. Fight 'em every step of the way so that the public will understand, when the benefits of ACA arrive, just who made them possible.
Posted by: Tom Johnson on November 8, 2010 at 1:28 PM | PERMALINK
This conversation will never happen unless the Democrats INSIST LOUD AND LONG that it happen.
The message is not really about repealing the ACA. The message is "socialist big gummint bad." It's the same as the deficit issue. They don't REALLY want to cut the deficit; they just want to be "on the side of the common man" and against "bad big gummint taxes."
That this is rank hypocrisy is obvious to anyone who knows anything, but the point is, MOST AMERICANS DON'T KNOW ANYTHING. The Democrats are going to have to TELL them, or they'll go on believing the Republicans.
You would think this is Politics 101, but apparently someone in the Democratic Party needs to be reminded...
Posted by: bleh on November 8, 2010 at 1:28 PM | PERMALINK
Please. What they really want is to kill medicaire AND force everyone into mandatory plans that feature "health savings accounts" with catastrophic insurance that pays for virtually nothing.
In other words, they want everyone to self insure while still lining big insurance company's pockets.
I really HATE THESE PEOPLE. Hate them.
Posted by: fourlegsgood on November 8, 2010 at 1:31 PM | PERMALINK
Is the Tea Party in favor of waste as long as it lines the pockets of insurance executives rather than Uncle Sam?
Short answer: yes.
Longer answer: of course.
Posted by: Gummo on November 8, 2010 at 1:35 PM | PERMALINK
If only Republicans had some sense of what it was they were talking about, we could have a far more compelling debate.
And this is different from every other issue how?
Posted by: SteveT on November 8, 2010 at 1:36 PM | PERMALINK
Cohn: “But here's where things could get complicated for the advocates of repeal. Consider what undoing the cuts in Medicare would entail. It would start, first of all, with restoring higher payments to the insurers that provide private coverage for people in Medicare, through what's known as the Medicare Advantage plans. There's a reason the health law reduces those payments: Repeated independent studies, including those by the well-respected Medicare Payment Advisory Commission, determined that the government was paying the insurers too much.”
FOURTEEN PERCENT more than fee-for-service providers. It’s called Corporate Welfare, and it was enacted by Chimpy Bush and the Republican Majority.
Posted by: Joe Friday on November 8, 2010 at 1:40 PM | PERMALINK
Why do Republicans need to know what they are talking about in order to have a serious debate. Democrats should bring the serious debate to the GOP and tear them a new one. Where are the Democratic soundbytes blasting ignorant GOP politicians who want to create deficits with 1/2 baked ideas while short changing the American people's well being and prosperity?
Posted by: Mick on November 8, 2010 at 1:43 PM | PERMALINK
I saw a Republican CNN over the weekend laugh off the CBO analysis that says the HCR will reduce the deficit. ("If you believe that then I have a bridge to sell you," were his exact words.")
Posted by: Stephen on November 8, 2010 at 1:51 PM | PERMALINK
NO, if only Dems had the good sense to stop running away from a fight they should be able to win.
Posted by: Barbara on November 8, 2010 at 1:51 PM | PERMALINK
My hero Rush Limbaugh has spoken out vigorously against the socialist aspects of ACA and is now targeting the evil provision of requiring health insurance companies to require providing insurance to those with pre-existing conditions.
Everyone knows that such provisions are a evil intrusion into the free market system and designed to turn us all into pinkos. When he gets a complete grasp on the situation, Rush will also call for allowing the health insurance industry to do genetic testing of applicants and allow them to bar from insurance those who have genetic markers that indicate a predisposition to illnesses.
What the hell is the point of people getting sick and injured if we, of the wealthy ruling class, cannot make a profit from it?
Posted by: RepublicanPointOfView on November 8, 2010 at 1:53 PM | PERMALINK
The large Republican vote from seniors in 2010 is one of the more perplexing aspects of the election. I mean Republicans have always been the party wanting to repeal/gut/etc. Medicare (and SS). And, yet, all it took for seniors to vote for them was for the Republicans to demagogue on the issue for one campaign cycle.
Despite that demagoguery, however, clearly the Republicans still want to repeal/gut/etc. Medicare. Way to go old people!
Posted by: Vince on November 8, 2010 at 1:53 PM | PERMALINK
Is the Tea Party in favor of waste as long as its lines the pockets of insurance executives rather than Uncle Sam?
Yes. SASQ.
Posted by: Gregory on November 8, 2010 at 2:00 PM | PERMALINK
It’s called Corporate Welfare, and it was enacted by Chimpy Bush and the Republican Majority.
Posted by: Joe Friday on November 8, 2010
Once upon a time in Canada, people who received corporate welfare were called Corporate Welfare Bums. Please feel free to use.
Posted by: Johnny Canuck on November 8, 2010 at 2:02 PM | PERMALINK
So, Sen Kyl said in AZ illustrated Friday that he thinks AZ should cancel it's version of Medicaid because even though it brings in money the state cannot afford it.
Meanwhile, he supports SB 1070 which if it is upheld by the courts the cost to Arizona will be massive. Using the $61.64 per prisoner per day cost per the Arizona Dept of Corrections web page, if even 10% of the 485,000 illegal aliens as reported by Jan Brewer were caught and housed the cost is something the state cannot afford. We're talking about an extra $1.09 Billion per year or about an extra 11% added to the state's budget.
Money which goes directly into the pockets of the excessively wealthy owners of Arizona's private prisons at the expense of school children and Medicaid recipients
Posted by: KurtRex1453 on November 8, 2010 at 2:02 PM | PERMALINK
Johnny Canuck can go stick his tush in the deep freezer of his socialist country.
All of us good Americans believe in personal responsibility and are totally opposed to 'welfare' being provided to people. However, you must remember that "the business of government is business" and that what you call corporate welfare is just good business!
Posted by: RepublicanPointOfView on November 8, 2010 at 2:06 PM | PERMALINK
It's not a plan seniors are going to like.
I wouldn't be so sure about that. If they are stupid enough to fall for the Republican BS this time around, I'm sure they'll be just as clueless next time.
Posted by: Harry Louise on November 8, 2010 at 2:07 PM | PERMALINK
There are also positive cost-savings coming under ACA. Look at the "reduction in hospital cost growth" under Romneycare in Massachusetts: reduction in the number of hospitalizations for preventable conditions, decreasing length of stays in hospital, and less in-patient admissions from emergency rooms. Among hospital discharges, the uninsured dropped 36%. Taking care of everybody, i.e. universal coverage, saves on provider costs and increases consumer utility.
Posted by: Lee A. Arnold on November 8, 2010 at 2:09 PM | PERMALINK
Fuck seniors, they're idiots for voting "tea-party" astroturf bullshit. As you sew so should you reap. I hope they have to eat cat food for their stupidity.
Progressives repent, our leaders couldn't even restore Habeas Corpus with a majority across the board. That is the life-threatening wound in Liberty's side. Obama and the Democrats have been worthless with the prescience of liberty. Look upon the weeping Orange-assed Neo-Clown and Despair.
Posted by: Trollop on November 8, 2010 at 2:17 PM | PERMALINK
Republicans have no idea about the ACA. They never read it. They just want ot get more money in their own pockets and the hell with America and Americans. The Republicans got their botes and that is all they wanted. An excuse to continue the raping and pillaging of America and Americans.
Posted by: MLJohnston on November 8, 2010 at 2:30 PM | PERMALINK
It isn't the seniors who voted last Tuesday who will suffer. It is the forty- and fifty-somethings who have had the rug pulled out from under them once already - twice if they were among those getting survivor's benefits while they were in college in the early 80s and had their benefits cut 25% per year while they were in college until eventually survivor benefits were phased out completely over four years.
Posted by: Realist on November 8, 2010 at 2:36 PM | PERMALINK
Harry Louise beat me to it. It doesn't matter if Seniors like it. Angry Old White People have been identified as the big winners of the Easiest-To-Fool Sweepstakes, and there's little doubt they can be hoodwinked into voting Republican pretty much every time they're asked. They remember a time when Republicans were interested in what was good for the country, and at a certain point, their memories....just stopped storing stuff.
Posted by: Mark on November 8, 2010 at 3:34 PM | PERMALINK
Is the Tea Party in favor of waste as long as it lines the pockets of insurance executives rather than Uncle Sam?
Short answer: yes.
Longer answer: of course.
Posted by: Gummo
Is the Tea Party in favor of waste as long as its lines the pockets of insurance executives rather than Uncle Sam?
Yes. SASQ.
Posted by: Gregory
Two Bingos.
There is no problem here. Consistency is the hobgobblin of sane minds of which modern conservative minds don't qualify.
Posted by: Alrighty Then on November 8, 2010 at 3:42 PM | PERMALINK
And they talk about Medicare and waste, but repealing the health care law would lead to more wasteful spending while undermining Medicare.
Well, yeah, but at least we'd be rid of those death panels.
Posted by: josef on November 8, 2010 at 3:46 PM | PERMALINK
But it's not even a matter of "lining the pockets of Uncle Sam" -- government bureaucrats are not getting their pockets lined. Tax dollars are used to pay salaries of employees overseeing and running programs that directly benefit American taxpayers.
When money goes to insurance companies, sure, some of it goes to pay employee salaries -- when they get more money, they might even hire more employees -- but increased profits are not used to benefit policyholders, they're siphoned off into the pockets of executives whose jobs are to ensure ever greater profits by making sure policyholders pay in more than they receive in benefits.
Posted by: karen marie on November 8, 2010 at 4:05 PM | PERMALINK
We hear the same thing time after time. There is more information available now than ever before about legislation - and yet, the more information available, the dumber American voters seem to get.
The day Fox News turned on its lights was the day critical thinking being the norm, rather than the exception, ceased in this country.
Posted by: June on November 8, 2010 at 4:54 PM | PERMALINK
Medicare isn't the only thing that will take a hit if ACA is repealed. How about all of the 20-26 yr olds that are riding on mom and dad's insurance or all the kids with pre-existing conditions? I could go on.
Posted by: gridlock on November 8, 2010 at 11:22 PM | PERMALINK
Dear House GOP,
Hi, I am Ms. Middle Class. May I make a small point?
I'm still paying off the federal student loans I used to get my degree from a modest college. I am now saving for my kids college. I scraped and saved for the down payment on our house, and now I am saving for my retirement as well as setting aside something to help my aging parents who are living longer. My kids don't want to move out of the house while they're going to college. And our emergency fund in case something happens to my job (single income family) is actually way too low. We're already discussing as a family to drop luxury services like Cable/Internet/Cell Phone plans. And my property taxes have gone up the past four years.
Now you, dear conservatives want social security "privatized" and to repeal the health care bill as well as diminish if not annihilate, social safety nets.
My job isn't even minimum wage, which you also want to diminish.
I know you like your gated community, your country club, your tailored suits, your nice car, your little perks. It's nice to know that not only am I working to serve my family, I am working to pay for your bloated lifestyle as well.
Just wanted to make that little point, you selfish pampered bunch of assholes.
Signed,
A American Citizen (if Sarah Palin, conservative allows)
Posted by: Skip on November 9, 2010 at 11:20 AM | PERMALINK