Tag Archives: affordable

On Health Care, Republicans Are Caught Between a Rock and a Hard Place

Mother Jones

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The New York Times reports that the Koch brothers are about to unleash the hounds. They. Have. Had. Enough:

Saying their patience is at an end, conservative activist groups backed by the billionaire Koch brothers and other powerful interests on the right are mobilizing to pressure Republicans to fulfill their promise to swiftly repeal the Affordable Care Act.

….The sudden caution of the Republican Party leadership, as it grapples with the enormously complicated challenge of replacing the Affordable Care Act, has baffled conservatives who have been fighting the health law for years. In the House, Republicans have voted dozens of times to dismantle the law, and it has been a primary issue in congressional races since 2010. Repealing the law, many conservative lawmakers believe, is the one clear mandate they have from voters.

….The repeal effort by the conservative groups is intended to sway members of Congress who may be hesitating because of public pressure back home. That pressure, conservatives said, is no reason to renege.

Talk about clueless. Sure, constituent pressure is having an effect, but it’s nowhere near the biggest issue here. The biggest issue is that after voting to dismantle Obamacare dozens of times when they knew it was just a symbolic protest vote, Republicans suddenly have to think about what will happen if they dismantle it in real life. Answer: they now have to admit that they can’t dismantle the whole thing. They never fessed up to that before, so it’s no wonder the base is confused, but the House and Senate leadership have always known it. They can only dismantle the parts related to the budget because Democrats can filibuster the rest. And if Republicans dismantle only half the law, it will probably destroy the individual insurance market.

Oops. That would be bad, even by Republican standards. Plus there’s the fact that millions of people would lose coverage, which is bad by centrist voter standards, even if Republicans don’t really care about it. In other words, the GOP leadership is finally having to face up to the fact that repealing and replacing Obamacare is a tough nut to crack. Centrists will abandon them if they cause chaos, but hardliners will abandon them if they spend too much money. That’s why they’ve agreed to modify their current plan to exclude subsidies for the well-off:

The concession on tax credits is a middle ground between what conservatives were demanding and what leadership wanted. Freedom Caucus Chairman Mark Meadows (R-N.C.) and RSC Chairman Mark Walker (R-N.C.) in recent weeks came out against the GOP plan to replace Obamacare tax subsides with advanceable health care tax credits.

They preferred a tax deduction that would not allow those who don’t pay taxes to receive a check in the mail, calling such “advanceable” credits a “new entitlement.” At the crux of their concerns is the price tag, which they worry would increase the deficit.

A tax deduction, of course, would be useless to the poor and working poor, the very people who need help the most. But the Freedom Caucus doesn’t care about that. Luckily for them, their leadership understands just what a political disaster that would be.

In any case, the Freedom Caucus is right about one thing: advanceable tax credits are a new entitlement. Or, more accurately, a continuation of an old entitlement. There’s really not much difference between Obamacare’s subsidies, which are paid directly to insurance companies, and Ryancare’s tax credits, which are paid to the taxpayer, who then pays the insurance company.

As for the deficit, well, Ryan’s plan will only increase the deficit if Republicans also repeal all of Obamacare’s taxes and then decline to pass any new ones. Which they will. So that’s a legitimate complaint too.

As usual, it all comes down to money. That’s really the only thing that matters.

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On Health Care, Republicans Are Caught Between a Rock and a Hard Place

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4 Republican Senators Just Rebelled Against the House Plan to Repeal Obamacare

Mother Jones

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After a week of keeping their bill under guard by Capitol Police, House Republicans introduced their plan to repeal Obamacare late Monday afternoon. But a band of four Republican senators had already begun revolting in public—even before the language of the new measure had seen the light of day. They sent a letter to their caucus leader Monday afternoon saying that they couldn’t support the latest leaked version of the House plans because it doesn’t protect people who gained Medicaid under Obamacare.

One of the Affordable Care Act’s most effective ways of lowering the number of people who lack health insurance has been a provision that allows those who earn 138 percent or less of the federal poverty level to enroll in Medicaid. The Supreme Court added a level of uncertainty to this implementation by allowing states to decide whether or not they want to opt into that program, but 31 states have accepted Medicaid expansion to date, granting government-covered insurance to about 11 million additional people.

Republican Sens. Rob Portman (Ohio), Shelley Moore Capito (West Virginia), Cory Gardner (Colorado), and Lisa Murkowski (Alaska) sent a letter to Senate Majority Leader Mitch McConnell on Monday voicing their concerns. “While we support efforts to repeal and replace the Affordable Care Act and make structural reforms to the Medicaid program,” the letter says, “we are concerned that the February 10th draft proposal from the House of Representatives does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states.”

The four senators all hail from states that have accepted Medicaid expansion, and they made that necessary prerequisite for any plan they’d be willing to consider. “We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states,” the letter explains.

This early warning spells serious trouble for Republican hopes of repealing Obamacare. Republicans plan to pass their repeal bill through a budget reconciliation process in which only a simple majority is necessary, so they don’t have to worry about a Democratic filibuster. But with just 52 Republican senators (and few possible Democratic defections), Republicans probably can’t pass a bill without these four senators. At the same time, the GOP leadership is having to fend off the Freedom Caucus in the House, as this group of tea-party-supported legislators threaten to withhold support because the bill doesn’t go far enough in ditching policies—such as the government offsetting the cost for low-income individuals to buy health insurance—implemented by the ACA. While the four renegade senators sent their letter to McConnell, Sen. Rand Paul was complaining on Twitter that the House proposal wasn’t conservative enough.

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4 Republican Senators Just Rebelled Against the House Plan to Repeal Obamacare

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Reality Begins to Set in on Obamacare—For Both Sides

Mother Jones

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Reality is setting in:

For seven years, few issues have animated conservative voters as much as the repeal of the Affordable Care Act. But with President Barack Obama out of office, the debate over “Obamacare” is becoming less about “Obama” and more about “care” — greatly complicating the issue for Republican lawmakers.

….As liberals overwhelm congressional town hall-style meetings and deluge the Capitol phone system with pleas to protect the health law, there is no similar clamor for dismantling it, Mr. Obama’s signature legislative accomplishment. From deeply conservative districts in the South and the West to the more moderate parts of the Northeast, Republicans in Congress say there is significantly less intensity among opponents of the law than when Mr. Obama was in office.

Intensity is the key word here, since actual opinions about Obamacare don’t seem to have changed more than a eyelash over the past seven years:

But the intensity of opinion has changed. With Obama out of office, the Republican base doesn’t care as much. Hating Obamacare was mostly just a way of hating Obama. Likewise, the Democratic base cares more. They spent the past seven years griping about how weak Obamacare was—no public option, too friendly to insurance companies, subsidies too low, blah blah blah—under the apparent assumption that it didn’t matter that practically no one was passionately defending the law. With Trump in office, Democrats have finally figured out that it matters, and congressional phones are now ringing off the hook.

So reality has set in for everyone. The Republican rank-and-file has finally figured out they never really cared all that much about taxing the rich an extra three points to provide health care for everyone. The Democratic rank-and-file has finally figured out that Obamacare is a pretty good program and it’s worth fighting for.

But did we really have to elect Donald Trump to figure this out?

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Reality Begins to Set in on Obamacare—For Both Sides

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Congress Just Got a Lot Closer to Defunding Planned Parenthood

Mother Jones

On Thursday afternoon, the House voted to approve a resolution that is widely seen by advocates as a step towards defunding Planned Parenthood. Should it become law, the measure would weaken contraceptive access across the country.

The bill, HJ Resolution 43, allows states to withhold Title X family planning funds—about $300 million distributed to states annually—from providers who also offer abortion care, a group that includes Planned Parenthood affiliates. In December, Obama’s Department of Health and Human Services finalized a rule that anticipated this sort of effort by prohibiting states from withholding Title X family planning money from Planned Parenthood and other providers. This House resolution proposed overturning that HHS rule via the 1996 Congressional Review Act, which allows Congress to repeal new regulations within 60 days of their passage. A version of this bill is also moving through the Senate.

At a House committee hearing earlier this week, Rep. Louise Slaughter (D-N.Y.) called this bill “the most serious threat women have faced so far this Congress.” Rep. Jim McGovern (D-Mass.) called this the Republicans’ “first salvo” in defunding Planned Parenthood.

This development comes on the heels of several actions by the Trump administration and Congress that threaten women’s health care. They include Congressional efforts to repeal the Affordable Care Act’s mandate requiring insurance coverage for contraception; the approval by the House of a bill to codify the Hyde Amendment, which prevents the use of federal funds for most abortions; and Trump’s expansion of the global gag order, which prohibits health providers overseas from receiving any US funding if they so much as mention abortion as an option for patients.

In the last Congress, a broader bill to deny federal funds to Planned Parenthood passed both chambers, but was vetoed by then-President Barack Obama. In contrast, Trump’s campaign said often that defunding Planned Parenthood would be a top priority for his administration.

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Congress Just Got a Lot Closer to Defunding Planned Parenthood

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Cancer Survivor and Former Republican Tells Paul Ryan Obamacare Saved His Life

Mother Jones

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A former Republican who once worked for the Reagan and Bush campaigns confronted House Speaker Paul Ryan on Thursday, asking why the GOP is seeking to repeal the Affordable Care Act without a serious replacement plan. The moment came during a CNN town hall event, where Jeff Jeans revealed that like Ryan, he too once opposed the health care law.

“When it was passed, I told my wife we would close our business before I complied with this law,” Jeans said. “Then at 49, I was given six weeks to live with a very curable type of cancer. We offered three times the cost of my treatment, which was rejected. They required an insurance card.”

“Thanks to the Affordable Care Act, I’m standing here today.”

As Ryan attempted to respond, insisting Republicans are working to replace Obamacare with “something better,” Jeans interjected to publicly express his gratitude to the president.

“I want to thank President Obama from the bottom of my heart because I would be dead if it weren’t for him.”

Hours before the televised event, Republicans took a major step at dismantling Obamacare. On Friday morning, President-elect Donald Trump tweeted in support of repeal efforts:

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Cancer Survivor and Former Republican Tells Paul Ryan Obamacare Saved His Life

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