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Obamacare Is One of the Best Social Welfare Programs Ever Passed

by JamisonJose503 Posted on January 6, 2017

Mother Jones

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Jeff Stein reports on Democratic plans to fight any attempt to repeal Obamacare:

“We are united in our opposition to these Republican attempts to Make America Sick Again,” Schumer said, cracking a slight smile at the inversion of Donald Trump’s campaign slogan. The line suggests that Schumer wants to reframe the fight over Obamacare into one about the broader GOP health care agenda, which includes proposals to change Medicaid andMedicare.

Since the health care law passed in 2009, Schumer and other Democrats in Congress have learned that defending it can be a political loser. Republicans stayed unified in their opposition, and public opinion stayed on their side. But in their final push to save it, Democrats are moving the battle to new turf, fighting over Americans’ shared frustration with the inadequacies of the country’s health care system, not the law itself.

This is sadly true. Democrats have never been willing to defend Obamacare, and they still aren’t. It’s crazy. Obamacare isn’t perfect. Nothing this side of the pearly gates is. But if politicians limited themselves to defending programs with no problems, we’d never hear from them again.1

But considering where we started—with a Rube Goldberg medical system dominated by well-heeled special interests and all but indifferent to the near-poor—Obamacare is almost miraculously close to perfect. I know that Republicans have convinced everyone otherwise, but take a look at the results of this Kaiser tracking poll from November. Virtually every single aspect of Obamacare is not just popular, but very popular:

Even Republicans like practically everything about Obamacare, including the taxes to pay for it. People like the subsidies; they like the exchanges; they like the out-of-pocket caps; they like the Medicaid expansion; they like the pre-existing conditions ban; and they like taxing the rich to fund it all. The only unpopular part of the whole law is the individual mandate.

What’s more, Obamacare has been a huge success. It’s provided health coverage to 20 million people. It’s massively reduced the cost of health coverage for low-income families. It’s slashed the number of uninsured by half among blacks and whites and by a quarter among Hispanics. It’s allowed people with expensive chronic illnesses to get treatment. It will help keep overall health costs down in the future. It’s had no negative impact on the employer health care system. And it’s done all this without raising the deficit. In fact, it’s cut the deficit.

And yet, Democrats are still afraid to defend it loudly and proudly. This just boggles me. Sure, Obamacare has some problems. Certain regions don’t have enough competition. Deductibles are high if you buy a bronze plan. And a small part of the population has been hit with large premium increases.

But this is something like 10 percent of Obamacare. The other 90 percent is purely positive. Why are so many liberals unwilling to say so? Why aren’t they willing to defend Obamacare with the same fervor they defend other imperfect programs, like Medicare or the ADA or the Clean Air Act or Social Security? Obamacare is at least as good as any of them. But no one will ever believe it if Republicans are attacking it relentlessly while Democrats mutter resentfully that there’s no public option and politicians hide in their offices in the hope that nobody will blame them if their premiums have gone up.

If Democrats aren’t willing to defend Obamacare, it’s hardly a surprise that Republicans feel free to go after it without consequence. Maybe they should start.

1Yes, I know, that might not be a bad thing.

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Obamacare Is One of the Best Social Welfare Programs Ever Passed

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Trump Didn’t Invent “Make America Great Again”

by MaribelFoskett Posted on January 3, 2017

Mother Jones

Did you ever wonder why Donald Trump’s “Make America Great Again” slogan took such root among the Republican base? Did it symbolize a return to an age when wages were higher and jobs more secure? Or was it coded racial language designed to signal a rollback to a time when people of color (and women) knew their place? In the soul-searching and recrimination among Democrats after Hillary Clinton’s defeat, both theories have their champions.

But a closer look at conservative rhetoric in recent years reveals that “Make America Great Again” was not Trump’s invention. It evolved from a phrase that became central to the Republican establishment during the Obama years: “American exceptionalism.” People often equate the expression with the notion that God made America “a city upon a hill,” in the words of the Puritan colonist John Winthrop. However, as University of California-Berkeley sociology professor Jerome Karabel noted in a 2011 article, this usage only came into vogue after Barack Obama became president. Previously it was mainly used by academics to mean that America is an exception compared with other Western democracies, for better or worse, as illustrated by its top-notch universities or its bare-bones gun control.

Prior to 2008, “American exceptionalism” appeared in news articles a handful of times a year, but after Obama was elected the references skyrocketed, largely because of a drumbeat from Republicans. Once the tea party wave made John Boehner speaker of the House in 2010, for example, he summarized the growing consensus among Republicans: Obama had turned his back on the Founding Fathers to the point where he “refused to talk about American exceptionalism.” (In fact, in 2009 the president had stated, “I believe in American exceptionalism.”) The phrase’s popularity in GOP talking points—often in attacks on Obama’s “socialist” policies—paralleled the spread of conspiracy theories about his citizenship and supposed jihadi sympathies.

Defending “American exceptionalism” was a theme of Mitt Romney’s 2012 campaign; he blasted Obama for supposedly thinking that “America’s just another nation” destined to become “a European-style entitlement society.” Romney’s campaign co-chair John Sununu added that Obama should “learn how to be an American.” (He later apologized.)

The 2016 Republican presidential candidates and their surrogates sang the same tune. When Fox News pundit Sean Hannity asked Jeb Bush for his thoughts on exceptionalism, Bush replied, “I do believe in American exceptionalism,” unlike Obama, who “is disrespecting our history and the extraordinary nature of our country.” Rudy Giuliani was more explicit. “I do not believe that the president loves America,” he asserted, suggesting Obama did not think “we’re the most exceptional country in the world.” During a speech a month later in Selma, Alabama, the president pointed out that the ongoing fight for civil rights is a cornerstone of what makes America exceptional.

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To get more of a quantitative sense of the phrase’s evolution, I analyzed the Republican Party platform. All party platforms typically emphasize faith in American greatness, but between 1856 and 2008, the GOP never used the expression “American exceptionalism” or even the adjective “exceptional” to describe the country. By contrast, the final section of the 2012 Republican platform lambasting the Obama presidency was titled “American exceptionalism.” The 2016 platform put the phrase into the first line of its preamble: “We believe in American exceptionalism.” The evolution of “American exceptionalism” into an anti-Obama rallying cry with nativist overtones evoked earlier appeals to “states’ rights” to rouse whites resenting the end of segregation.

In his book Time to Get Tough: Making America #1 Again, Trump, too, framed his agenda as a defense of “American exceptionalism.” “Maybe my biggest beef with Obama is his view that there’s nothing special or exceptional about America—that we’re no different than any other country.” Trump later adopted a catchier slogan, “Make America Great Again,” but it retained the nativist overtones and racial dog whistles of the first. Paired with Trump’s open conspiracy-mongering about Obama’s forged birth certificate and supposed Muslim faith, it amplified and dramatized the Republican establishment’s slyer assertions about Obama’s un-American values.

Trump would eventually abandon dog whistles in favor of blunter race-baiting. What remains to be seen is whether he and the Republican establishment will continue flashing the “exceptionalism” signal in the post-Obama years—to paint new opponents as un-American—or whether that language was uniquely deployed to delegitimize the nation’s first black president. At the very least, it provided fertile ground for Trumpism.

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Trump Didn’t Invent “Make America Great Again”

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How the "Trump Effect" Could Undermine Germany’s Clean Energy Revolution

by EmilieSouthard Posted on December 29, 2016

Mother Jones

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The world’s most advanced energy revolution has hit an obstacle: the Trump effect.

Germany has long been a clean energy pioneer. Despite the fact that the sun hardly shines there, the country was the world leader in installed solar capacity until it was finally overtaken last year by China, a vastly larger and sunnier country. By 2050, Germany aims to get 80 percent of its electricity from renewable sources and to cut its greenhouse gas emissions by as much as 95 percent. It currently derives about one-fifth of its power from wind and solar (and one-third from total renewables), compared to just 5 percent in the United States. Even though this dramatic energy transition—known as the Energiewende—has contributed to higher household electricity costs, 90 percent of Germans say they support it.

For years, Germany’s mainstream political parties have supported clean energy, too. But that broad consensus could soon face a significant test, another possible casualty of the resurgence of right-wing, nativist politics across the Western world. Unlike many of its neighbors, Germany hasn’t had a far-right party represented in its parliament since the Second World War. But that’s almost certain to change next year, when national elections could make the Alternative for Germany party (known by its German acronym, AfD) the second- or third-strongest faction in the government, if polling trends continue. The party, which began as a euro-skeptic movement, has built its success on stringent opposition to immigration and admission of refugees—and on inflammatory rhetoric that echoes the campaign of Donald Trump.

The AfD also opposes Germany’s clean energy policies. It’s calling for an end to the law behind the Energiewende and even questions the existence of human-induced climate change, stating on its website, “Scientific research on the long-term development of the climate because of man-made CO2 emissions is fraught with uncertainty.” Now, in an effort to slow the AfD’s rapid rise, the country’s mainstream parties could be poised for a step back in the fight against global warming.

It’s hard to overstate the importance of Germany’s energy transition. Several countries get a higher percentage of their electricity from renewables, but Germany’s economy and manufacturing industry are far larger, making the Energiewende a model for a cleaner future among economic superpowers.

“If it succeeds, it could be a great case study for the world,” says Sven Egenter, executive director of Clean Energy Wire, which provides information about the Energiewende to journalists in Germany. “And if it fails, it could be a great case study for the world.”

But Germany will almost certainly fall short of its emissions reduction target for 2020, for one reason: It can’t kick its coal habit. Germany still gets more than 40 percent of its electricity from coal—a higher share than in the United States or any other major Western economy. That’s in part because Chancellor Angela Merkel doubled down on the country’s commitment to abandoning nuclear power after Japan’s 2011 Fukushima disaster, shutting down eight plants virtually overnight and pledging to take all the others offline by 2022. Something had to fill the void, and renewable energy production wasn’t adequate to the task, so the reliance on coal continued.

If Germany is to have any chance of meeting its longer-term targets, it will have to find a way to move off coal almost as quickly as it’s ditching nuclear. But there are several impediments to doing so. One is that wind and solar aren’t quite ready to take over. Even if their production numbers were sufficient, electricity storage and transmission would require major advances to make renewables the country’s primary electricity source.

And then there are the political hurdles—what Katharina Umpfenbach of the Ecologic Institute, an environmental think tank based in Berlin, calls “the Trump effect.”

During the US presidential campaign, Trump promised to bring coal-mining jobs back to Appalachia (and bashed alternative energy sources like wind). Voters in the region—parts of which were once Democratic strongholds—responded enthusiastically. They waved “Trump Digs Coal” signs at rallies and voted for him by overwhelming margins. Market forces will make Trump’s coal promises nearly impossible to keep, but his victory is already having a very real impact in Germany. Politicians there are looking at Trump’s success among disaffected voters in coal country and seeing similar fears among their own constituencies in areas where coal production is being phased out.

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Trump’s election capped a year of successes for the populist right that has left mainstream politicians scrambling to shore up their support. There was the British vote to exit the European Union, the resignation of Italy’s prime minister, the near-victory of a right-wing extremist in Austria, and the growing strength of the far right in France. Merkel, dubbed the “liberal West’s last defender” by the New York Times, is now facing her own insurgency in the form of the AfD. And so she and her coalition partners, the center-left Social Democrats, are tacking to the right to bolster their eroding support.

The biggest effect is likely to be on immigration and refugee policy: Earlier this month, Merkel proposed a ban on the face veils worn by some Muslim women. Anti-refugee sentiment has only climbed since then with the attack on a Berlin holiday market last week; the chief suspect is a Tunisian asylum seeker.

But clean energy advocates worry that the Energiewende could suffer as well. “My biggest fear is that the conservatives in Merkel’s center-right Christian Democratic Union get so nervous that they also move to the right,” says Annalena Baerbock, a member of the German parliament and the Green Party’s parliamentary spokeswoman on climate policy.

Few lawmakers in Germany’s longstanding political parties—Merkel’s Christian Democrats, the Social Democrats, and the Greens, as well as smaller parties like the pro-business Free Democrats—would deny that the country ultimately has to move away from coal. That’s particularly true when it comes to lignite, a type of coal that is less efficient and burns dirtier than hard coal. Lignite alone accounts for half of the country’s carbon emissions in the electricity sector.

Just 20,000 Germans work in lignite mining, compared with at least 300,000 in renewable energy, according to Christian Redl of the think tank Agora Energiewende. (The coal industry says its figure is more like 100,000, according to Baerbock, if you include associated roles such as delivery workers.) “The issue is that it’s very concentrated in specific regions,” Redl says. “In those regions, huge numbers of people work in that sector, and there’s no renewables industry there yet.”

These regions are similar to Appalachia: economically distressed and reliant on a dying coal industry, but with an outsized influence on the political debate. One of the main regions is Brandenburg, just outside of Berlin, a portion of which Baerbock represents in the parliament. The center-left Social Democrats are doing all they can to maintain their strength in these coal regions as the AfD attempts to attract discontented voters by campaigning for the continued use of lignite to generate electricity. Already struggling to remain relevant as Merkel has established herself as the bulwark against the rising right, the Social Democrats can hardly afford to lose support among coal workers, a heavily unionized group that has historically backed them.

The political situation has created an incentive for the Social Democrats to drag their feet on the transition away from coal. It’s an uncomfortable development for Baerbock’s Greens, who laid the groundwork for the Energiewende while in a ruling coalition with the Social Democrats in the late 1990s and early 2000s

“The Social Democrats in Brandenburg, they want to keep lignite running for decades,” says Philip Alexander Hiersemenzel, a spokesman for Younicos, which is working to develop large-scale battery storage for renewable electricity, while giving a tour to journalists of the company’s industrial facility on the outskirts of Berlin.

Sigmar Gabriel, Germany’s economy and energy minister and the Social Democrats’ party chairman, rejected calls this summer for a rapid phaseout of coal. In October, he said he expects Germany to continue burning lignite into the 2040s. (“That’s absolutely hilarious,” responds Umpfenbach, “because how will we reduce emissions by 95 percent if we still have coal?”)

Hubertus Heil, vice chairman of the Social Democrats’ parliamentary group, said recently that if people in coal-producing regions were presented with an end date for the use of coal without a plan for economic assistance, “you might as well send them to the AfD right away.” (The Social Democrats’ press spokeswoman did not respond to a request for comment.)

A lignite mine in the German state of North Rhine-Westphalia. Tim McDonnell/Climate Desk

As Mother Jones reported in 2014, open-pit lignite mining has destroyed the landscapes of large swaths of Germany and has even threatened to swallow villages that stand in its way. But the devastation caused by mining could actually present an opportunity for the country to phase out coal without killing too many jobs. In the aftermath of the abrupt nuclear phaseout, I visited a small town in northern Germany whose nuclear plant had employed as many people as the town had residents. Workers there were upset at the sudden shutdown of the plant, but their frustration was mitigated by the knowledge that many of them would remain employed decommissioning the plant, a process that can take up to 15 years. Similarly, clean energy advocates suggest, some lignite miners could get jobs repairing and rebuilding the decimated landscapes of the former mines.

“It will take centuries to reconstruct the whole area,” says Baerbock, speaking in a conference room in the parliamentary office building, with a wide bay window looking out over rows of bicycle racks in the government quarter. Looming over that view is a towering smokestack from a gas-powered plant two kilometers to the north, a reminder of the work still to be done.

Residents of Appalachia have been turned off by what they see as decades of empty promises from politicians pledging to preserve coal jobs. Baerbock is determined to avoid the same fate. “We have to be very honest,” she says. “So I would never say this will not cost a single job, because I don’t believe this is true.”

The key is to manage the coal phaseout in a “socially inclusive” way, says Umpfenbach. For Germany’s mainstream parties, that means being more successful than US Democrats have been in both retaining the support of voters in mining regions and sharply cutting greenhouse gas emissions. In other words, it means finding a way to sidestep the Trump effect by coming up with a concrete solution for coal regions that has evaded American politicians.

“In my point of view,” says Baerbock, “if we find a good solution for the workers, then it’s not so hard to have the discussion of the coal phaseout.”

Success or failure, the world is watching.

Reporting for this story was supported by the International Center for Journalists.

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How the "Trump Effect" Could Undermine Germany’s Clean Energy Revolution

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Vladimir Putin Is a Happy Camper These Days

by FrankieKpg Posted on December 23, 2016

Mother Jones

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In his annual press conference, Vladimir Putin took a victory lap:

“Democrats are losing on every front and looking for people to blame everywhere,” Putin said in answer to a Russian TV host, one of 1,400 journalists accredited to the marathon session. “They need to learn to lose with dignity.”

….“Trump understood the mood of the people and kept going until the end, when nobody believed in him,” Putin said, adding with a grin. “Except for you and me.”

Putin has repeatedly denied involvement despite the accusations coming from the White House, and the Kremlin has repeatedly questioned the evidence for the U.S. claims. On Friday he borrowed from Trump’s dismissal of the accusations, remarking “maybe it was someone lying on the couch who did it.”

“And it’s not important who did the hacking, it’s important that the information that was revealed was true, that is important,” Putin said, referring to the emails that showed that party leaders had favored Hillary Clinton.

That last line is almost word-for-word what Republican apologists say. As near as I can tell, Putin is basically just admitting that Russia was behind the hacks and then smirking about it. He must be having a good old time these days. I wonder how Republicans are going to feel about this when Putin decides it’s time to get rid of Trump and help the other side?

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Vladimir Putin Is a Happy Camper These Days

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North Carolina’s Bathroom Bill Is Still on the Books Because Republicans Pulled a Bait and Switch

by Ernest73It Posted on December 22, 2016

Mother Jones

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In a surprising move, North Carolina lawmakers ended a special session on Wednesday without repealing House Bill 2, one of the country’s most sweeping anti-LGBT laws. The decision to leave the “bathroom bill” on the books came as a shock after Governor-elect Roy Cooper announced earlier in the week that leaders in the Republican-majority Legislature had promised to get rid of it. It seemed like a done deal, but on Wednesday the state Senate opted against a repeal, while the House adjourned without voting, leaving the law intact. “The Republican legislative leaders have broken their word to me and they have broken their trust with the people of North Carolina,” Cooper told reporters.

But why, and what went wrong?

To understand the drama in North Carolina, you need to first understand why Republicans had initially agreed to repeal HB2—which blocks transgender people from bathrooms of their choice and leaves other people open to discrimination. Republican leaders in the Legislature supported the law but told Cooper they’d get rid of it in exchange for something else: Charlotte, the state’s biggest city, had to nix a local nondiscrimination ordinance that protected LGBT people in the city. (Charlotte’s ordinance was a main reason why Republicans had wanted to pass HB2 in the first place, because, among other things, HB2 prohibited other cities from creating similar nondiscrimination ordinances.) With the offer on the table, Charlotte took the next step. After getting a call from Cooper, the Charlotte City Council on Monday voted to repeal key parts of its ordinance, and then Republican Gov. Pat McCrory—a passionate supporter of HB2—called for a special session of the Legislature to do away with the controversial law.

Problems quickly arose. On Tuesday, Republican leaders accused the Charlotte City Council of acting in bad faith by keeping parts of its nondiscrimination ordinance in place—the council had only gotten rid of the section dealing with LGBT protections in public accommodations and bathrooms, not the sections that prevented discrimination by city contractors or taxi drivers. “I think the city of Charlotte has been as disingenuous as anybody I’ve ever seen,” said Republican state Sen. Harry Brown, according to the Charlotte Observer. Charlotte’s city attorney said council members thought they’d done enough by addressing the issues around the public accommodations in HB2, but GOP leaders were not appeased.

On Wednesday morning, hours before the Legislature was set to meet for its special session, the Charlotte City Council called a rare emergency meeting and repealed the rest of its ordinance—effective immediately. When the special session began, however, Democrats did not get what they had hoped. A Republican leader in the Senate introduced a bill that would repeal HB2 in part but would still temporarily ban cities like Charlotte from creating nondiscrimination ordinances to protect LGBT people. LGBT rights groups were outraged—the National Center for Transgender Equality called the Republican proposal “unacceptable” and referred to the Legislature as a “national disgrace.” Cooper urged Democrats not to support the proposal, and in the end it didn’t get enough votes in the Senate. The House adjourned without voting on the repeal, leaving HB2 on the books.

Protesters immediately gathered outside the Senate chamber shouting “Shame!”

“Today the Legislature had a chance to do the right thing for North Carolina, and they failed,” Governor-elect Cooper told reporters. “I’m disappointed for the people of North Carolina—for the jobs that people won’t have,” he said, referring to the companies that have protested the law by scaling back business in the state. “I’m disappointed that we have yet to remove the stain on the reputation of our great state.” North Carolina has lost millions of dollars in revenue because of the law—companies like PayPal and Deutsche Bank decided not to expand operations in the state, musicians like Bruce Springsteen canceled performances in protest, and the NCAA pulled its championships from the state.

The city of Charlotte did not respond to a request for comment, but in a statement the city council pledged that its “commitment to maintaining and protecting diverse and inclusive communities remains unchanged.” Meanwhile, a majority of North Carolinians remain opposed to HB2, according to Public Policy Polling. The Rev. William J. Barber II, a progressive leader in North Carolina and president of the state’s NAACP, said Thursday he would ask the national NAACP to call for an economic boycott of the state. And though Republicans in the Legislature seem dead set on fighting Cooper, the governor-elect vowed to keep pushing for a full repeal of the law: “This was our best chance,” he said. “It cannot be our last chance.”

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After Losing Millions in Revenue, North Carolina Is Set to Repeal Its Horrible Bathroom Law

by ora6exacta1l8 Posted on December 19, 2016

Mother Jones

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The North Carolina law that famously blocks transgender people from using the bathrooms of their choice appears to be on its deathbed. On Monday, Governor-elect Roy Cooper announced that House Bill 2, seen as the most sweeping anti-LGBT law in the country, would be repealed in a special session of the Legislature Tuesday.

The announcement came after the city council in Charlotte voted Monday morning to rescind a local nondiscrimination ordinance, passed in February, that had inspired state lawmakers to speed HB2 through the legislative process in a single day in March. In addition to blocking trans people from bathrooms, HB2 preempted local governments like Charlotte’s from passing measures that protect gay and trans people from discrimination.

Republican Gov. Pat McCrory, who passionately supported HB2 and narrowly lost his reelection bid, confirmed he would call a special session of the Legislature on Tuesday to repeal HB2. Governor-elect Cooper said the state Senate majority leader and House speaker had assured him they would kill the law because Charlotte had agreed to get rid of its local ordinance. “I hope they will keep their word to me and with the help of Democrats in the legislature, HB2 will be repealed in full,” Cooper said in a statement.

“Full repeal will help to bring jobs, sports and entertainment events back and will provide the opportunity for strong LGBT protections in our state,” he added. North Carolina lost millions of dollars of revenue after the law passed, as companies protested by canceling plans to bring jobs to the state, Bruce Springsteen and other musicians pulled out of concerts there, and the NBA and the NCAA moved sports events to other locations

Charlotte’s city council had previously refused to rescind its nondiscrimination ordinance. On Monday Charlotte Mayor Jennifer Roberts defended the decision to do so. The vote “should in no way be viewed as a compromise of our principles or commitment to nondiscrimination,” she said.

Outgoing Gov. McCrory, whose popularity fell after HB2 was passed, criticized Charlotte leaders for not getting rid of the local ordinance sooner—and argued they waited for political reasons. “This sudden reversal, with little notice after the gubernatorial election, sadly proves this entire issue originated by the political left was all about politics and winning the governor’s race at the expense of Charlotte and our entire state,” McCrory’s office said in a statement.

LGBT rights organizations praised the plan to repeal HB2, which Human Rights Campaign President Chad Griffin described as “shameful and archaic” legislation. But they added they were disappointed to see Charlotte’s local ordinance go. “The problem has never been Charlotte,” said Equality North Carolina Executive Director Chris Sgro, noting that hundreds of cities across the country have similar ordinances to protect gay and transgender people from discrimination. Mara Keisling, executive director of the National Center for Transgender Equality, said in a statement that the repeal of HB2 could open a door for other cities in the state to pass nondiscrimination protections in the future: “Completely repealing HB2 is only the first step lawmakers must take to repair the harm they have done to their own constituents. Even after it is repealed, there will be a long way to go.”

If the Republican-majority Legislature follows through and repeals HB2, it would be a surprising act of cooperation with the incoming Democratic governor. Just last week, Republican lawmakers in the state introduced a series of bills that would curtail his powers in office.

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After Losing Millions in Revenue, North Carolina Is Set to Repeal Its Horrible Bathroom Law

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The Price Is Wrong

by EduardoShultz Posted on December 15, 2016

Mother Jones

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The American Medical Association, the country’s largest professional group of doctors, wasted no time in throwing its support behind Rep. Tom Price (R-Ga.) after he was announced on November 29 as President-elect Donald Trump’s pick to be secretary of health and human services. “His service as a physician, state legislator and member of the U.S. Congress provides a depth of experience to lead HHS,” the AMA said in a press release that same day. “Dr. Price has been a leader in the development of health policies to advance patient choice and market-based solutions as well as reduce excessive regulatory burdens that diminish time devoted to patient care and increase costs.”

It’s not surprising that the organization, which has battled against various health care regulations, would be eager to see Price appointed. The former orthopedic surgeon has long complained that doctors face, as the AMA put it, “excessive regulatory burdens,” and his proposals would lead to increased pay for doctors. But they would also reverse reforms that have kept health care spending in check during Barack Obama’s presidency and could send costs skyrocketing once again.

For all of the controversy over health care under Obama, there has been general agreement on one area of success: Growth in health care spending has slowed. The Affordable Care Act, popularly known as Obamacare, created new schemes for paying doctors and hospitals that helped sharply reduce the annual increase in national health care spending and keep it below pre-recession levels. Both Republicans and Democrats have supported these provisions, which have centered on charging for the overall quality of care rather than for each service performed. But now Price, a longtime booster of freeing doctors from government restrictions, appears eager and able to undo them.

David Cutler, a Harvard professor who served as Obama’s senior health adviser during the 2008 campaign and helped craft the ACA, is worried that the progress on slowing health spending would stall or reverse under Price. “Price has expressed skepticism about many of the payment changes that have been ongoing and have bipartisan support,” he says. “This is quite scary, as they are starting to pay off. He seems to want to go back to the days when price was based on the volume of services provided, not the value. I don’t know if it’s a product of being an orthopedic surgeon, where that is how one earned a lot of money. In any case, I don’t think it bodes well for the vast changes in the health care landscape that are taking place.”

Much of the attention paid to Price’s plans for dismantling the ACA has focused on his proposal to undo the expansion of health insurance coverage. In short, Price would wipe away the Medicaid expansion that has given millions of poor people access to health insurance. The effect, as Sarah Kliff explains in Vox, would be to make the individual market more expensive for people who have been sick.

But the ACA wasn’t just an effort to expand health insurance. Until the 2008 recession slowed it, the cost of health care was rising at an alarming rate, accounting for an increasing share of the country’s total spending, and the trend lines projected unsustainable spending levels in the future. The ACA introduced a host of reforms and pilot programs for different schemes to reward doctors based on health outcomes in order to keep spending under control. The exact mechanisms were complex, but the basic idea was simple: The fees charged by US doctors and medical facilities were far higher than worldwide norms, and the best way to slow the growth of health care spending was to keep those pay rates in check.

Despite the hoopla this fall over rising premiums in the ACA marketplaces, the growth in health care spending slowed immensely during the Obama years, before a recent uptick. That growth peaked in 2002, at an 9.6 percent annual rate. During the recession, the rate dropped sharply, to 4.5 percent in 2008. But even as the economy rebounded, health care spending growth continued to decline, dipping to 2.9 percent in 2013—the lowest growth rate in more than half a century. It inched back up again in 2014, and earlier this month the Centers for Medicare & Medicaid Services announced a 5.8 percent growth rate for health spending in 2015—still below pre-recession levels, even though the ACA expanded insurance coverage to 20 million more Americans. A study from the Urban Institute earlier this year found that the amount the United States spent on health care under the ACA was far lower than anticipated—$2.6 trillion lower over five years.

Price has never been shy about his advocacy on behalf on doctors. When he first ran for Congress in 2004, he complained that people who lacked a background in the medical field were setting regulations and policy. Health professionals are by far the largest group funding his congressional career, having donated $3.6 million to his campaigns. The insurance industry is second, with more than $800,000 in donations.

Easing the restrictions doctors face when accepting patients with government-funded health insurance has been a central part of his health care policy proposals. When he reintroduced his Obamacare replacement plan earlier this year, he described it as “one that empowers patients and ensures they and their doctor have the freedom to make health care decisions without bureaucratic interference or influence.”

One of his key pushes over his time in Congress has been “private contracting” that would give Medicare patients access to doctors who don’t normally accept Medicare because of the lower rates it pays. But there’s a catch: The patients must pay extra fees to the doctor, on top of the rate Medicare pays the doctor. That gives doctors a perverse incentive to abandon Medicare so that they receive more from those patients than they’d get under Medicare alone. The consequence would be a reduction in Medicare participation among doctors, which would in turn reduce the government’s bargaining power in negotiating prices.

Price’s background as an orthopedic surgeon might be part of the reason he’s disinclined to support payment reforms, says Len Nichols, director of the Center for Health Policy Research and Ethics at George Mason University. Nichols notes that specialists who see patients only for specific problems have different incentives from doctors who see patients repeatedly. “They are almost perfectly tailored for fee-for-service, episodic, fix your knee, they make sure it works, goodbye,” Nichols says. “Because of that, as a class they tend to be rather skeptical of all this bundling, payment reform, incentive stuff, because they look at it like: I have a price for your knee, I fix your knee, then I’m done with you, you’re done with me.”

Price has been harshly critical of the Center for Medicare & Medicaid Innovation, an office created by the ACA to conduct experiments in new ways of compensating doctors that can, if successful, be expanded without congressional approval. Price spearheaded a letter from Republican members of Congress in September demanding that CMMI stop all of its mandatory payment reforms. “CMMI has overstepped its authority and there are real-life implications—both medical and constitutional,” Price said at the time. “That’s why we’re demanding CMMI cease all current and future mandatory models.”

Price did join the majority of both Democrats and Republicans in the House voting in favor of the Medicare Access and CHIP Reauthorization Act of 2015, which will eventually require doctors to bill Medicare patients based on quality, rather than quantity, of care. But he’s since sounded a more skeptical note, objecting earlier this year to the Obama administration’s rulemaking language on the bill because it would move doctors away from a fee-for-service model.

“He was a founding member of the tea party caucus,” Nichols says. “Skepticism of government is in his veins. If you have a natural, professional distaste, disinclination, distrust of these payment reform things, and you couple that with they’re coming from government, then it’s a double whammy.”

Price has also proposed some more extreme health care reform ideas, such as privatizing Medicare and turning Medicaid into a block grant program—in effect reducing the amount of money spent on poor people’s health coverage over time. But these large-scale changes would require acts of Congress. Many of the programs for cost control experiments and pilot programs, by contrast, are at the direction of HHS—leaving the prospective secretary in broad control of the way doctors and hospitals are paid.

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The Price Is Wrong

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Trump Wants to Deport Millions of Immigrants. Here’s One Way to Slow Him Down.

by KrystynaK18 Posted on December 14, 2016

Mother Jones

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Throughout his presidential campaign, Donald Trump ran on a staunchly anti-immigrant platform, vowing to build a wall along the US-Mexico border and deport millions of “criminal aliens” in his first hours in office. Last week, Democratic legislators in California—home to about one-fifth of the country’s estimated 11 million undocumented immigrants—introduced a series of measures aimed at protecting the state’s immigrants under Trump’s policies. Two of those bills could help immigrants facing deportation in a crucial way: by making sure they have legal representation in court.

Unlike defendants in criminal courts, immigrants facing deportation aren’t guaranteed a right to a court-appointed attorney. These immigrants have to bear the costs of securing a lawyer on their own, and this can be a costly and difficult process, especially for those held in detention centers. Nationally, only 37 percent of immigrants facing deportation proceedings have access to a lawyer, according to a study released by the American Immigration Council, a pro-immigration nonprofit. Immigrant detainees have it even worse: Only 14 percent receive legal representation. Studies have shown that one of the most important factors in determining an immigration case is whether immigrants had a lawyer—women and children, for instance, are up to 14 times more likely to win some form of relief from deportation or be released from detention when they have access to legal representation.

Together, California’s Assembly Bill 3 and Senate Bill 6 would provide funding so immigrants facing deportation would have access to free legal assistance, as well as set up state-funded trainings in immigration law so defense attorneys and public defender’s offices can better assist immigrants. Nearly 70 percent of detained immigrants in the state do not have legal representation, according to a report by the California Coalition for Universal Representation, and without it, only 6 percent of immigrants have won their cases over the past three years.

State Sen. Ben Hueso, a Democrat from San Diego who introduced SB 6, estimates that the state could allocate between $10-$80 million to fund these efforts. The measures “send a clear message to undocumented Californians that we won’t turn our backs on them,” said Hueso. “We will do everything in our power to protect them from unjustified deportation.”

The measures would require a two-thirds majority to be enacted, and with Democrats holding the majority in the state Legislature, the bills are likely to pass. Gov. Jerry Brown has yet to comment specifically on the legislation, taking a more cautious tone at a press conference last week, according to the Los Angeles Times. “I’m going to take it step by step and work in a collaborative way, but also defend our principles vigorously,” Brown said. “I think that’s the wiser course of action.” The measures will be voted on next month.

California could become the second state to help fund legal assistance for immigrants facing deportation, following an approach first implemented in New York: In 2013, nonprofit groups in New York City piloted a program that gave free representation to immigrants who couldn’t afford lawyers at one of the city’s immigration courts. Within a year, attorneys in the project won almost 70 percent of their cases, and the approach was so successful that the city fully funded the program. The model inspired similar programs in New Jersey, Chicago, Los Angeles, and San Francisco.

Despite a recent interview in which Trump appeared to soften his stance toward deporting so-called Dreamers, or young immigrants brought to the United States illegally as children, immigration advocates say they are preparing for a mass deportation plan under his administration. Shortly after the election, Trump insisted he would deport immigrants who had committed crimes, saying he still planned to remove some 2-3 million undocumented immigrants immediately. (A Migration Policy Institute report found that about 820,000 undocumented immigrants had criminal records, but some advocates worry that Trump will broaden his definition of a “criminal” immigrant to include people who have been arrested—though not necessarily convicted of a crime—to gain popular support for deportations.) And his nomination of Jeff Sessions as attorney general and appointment of Kris Kobach as an immigration adviser to his transition team have also concerned immigration advocates.

Francisco Ugarte, a public defender in San Francisco, where community groups and the city’s public defenders have asked the city to set aside $5 million for free legal assistance, says the funding is desperately needed. “We have to provide representation for any noncitizen facing deportation proceedings,” Ugarte says. “That’s how fairness works.”

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Trump Wants to Deport Millions of Immigrants. Here’s One Way to Slow Him Down.

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How Putin Got His Pet Game Show Host Elected President

by DianFritzsche Posted on December 13, 2016

Mother Jones

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Over lunch I read today’s big New York Times story about the Russian cyberattacks aimed at disrupting the US election. It was mesmerizing even though I already knew a lot of it, and it was also depressing as hell. By the time I finished, I was pretty close to thinking that the right response would be a couple dozen cruise missiles aimed straight at Putin’s lone remaining aircraft carrier. I guess we’re all lucky I’m not the president.

There are a dozen depressing things I could highlight, but somehow I found this the most depressing of all:

By last summer, Democrats watched in helpless fury as their private emails and confidential documents appeared online day after day — procured by Russian intelligence agents, posted on WikiLeaks and other websites, then eagerly reported on by the American media, including The Times….Every major publication, including The Times, published multiple stories citing the D.N.C. and Podesta emails posted by WikiLeaks, becoming a de facto instrument of Russian intelligence.

I know: news is news. Somehow, though, that doesn’t seem sufficient. I’m still not entirely sure what the right response is to leaks like this, but simply publishing everything no matter where it came from or what its motivation no longer seems tenable. There has to be something more to editorial judgment than that.

Anyway, Putin won this round. He didn’t do it all by himself—he had plenty of help from the FBI and the media—but in the end, he got his pet game show host elected president of the United States. I hope we all live through it.

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How Putin Got His Pet Game Show Host Elected President

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Obama Orders a Review of Russian Meddling in the US Election—But How Much of It Will Be Public?

by MargaritoBarrie Posted on December 9, 2016

Mother Jones

President Barack Obama has added momentum to the call for an investigation of Russian meddling in the 2016 election. On Friday morning, Lisa Monaco, a top White House aide on homeland security, told a group of reporters that the president has directed the national intelligence community to conduct a “full review” of Russian interference in the campaign.

Obama’s decision comes as members of Congress have upped the volume on demands that the Russian hacking of Democratic targets be probed. Rep. Elijah Cummings (D-Md.), the top Democrat on the House government oversight committee, has urged Rep. Jason Chaffetz (R-Utah), the chairman of that committee, to mount a congressional investigation of Moscow’s intervention in the election. But Chaffetz, who prior to the election vowed to fiercely investigate Hillary Clinton should she win, has not responded to Cummings’ request, according to a Cummings spokeswoman. House Minority Leader Nancy Pelosi of California and incoming Senate Minority Leader Chuck Schumer of New York have seconded Cummings’ call for a congressional investigation.

This week, Sen. John McCain (R-Ariz.), who chairs the Senate Armed Services Committee, said he will mount a probe of Russian cyber penetrations of US weapons systems and noted that he expects this inquiry will also cover hacking related to the election. “The problem with hacking,” McCain said, “is that if they’re able to disrupt elections, then it’s a national security issue, obviously.” And the Washington Post reported that Sen. Bob Corker (R-Tenn.), the chair of the Senate Foreign Relations Committee, and Sen. Richard Burr (R-S.C.), chair of the Senate Intelligence Committee, have also expressed interest in examining the Russian hacking.

Meanwhile, a group of high-ranking House Democrats sent a letter to President Barack Obama requesting a classified briefing on Russian involvement in the election, and seven Democrats on the Senate Intelligence Committee publicly pressed the Obama administration to declassify more information about Russia’s intervention in the election. Republican Sens. Lindsey Graham and Marco Rubio have also urged a congressional investigation of Russian interference. “I’m going after Russia in every way you can go after Russia,” Graham told CNN. “I think they’re one of the most destabilizing influences on the world stage, I think they did interfere with our elections, and I want Putin personally to pay a price.”

Cummings has also joined with Rep. Eric Swalwell, (D-Calif.), a Democrat on the House Intelligence Committee, to introduce legislation to create a bipartisan commission to investigate attempts by the Russian government or persons in Russia to interfere with the election. The commission would consist of 12 members, equally divided between Democrats and Republicans, and would be granted subpoena power, the ability to hold public hearings, and the task of producing a public report.

And that’s the key thing: a public report.

With the Obama administration and its intelligence services having already declared that Russia hacked Democratic targets during the election and swiped material that was ultimately released through WikiLeaks, the public certainly deserves to know more about this operation. How did it happen? How has it been investigated by US agencies? How can future cyber interventions be prevented and future US elections secured from foreign influence?

The Obama-ordered probe is due before he leaves office on January 20, and it will likely be the first of all the possible investigations to be completed. (Presumably, the CIA, the FBI, and the National Security Agency were already looking into the topic.) But there’s no telling how much of this review, if any, will be released publicly. A White House spokesman tells Mother Jones, “Hard to say right now, but we’ll certainly intend to make public as much as we can consistent with the protection of classified sources and methods and any active law enforcement investigations.”

In response to the news of the Obama review, Rep. Adam Schiff (D-Calif.), the top member of the House Intelligence Committee, declared, “The Administration should work to declassify as much of it as possible, while protecting our sources and methods, and make it available to the public.”

Yet this review may or may not yield a public accounting. And a congressional investigation might or might not include public hearings and a public report. Only the independent bipartisan commission proposed by Cummings and Swalwell would mandate the release of a public report.

While all the recent developments on this front are heartening for citizens who want to know to what degree American democracy was affected by covert Russian actions, there is so far no assurance that Americans will be presented the full truth. For Obama’s review to be released publicly, it will likely have to be scrubbed for classified information—a process that can take time. And if time runs out, the new Trump administration might not be keen on putting out a declassified version of the report. President-elect Donald Trump has repeatedly refused to acknowledge Russian involvement with the hacking of the Democratic National Committee and other Democratic targets. Would he want to release a report that contradicted him or that could be seen as tainting his electoral victory?

Talking to reporters, Monaco declined to say what she expected the Obama-ordered review to unearth. “We’ll see what comes out of the report,” she said. “There will be a report to a range of stakeholders, including Congress.”

But the biggest stakeholder of all is the American voter.

UPDATE: On Friday night bombshell news reports noted that the CIA had assessed Russia intervened in the US election to help Trump win; that during the campaign senior congressional Republicans, including Senate majority leader Mitch McConnell, had resisted a private White House request to be part of a bipartisan effort to call out Russian hacking of Democratic and political targets; and that Moscow had penetrated the computer system of the Republican National Committee but had not publicly disseminated any of the stolen material.

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Obama Orders a Review of Russian Meddling in the US Election—But How Much of It Will Be Public?

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