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The House Freedom Caucus Finally Comes Clean

Mother Jones

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Sarah Kliff reports on the latest from House conservatives:

The House Freedom Caucus laid out two demands on Thursday for a health care bill its members would support: ending Obamacare’s essential health benefits and its “community rating” provisions.

Good for them! I’m serious. The key starting point for any kind of comprehensive health care plan is a ban on turning down customers with pre-existing conditions. But once you do that, you have to control the price insurers can charge (aka “community rating”), or else they’ll simply jack up premiums for people with expensive conditions to a million dollars per year, which accomplishes the same thing as turning them down. But if insurers are required to cover anyone who applies, they also need plenty of healthy people to balance out their risk pool. So you end up with an individual mandate. But if you have a mandate, you have to have subsidies for poor people. You can hardly expect to legally require insurance for people who don’t have the money to buy it, after all.

At that point, you have the entire edifice of Obamacare. There’s no way around it. That’s why Paul Ryan’s plan looked an awful lot like Obamacare lite.

So if you’re a conservative who flatly doesn’t want an expensive, comprehensive, government-funded health care program, there’s only one way to get there: ditch the pre-existing conditions ban by calling for an end to community rating. This is hugely unpopular, so it takes some guts to tell the truth and propose getting rid of it.

It’s also cruel and meanspirited, but that goes with the ultraconservative territory. But at least they’re being honest. Compare this to Paul Ryan, who kept the pre-existing conditions ban (via his “continuous coverage” provision), which then forced him to accept all the bells and whistles of Obamacare. His solution was to wave his hands and then keep the funding so low that his program essentially did no good at all. He didn’t have the stones to simply admit that what he really wanted to do was repeal Obamacare and then do nothing at all to replace it.

Now, it so happens that Obamacare’s pre-existing conditions ban has no direct effect on the federal budget, and therefore can’t be repealed via reconciliation. It can only be repealed under regular order, which requires 60 votes in the Senate. So the Freedom Caucus folks are out of luck. But at least they’re displaying a bit of honesty.

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The House Freedom Caucus Finally Comes Clean

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Is Contraception Really Key?

Mother Jones

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Sarah Kliff reports today that the teen birthrate has plummeted over the past decade. That’s not news. The interesting question is why the teen birthrate has plummeted, and a new paper in the Journal of Adolescent Health says the reason is better access to contraceptives. That sounds reasonable, but Kliff backs up this idea with the following chart, taken from data in the paper:

This is a problem. Contraception use dropped slightly between 2009 and 2012. Sexual activity stayed about the same. And yet teen pregnancies declined by an astounding 20 percent over the same period. This does not fit with the notion that contraception is key.

Plus there’s longer term data. The chart below shows the teen pregnancy rate since 1990. It dropped steadily from 1992 to 2006, despite virtually no change in contraceptive use. I’ve subbed in contraceptive use from the new paper for 2007-12 (dashed line), and it doesn’t really seem to correlate with teen pregnancy rates either:

So count me skeptical about the contraception theory. Teen pregnancy has been dropping for 25 years, and any explanation needs to account for this. But what could it be?

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Is Contraception Really Key?

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