Tag Archives: obamacare

Obamacare Has Now Been MIA in Two Debates

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In the first Republican debate, Obamacare was barely mentioned. Over at National Review, Ian Tuttle notes that last night it was also MIA:

Beyond a few brief in media res mentions from candidates, a repeal line in Cruz’s closing address, and an allusion or two (e.g., the question about John Roberts), the president’s signature piece of legislation was a non-issue.

Which makes one wonder: Is it a non-issue?….I suspect that the anti-Obamacare fervor is in a period of quiescence. We have now seen Obamacare implemented sans “death spiral.” The website works. The Supreme Court has handed the Obama administration two affirmative Supreme Court decisions. And the president has made sure to do much in the interim — immigration executive actions and Iran deals, for example — to draw fire away from his healthcare law. Conservative heads have a limited supply of steam.

Tuttle is right. Obamacare has become a brief, pro forma applause line these days, but not much more. Partly this is for the reason Tuttle rather surprisingly concedes: It’s up, it’s running, and it’s working reasonably well. The nation still stands, and it’s hard to keep whipping up hysteria for years and years over something that, it turns out, just isn’t affecting all that many people.

I don’t think this means that Obamacare is going away as a political issue. But I do think that the repeal movement has lost a lot of steam as a winning issue for Republicans. The tea party types are starting to realize that nothing in their lives has changed, and the more moderate types realize—maybe via personal experience, maybe via news reports—that it’s doing a lot of good for poor and working class folks. So it’s become something of a wedge issue: Pounding on it loses about as many votes as it gains.

This is becoming a real problem for the GOP. A lot of issues that used to be pretty reliable winners have now turned into dangerous wedge issues: gay marriage, taxes, terrorism, illegal immigration, military adventurism, abortion, crime, education, global warming, Ukraine, free trade, Social Security cuts—the list goes on and on. And this is coming at the same time that their bread and butter, the angry white guy demographic, is declining. I’m not sure what they’re going to end up doing about this. The GOP has a tough decade ahead.

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Obamacare Has Now Been MIA in Two Debates

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Iran Will Always Be Three Months Away From Having Nukes

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Paul Waldman writes about the asymmetric political risks that Democrats and Republicans face over the Iran nuclear deal:

If the agreement proves to be a failure — let’s say that Iran manages to conduct a nuclear weapons program in secret, then announces to the world that they have a nuclear weapon — it will indeed be front-page news, and the Democrats who supported the deal might suffer grave political consequences. So in order to vote yes, they had to look seriously at the deal and its alternatives, and accept some long term political peril.

By contrast, there probably is less long term risk for Republicans in opposing the deal.

It’s true that if the deal does achieve its goals, it will be added to a list of things on which Republicans were spectacularly wrong, but which led them to change their opinions not a whit….Iraq War….Bill Clinton’s tax-increasing 1993 budget….George Bush’s tax cuts….But if the deal works as intended, what will be the outcome be? Iran without nuclear weapons, of course, but that is a state of being rather than an event. There will be no blaring headlines saying, “Iran Still Has No Nukes — Dems Proven Right!” Five or ten years from now, Republicans will continue to argue that the deal was dreadful, even if Iran’s nuclear ambitions have been contained.

In a way, it’s actually worse than this. Even if Iran doesn’t get nukes there will be endless opportunities to raise alarms that it’s going to happen any day now. Israeli leaders have been warning that Iran is three months away from a nuclear bomb for over two decades. There will always be new studies, new developments, and new conflicts that provide excuses for hysterical Fox News segments telling us we’re all about to die at the hands of the ayatollahs. To see this in action, just take a look at Obamacare. All the top line evidence suggests it’s working surprisingly well. Maybe better than even its own supporters thought it would. But that hasn’t stopped a torrent of alarming reports that provide countless pretexts for predicting Obamacare’s imminent doom. Premiums are going up 40 percent! Workers’ hours are being slashed! You won’t be able to see your family doctor anymore! Death panels!

So have no worries. Iran could be nuclear free in 2050 and Bill Kristol’s grandkids will still be warning everyone else’s grandkids that the ayatollahs are this close to getting a bomb. It’s kind of soothing, in a way, like a squeaky door that you’d miss if you ever oiled it.

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Iran Will Always Be Three Months Away From Having Nukes

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Three Studies Confirm: Obamacare Isn’t a Job Killer

Mother Jones

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Among the many (many, many) catastrophes predicted by opponents of Obamacare was that a lot of workers would find their hours reduced against their wishes. Why? Because Obamacare requires firms to provide health insurance only to employees who work 30 hours or more. So lots of companies would do their best to reduce worker hours to 29 or less in order to avoid having to pay for health coverage.

Unlike a lot of the gloomy scenarios tossed out by Obamacare opponents, this one wasn’t entirely ridiculous. Any employer mandate is going to have a cutoff somewhere, and there really is an incentive for companies to drop as many workers as possible below that cutoff. So it’s something that can only be settled by actual research. The question is: was there an increase between 2013 and 2014 of workers just under the 30-hour threshold? Max Ehrenfreund surveys a few recent studies and says the answer is no:

Analysts at ADP studied the payrolls of the firms’ clients, about 75,000 U.S. firms and organizations. They expected that as businesses prepared for the mandate to take effect, they would adjust their employees’ schedules, limiting them to no more than 30 hours a week. Yet ADP found no overall change in employees’ weekly schedules between 2013 and last year.

According to ADP’s analysis, shifts in scheduling were trivial in every sector of the economy, even in industries that rely heavily on part-time work, such as leisure and hospitality.

….ADP’s findings were confirmed in another study by Aparna Mathur and Sita Nataraj Slavov of George Mason University and Michael Strain of the conservative American Enterprise Institute.

Their paper, published this month in the journal Applied Economics Letters, uses data from the federal Current Population Survey and finds no statistically significant change in the proportion of part-time workers in the sectors most likely to be affected by Obamacare, such as janitorial and restaurant work.

A third study confirmed these findings, and also found that eligibility for Medicaid didn’t discourage people from holding down a job (since they no longer needed a job in order to get health insurance). The study found no difference between states that expanded Medicaid and those that didn’t.

Why does it turn out that employers didn’t cut their workers’ hours? One possibility is that a year isn’t long enough for a study like this. Maybe over the next few years, as the cost of the mandate becomes clearer, companies will start getting more aggressive about cutting worker hours.

But I’d offer another possibility: the mandate didn’t have a big effect because most companies already do something like this on their own. They offer health insurance as a standard benefit only to full-time workers, and the cutoff for full-time status is usually somewhere between 25 and 35 hours. So when the mandate came along, it just didn’t change anything for most employers.

This is why two of the studies looked specifically at things like hospitality and restaurant work. These are sectors where employers (a) already maintain highly variable schedules and (b) mostly didn’t offer health insurance at all prior to Obamacare. When the mandate came along, these folks were faced with a sudden additional cost, but one that they could reduce pretty easily reduce by limiting schedules to less than 30 hours. And yet, even there the researchers found no change—or at least, no change large enough to measure.

This is not the final word, but it’s the best we have right now. Three research teams, including one not especially sympathetic to Obamacare, have all found the same thing: Obamacare isn’t a job killer. Nor is it even a schedule killer. Life goes on normally, except for the fact that millions of people now have health insurance who didn’t before.

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Three Studies Confirm: Obamacare Isn’t a Job Killer

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Republicans Is Weird, Summer 2015 Edition

Mother Jones

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No, this isn’t about Donald Trump. It’s about Sen. Mike Lee of Utah—who plans to offer yet another amendment to repeal Obamacare, but this time with a special super-duper secret sauce added to the upcoming highway funding bill:

Lee said he will try to re-offer the Obamacare repeal as a special amendment that is directly related to highway funding. Under Senate rules, amendments that are directly related, or germane, to the underlying legislation can pass with just 51 votes.

Lee knows that the chair of the Senate is likely to reject his logic that Obamacare repeal is germane to highway funding, so he plans to use the nuclear option. That means he will formally object to the ruling of the chair, which requires a 51-vote simple majority — then he plans to move on to the coveted simple majority vote.

….If his plan works, Lee gets to tell his supporters that he’s responsible for a major vote to kill the health care law he reviles. The House voted to repeal the law in February, so the two chambers could then theoretically conference the bills — leaving it up to Obama to veto a bill to kill his own signature policy achievement.

So the plan is simple: have Republicans declare ex cathedra that repeal of Obamacare is germane to highway funding, and then pass Lee’s amendment with 51 votes. It’s brilliant! All that’s missing are the sharks with lasers attached to their heads!

Aside from being mind-numbingly stupid1, it also won’t work. Democrats will just filibuster the entire highway bill, or else they’ll vote for it and then Obama will veto the entire mess. Result: Obamacare stays in place but our highways continue to crumble into dust. Nice work, Senator! It’s good to see that the Republican Party remains committed to the sober, responsible kind of leadership that makes our great nation the envy of the world.

1It’s times like this that I regret the recent banishment of “retarded” from polite conversation. Because I think we all know that it’s the word that really fits here.2

2Though I suppose there’s no reason to insult the developmentally disabled by comparing them to Mike Lee.

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Republicans Is Weird, Summer 2015 Edition

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Chart of the Day: Obamacare Keeps On Working

Mother Jones

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I got distracted on Friday and failed to pass along the latest Gallup poll of health insurance coverage in the US. As you can see, it’s dropped once again, from 11.9 percent last quarter to 11.4 percent this quarter. In case that seems a little bloodless, that means that over a million Americans are now insured who weren’t last quarter. For the entire year, nearly 4 million people are newly insured. Since the peak just before Obamacare went into effect, 16 million Americans have gained health insurance. And if Republican-controlled states hadn’t thrown a collective temper tantrum and refused to accept Obamacare’s Medicaid expansion, the total number would be more like 20 million.

Not bad. Still a lot of work to do, but not a bad start.

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Chart of the Day: Obamacare Keeps On Working

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Obamacare Still Isn’t Safe, and Liberals Better Not Forget It

Mother Jones

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Greg Sargent warns Democrats not to get complacent about Obamacare:

House Republicans are still forging ahead with a separate lawsuit against Obama over the law (though it may not be resolved for years). Conservatives like Ted Cruz are still calling for holding spending bills hostage to roll back the ACA. GOP presidential hopefuls Jeb Bush, Marco Rubio, Bobby Jindal, and Cruz are all pledging to keep up the fight to repeal Obamacare — “every single word,” as Cruz puts it.

….Democrats should take continued GOP opposition to Obamacare very seriously. It has serious real-world consequences. As long as states hold out against the Medicaid expansion, it could slow the law’s efforts to realize its goal of expanding coverage. One thing this means is that Democrats should redouble their efforts to regain electoral ground on the level of the states, where future decisions about the Medicaid expansion will be made.

When Obama won the 2012 election, I figured Obamacare was finally safe. Except….there was still the Supreme Court. But they mostly upheld Obamacare, and once again I thought it was finally safe. Whew. Still, Republicans kept fighting. And things were still dicey as long as Obamacare was still vaporware. Then it finally went into effect in 2014, and disastrous rollout or not, I figured that was it. Once it’s actually helping millions of people, it’s safe. But wait! Then there was another Supreme Court case. But that dropped this week, and Obamacare was once again upheld.

So now Obamacare is finally safe, right? You’d think so, wouldn’t you? But Republicans are obsessed with Obamacare like no other law that’s been passed in decades. It’s kind of scary, the same way it was scary watching the unhinged Captain Ahab stumping around the Pequod. So no, Obamacare is still not safe. Not unless Democrats win at least the White House, and maybe both the White House and the Senate, in 2016. At that point, Republicans will finally have to give up. They’d have no plausible path to repeal, and by 2020 the law would have been in place for seven years; it would be covering upwards of 25 million people; and the health care industry would be so plugged into Obamacare’s rules that it would literally take years to extricate them if the law was repealed.

It sounds bizarre—not least of all to me, who badly underestimated how long Republicans could stay maniacally fixated on Obamacare—but it won’t truly be safe until and unless Democrats win in 2016. I sure hope Democrats figure this out. If you want to know what we’re up against, use Kevin’s Quick Zeitgeist Test. Type “Obamacare” into Google and then go to image view. Here’s the URL:

https://www.google.com/search?lr=&cr=&safe=images&gws_rd=ssl&um=1&ie=UTF-8&hl=en&tbm=isch&source=og&q=obamacare&sa=N&tab=wi&ei=-HSNVfnbNMLFggSu7YbIAw

Now do a quick count of pro vs. anti Obamacare images in, say, the top 50 results. Not counting neutral photos, I put it at about 10:1 for the haters. These guys aren’t giving up. Those of who support Obamacare had better show a similar level of passion for keeping it around.

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Obamacare Still Isn’t Safe, and Liberals Better Not Forget It

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John Roberts Now Officially the Fourth Conservative Sellout on the Supreme Court

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From Quin Hillyer at National Review:

With today’s Obamacare decision, John Roberts confirms that he has completely jettisoned all pretense of textualism. He is a results-oriented judge, period, ruling on big cases based on what he thinks the policy result should be or what the political stakes are for the court itself. He is a disgrace. That is all.

So there you have it. Roberts has now joined a long line of conservative sellouts, from Harry Blackmun to John Paul Stevens to David Souter. After Souter, Republicans swore this would never happen again and insisted on nominating only hardline conservatives with a long paper trail: Clarence Thomas, John Roberts, and Sam Alito. But now Roberts has let them down. It turns out that the ability to hold onto conservative principles while serving under Ronald Reagan is insignificant next to the power of the Washington DC cocktail party circuit.

Still, at least Republicans can now end their embarrassing charade of pretending to have a plan to fix things up if the court had ended Obamacare subsidies in states without their own exchanges. I think it’s pretty safe to say that even the pretense of “working on” a plan to replace Obamacare will now be dumped quietly on the ash heap of history—until Republicans have a presidential nominee in hand, at which point the charade will have to start all over. But I think we already know what their bold new plan it will contain. There are few surprises in the land of conservative ideas.

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John Roberts Now Officially the Fourth Conservative Sellout on the Supreme Court

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Obamacare Survives Supreme Court to Fight Another Day

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Hey, I finally got one right! The Supreme Court decided to keep Obamacare subsidies intact, with both Roberts and Kennedy voting with the liberal judges in a 6-3 decision. And apparently they upheld the subsidies on the plainest possible grounds:

Chief Justice Roberts wrote that the words must be understood as part of a larger statutory plan. “In this instance,” he wrote, “the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”

Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” he added. “If at all possible, we must interpret the act in a way that is consistent with the former, and avoids the latter.”

So this had nothing to do with the possibility that if Congress required states to build their own exchanges in order to get subsidies, that would be unconstitutional coercion on the states. That had been something a few of us speculated on in recent days. Instead it was a white bread ruling: laws have to be interpreted in their entirety, and the entirety of Obamacare very clearly demonstrated that Congress intended subsidies to go to all states, not just those who had set up their own exchanges.

So that’s that. As far as I know, there are no further serious legal challenges to Obamacare. The only challenge left is legislative, if Republicans capture both the House and the Senate and manage to get a Republican elected president. So let’s all hope that doesn’t happen, m’kay?

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Obamacare Survives Supreme Court to Fight Another Day

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Read the 7 Most Ridiculous Lines from Justice Antonin Scalia’s Obamacare Dissent

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On Thursday morning, the Supreme Court upheld Obamacare’s insurance subsidies in a 6-3 decision penned by Chief Justice John Roberts. Legal experts had long dismissed the merits of the case, and it even turned out that the plaintiffs had questionable standing.

But to three of the court’s conservative justices, the court’s decision to side with the government is a sign not only that the court is full of partisan hacks, but also that words themselves hold no meaning.

In a blistering 21-page dissent, Justice Antonin Scalia accused John Roberts of abandoning his judicial independence to defend Obamacare at any and all costs. “Normal rules of interpretation seem always to yield to the overriding principle of the present Court: The Affordable Care Act must be saved,” Scalia writes.

Just how absurd is it, in Scalia’s mind, that the court upheld the subsidies? Here are his other prime quotes of indignation at the majority’s opinion:

“Words no longer have meaning if an Exchange that is not established by a State is ‘established by the State.'”
“The decision rewrites the law to make tax credits available everywhere. We should start calling this law SCOTUScare”.
“The Court holds that when the Patient Protection and Affordable Care Act says ‘Exchange established by the State’ it means ‘Exchange established by the State or the Federal Government.’ That is of course quite absurd, and the Court’s 21 pages of explanation make it no less so.”
“You would think the answer would be obvious—so obvious there would hardly be a need for the Supreme Court to hear a case about it.”
“Impossible possibility, thy name is an opinion on the Affordable Care Act!”
“Today’s interpretation is not merely unnatural; it is unheard of.”
“The cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.”

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Read the 7 Most Ridiculous Lines from Justice Antonin Scalia’s Obamacare Dissent

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Will Supreme Court Uphold Obamacare Subsidies On Same Grounds It Struck Down Medicaid Expansion?

Mother Jones

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Back when the Supreme Court ruled on NFIB vs. Sebelius—the original Obamacare case—there were two basic parts to the opinion: The individual mandate was upheld and the Medicaid expansion rules were struck down. Most liberals thought the reasoning behind the Medicaid decision was absurd, but I didn’t. I found it quite plain and persuasive. Basically, Congress had told the states that if they didn’t accept the Medicaid expansion, they’d lose all Medicaid funding. But states are supposed to have a legitimate choice about whether to accept new government programs, and this clearly didn’t give them any real choice. No state can afford to lose all its existing Medicaid funding. Congress had set things up so that technically each state had a choice, but it was really no choice at all. In practical terms, every state had to accept the expansion, and this was constitutionally unacceptable.

Two liberal justices agreed with this reasoning, as did the five conservative justices, including Anthony Kennedy. Over at the New Republic, Simon Lazarus notes that during oral arguments in the latest Obamacare case, Kennedy suggested a similar dynamic was at work. The plaintiffs were arguing that the text of the law clearly stated that federal subsidies were available only to states that set up their own insurance exchanges. The problem here is that without subsidies Obamacare is not only useless, but could severely damage the existing insurance market in a state:

Such a threat, he observed, could amount to unconstitutional “coercion” to pressure states to set up exchanges. If this is Justice Kennedy’s take, his most likely outcome would be to adopt an alternative interpretation that avoids having to face the constitutional issue. The Obama administration’s interpretation—that the ACA prescribes credits for customers on all exchanges, whether state-run or federally facilitated—fits that bill.

….Previously, only one case had invalidated a law under a coercion theory like the one Kennedy advanced—NFIB v. Sebelius itself. Then, the Court held unconstitutional the ACA’s method to incentivize states to expand Medicaid coverage to all adults up to 138 percent of the Federal poverty level. If they declined, states risked losing federal financial support for their pre-existing Medicaid programs, on average over 10 percent of state budgets. That, seven justices agreed in two separate opinions, was a bridge too far. Chief Justice Roberts, joined by progressive Justices Breyer and Kagan, ruled that this “financial inducement” amounted in effect to “a gun to the head . . . so coercive as to pass the point at which pressure turns into compulsion.”

Why were both sides caught off-guard by Kennedy’s attraction to extending the NFIB coercion holding to King, but this time for the benefit of the ACA? The reason, I suggest, is a deep bipartisan cynicism about the Court’s “federalism” jurisprudence….What that cynicism seems to have missed is that, as an ideological matter, Justice Kennedy takes very seriously what he repeatedly lauds as the “federal balance.”….In sum, Justice Kennedy might well see King v. Burwell more as an opportunity to advance his federalism ideology, than as a second shot at vindicating the Republican political priority of crippling Obamacare, for which he showed evident sympathy three years ago.

Interesting. Both Kennedy and Roberts could see this case as a way of gaining bipartisan support for a ruling that saves Obamacare but further entrenches the view of federalism stated in NFIB. They might both consider that worth it. While we all twiddle our thumbs waiting for the decision in King v. Burwell to be handed down, it’s an interesting possibility to ponder.

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Will Supreme Court Uphold Obamacare Subsidies On Same Grounds It Struck Down Medicaid Expansion?

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