ACA succeeding despite Republicans' scorched-earth tactics

A number of reports this week document notable successes of the Affordable Care Act (ACA) despite Republicans' scorched-earth attempts at nullification.

On Monday, the nonpartisan Congressional Budget Office (CBO) forecast that government expenditures for the ACA would be $5 billion lower than anticipated this year and $109 billion lower than anticipated for the next decade.

The budgetary news is good in and of itself, but the principal reason behind it--that private health insurance premiums would be much lower than expected (thus requiring fewer subsidies)--was even better. The lower expenditures also come despite other good but potentially costly news--higher than expected enrollments in the health insurance exchanges.

The CBO now forecasts that 12 million more Americans will have health insurance coverage in 2014 (and 19 million more in 2015) than they would have in the absence of the ACA.

Health insurance coverage would be higher still were it not for Republicans' cynical strategy to undermine the ACA for purely partisan purposes. Indeed, Gallup estimates that between 2013 and the first quarter of 2014 the proportion of uninsured non-elderly adults dropped three times faster in states that set up their own health insurance exchanges and accepted the federal government's fully-paid offer to expand Medicaid coverage to low-income working families than in states that rejected these policies.

The truly despicable aspect of Republicans' nullification strategy is its cynical use of low- and moderate-income workers. These are Americans who "play by the rules" by working, even though their wages are incredibly low. They are also the Americans that Republicans say that the non-working poor should emulate.

Unfortunately, they are also the Americans that Republicans have thrown under the bus, by denying many access to Medicaid.

How perverse are these policies? Consider North Carolina, where a working single mother with one child loses eligibility for Medicaid once her countable income reaches $434 per month. A single mother in a minimum-wage ($7.25/hour) job would lose her eligibility after working 83 hours per month (20 hours per week). Talk about cruel incentives and a horrible choice--work more than part-time or have health insurance!

In other Republican-led states, governors and legislators have undermined the ACA (and their own constituents) by going after organizations that helped to sign low- and moderate-income families up for federally-subsidized insurance.

And these actions have been compounded by Republican actions to underfund the ACA's implementation and to sow as much uncertainty and confusion as possible.

In all of this, who gets hurt? Low- and moderate-income working families without insurance.

And despite this, the law is working.

Imagine what today's headline could have been

Two immediately pressing pieces of legislation are currently in front of the Congress: extension of jobless benefits for the long-term unemployed and extension of the country's borrowing authority.

Both pieces of legislation are worthy. One of the pieces of legislation--expanding the debt ceiling--is absolutely necessary. Both have enjoyed bipartisan support in the past (Republicans were happy to provide more jobless benefits and to raise the debt ceiling when their guy occupied the White House; in fairness, both were also happy to demagog these issues when the other guy occupied the White House). Both would almost surely pass if given up or down votes.

Imagine the headlines--and the increased respect for Congress--if both had received those votes yesterday.

Instead, a minority of Republican senators, including North Carolina's Richard Burr, blocked consideration of jobless benefits--even though a key Republican demand, that the cost of the benefits be offset, had been met.

And, the Republican House, which can't decide exactly which hostage to take (and eventually release), left town without a debt ceiling vote.

In the meantime, the rest of us are left to shake our heads and just imagine positive headlines.

"Somewhere Pavlov is smiling"

A beloved teacher frequently admonished our class when we would reflexively start to pack up our things at the sound of the dismissal warning bell, "somewhere Pavlov is smiling."

She was referring, of course, to Ivan Pavlov, who conditioned dogs to reflexively salivate at the sound of a buzzer.

Somewhere Pavlov is smiling about Republicans' reflexive rejection of President Obama's announcement that he is creating a myRA program to help people begin saving.

The program allows for voluntary, after-tax payroll deductions--as little as $5 per week--that can be used to purchase risk-free Treasury securities with no fees charged to either the worker or his/her employer. Funds in accounts would accumulate tax free. The program mimics, on a small scale, a risk-free retirement savings option that is available to federal civil servants.

Republicans' reactions to this and nearly every other Obama initiative have followed a drearily predictable path--if the President is for it, they're against it.

This latest rejection may be one of the oddest yet, because the President's program, modest though it is, actually advances conservative principles.

Consider that by making saving easier, the program promotes self-sufficiency and ownership.

Also, the savings would be entirely privately-funded--indeed, funded by workers themselves.

In addition, every aspect of the program is voluntary. Employers are free to offer this or not as they wish; eligible employees are free to contribute or not as they wish. The only mandatory component is that employees must move their funds to a regular retirement account once their myRA savings reach $15,000.

And the returns on the savings escape taxation.

Effectively, the only thing that this program does is to eliminate the transactions costs associated with setting up or contributing to retirement accounts. As transaction costs interfere with the beneficial outcomes with free-markets (especially the amounts traded are small), the program facilitates a free-market outcome.

This may be why the Heritage Foundation and other conservative organizations have advocated for exactly these types of savings vehicles.

Right up to the point where the President agreed with them.

Come to think of it, Bugs Bunny might be smiling too.

"I'll break you in half, like a boy"

Stay classy, Republicans.

Republicans near, far (and increasingly far-out) seem to be losing it.

Locally, state Sen. Bill Rabon's delivered a profane, arrogant, and condescending tirade against his constituents, General Assembly "colleagues," the Governor, and the state's first lady--basically everyone except state Sen. Bill Rabon.

In Washington (we think), Rep. Steve Stockman (R-TX) re-appeared on Monday after a mysterious and unexplained absence, claiming that part of it was a game of hide-and-seek with the media.

Last night, just prior to the President's state of the union speech, Rep. Randy Weber (R-TX) tweeted,

On floor of house waitin on "Kommandant-In-Chef"...the Socialistic dictator who's been feeding US a line or is it "A-Lying?"

And following the speech, Rep. Michael Grimm (R-NY) menaced a reporter, yelling

Let me be clear to you: If you ever do that to me again, I'll throw you off this f***ing balcony.

After the reporter attempted to reply, the aptly-named Rep. Grimm continued

No, no. You're not man enough, you're not man enough. I'll break you in half, like a boy.

At least they're not threatening to blow up the economy...this week.

Nullification all in a twist

As if we needed more evidence that congressional Republicans lack any agenda or principles whatsoever except opposing the President, The Hill reports that they may now sue to enforce all of the temporarily suspended parts of the Affordable Care Act (ACA).

Republican lawmakers bashed the Obama administration at a House Judiciary Committee hearing Tuesday for opting not to enforce core parts of the Affordable Care Act, such as minimum requirements for individual healthcare plans.

Rep. Trent Franks (Ariz.), the chairman of the Judiciary panel’s Constitution and Civil Justice subcommittee, said Congress should sue the administration to spur Obama to enforce the healthcare law as written.

This would be the same ACA that Republicans aver to oppose stem to stern. The same ACA that House Republicans have voted nearly four dozen times to repeal in its entirety. The same ACA that they describe as a job-killer. The same ACA that they shut down the government to, well, suspend.

Now they propose suing to enforce it in its entirety.

As former President Bill Clinton quipped last year, that takes some brass.

"Good fight?" Good grief

In the end, the Republicans accomplished nothing, and to hear House Speaker John Boehner describe it, the Republicans learned even less.

In a radio interview yesterday following his and his party's capitulation on their latest extortion attempt, Speaker Boehner said that he was "doing good" because "we fought the good fight; we just didn't win."

Give him credit for recognizing orange-tinted failure when he looks in the mirror. The "good fight" part, however, is delusional.

While Speaker Boehner's "good fight" accomplished nothing, it cost Americans a whole bunch.

The needless government shutdown hurt the economy. Bloomberg reports

Standard & Poor’s Ratings Services yesterday said the shutdown has shaved at least 0.6 percent off of fourth-quarter 2013 gross domestic product growth, or taken $24 billion out of the economy.

IHS Inc. of Lexington, Massachusetts, reduced its fourth-quarter GDP growth estimate to 1.6 percent, from 2.2 percent in September.

That $24 billion works out to about $200 per American household.

And that's not all, the latest damage to the economy can be added to the costs from previous extortion efforts.

Macroeconomic Advisers LLC said in a report prepared this week for the Peter G. Peterson Foundation that the recurring budget battles in Washington have lowered U.S. economic growth by about 0.3 percentage points a year since 2009. It has also added more than a half-point to this year’s unemployment rate, or the equivalent of about 900,000 jobs, the report said.

Republicans' extortion strategy and default nihilism are also damaging America's credit rating and will increase our borrowing costs going forward. Their "good fight" is the gift that keeps on giving.

The shutdown was also wasteful. Although the furloughed government employees will be repaid and made whole, taxpayers won't be compensated for the work that couldn't be performed while the workers were idled (as well as the needless work that was required to prepare contingencies for the shutdown). The GOP rails against waste and abuse yet singlehandedly caused billions in foregone government production.

Worse, the Speaker has promised that "the fight will continue."

Games but not so much fun with Speaker Boehner

Referring to the government shutdown that he caused, House Speaker John Boehner petulantly cried, "This isn't some damn game"--an odd statment given all of the games that Speaker Boehner has played leading up to and during the shutdown.

Here are just a few of the games.

Games with the shutdown. The first and biggest game was loading a temporary, short-term continuing resolution for spending with a poison-pill amendment to defund the Affordable Care Act (ACA). This only 11 months after promising that he would stop with these games.

Asked whether he will make another attempt to fully repeal the Affordable Care Act, Boehner said "the election changes that" and "Obamacare is the law of the land."

Games with lawmaker subsidies. After the Senate approved the continuing resolution but rejected the defunding amendment (and another delaying the ACA), Speaker Boehner insisted on including an amendment that removed an "exemption" that would have provided subsidies to Senators, Representatives, and their staffs to help cover the costs of mandated health insurance.

However, as Politico reports, Speaker Boehner had earlier worked to provide the same subsidies.

Yet behind-the-scenes, Boehner and his aides worked for months with Senate Majority Leader Harry Reid (D-Nev.), House Minority Whip Steny Hoyer (D-Md.), and others, to save these very same, long-standing subsidies, according to documents and e-mails provided to POLITICO.

Games with the conference committee. When Speaker Boehner lost that game, he next moved a resolution with an amendment calling for a conference committee to "negotiate" the terms of the House's extortion.

However, over the previous seven months, Speaker Boehner and Senate Minority Leader Mitch McConnell rejected 18 requests for conference committees for the Senate-passed budget.

Games with piecemeal legislation. When that gambit also failed, Speaker Boehner moved on to a new game. Instead of his original ploy of passing a single continuing resolution that omitted funding for the ACA, he pushed for a series of piecemeal funding bills. Taken together, these bills would have accomplished exactly what his original legislation proposed--funded what the Tea Party liked but dropped the funding for the ACA and other things that it didn't.

Games with an up-or-down vote. And Speaker Boehner continues to block the House from voting up-or-down vote on any of the versions of the continuing resolution that the Senate has passed, saying "That's not going to happen." A so-called "clean" continuing resolution appears to enjoy the support of a majority of House members, not to mention a majority of Americans and plurality of Republicans.

Sadly, the Speaker's games have had real consequences for the 800,000 idled federal workers, for citizens who depend on or enjoy government services, and for the economy as a whole.

As my parents used to say, "it's all fun and games until someone gets hurt."

The country is hurting, Mr. Speaker, and it's long past time to end your games.

Update (10-4-13, 4:25 p.m.): More games: Roll Call retrieves a previous Republican plan from the memory hole.

Senior Republicans were for “clean” CRs before they were against them.

Conservative Republicans have been pushing “automatic” continuing resolutions going back at least to the 1995-96 government shutdown era. The idea was popular on the right because an automatic freeze of government spending would take a shutdown off the table, lessening the leverage appropriators had to increase spending or include extraneous items.

Mr. Speaker are jobs still your "number one priority?"

Speaker of the House, Rep. John Boehner, has repeatedly said that jobs are his "number one priority"--a statement that's hard to square with his and House Republicans' current actions. From Bloomberg

A shutdown of the U.S. government would reduce fourth-quarter economic growth by as much as 1.4 percentage points depending on its length, economists say, as government workers from park rangers to telephone receptionists are furloughed.

Mark Zandi of Moody’s Analytics Inc. estimates a three-to-four week shutdown would cut growth by 1.4 points. Moody’s projects a 3 percent rate of growth in the fourth quarter without a closure. A two-week shutdown starting Oct. 1 could cut growth by 0.3 percentage point to an annualized 2.3 percent rate, according to St. Louis-based Macroeconomic Advisers LLC.

If the number one priority truly is creating jobs, the economic hostage-taking must end.

Just a hopeless dreamer

Republicans have strange dreams. Buzzfeed reports

Michigan Republican Rep. Kerry Bentivolio said Monday it would be a “dream come true” to submit a bill to impeach President Obama. Bentivolio also said he had meetings with lawyers asking them to “tell me how I can impeach” the President of the United States. Bentivolio was speaking at the August 2013 Birmingham Bloomfield Republican Club Meeting.

So what's the hold up on that impeachment bill? The article continues

“Until we have evidence, you’re going to become a laughing stock if you’ve submitted the bill to impeach the president because number one you’ve got to convince the press,” he said. “There are some people out there no matter what Obama does he’s still the greatest president they’ve ever had. That’s what you’re fighting.”

Well, at least he got the laughing stock part right.

The Audacity of Nope

Showing his own profile in discourage, North Carolina Governor Pat McCrory agreed with Republican legislators that the state should not expand its Medicaid program nor run its own health exchange. His feeble excuse is that the state is too feeble.

Gov. Pat McCrory doesn’t think the state is ready to expand Medicaid or ready to run its own health exchanges – two provisions of the Affordable Care Act.

McCrory’s office made the announcement Tuesday morning just hours before the state House is supposed to take up a bill that would bar the state from participating in those two actions. The Senate passed the bill last week.

According to the Governor, NC is not ready for better health and longer lives for hundreds of thousands of its most vulnerable citizens, tens of thousands of jobs, more productive workers, billions in economic output, and billions in savings in hospitals' uncompensated care.

Apparently, the Governor's last few years in the political wilderness have left him tanned, rested, and not ready.

Medicaid expansion and jobs

"Own goals" in soccer occur when a team kicks the ball into its own net, resulting in a point for the other team. Own goals are usually accidents.

The Republican-led North Carolina General Assembly seems poised to score an own goal against its own economy--on purpose.

Legislation is moving forward in the General Assembly to opt out of the Medicaid expansion under the Affordable Care Act. The expansion would provide health insurance to people living in households with incomes below 133 percent of the poverty line. The federal government would cover 100 percent of the costs for the first three years and 90 percent of the costs thereafter.

Besides extending coverage to about 400,000 poor NC residents who wouldn't get health insurance otherwise, the expansion would bring in $40 billion on net (about $50 billion in total spending), which would jolt the economy and create jobs.

A new report by Regional Economic Models, Inc. forecasts that the expansion would add nearly 6,000 jobs to the NC economy in the first year of the expansion, as participation in Medicaid starts to grow, and 20,000 to 25,000 jobs in subsequent years, as participation stabilizes at a higher level. A figure showing the predicted job growth appears below.

Figure from REMI report "A Contrast: Modeling the Macroeconomic Impact of 'Medicaid Expansion' in North Carolina.

These are substantial numbers of jobs, especially for an economy that only managed to add 72,000 in total last year.

Noses, faces, Medicaid expansion

As policy choices go, the direction North Carolina should take with respect to Medicaid expansion couldn't be clearer. However, we live in interesting times.

Medicaid is a public health insurance program for certain groups of poor and needy people, mostly poor children, poor elderly people, poor blind and disabled people, and recipients of federal cash assistance. With the exception of pregnant women and some parents, NC's Medicaid program generally does not cover able-bodied, working-age adults. Not surprisingly, hundreds of thousands of poor and near-poor working-age adults in the state are uninsured.

Provisions of the Affordable Care Act (ACA) are supposed to change that, starting in 2014. The ACA allows states to expand Medicaid eligibility to all low-income people, living in households with incomes below 133 percent of the federal poverty line. For the first three years of the expansion, the federal government will pay 100 percent of the costs. Starting in 2017, participating states will have to contribute $1 for every $9 that the federal government pays.

In the original legislation, states risked losing all their federal Medicaid money if they chose not to expand their programs. However, the Supreme Court decision upholding most of the ACA scaled that back, and non-participating states will now only forfeit the federal funds directly tied to the expansion. The Supreme Court made it less costly for states, like NC, controlled by the Party of No to, um, say "no."

While NC lawmakers have the ability to say "no," they would be hurting the state far more than they would be helping it.

Deflation

My dad used to tell a story about how one day as a very young boy he suffered some monumental slight at the hands of my grandmother. Concluding that this slight was one too many, he stomped his foot and yelled, "I'M RUNNING AWAY, AND I'M NOT COMING BACK!"

My grandmother's response was, "We'll miss you."

My dad sulked out of the house, made it around the corner, and sat on the curb. Utterly deflated, he was back home within half an hour.

House Republicans must be feeling similarly deflated.

After stomping their collective feet and threatening to bring down the U.S. economy through a debt default, Republicans have decided to approve a small expansion of the debt ceiling that will push the issue off for three months.

Entire NC Republican delegation opposes storm relief

The second part of the Sandy relief legislation--a $50 billion package to help New York, New Jersey, and other northeast states rebuild and prepare for future storms--passed the House of Representatives last night despite overwhelming Republican opposition--including "no" votes from every single member of North Carolina's Republican delegation.

Representatives Foxx, Holding, Hudson, and Meadows, who had already voted against borrowing to allow the National Flood Insurance Program to pay its obligations to victims, were joined in the latest vote by Representatives Coble, Ellmers, Jones, McHenry, and Pittenger.

All four NC Democratic representatives voted for the measures.

A closely-related measure that combined both parts of the House bill passed the Senate late last term with a bipartisan 62-32 vote. Democratic Senator Hagan voted for that measure; Republican Senator Burr voted against.

I can't predict the weather. But I can predict that the "attaboys" the Republican delegation are getting from its Tea Party supporters will be replaced with cries for federal relief when a big storm eventually hits Hurricane-prone NC.

Death by dysfunction

As nauseating and potentially damaging as the current stalemate over the fiscal cliff is, it's only one of several important pieces of legislation to run afoul of the dysfunctional Republican House of Representatives.

Farm Bill. In June, the Farm Bill, which sets the country's agricultural policy, authorizes U.S. Department of Agriculture programs, and funds food and farm disaster assistance programs passed the Senate (S. 3240) with a bipartisan 64-35 majority. The bill includes several tough reforms; the Congressional Budget Office estimates that the bill would cut $23.1 billion in expenditures over the next ten years

The House Committee on Agriculture marked up a version of the bill and passed it with an overwhelming and bipartisan 35-11 vote. However, there it stopped, as House leaders, under pressure from extreme conservatives, refused to allow a general vote. Foreshadowing the shrewd strategy that he would later adopt for the fiscal cliff, House Speaker Boehner substituted a one-year "plan B" bill but then pulled that when the radical right wouldn't go along.

As the year ends, $23.1 billion in program cuts along with five-year certainty for farm policy languish without an up or down vote because the cuts aren't extreme enough for a portion of the radical right. Worse, several provisions of the current farm bill are set to expire on January 1, including the dairy cliff.

RNC autopsy to reveal...

Last night on Piers Morgan Tonight, Reince Priebus, chairman of the Republican National Committee, commented on his party's recent electoral setback, saying "in order to get back in the game, you've got to look at and do a full autopsy of what happened."

I might be able to save Mr. Priebus some time.

When the patient lacks both a heart and a brain, the outcome is pretty predictable.

Questionable squared--your tax dollars at work

Rep. Darrel Issa used tax dollars to produce the following video, which was released just a few days before the election.


Without a doubt, the irony of the questionable use of tax dollars to call attention in a questionable use of tax dollars is lost on the congressman.

Let's hope that the House Ethics Committee brings this irony to his attention.

Republicans' phony, bogus, and artificial outrage

The list of Republicans pompously bellowing for Missouri Rep. Todd Akin to withdraw from his state's U.S. senate race keeps growing and growing, with NC Senator Richard Burr joining the list.

You can tell that these Republicans are really, really serious because they don't just use one adjective to condemn Rep. Akins remarks, but three!

Sen. Brown: "I found Todd Akin’s comments about women and rape outrageous, inappropriate, and wrong."

Gov. Romney: "Congressman’s Akin comments on rape are insulting, inexcusable, and, frankly, wrong."

Sen. Cornyn: "Congressman Akin's statements were wrong, offensive, and indefensible."

Sen. Burr: "Congressman Akin’s comments about rape were outrageous, offensive, and, simply put, wrong."

In the weird math of Republican politics, three adjectives appear to equal one category-5 shit-storm.

The Republicans seem to be saying that Rep. Akin, by his remarks, is unfit, unsuited, and ill-equipped for public office (hey, I can read a thesaurus too).

However, if they are actually concerned with Rep. Akin's fitness to serve, why aren't any of them calling on him to immediately resign his House seat?

BTW, double bonus points for phony outrage go to Sen. Claire McCaskill for her complaint that national Republicans were trying to "dictate" to Missouri's primary voters.

Read more here: http://projects.newsobserver.com/under_the_dome/burr_calls_for_akin_to_exit_race#storylink=cpy

Party of None of the Above

People have discussed a lot of motives behind Republicans' obstructionism.

A simpler motive, however, is that Republicans just want to put their collective heads in the sand.

Slate reports on people's responses about ways to cut the deficit.



When Republican legislators vote "no" on everything, they're just following the childish, fairy-tale wishes of their party members.

Is Speaker Boehner trying to tank the economy?

You really have to wonder whether House Speaker John Boehner is purposefully trying to tank the U.S. economy and possibly the world economy with his reckless statements.

Two days ago, Speaker Boehner poured a big steaming bowl of economic uncertainty into the U.S. markets by announcing a return to debt-ceiling brinksmanship--that Republicans would be using the specter of a U.S. bond default to enact their extremist, radical slash-and-burn budget.

Not content with the uncertainty that he had created at home, Speaker Boehner today turned to roiling markets in Europe by commenting, "What’s going in Greece, and the effect it’s having on Spain … it’s quite likely that this contagion is going to continue."

To be sure, the U.S. and E.U. economies face real challenges. Their problems shouldn't be sugar-coated and their structural deficiencies must be addressed. But to artificially inject the possibility of a default into the U.S. markets and to blithely comment that financial "contagion" is likely across Europe risks a wider financial panic.

Perhaps that's what the Speaker has in mind.