The balance the GOP Leadership Wants in Health Insurance Reform

"Now that they’ll be held accountable for the changes they make, Republicans aren’t all sure they want to get rid of all that. Republicans might want to kill the taxes, but that would mean they’re going to have trouble paying for a replacement. Republicans would like to convert those subsidies to refundable tax credits, but it’s not yet clear how Republicans would design them. Many Republican states took the Medicaid expansion — and saw their uninsured rates plunge. They like the flexibility involved in Republican plans to turn Medicaid into a block grant, but they don’t want to give up the money they’re getting from the federal government."

"In short, this stuff is complicated, especially if you want to avoid the enormous public backlash that would increase exponentially if you just repealed the law. There may be no way to avoid that backlash, particularly since everything Republicans are considering is guaranteed to produce more uninsured people, higher out-of-pocket costs, and enormous disruption to the system (and that’s if it works as planned). But Ryan and other GOP leaders are hoping to finesse it all with a carefully constructed Jenga tower of a bill that minimizes the political damage they’ll suffer. Some parts of the ACA (the popular ones) will likely be kept in some form, and the whole thing will be rolled out gradually, perhaps with a delay that pushes the most dangerous parts of the transition past the 2018 midterm elections (or even the 2020 elections). And it’s already clear that Ryan doesn’t want to rush into anything when the political stakes are so high."

From WAPO column by Paul Waldman 

GOP Congressman Afraid to Meet Constituents

It's only been 3 1/2 weeks and already GOP Congressman are canceling meetings where they are supposed to explain themselves to the people they represent and hear their concerns.  Why, because they can't take the heat.  While I think people who attend these should be respectful, their questions can be forthright and direct.

I hope the voters hold them accountable.



Being in charge is not helping GOP cohesion

Might Obama Still Win the Health Care Legacy Fight, It IS NOW Looking Possible

I don't want to jump the gun on this, but after seeing Paul Ryan blabber his way though another interview on many issues and then reading the column I will link to below, I think the headline is true.

I would rather be skiing today in the semi-blizzard that is hitting us right now, but I wasn't up for driving 2 to 3 hours through it both ways to do so.  So here is one day when I would rather be living in BTV.

Anyway, despite Paul Ryan saying the GOP was working on a replacement for ObamaCare, it turns out that are not even talking about it quietly.  I have gone into these reasons ad nauseum in prior posts, but I will do so again for any new readers.

The ACA, aka ObamaCare, was designed by the Heritage Foundation, a right wing think tank.  It was designed to keep the private health insurance market solvent so it would be a viable alternative to Universal Health Insurance provided by the Federal Government, while controlling the aggregate cost of health care in the economy, which in the U.S. is close to 20% of GDP vs 10%-12% of most of the rest of the Industrial World.  And of course, the 1st Governor to implement this design was Gov. Romney the 2012 GOP candidate for President.

So, the ACA is the best design the GOP has for controlling the aggregate cost of health care while not adopting a single payer health insurance plan, or even a public option for people who don't have health insurance through their employer and have too much money to be on Medicaid, the state run national plan for providing health insurance to the poor.

Of course, the key is forcing younger healthy people to buy health insurance so those who get cancer or some other horrible illness can be treated in a timely manner and are covered and older people who have even more go wrong sometime and with frequency can afford to buy health insurance.

And while I think all of this is an argument to offer Medicare for All as an option, the GOP doesn't want to do that and they don't want to require everybody to buy health insurance, except that is the only way the ACA can work.  You have to require that healthy people share in the risk pool financially because they will end up in the risk pool eventually.  It's the same risk sharing principle behind every other kind of insurance and even why we pay taxes to support the public safety system, the judicial system (to protect our rights) and to pay for national defense.

Link to WAPO column that prompted this

Trump Get's a Bit Closer to Impeachment

As I wrote a week ago, I don't know what will put the House GOP and Senate GOP over the edge, but I do believe we are heading there.

Yesterday, in court, one of Trump's lawyers was asked by a  Judge,

"Are you arguing, then, that the president's decision in that regard is unreviewable?"

The lawyer paused, then he said "Yes"

So when Trump's lawyers are arguing in court that the President is above the law and beyond the judgement of the court, then we know that King Donald is getting advice from his lawyers that he is above the law and it is just a matter of time until he does something so outrageous (I know, he has done plenty of outrageous things already) that impeachment will be the result.

Democrat's should not cheer this although many will, Mike Pence has no liberal instincts and will slash things that they care about using many of those King Donald has already appointed as Cabinet Members.

Fighting Trump and the GOP policies will not be easy

3 Columns today highlight the difficulty in opposing King Donald and the necessity of doing so.

The 1st column, written by a former conservative radio talk show host, highlights the success and danger of the successful delegitimization of main stream media by conservative media.  Many Trump supporters believe the truth and facts are fabrications and only alternative facts and King Donald's beliefs are the truth.  The writer regrets participating in this, but it stills highlights the need for a focused Democratic effort on the policy front to convince Trump supporters who still read main stream media that they have a coherent economic message.

Why Trump Supporter's Don't Care That He Lies

The danger of this is the fact that some of these Trump supporters think 9/11 and Sandy Hook were executed by agents of the U.S. Government because that is what Alternative Media like the Drudge Report and Breitbart News are telling them.  Unless those sites change their ways, which they will not because they make their money off the clicks on their website and giving the reader what they want to read is the way to keep them coming back.  They are the media equivalent of the Tobacco and Alcohol Industries.  Not to mention that most of them think President Obama is a muslim born in Kenya and who rode that falsehood to the pinnacle of power.

The 2nd column is written by Ross Douthat and simply highlights the fact that the country is split 50/50 and the rhetoric that the Democrat's both need to use to combat Trump and and keep their base motivated turns off the other 50% and makes it difficult to get them to listen to what else the Democrats have to say.  Crafting something that will make sense to potential swing voters in the Rust Belt and N.H./N.C./Florida is essential but how you communicate that is a challenge that must be meet for the Democrats to have success in 2018/2020.

Douthat "The Counternarrative ...Excludes too much of America"


Meanwhile, there is the issue of the courts and they are the last obstacle to holding King Donald somewhat in check.  And the key issue that Democrats must focus on is not Roe v Wade, other Social issues, or gun control, it is basic civil liberties and the separation of powers.  The courts are last barrier between President Trump and King Donald.  And how Supreme Courts nominee Judge Gorsuch answers questions about those issues should determine how Democrats vote on his nomination.

Link to Linda Greenhouse column

What Democrat Candidates Need to Do

I have been trying to figure out how the Democratic candidates almost uniformly across the entire range of office running lost their economic message.  Today David Brooks wrote a wonderful column that points the way.  I will provide the link later.

I have recognized that Democrat's did not offer an economic message to anyone other than those involved in the global economy, but their platform and basic instincts certainly pointed at realistic solutions involving training, better education and access to both education and healthcare that would help those in rural areas.  Combine that with some sensible tax reform, some rethink of regulation (not wholesale like Trump wants to do, I mean who wants coal waste in streams), and you would have an economic platform to run on.

But the really distressing part of this past election was that King Donald had a snappy saying, Make America Great Again, that conveyed an upbeat economic message that the Democrats could not counter running their negative campaign against Dangerous Donald.  While the Democratic message worked on the Coasts, it did not work in rural dominated states who were looking for a positive message.

What Brooks highlighted is something I have felt but couldn't find the words for.

America was founded and has endured through the two centuries on the unifying myth that America is a country that "embraces strangers and seizes possibilities".  "That the physical stuff in front of us is also a manifestation of something eternal".

That myth has been battered in rural America and the Democrats had no answer for them. So they gravitated to an alternative myth promised by Donald Trump that the world is a zero sum game:  if someone else wins, we lose and if they lose, we win.  It's a very Russian view that a country is "bound by its nostalgia, not its common future and the pure folk, who live in the heartland embody the pure soul of the country and are threatened by the cosmopolitan elites."

So before your read Brook's more evolved summation of this, I propose that Democratic candidates need to jump shift their rhetoric, combined with some rational policies to encourage job creation in rural areas.  I believe the GOP's policies will just encourage job creation in urban areas and thus rural voters are bound to be open to new ideas by the Democrats.  The rhetoric has to be focused on an upbeat revival of our unifying myth with a focus on including those rural people in the vision and having policies that will bring concrete evidence to them that the myth is reality.  People want to have hope.

Link to David Brooks "A Return to National Greatness"

Jennifer Rubin Nails King Donald Again

"America elected someone entirely unfit for the job. Now the world knows it, too."

Link to Rubin's column King Donald's phone calls are worse than his tweets