Wednesday, October 02, 2013

Obamacare Rolls Out Even As GOP Seeks Defund/Delay/Destroy Poison Pill Provisions In Budget and Debt Ceiling Talks

Yesterday marked the beginning of the Affordable Care Act's (ACA) health exchange rollout. While some refer to this as Obamacare with derision (and there are polls that indicate that people have a much more favorable view of the term ACA than Obamacare even though they refer to the same program/law), the purpose of the law is to provide access to affordable health insurance for more than 20 to 30 million people.

The rollout yesterday was not without its hiccups. Some people were met with overloaded servers so that they couldn't complete the registration, and there were some bugs in the process.

That is to be expected with any rollout of any major software/website. It shouldn't be a surprise given how the Republicans have sought to defund, delay, and destroy the ACA at every opportunity.

They've attempted to repeal the ACA more than 40 times in the House alone.

Years of litigation over the constitutionality of the law was concluded with a landmark decision that found the central provision, the individual mandate, constitutional. The GOP claimed that this was unconstitutional, even though the GOP and the Heritage Foundation had made the individual mandate a central part of their alternative plan to Hillarycare when that proposal was rolled out in the early 1990s. Republican Mitt Romney made the individual mandate part of the MassCare program.

But, the moment that the Obama Administration made it a central tenet of the ACA, the GOP savaged it as an affront to personal liberty. We'd have to have collective amnesia to follow the Republican argument and logic. We'd have to ignore that the ACA is modeled on the very successful MassCare, which has reduced the number of uninsureds in Massachusetts by expanding access to affordable health insurance.

Then, we get to the claims by the Tea Party extortionists who think that this is some form of socialism or worse.

The government created health exchanges where private insurance companies offer policies that include minimum levels of coverage that protect against catastrophic health costs to the individual that would otherwise bankrupt them or deny them further insurance. Insurance companies were instrumental in shaping the law, which is why the taxes and fees imposed by the act were written the way they were. Insurers wanted to be part of this - and they're going to be key facilitator to the Obamacare's success. Obamacare created an entirely new market that didn't exist before. That's a market capitalism failure. Obamacare sets up a situation where insurers can profit from millions of new insureds and their premiums (including the subsidies that help those who are eligible afford the insurance).

At the same time, insurance companies can no longer deny policies due to preexisting conditions or include lifetime limits. That's key to millions of people across the country who have had diagnoses for mental health issues, cancer, and other chronic conditions. Someone who was diagnosed with cancer as a child or young adult will no longer be denied insurance because of their cancer diagnosis. Someone who was diagnosed with lung or kidney disease that needs ongoing care will no longer be denied insurance.

People who are under the age of 26 can still be covered on their parents' insurance. That eliminates a period of time when many are in college and allow their insurance coverage to lapse (before the ACA, many insurers didn't allow dependents to stay on parents' insurance beyond age 21).

People with small businesses can now find insurance for themselves or their employees because the purchasing power of the exchanges helps reduce the costs to them.

And for those who think insurance costs are going up solely because of ACA have amnesia because health costs have been soaring for years (and this chart goes back decades). This isn't a new trend that began suddenly in 2009. It has been going on for decades as the cost of health care outraced the rate of inflation.

With this as the backdrop, the Tea Party extremists and the GOP have conspired to shut down the government with the extortionist demand that Democrats defund, delay, and ultimately destroy Obamacare in exchange for a short continuing resolution that allows government to continue operating. Thus far, Democrats have been resolute in defeating the GOP efforts, and some in the GOP are realizing that this is a losing hand and that they've screwed themselves and the nation of an opportunity to actually reform some of the problems with the ACA. The GOP's extremism in seeking defunding, delaying, or destroying Obamacare puts Democrats in position of having to defend the entirety of the program. They're willing to do this, even as some parts of the program should be further reformed. But a better situation than before the ACA is not the opposite of the perfect. The GOP claims that ACA needs to be repealed ignores the fact that the health insurance situation in the nation was a disaster and bleeding hospitals dry for indigent care.

Some Republicans are beginning to realize the damage being done to their party. This includes Rep. Peter King, who announced he was running for President, but also suggested that the government shutdown is the result of a cadre of extremists in his party who refuse to view the President as legitimate and are looking to roll back every single one of the President's achievements. They're willing to burn the government to the ground to achieve their ends.

The government shutdown is a minor trifle compared to the fact that the same Republican extremists are pushing poison pill provisions into the debt ceiling argument. They refuse to accept anything less than a defund/delay/destroy Obamacare for raising the debt ceiling, despite the fact that this Congress has already appropriated the funds. It is an incontrovertible fact that granting the hike does not authorize any new spending and failing to grant it does not cut spending.

These facts, and the fact that the polling doesn't favor the GOP, doesn't faze the Tea Party extortionists who think that if they take this to what they think is the logical conclusion that the Democrats will cave and they'll get the delay they seek. The polling suggests otherwise, but the GOP and its leadership are unwilling to confront the Tea Party cadre and put down this nonsense once and for all. In fact, expect the extremists to take the brutal punishment they're getting in newspaper opeds and editorials today as a badge of honor in rattling the mainstream media's cage.

However, House Speaker John Boehner can't or wont take those sensible measures because the Tea Party threatens to primary anyone who isn't sufficiently conservative enough. These extremists think that if only they have enough pure conservatives that they can succeed in taking down President Obama and his signature achievement in health care reform. Heck, there are reports that the Speaker wont allow a clean CR to come up for a vote because of the fear it might pass. That would effectively put Boehner in the extremist camp because he's catering to the very extremists who are shutting down the government.

Yet, he might be pushing this now, because if the debt ceiling isn't increased, it will result in damage that both sides acknowledge - a loss in credit ratings, increased borrowing costs, and tremendous damage to the US economy.

After all, if the leadership in the House drops the Hastert Rule, a bipartisan continuing resolution to fund government would happen today. If they adopt the Gephardt Rule, the nonsensical debt ceiling negotiations would be an afterthought since the budget appropriations process would allow for a concurrent increase in the debt ceiling to cover the contingency of the government spending more than it takes in revenue. In doing both, Speaker Boehner would marginalize the tyranny of the minority TP Extortionist camp, allow Congress to focus on the business of governance, and signal that the TP movement is nothing more than a bunch of nihlists who are willing to torch government in furtherance of a goal of denying access to health insurance for millions of people.

Cross posted at LGF. (Edited to add more link attributions to buttress the argument)

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