GOP’s Mad Health-Care Vendetta

Republicans and their Tea Party allies are plotting one more frenzied assault on the Affordable Care Act by disrupting congressional townhall meetings and possibly holding the full-faith-and-credit of the United States hostage. But the madness may just expose how crazy the GOP has become, writes Beverly Bandler.

By Beverly Bandler

Norman Ornstein, celebrated political scientist and independent scholar of the conservative American Enterprise Institute, suggests that today’s Republican Party and its nihilistic approach to the Affordable Care Act takes one’s breath away.

Ornstein has noted that there are traditional and respectable ways for legislators to act toward an existing law that they disagree with and then there is what the current Republicans are doing toward Obamacare.

As Ornstein has commented: “When a law is enacted, representatives who opposed it have some choices (which are not mutually exclusive). They can try to repeal it, which is perfectly acceptable, unless it becomes an effort at grandstanding so overdone that it detracts from other basic responsibilities of governing. They can try to amend it to make it work better, not just perfectly acceptable but desirable, if the goal is to improve a cumbersome law to work better for the betterment of the society and its people.

“They can strive to make sure that the law does the most for Americans it is intended to serve, including their own constituents, while doing the least damage to the society and the economy. Or they can step aside and leave the burden of implementation to those who supported the law and got it enacted in the first place.

“But to do everything possible to undercut and destroy its implementation, which in this case means finding ways to deny coverage to many who lack any health insurance; to keep millions who might be able to get better and cheaper coverage in the dark about their new options; to create disruption for the health providers who are trying to implement the law, including insurers, hospitals, and physicians; to threaten the even greater disruption via a government shutdown or breach of the debt limit in order to blackmail the president into abandoning the law; and to hope to benefit politically from all the resulting turmoil, is simply unacceptable, even contemptible.

“One might expect this kind of behavior from a few grenade-throwing firebrands. That the effort is spearheaded by the Republican leaders of the House and Senate, even if Speaker John Boehner is motivated by fear of his caucus, and [Sen. Mitch] McConnell and [John] Cornyn by fear of Kentucky and Texas Republican activists, takes one’s breath away.”

But that’s because today’s version of the GOP has evolved into an authoritarian, right-wing party unlike any political party in U.S. History, a destructive political force worse than McCarthyism by several orders of magnitude.

The Republican Party has been considered obstructionist and nihilistic for some time, even “crazy” comprised of so many laissez faire corporatists and neo-confederates determined to roll back the 20th Century, take revenge on Reconstruction, reverse the outcome of the Civil War and create an oligarchic, antebellum South within the United States of the 21st Century while they attempt to re-write American history along with the Constitution.

In 2012, Ornstein and his equally respected liberal colleague Thomas E. Mann made this assessment: “We have been studying Washington politics and Congress for more than 40 years, and never have we seen them this dysfunctional. In our past writings, we have criticized both parties when we believed it was warranted. Today, however, we have no choice but to acknowledge that the core of the problem lies with the Republican Party.”

That the Republicans are now spinning out of control is demonstrated by their extraordinarily irresponsible behavior in relation to what is known as “Obamacare.”

Ezra Klein, Washington Post columnist points out: “Three years after the law passed, one year after the U.S. Supreme Court upheld it, and nine months after Republicans lost the election that might have allowed them to repeal it, the Washington conversation is still about Republicans’ rear guard actions to undermine the Affordable Care Act and profit politically from the damage.”

Prolific blogger Jon Perr writes: “With Congress set to adjourn for the summer, Republican leaders are hoping to reprise the recess of 2009, when furious Tea Partiers armed with incendiary signs, bogus GOP talking points and occasionally guns (though not the truth) ran roughshod over town hall meetings nationwide.

“But along with their streams of sound bites and planted questions [and aggressive bad manners], the centerpiece of the Republican summer strategy to go ‘on the offense’ against Obamacare is what planners are calling ‘Emergency Health Care Town Hall’ meeting designed to showcase ‘the negative effects of the health care law and the House Republicans’ plan to dismantle it.’”

The most likely consequences of the sabotage efforts of Republican congressmen and governors will be that of the 32 million Americans reportedly still without health care insurance, most of them will be in the reddest states in 2014. “Though they have voted 37 times to repeal the Affordable Care Act,” notes Perr, “Congressional Republicans have yet to offer their own proposal to replace it.”

Let’s call the law by its correct short name: the Affordable Care Act (ACA). Reuters reported July 25, that when it comes to implementation of ACA, Republicans and their allies “are mobilizing … to dissuade uninsured Americans from obtaining health coverage.”

Steve Benen of the Maddow Blog is one of many who might be called the Astounded and Appalled: “I hope folks will pause to let that sentence sink in for a moment,” he writes. “Unlike every other industrialized democracy on the planet, the United States — easily the wealthiest nation on earth — tolerates a significant chunk of its population to go without basic health care coverage. These Americans and their families can’t afford to see a doctor and are one serious illness from financial ruin.

“After nearly a century of politicians talking about the problem, President Obama actually signed the ACA into law three years ago, giving working families a level of health-care security they’ve never had before, and throwing a life preserver to the uninsured. Now, Republicans aren’t just actively trying to sabotage the law, they’re telling struggling Americans it’s better to drown than accept the life preserver.”

Not only are Republicans dissuading uninsured Americans from obtaining health coverage, some slash-and-burn Republican members of Congress are actually refusing to help their constituents benefit from or understand the law. The GOP is trying to stop the law before it take effect. Unbelievable. Irresponsible. Crazy.

Let’s get some basics out of the way:
–Health care reform was initiated by the Obama administration in early 2009 because of the relentless, decades-long rise in the cost of health care that left many Americans struggling to pay their medical bills, the worst long-term fiscal crisis facing the United States, the only wealthy industrialized nation that did not ensure that all citizens had health care coverage.
–In 2009, the statistics were alarming: 18,000 unnecessary U.S. deaths every year, 42% of all adults were either uninsured or underinsured (2007), an estimated 14,000 Americans were losing their health insurance every single year, the health system was rejecting 36% of Americans (12.6 non-elderly adults) who applied for insurance (2008), 46 million Americans (15% of the population) were without health insurance, of which more than 80% were working families. There are reportedly still about 32 million people who don’t have health insurance. Current statistics are still alarming.
–The U.S. spends twice per capita what other major industrialized countries spend on health care. Health care spending in the United States reached $2.4 trillion in 2007, or $7,900 per capita. As a nation we are spending $1 out of every $6 we earn on health care. Ever-rising health care costs are threatening to drive an unsustainable explosion in the national debt.
–One major reason for the health insurance crisis is that many employers have stopped offering insurance to employees because of the high cost of insurance. The proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61% between 2000 and 2007.
–Americans are paying more for health care coverage every year. Between 2006 and 2007, the cost of premiums offered by employers increased 6.1 percent. In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job. The typical elderly couple may have to save nearly $300,000 to pay for health costs not covered by Medicare alone.
–Half of all personal bankruptcies are at least partly the result of medical expenses. It has been estimated that health care costs cause a bankruptcy in America every 30 seconds.
–In 2009, the U.S. faced that without reform: health care costs would continue to skyrocket. We could be spending $4.2 trillion by 2016, and projections suggest that the number of Americans without health insurance would rise to about 72 million in 2040.
–Across 37 core indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with U.S. and international performance benchmarks. Overall, performance did not improve from 2006 to 2008. The Veterans Health Administration is considered the highest-quality healthcare provider in the United States. [“Healthcare Reform information Packet” by Beverly Bandler, Aug. 17, 2009.]

For Americans who do not know how a bill becomes law (which apparently is most), this is the complex process in brief: Article I of the Constitution states “all legislative powers herein granted shall be vested in a Congress of the United States, which shall consist of a Senate and a House of Representatives.” The Congress is charged to: “make all laws which shall be necessary and proper for the carrying into execution the foregoing powers, and all other powers vested by this Constitution in the government of the United States.”

The House and Senate are equal partners in the legislative, law-making process, legislation cannot be enacted without the consent of both chambers. Legislation is introduced by any one of the 535 members of the bicameral Congress (435 members of the House, 100 members of the Senate), the Congress being the branch of the federal government that creates laws (the President and the Executive Branch carry out laws), bills are referred to the appropriate committees/subcommittees of the House and Senate for action, bills are sent to the floor for debate and voting. If passed, a bill is then sent to the other chamber unless that chamber already has a similar measure under consideration.

If either chamber does not pass the bill then it dies. If the House and Senate pass the same bill then it is sent to the President. If the House and Senate pass different bills they are sent to Conference Committee. Most major legislation goes to a Conference Committee. The conference report must be approved by both the House and the Senate. An approved bill is sent to the President who can veto or sign the bill. Once a bill is signed by the President or his veto is overridden by both houses it becomes a law and is assigned an official number. [See Vote Smart]

Therefore, “Obamacare” belies the fact that the Affordable Care Act is a law that was created by the U.S. Congress, not by Barack Obama.

That bears repeating: The Affordable Care Act is the law created by the U.S. Congress in 2010.
President Barack Obama presented a health reform proposal to Congress shortly after becoming president. The President asked Congress to come up with a health care reform plan reflecting these eight principles:

Reduce long-term growth of health care costs for businesses and government; Protect families from bankruptcy or debt because of health care costs; Guarantee choice of doctors and health plans; Invest in prevention and wellness; Improve patient safety and quality of care; Assure affordable, quality health coverage for all Americans; Maintain coverage when you change or lose your job; End barriers to coverage for people with pre-existing medical conditions

“Obamacare” is not only an incorrect title, it is also a misnomer since the new law is said to most resemble [GOP Gov.] Mitt Romney’s Massachusetts health care legislation. The term “Obamacare” has been promoted by the GOP for anti-Obama political purposes. The law enacted is: The Patient Protection and Affordable Care Act of 2010, Public Law 111-148 (March 23, 2010), the Affordable Care Act (ACA) for short, and should be referred to as such.

ACA is one of the most complex laws ever enacted. It’s so complicated that it is being phased in over five years. Insurance is complex. Health care insurance is particularly complex. The complexity of ACA is partly because its sponsors had to make so many convoluted compromises, convoluted compromises forced by congressional conservatives who oppose universal health insurance period. After making every effort to compromise the bill’s process and content, they didn’t vote for it: no Republican voted in favor of ACA.

Americans need to understand that the Affordable Care Act, the law created by the U.S. Congress in 2010, which is far from the ideal universal national care the country needs and that so many Americans want, represents a major achievement. ACA was amended by P.L. 111-152, an amendment that removed some of the more controversial provisions of the comprehensive health care law, while making others more popular. But there has never been a “perfect” piece of legislation passed by Congress in the history of the United States. There will never be a perfect piece of legislation passed by the U.S. Congress. Get over it.

The Affordable Care Act represents the biggest expansion of the safety net in 40 years. It also represents a remarkable Democratic victory and a culmination of a health care reform quest that began in the early 20th Century, one in which seven presidents tried and failed.

It is the most significant piece of economic and social legislation since FDR signed the Social Security Act in the 1930s, and the largest expansion of health care since Medicare helped to transform the lives of America’s seniors in the 1960s.

A vicious, unprincipled fear offensive failed to block reform. The vast majority of Democrats voted for it; every single Republican opposed it. Conservatives oppose universal health care, a fundamental position that Americans should seriously question in terms of social justice and economic common sense.

This comprehensive landmark law expanded insurance coverage largely for middle-class and poor families. It puts American families and small business owners, not the insurance companies, in charge of their own health care and lowers costs. It brings greater accountability to health care by laying out common sense rules of the road to keep premiums down and prevent insurance industry abuses and denial of care. Americans will see significant benefits take effect this year with other important reforms following shortly after.

ACA reportedly provides coverage to more than 94% of Americans, is designed to strengthen Medicare and lower health care costs over the long term. The bill provides stability and security to Americans who have insurance, affordable options for those who don’t and lower costs for families, businesses and our country as a whole. It provides the largest middle class tax cuts for health care in our history. Some of the bill was paid for by taxing households making more than $250,000 a year.

This historic legislation is also designed to create up to 4 million jobs and to reduce the deficit by $143 billion over the next ten years, with $1.2 trillion in additional deficit reduction in the following ten years. Beginning on Oct. 1, Obama’s health reform will help millions of uninsured people buy subsidized health insurance for the first time, Reuters has reported.

ACA’s big provisions take effect Jan. 1, 2014. Already more young people have health insurance, thanks to ACA’s requirement that insurers make coverage available to people under 26. That’s a reminder of benefits the law has already delivered, without the ill effects critics had predicted.

The fact that premium bids seem to be coming in lower than the Congressional Budget Office and other experts predicted is a pretty big deal, and not for reasons widely understood. The overall price of ACA, the amount of money the government must spend, in order to make the law function, is going to be even lower than predicted.

Recent news about the Affordable Care Act is genuinely encouraging. Public policy journalist Jonathan Cohn notes that there will be inevitable glitches because of the complexity of the law, but the Obama administration is armed with a host of contingency plans.

Political commentator Jonathan Chait reminds us that: “any new large initiative is complex. Rolling out a new product is hard, and it would be harder if half the retail managers were working for a rival firm.” (For those with short memories, the “new product” that the Republican Party was to “roll out” as announced by President George W. Bush’s press secretary in the summer of 2002 was the Iraq War.)

Cohn emphasizes the need to distinguish between hysteria and well-founded fears, bad-faith arguments from legitimate worries. There are concerns that not enough healthy people will sign up, that computers won’t work, that insurance companies will act like insurance companies and jack up premiums, that anti-ACA state leaders will actively try to make the law fail, that anti-universal health care, anti-Obama, and anti-Democratic Party conservatives will engineer full-blown political firestorms that will undermine the entire system.

The Republicans have clearly demonstrated that they are unabashed purveyors of deliberate misinformation and that they have no hesitation to blatantly lie for political purposes. It is clear that the current version of conservatives, who have been characterized by former Republican now Independent John Dean as “conservatives without conscience,” don’t understand ACA any more than they understand good governance. They appear to be driven by some misguided sense of “ideological purity” that is unrelated to both reality, economics, and U.S. history.

The “overwrought right,” therefore, is given to irrational fakery while the “cautious left” is too often given to confrontation avoidance. Democrats, liberals and progressives should be less worried about what are inevitable wrinkles, and should aggressively step up to the plate and educate themselves and the public about the law.

Chait points out: “the best thing Republicans have going for them is that most Americans have little idea what the law does, which is why its specific provisions always poll way better than the overall impression of the law itself. Forty-two percent of Americans don’t even know the law is in place.” Clear, coherent public education about the law is crucial.

The Affordable Care Act may have a bumpy start Jan. 1, 2014, when ACA starts making insurance coverage available to nearly all Americans. But there is good reason to be optimistic. The nation is better off with ACA than without it. Millions of people will get the kind of affordable, comprehensive, and stable insurance they never could before.

Cohn points out: “that this may be quicker to happen in some states than others and the experience may not always be easy. But it will certainly be an improvement on the current state of affairs.”

Republican “obfuscation” is an understatement. One day, Americans are going to understand just how much destructive damage to our republic has been caused by the radicalized Republican Party and the so-called “fundamentalist/religio/values” conservatives in general. One wonders just how long that is going to take. One wonders if the discovery will come too late.

Beverly Bandler’s public affairs career spans some 40 years. Her credentials include serving as president of the state-level League of Women Voters of the Virgin Islands and extensive public education efforts in the Washington, D.C. area for 16 years. She writes from Mexico.

Resources

AARP. http://www.aarp.org
About.com U.S. Economy. (Kimberly Amadeo) http://useconomy.about.com/od/healthcarereform/
Cohn, Jonathan. http://www.tnr.com
The Commonwealth Fund. A Private Foundation Working Toward a High Performance Health System. http://www.commonwealthfund.org/
Congressional Budget Office. http://www.cbo.gov
Henry J. Kaiser Family Foundation. www.kff.org/healthreform
Urban Institute http://www.urban.org
White House. http://www.whitehouse.gov

Resources and Suggested Links.

Amadeo, Kimberly. About.com Guide. Obamacare series: “Obamacare Explained.” Simple enough to Explain to Your Kids.http://useconomy.about.com/od/healthcarereform/a/Obamacare-Explained.htm ~ “How Does Obamacare Work? Find Out How It Works for You.” http://useconomy.about.com/od/healthcarereform/a/How-Does-Obamacare-Work.htm ~ “How Obamacare Affects You.”http://useconomy.about.com/od/criticalssues/a/Obamacare-Summary.htm ~ “Detailed Advantages and Disadvantages of the Affordable Care Act.” http://useconomy.about.com/od/healthcarereform/a/Obamacare-Pros-And-Cons.htm ~ “Obamacare Ruling A Summary of the Supreme Court Ruling and How It Affects You.” http://useconomy.about.com/bio/Kimberly-Amadeo-22286.htm ~ “Obamacare Bill A Summary of the Bill’s 10 Titles.” http://useconomy.about.com/od/healthcarereform/a/Obamacare-Bill.htm ~ “Obamacare Taxes Find Out How These Taxes Impact You.” http://useconomy.about.com/od/healthcarereform/a/Obamacare-Taxes.htm ~ “The Facts About the True Cost of the Affordable Care Act.” http://useconomy.about.com/od/healthcarereform/a/Cost-of-Obamacare.htm ~ “Repeal Obamacare?” http://useconomy.about.com/od/healthcarereform/f/Repeal-Obamacare.htm

Bandler, Beverly. “Healthcare Reform information Packet.” August 17, 2009.
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Blumberg, Linda J. and Matthew Buettgens. “Why the ACA’s Limits on Age-Rating Will Not Cause ‘Rate Shock’: Distributional implications of Limited Age Bands in Nongroup Health Insurance. Timely Analysis of Immediate Health Policy Issues. Robert Wood Johnson Foundation/Urban Institute. March 2013.http://www.rwjf.org/content/dam/farm/reports/issue_briefs/…/rwjf404637
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_______ “Health Care Reform And Our Myopic Polity.” The New Republic, 2010-03-08. http://www.tnr.com/blog/jonathan-chait/health-care-reform-and-our-myopic-polity
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_______ Another Obamacare Train Wreck Not Happening Federal exchanges look like they’ll have plenty of insurance options. New Republic, 2013-05-31. http://www.newrepublic.com/article/113346/obamacare-insurance-options-looks-exchanges-will-have-plenty
_______ “My Five Obamacare Anxieties.” The scenarios that keep this reform advocate up at night. The New Republic, 2013-05-13.
http://www.newrepublic.com/article/113175/obamacare-anxiety-five-ways-health-care-reform-could-fail
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_______ “New National Scorecard on Health System Performance: U.S. Gets Only 64 Out of 100.” 2011-10-24.http://www.commonwealthfund.org/Newsletters/The-Commonwealth-Fund-Connection/2011/Oct/Oct-24-2011/Whats-New/National-Scorecard.aspx
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_______ Health Care Costs: A Primer, Key Information on Health Care Costs and Their Impact. http://www.kff.org/insurance/7670.cfm The Uninsured: A Primer, Key Facts About Americans without Health Insurance, 2007. http://www.kff.org
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________ “GOP sacrificing constituents to sabotage Obamacare.” VIDEO: Jonathan Cohn, senior editor at the New Republic, talks with Ezra Klein about the renewed effort by Republican activists to sabotage Obamacare ahead of the 2014 elections, and wonder at the political strategy Republicans will employ when states that embraced Obamacare show results and states like Texas that rejected Obamacare to spite President Obama have a healthcare system in shambles. 2013-07-25. GOP sacrificing constituents to sabotage Obamacare VIDEOS from 2009, 2010, 2012. Rachel Maddow Show, 2013-07-25.http://video.msnbc.msn.com/rachel-maddow-show/52583214#52583214
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PBS. “Gambling With Health Care.” NOW /2009-08-14. Provides excellent resources, including an interview with Howard Dean, tips, links, reports.http://www.pbs.org/now/shows/512/index.html
Perr, Jon. “The Republican Health Care Emergency in One Chart.” Perrspectives, 2013-07-24. http://www.perrspectives.com/blog/archives/002824.htm
_______ “To Attack Obamacare, Republicans Forget the Lessons of Bush’s Medicare Reform.” Perrspectives, 2013-07-13.http://www.perrspectives.com/blog/archives/002818.htm
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