Thursday, October 31, 2013

No, 93 million Americans will not lose their health plans under Obamacare

Avik Roy is within his conservative pundit rights in spotlighting the grievances of the estimated 3 percent of the population who may be subject to higher health insurance premiums when the ACA takes full effect in 2014 than they currently pay for plans in the existing individual market.  He descends into partisan hackery, however, in suggesting that tens of millions more will "lose" their coverage as employers' "grandfathered" plans fall by the wayside, as they are bound to do -- and that therefore, "93 million Americans will be unable to keep their health plans under Obamacare."

Roy purports to find a nuclear bomb in interim final regulations for group health plans issued in the Federal Register in 2010:
Contrary to the reporting of NBC, the administration’s commentary in the Federal Register did not only refer to the individual market, but also the market for employer-sponsored health insurance.

Wednesday, October 30, 2013

Will red states stonewalling the ACA pay for self-inflicted punishment?

The long-term effects of the Affordable Care Act that everyone should ardently wish for are 1) access for all Americans to affordable, adequate health insurance and 2) reduced or reversed health care inflation.

Republican governors and/or state legislatures determined to sabotage the law are causing needless suffering, by denying millions the access to Medicaid the law was designed to provide, and by refusing to run the private insurance marketplaces, forcing the federal government to operate them in 34 states, with so-far disastrous results. State-level stonewalling goes beyond refusal to build a website: it also means abjuring the responsibility both to entice insurers into the exchanges and to impose discipline on those that participate, via state adaptation of the federal coverage guidelines, and by working to prevent adverse selection in the exchanges through state regulation of the individual market outside them.

No real good can come of deliberate misgovernance. But its consequences may trigger self-correction over time. States that try to make the law work may emerge as better places to live than states that don't -- offering Medicaid to the lowest-income adults, and a competitive, well-regulated and subsidized market to those with modest incomes. That creates a range of economic freedoms -- to leave a full-time job to start a business or go to school, to go from full- to part-time to do either, or undertake the kind of de facto apprenticeships that a career change often requires, or care for a sick parent.

On the most basic level, Donald Taylor points out that the states refusing Medicaid expansion are effecting a wealth transfer to states that embrace it:

Sunday, October 27, 2013

"What if Obamacare works?" -- What Ross Douthat leaves out

Ross Douthat "fairly fairly" describes the differences between the cheapest health insurance plans available on the ACA exchanges and the cheapest plans currently available on the individual market, most of which will be phased out because they don't comply with ACA minimum coverage requirements.  But he leaves some important facts out.

Douthat acknowledges that the ACA's premium subsidies will offset the price increase for many who buy on the exchanges, and he fairly if too briefly presents the limitations of a cheap plan currently available on the individual market ("a $5,000 deductible, an annual out-of-pocket limit of $12,500, and all kinds of copays and coverage restrictions"). He then frames the ACA's political prospects like this:
With some grandfathered exceptions, Obamacare makes those kinds of plans illegal. The out-of-pocket limit for individuals is capped at $6,500 a year, preventive services are fully covered, and various “essential benefits” as well. 

If we ever get beyond the follies of HealthCare.gov, the politics of the rollout will probably be defined by how (and how vocally) middle-class Americans just above the subsidy threshold react to this “pay more, get more, subsidize other people” deal.
True, perhaps -- though the politics will also be defined by the reactions of those eligible for the subsidies, and those shut out of the current market by preexisting conditions or age (the ACA limits age-related price differentials to 3-to-1; currently they're as high as 6-to-1), or, to a lesser extent, by those newly eligible for Medicaid (who are less likely to be politically vocal and perhaps less likely to recognize that their new benefits are a product of the ACA).

It's Douthat's presentation of the likely long-term consequences of a successful ACA rollout that tilts our view of past and future playing fields:

Friday, October 25, 2013

A companion list to The Atlantic's "50 Greatest Inventions"

The Atlantic has a panel-generated list of the 50 greatest inventions since the wheel, which is entertaining, and an accompanying James Fallows meditation on what the exercise can teach us about innovation's impact, value and future prospects, which is humane, urbane and deeply informed, as you'd expect from Fallows.

Fallows also provides a "taxonomy" of the 50 chosen items. I had read the listicle first, and when I came to the lead-in to the taxonomy, it immediately made me sense a category missing from the list:
One of our panelists, Leslie Berlin, a historian of business at Stanford, organized her nominations not as an overall list but grouped into functional categories. From our panelists’ nominations, a similar but slightly broader set of categories emerges. Here is my adaptation of Berlin’s useful scheme.
Fallows' categories are as follows: innovations that 1) expand the human intellect; 2) are integral to the infrastructure of the modern world; 3) enabled the industrial revolution; 4) extend life; 5) allow real-time communication out of voice range; 6) enhance transportation; 7) enable organizational breakthroughs (clocks, calendars, alphabetization); and 7) facilitate killing.

I shouldn't say that what I want to add was "missing" -- arguably it didn't belong. Let's call mine a companion list. But it occurred to me a while back that the U.S. Constitution was a kind of enabling technology of the modern world, and that makes me want to think more about what you might call social technologies, from those traceable to the dawn of recorded history to the present (excluding an earlier strata including language, worship and prayer, marriage and tribal organization). Here's a first pass at a list of key "inventions" of this kind. It's neither chronological nor ranked in order of "importance," but rather loosely grouped according to type: legal, political, economic, pedagogical.

Thursday, October 24, 2013

John G. Taft's evasive honesty

What a peculiar exercise in moral exhortation. John G. Taft rather bravely excoriates the recklessness and cruelty of the current Cruzified GOP in the name of the party's grand old traditions of responsible governance and fiscal probity-- presumably embodied in "Five generations of Tafts [who] have served our nation as unwaveringly stalwart Republicans." And yet he does so by invoking the party's -- and his family's -- past shame: its collusion with Joe McCarthy's communist witch hunt. Taft manages to be refreshingly honest and subtly evasive all at once.

Taft levels his attack against Ted Cruz & co. in the name of his grandfather:
As I write, a photograph of my grandfather, Senator Robert Alphonso Taft, looks across at me from the wall of my office. He led the Republican Party in the United States Senate in the 1940s and early 1950s, ran for the Republican nomination for president three times and was known as “Mr. Republican.” If he were alive today, I can assure you he wouldn’t even recognize the modern Republican Party, which has repeatedly brought the United States of America to the edge of a fiscal cliff — seemingly with every intention of pushing us off the edge.

Throughout my family’s more than 170-year legacy of public service, Republicans have represented the voice of fiscal conservatism. Republicans have been the adults in the room. Yet somehow the current generation of party activists has managed to do what no previous Republicans have been able to do — position the Democratic Party as the agents of fiscal responsibility.
"The adults in the room" -- except with respect to one little issue that is the focus of Taft's historical analogy:

Tuesday, October 22, 2013

The Obamaquester according to Harry

Harry Reid's view of the sequester -- and how we got saddled with it -- has been seeping into the national political narrative in recent weeks. Notwithstanding his alleged renewed bonds and recent successful teamwork with Obama, his view is not a pretty picture for the president.

In Twitter exchanges with Greg Sargent and others -- I think Jonathan Bernstein and Brian Beutler -- I have sought a convincing account and analysis and possibly justification of the Obama administration's thinking at the fiscal cliff -- why Biden, with Obama's backing, cut in on Reid's negotiations with McConnell and settled for half a revenue loaf and only a short-term sequester postponement. I haven't found one. And today's somewhat triumphal narrative by Sam Stein and Ryan Grim of the Democrats' short-term shutdown victory -- a purported tale of renewed harmony and mutual trust -- also provides the opposite of what I've sought: Reid's indictment of Obama's fiscal cliff conduct.
 He complained that Vice President Joe Biden had undercut fiscal cliff negotiations at the end of 2012, when Senate Minority Leader Mitch McConnell (R-Ky.) was offered a more generous deal on tax revenue and sequester spending than Reid felt he could have crafted.
It didn't escape his notice, Reid said, that the deal Biden made conveniently postponed the budget cuts two months, or just long enough to allow the Inauguration and the State of the Union address to pass without the sequester's shadow. Senate Democrats had been pushing for a two-year delay and had been prepared to settle for just one.

Monday, October 21, 2013

Okay, so our problem is GOP extremism -- but what's driving that?


Jonathan Bernstein advances a kind of Bad Man theory of contemporary American politics -- the bad man being Newt Gingrich, the GOP's Faust. The problem with U.S. politics, he argues, isn't structural, and it's not political polarization per se:
No, the problem is the Republican Party, which has developed a weird and dysfunctional set of incentives along with the legacy of a handful of role models they would be better off without. There’s the race to be the True Conservative, which requires staking out ever-more-crazy positions in order to differentiate from RINOs and squishes – and the reaction by mainstream conservatives who are terrified at losing their conservative credentials and therefore cling as close as possible to the nuttiest radicals out there. There’s the lucrative conservative marketplace, which thrives on incivility and conflict – that’s one set of perverse incentives – and which also thrives when Democrats are in office, which is another set of perverse incentives. There’s the conservative closed information feedback loop, with Republican Party actors and politicians failing to see the U.S. that the rest of the nation sees.

Sunday, October 20, 2013

We're still in the sequester's grip

George Packer zooms out from the latest fiscal skirmish to assess the state of budgetary warfare in the Obama era:
President Obama and the Democrats in Congress appear strong for refusing to give in to blackmail.

But in a larger sense the Republicans are winning, and have been for the past three years, if not the past thirty. They’re just too blinkered by fantasies of total victory to see it. The shutdown caused havoc for federal workers and the citizens they serve across the country. Parks and museums closed, new cancer patients were locked out of clinical trials, loans to small businesses and rural areas froze, time ran down on implementation of the Dodd-Frank financial-regulation law, trade talks had to be postponed. All this chaos only brings the government into greater disrepute, and, as Jenny Brown’s colleagues dig their way out of the backlog, they’ll be fielding calls from many more enraged taxpayers. It would be naïve to think that intransigent Republicans don’t regard these consequences of their actions with indifference, if not outright pleasure. Ever since Ronald Reagan, in his first inaugural, pronounced government to be the problem, elected Republicans have been doing everything possible to make it true.

Saturday, October 19, 2013

Forever young in the New World

I can't remember what triggered it, but at dinner tonight I pulled out a copy of Death Comes for the Archbishop and read to my wife one of my favorite passages in American literature. It gives me a craving for something of which I've had intimation but never fully experienced -- except in reading this:
All his relatives at home, and his friends in New Mexico, had expected that the old Archbishop would spend his closing years in France, probably in Clermont, where he could occupy a chair in his old college. That seemed the natural thing to do, and he had given it grave consideration. He had half expected to make some such arrangement the last time he was in Auvergne, just before his retirement from his duties as Archbishop. But in the Old World he found himself homesick for the New. It was a feeling he could not explain; a feeling that old age did not weigh so heavily upon a man in New Mexico as in the Puy-de-Dôme.

He loved the towering peaks of his native mountains, the comeliness of the villages, the cleanness of the country-side, the beautiful lines and cloisters of his own college. Clermont was beautiful,-- but he found himself sad there; his heart lay like a stone in his breast. There was too much past, perhaps. . . . When the summer wind stirred the lilacs in the old gardens and shook down the blooms of the horse-chestnuts, he sometimes closed his eyes and thought of the high song the wind was singing in the straight, striped pine trees up in the Navajo forests.

Thursday, October 17, 2013

Twas the Night Before Shutdown (complete)

Twas the night before shutdown: the House changed its rules
To hold us all hostage to vain spiteful fools.

Poison pills had been stuffed in the CR with care
To deprive shiftless "others" of Obamacare.

A Senate CR, disinfected and clean,
Was blocked from a vote by the rightwing machine.

And Boehner with his baritone, and Cruz with his glower,
Took to podiums to prove gu'mmint could not sink lower.

So workers were furloughed and services shuttered.
The president was grounded, th'economy sputtered...

And all of a sudden the government mattered!
And Cruz and his crew with their own spite were spattered.

Twas the night be shutdown...Twas the night before default, cont.

The exciting conclusion...full epic after the jump.

     The leadership, stunned, called the vote off and soon
     The air fizzled out of the Tea Party balloon.

     The Senate bill, simplified, once more was tendered,
     As Boehner, Paul, Cruz in swift sequence surrendered.

     "We just didn't win. But we fought the good fight."
     Quite so -- if "good" equals "pumped full of spite."

     Thus did the caucus put on a brave face,
     Raised one more chorus of Ah-mazing Grace,

     Checked on their vitals and took a deep breath,
     Prepped to defend the sequester to death,

     Chanted their catechisms, glowing with pride --
     Beguiled, reviled and self-Cruzified.

Wednesday, October 16, 2013

Twas the Night Before Shutdown...Twas the Night Before Default

The epic continues...

Then Collins cooked up something Murray could swallow,
Five queens signed on, and the old bulls clicked "follow":

Senate-House conference on terms uncoercive,
Tweaks to Obamacare none too subversive,

Debt ceiling bump-up and short CR, clean,
Sequester not locked in for 2014.

Markets exhaled and the indexes soared,
Till Boehner rolled one more grenade of discord:

"Don't touch that hostage! A price must be paid --
Even if only by us and our aides...

National default is a bridge none too far
To uphold our values -- whatever they are."

Thus Boehner spooled his caucus one last yard of rope
To twine round their necks, as the nation's last hope.

Lo, Heritage Action gave one mighty yank,
The diehards jumped ship, and the House CR sank.

    To be continued (if the world does...)

Twas the Night Before Shutdown, Canto I
UPDATE: Here's the whole thing

Monday, October 14, 2013

Twas the Night Before Shutdown

Yesterday, Kurt Eichenwald tweeted:
Night before shutdown, House changed its rules so that ONLY GOP leadership could bring budget to floor. But it's the "Obama shutdown." Sigh. [Details here] .
The language sounded familiar, and seemed to gallop of its own accord as below -- with an assist from Matt Glassman as noted (MG):

Twas the night before shutdown: the House changed its rules
To hold us all hostage to vain spiteful fools.

Poison pills had been stuffed in the CR with care
To deprive shiftless "others" of Obamacare.

A Senate CR, disinfected and clean,
Was now blocked from a vote by the rightwing machine.

And Boehner with his baritone, and Cruz with his glower,
Took to podiums to prove gu'mmint could not sink lower.

Sunday, October 13, 2013

What McConnell could cook up with Reid

Well, the rumors are flying thick and fast this Sunday, and this post probably won't be worth the pixels it's printed on. But based on Mitch McConnell's past dealmaking history, his acknowledged relative lack of leverage this time, and the drop-dead taboos against raising spending levels or taxes that a primary challenge imposes on him, I can't resist a bit of speculation as to what he may be cooking up with Reid (Dick Durbin called the talks between them a "breakthrough" today, though Reid himself has sounded far less sanguine).

Recall that the Budget Control Act negotiated by McConnell in the last days of July 2011 created a mechanism whereby the executive branch could raise the debt ceiling and Congress could register a vote of disapproval -- or override the hike with a two-thirds majority in both houses. That deal was end-stopped by the amount required to raise the debt ceiling high enough to get past the 2012 election; it ran out in March of this year.

Recall too that progressive éminence grise Norm Ornstein has floated an acceptable exception to the Dems' current no-concessions-for-debt-limit-hike stance: trade a single concession to end debt ceiling terrorism forever:

Friday, October 11, 2013

The party that loses by winning

On July 4, 2011, when the Republicans were in the process of nailing Obama to the debt ceiling, David Brooks wrote:
If the Republican Party were a normal party, it would take advantage of this amazing moment. It is being offered the deal of the century: trillions of dollars in spending cuts in exchange for a few hundred billion dollars of revenue increases.
With about $4 trillion in deficit reduction over ten years the agreed target, Obama was ready to settle for just $800 billion in new revenue, a roughly 4-to-1 ratio of spending cuts to revenue . But the GOP passed up Brooks' 'deal of the century.' A four-fifths win for the no-new-taxes-ever crowd wasn't good enough for them.

They did "win," though, by forcing Obama to swallow, under threat of national default, the Budget Control Act, which purported to match every dollar of debt ceiling increase with a dollar of deficit reduction, with no concession on the Republicans' part that any of that reduction would come through tax increases. Nor has it, now that Republicans have learned to love the sequester, or professed to. The BCA imposed over $900+ billion in cuts to discretionary spending over ten years, and then another $1.2 trillion through sequestration if a Congressional supercommittee could not agree on a plan to replace that second tranche with a deficit reduction package of equal value. Since Republicans would not agree to any sequester replacement including new revenue, it is still with us, and the DBA's deficit reduction mix remains (approximately, counting interest savings), spending cuts $2.5 trillion, revenue 0.

Wednesday, October 09, 2013

Reading Oryx and Crake in the time of debt ceiling brinksmanship


I'm not quite sure when my long-held optimism about the human race took shape, but my read of history for some time has been that human life is steadily improving, that our progress, notwithstanding major setbacks, has been moral as well as material, and that we are adaptive enough to continue to increase wealth, freedom and peace. There's always been the caveat that global warming or some as-yet-unimagined disaster could undo all -- or that we would bioengineer or own evolution or replacement. But I've felt reasonably confident that the progress of the last few hundred years -- long lives, better health, less subjection to violence, more scope for more people to exercise their faculties -- would continue.

Margaret Atwood's Oryx and Crake trilogy, which I've read in the last couple of weeks, has dinged this optimism.  It's a double dystopia, with two narrative presents:  an anarchic world of balkanized corporate dominance and environmental degradation prior to the near-extinction of humanity by an engineered superbug, and a remnant community's life in the ruins - and interaction with a community of genetically engineered human mutants designed to be more pacific-- after the "waterless flood."

Tuesday, October 08, 2013

Maybe it doesn't matter, but...

I wish Obama would clarify, when laying out his current position on budget negotiations (as in today's press conference), that 1) he and Democrats in Congress have already agreed to the funding levels stipulated in the House GOP's bill funding the government for the next two months, and 2) what he's willing to negotiate is a bill funding the government on new terms for the rest of FY 2014 and the years beyond. In statements like this...
At the beginning of this year Speaker Boehner said, what we want is regular order and a serious budget process. So the Senate should pass a bill and the House should pass a bill, and then a committee comes together and they hash out their differences and they send the bill to the president. Well, that's exactly what Democrats did.

Except somewhere along the way, House Republicans decided they wouldn't appoint people to the committee to try to negotiate, and 19 times they've rejected that. So even after all that, the Democrats in the Senate still passed a budget that effectively reflects Republican priorities at Republican budget levels just to keep the government open, and the House Republicans couldn't do that either.
...it remains unclear what Democrats agreed to (Republican spending levels in a 6-10 week continuing resolution), what they've balked at (a litany and sequence of demands extraneous to that short-term funding), and what Obama is willing to negotiate if/when the threats of government shutdown and debt default are removed (funding for the remaining 9-10 months of FY 2014 and a long-term replacement of the sequester with a mix of more targeted spending cuts, including to entitlements, and revenue-yielding reductions in tax loopholes).

Saturday, October 05, 2013

General Giap and the GOP

Responding to Republican calls for a broad fiscal "dialogue" under the double threat of government shutdown and looming debt ceiling, the Times editorial board reacts with commendable incredulity -- but salts in, I think, a misconception (my emphasis):
This is a moment for immediate action to reopen government’s doors, not the beginning of a conversation that Republicans spurned when they lacked the leverage of a shutdown. They have refused to negotiate over the Senate’s budget, they have refused to negotiate over the president’s budget, and they have refused to negotiate to make the health law more efficient, insisting only on its demise. 
 The shutdown does not increase Republican leverage -- it erodes it.  Grover Norquist understands this:

Thursday, October 03, 2013

The Civil War, a distant mirror for Obama

Here's Obama speaking to* John Harwood of CNBC yesterday about what's at stake in the looming debt ceiling battle:
The fight that we're having right now is not about the healthcare law, it's not about a particular budget— what it has to do with is do we continue with that process where we have elections, the majorities are determined, there's some protections for minorities in the system, but ultimately, you know, we are able to strike compromises and then move forward. And if we can't do that— this country's too diverse, it's too big— you know, what you'll end up seeing is more and more the polarization that you talked about, that's not healthy for our politics. 

That is, debt ceiling terrorism must be tamed so that government of the people, by the people, for the people, shall not perish from...this country. It does now exist to some varying extents in other parts of the earth as well as (or better than) here, so let's alter Lincoln's formula accordingly.

A couple of days ago, I noted that Obama was channeling Lincoln a bit while categorizing his political opponents' values:

Wednesday, October 02, 2013

Do tell, NYT, of Israel's place at the US policymaking table

The New York Times editorial board does not like Benjamin Netanyahu, and hopes for success in the United States' upcoming round of negotiations with Iran. Yet they go rather easy on Netanyahu in response to his UN speech yesterday urging the U.S. and allies to regard Iran's seemingly conciliatory new president, Hassan Rouhani, as a wolf in sheep's clothing.

The Times editorialists note that the Iranians "were not happy that Mr. Obama, meeting Mr. Netanyahu at the White House on Monday, took a harsher tone toward Iran than he did when he spoke by phone with Mr. Rouhani last week"  -- but imply that Iran ought to be able to understand such posturing. The language in which they explain the political dynamic at work in both countries is revealing in what it assumes about U.S. politics:

Apocalypse now?

Robert Costa, perhaps the best-sourced reporter on Republican thinking, indicates that warnings in the wake of the 2011 debt ceiling deal that Obama had enabled debt ceiling terrorism for the foreseeable future were true:
Most of the conference is well aware of the consequences of default. In fact, over the past few years, the House GOP leadership has actually hosted private meetings for members about what default means and why it shouldn't happen. But, at the same time, Republicans are very eager to get some kind of 2011-esque concession from the White House and Senate Democrats on the budget, when they were able to pass legislation that led to sequestration. Of course, the political climate then was different, due to the GOP having recently won the House, but the GOP is hoping for a similar outcome this time, and you have leaders like Paul Ryan publicly talking about a larger agreement being possible. I'm still skeptical though, since most Republicans are unwilling, at all, to bend on taxes, and Democrats aren't exactly scrambling to cut a big deal with Boehner, who they think is in a weakened position.
Costa suggests that the current standoff over a short-term continuing resolution is likely to bleed into debt ceiling negotiations -- which Obama has stated categorically and repeatedly that he won't engage in. He also seems to think that Democrats are likely to waver in their resolve to negotiate neither the CR -- for which there's already agreement (on GOP terms) as to spending levels -- nor the debt ceiling. Here's Obama yesterday on the latter:

Tuesday, October 01, 2013

Does a clean CR mean a clean shot at Republicans?

I have been gnashing my teeth at Democrats' preemptive surrender on the spending levels in the ten-week continuing resolution passed by the House, which establishes the sequester as a spending baseline.  Why not amend the CR to reflect the spending levels in the House budget, I thought, as well as stripping out the defunding of Obamacare, and then negotiate over spending?  That would leave Republicans an out: they could claim the victory they've already won (on spending).

Maybe I was wrong.  Conceding the House spending levels puts the spotlight squarely on Republicans' extraneous demands. And oh did Obama shine that spotlight today.  He's fought two skillful election campaigns against Republicans, but I don't think he's ever so squarely accused them of moral bankruptcy as this:

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