Medicare

Bad Faith and Budget Politics

Obama has to do business with people who cannot be trusted to own up to their side of a deal.

AP Images/Jacquelyn Martin

Compromise is often an unhappily revealing art. “Ideals may tell us something important about what we would like to be. But compromises tell us who we are,” the philosopher Avishai Margalit writes. In finding compromises with Republicans on the federal budget, Democrats need to remember not only who they are but who the voters depend on them to be.

Why the Fight over Obamacare May Never End

Since the Affordable Care Act was passed in early 2010, I've held more than one opinion on just how the American public will feel about it as time goes by. Initially, perhaps influenced by the momentousness of the Act's passage, I wrote that once it was actually implemented, it would be much harder for Republicans to attack. They would no longer be able to frighten people with phantoms of death panels, and instead would have to talk about reality. Since people would have their own experience with the law to judge from as opposed to some hypothetical future, the attacks would lose their potency, Republicans would back off, and the law would rise or fall in public esteem on its own merits.

Then I began to have second thoughts. One of the biggest problems, which I wrote about a few months later, is that Obamacare isn't a single program like Medicare that people can come to love. It's a whole bunch of pilot programs and new regulations, many of which involve private insurance or existing programs like Medicare and Medicaid, and when people are affected by those changes they won't necessarily see them as being part of Obamacare. For instance, beginning in January, insurance companies will no longer be able to deny you coverage based on pre-existing conditions. But to most people, interacting as they will be with private companies, it will look like Aetna or Blue Cross or whoever just got more humane, and they may not even know that the government made them do it. Even the exchanges, if they work well, will just be the place where you go to shop for private insurance. Your relationship with the insurer you choose will certainly be affected deeply by the ACA's regulations, but most people still won't understand exactly how.

Among the consequences are that Republicans will be absolutely free to continue to blame every problem anyone has with the health care system on Obamacare, without concern of producing a backlash from the law's supporters.

The Unending War on Obamacare

Flickr/Fibonacci Blue

I'm not a historian, so maybe there's something I don't know, but it seems to me that there may never have been a piece of legislation that has inspired such partisan venom as the Affordable Care Act. Sure, Republicans hated Medicare. And yes, their rhetoric at the time, particularly Ronald Reagan's famous warning that if it passed, "We are going to spend our sunset years telling our children and our children's children, what it once was like in America when men were free," was very similar to what they now say about Obamacare. But once it passed, their attempts to undermine it ran more to the occasional raid than the ongoing siege.

I bring this up because Kevin Drum makes an unsettling point today about the future of Obamacare:

Has Obama Forgotten that Republicans Want to Shrink Government?

Jamelle Bouie/The American Prospect

The lead Politico story today is on President Obama’s rhetoric of “class warfare” and its implications for showdowns on guns, immigration, and budget politics. Politico takes an odd tone throughout, treating Obama’s push for higher taxes on “millionaires and billionaires” as opportunistic rhetoric, and not as a (half-hearted) response to yawning income inequality and tax policies skewed to favor the wealthiest Americans.

Mr. Brooks’s Planet

Josh Haner/The New York Times

Since New York Times columnist David Brooks is the very model of the sentient conservative, his acknowledgements of social reality are often more than just personal—they signal that a particular state of affairs has become incontestable to all but the epistemically shuttered.

Jack Lew: Obama’s Austerity Ambassador

AP Images

There is something seriously off about the mission of the new Treasury secretary, Jack Lew, to Europe. Secretary Lew has been visiting European capitals to persuade leaders there to ease up on the austerity. He has not had a good reception.

Speaking at a joint press conference with the chagrined Lew in Berlin, Wolfgang Schauble, the German finance minister and uber-austerity enforcer, dressed down Lew thusly: “Nobody in Europe sees this contradiction between fiscal consolidation and growth.”

Nobody among the elite, that is. 

Ordinary people in Greece, where output has declined by nearly 25 percent since the austerity tonic began, surely see the contradiction. So do young people in Spain, where the youth unemployment rate has reached 56 percent. 

Destroying the Economy and the Democrats

AP Photo/Susan Walsh

Job creation slowed to just 88,000 in March, signaling a sluggish economy. And President Obama, with unerring timing, picked this moment to put out an authorized leak that he is willing to put Social Security and Medicare on the block as part of a grand budget bargain that will only slow the economy further. The deterioration in economic performance was all too predictable, given the combined lead weights of the March 1 $85 billion of budget cuts in the sequester and the January deal to raise payroll taxes by about $120 billion. (The tax hike on working people was almost double the much-hyped tax increase on the top one percent, which totaled a little over $60 billion.)

How to Fix Social Security? Make it Bigger

401(K) 2013/Flickr

Many liberals, myself included, are frustrated by the mainstream conversation on entitlement spending, which holds as gospel that we need cuts to our two major retirement programs, Social Security and Medicare. But only one of them–Medicare–faces the prospect of high long-term costs. Social Security, by contrast, is a stable and well-funded program, and needs slight adjustments–at most–to ensure its long-term stability.

Take Social Security and Medicare Off the Bargaining Table

Flickr/Adam Fagen

Prominent Democrats—including the president and House Minority Leader Nancy Pelosi—are openly suggesting that Medicare be means-tested and Social Security payments be reduced by applying a lower adjustment for inflation. 

This is even before they’ve started budget negotiations with Republicans—who still refuse to raise taxes on the rich, close tax loopholes the rich depend on (such as hedge-fund and private-equity managers’ “carried interest”), increase capital gains taxes on the wealthy, cap their tax deductions, or tax financial transactions. 

It’s not the first time Democrats have led with a compromise, but these particular pre-concessions are especially unwise.

How to Fix Entitlements? More Immigrants

Gallup

Given Washington’s obsession with spending, this won’t enter the picture, but this figure—from a recent Gallup poll on immigration—is more important to the future of entitlement reform than any policy discussed by President Obama or Congress:

Ringside Seat: Grand Blergain

The sequester cuts have begun to bite, and if Congress doesn't pass a continuing resolution by the end of the month, the federal government will shut down. With that deadline looming, talk has turned once again to the possibility of a Grand Bargain, in which Republicans and Democrats come together in the spirit of compromise, putting aside their differences for the good of the country. "Yeah right," you may be saying, and you have good reason to be skeptical.

The Smart Strategy Behind Paul Ryan's Stupid Budget

Flickr/Donkey Hotey

For an ambitious politician, a spot on your party's presidential ticket is fraught with danger. On one hand, you immediately become a national figure, and if you win, you're vice president and you've got a good chance to become president. On the other hand, if you lose, you may wind up the target of contempt from forces within your own party and quickly fade away. Look at the list of recent VP losers: Sarah Palin, John Edwards, Joe Lieberman, Jack Kemp. None of them had any political future after their loss.

And then there's Paul Ryan. You have to give him credit for one thing. Unlike, say, Palin, he didn't let his time on the national stage give him delusions of grandeur. Instead of proclaiming himself the leader of a movement, he went right back to what he was doing before: using the budgeting process to push an extraordinarily radical agenda, all couched in enough numbers and figures to convince naive reporters that he's a Very Serious Fellow, despite the fact that his numbers and figures are about as serious as an episode of The Benny Hill Show. But this act is what got him where he is, and he seems to have concluded, probably wisely, that his best move is to get back on that same track, which might eventually lead him to the White House.

The Paul Ryan Medicare Shuffle

When Wisconsin Rep. Paul Ryan ran for vice president last year, he campaigned against the $716 billion Medicare cut in the Affordable Care Act, calling it a "raid" on the program. "Medicare should not be used as a piggy bank for 'Obamacare,'" said Ryan last August, after joining the Romney campaign, "Medicare should be used to be the promise that it made to our current seniors. Period. End of Story."

Next Up: Another Budget Fight

Flickr/Ryan McFarland

Senate Democrats are set to release a budget this week, the first time they've done so since 2009. As always, it will be a collection of the party's goals and priorities—more a political statement than a plan for governing. Democrats, according to National Journal, will propose new revenue beyond the fiscal-cliff deal as well as new spending on education, infrastructure, and job training.

When Public Is Better

Flickr/Mirsasha

Long before we thought of founding The American Prospect in 1989, I came to know Paul Starr through a prescient article titled “Passive Intervention.” The piece was published in 1979, in a now-defunct journal, Working Papers for a New Society.

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