Over at the New York Times, Ross Douthat has a mostly excellent take on the Wisconsin recall and what it means for American politics. The short story is that economic distress will result in a zero-sum politics, where both sides vie for the greatest gains while doing as much as possible to block their opponents. He exaggerates the extent to which this is true on the Democratic side—Democrats haven’t pushed laws to keep Republicans from voting, nor have they used legislation to attack core GOP constituencies—but the point is well taken.
Sometime soon—probably in three weeks or so—the Supreme Court is going to hand down its ruling on the Affordable Care Act. Given what happened at the oral arguments, there aren't too many people predicting that the ACA will be upheld, although that of course remains a possibility. Those oral arguments now seem like someone smacking us awake out of a dream in which we believed that the Republican-appointed justices might have something in mind other than the partisan and ideological advantage of their side. It was a weird dream, so weird that in the days before the arguments, some people seriously discussed the possibility that Antonin Scalia might be bound by the logic he had followed in previous cases involving the commerce clause and vote to uphold the law. What a joke.
I've written many times, by way of explaining congressional Republicans' actions on the issue of health care, that it just isn't something that conservatives as a group care very much about. They have other interests, like taxes and the military, that they'd much rather spend their time on. This may strike some as unfair, but I think it's pretty clear from everything that's happened over the last couple of decades that it's true. There are a few conservative health wonks, but not nearly as many as there are on the liberal side. I can't think of any conservative journalists who are deeply conversant with the policy challenges and details of the health care system, while on the liberal side we have a number of such people, like Ezra Klein and Jonathan Cohn. Liberals have organizations dedicated to reforming the health system and achieving universal coverage; conservatives have organizations dedicated to stopping liberals from reforming the health system and achieving universal coverage. Other than an eternal desire to limit the ability of patients to sue for malpractice (which is as much about hamstringing trial lawyers, who donate a lot of money to Democrats, as it is about improving health care), Republicans only propose anything intended to improve the health care system when political events make it impossible for them to remain silent.
Which is why it's reasonable to be highly skeptical whenever congressional Republicans start talking about what they'd like to do on health care. That's the proper spirit to take the latest news on how conservatives are positioning themselves:
Despite what the average voter probably thinks, presidential candidates keep the overwhelming majority of the promises they make. And most of the ones they don't keep aren't because they were just lying, but because circumstances changed or they tried to keep the promise and failed. But that's in the big, broad strokes, while the details are another matter. It's easy to put out a plan for, say, tax reform, but even if you achieve tax reform, it's Congress that has to pass it, and they will inevitably shape it to their own ends. This happened to a degree with President Obama's health care reform: it largely resembles what he proposed during the 2008 campaign, but not entirely. He had said he wanted a public option, for instance, but eventually jettisoned that, and had rejected an individual mandate, but eventually embraced it as unavoidable.
Which brings us to Mitt Romney's health care plan...
The Romney campaign is out with its first ad, a positive spot that highlights Keystone, health care, and tax cuts. The aim of the ad is to show Americans what President Romney would do in his first day of office, and to that end, it gets the job done, even if it’s mostly paint by numbers:
The House plans to vote today on a Republican plan to avoid the $110 billion in Pentagon sequestration cuts that would be triggered at the end of the year because of the failure of last year's supercommittee. "People know at the end of the day that this is not going to be all sunshine and cotton candy," said Representative Tom Cole, a Republican from Oklahoma.
I’m not surprised that Michael Gerson, architect of “compassionate conservatism,” has convinced himself that this generation of Republican leaders is carrying on in his footsteps (via Mike Allen):
Obama’s overreach has also produced another conservative reaction – a Reform Conservatism. The key figure here is Paul Ryan … Its brain trust includes thinkers such as Yuval Levin, James Capretta and Peter Wehner. The reform movement … looks for ways to achieve the ends of the welfare state both through more private means and more efficient public means. … Speaker John Boehner has adopted Ryan’s reform approach as the de facto ideology of the House Republican majority. [Emphasis mine]
Social Security will run out of funds in 2033—sooner than forecast last year—according to a new government report. Medicare's hospital insurance fund will be gone by 2024. Together, the programs account for 35 percent of all federal spending, and if the trust funds—which are made up of the difference between the payroll taxes paid toward the programs and the benefits doled out—were depleted, benefits would be automatically cut by 25 percent. Social Security's disability insurance faces the soonest expiration—it is now scheduled to run out of money in 2016, two years earlier than projected last year.
Paul Ryan's budget has become a rallying cry for Democrats, and President Obama's re-election in particular. Republicans have long expressed an antipathy for the general concept of government services, but these were often expressed in the abstract or lone exceptions, with the party generally focusing on the starve-the-beast philosophy of reducing taxes so that government outlays would eventually have to be reduced. Ryan's budget gets that down on paper in crystallized form, codifying those ideas into a specific vision for the future that would gut all government services except health spending, Social Security, and an increased budget for defense, discarding the rest of discretionary spending.
Sitting in the Supreme Court on March 27, I was stunned by the oral argument on the Affordable Care Act (ACA). From their first questions to Solicitor General Donald Verrilli, the conservative justices seemed to echo the arguments against the individual mandate that the opposing lawyers had set out in their briefs. When it was over, I was not 100 percent sure that Justice Anthony Kennedy would vote to overturn the mandate and related penalties. But if he does, the Court may well strike down the law’s other critical provisions, staging what amounts to a conservative judicial coup.
Paul Ryan, the supposed champion of fiscal restraint among right-wing Republicans, has put his colleagues in an awkward bind. His budget includes a host of unpopular provisions, and if implemented, would eviscerate almost every part of the government except defense, health care, and Social Security by 2050 according to the Center on Budget and Policy Priorities. Yesterday, all but 10 House Republicans entered their name in the congressional record as supporters of the bill, providing Democrats with ample material for negative campaigning this fall.
Today, the members of the Supreme Court will meet in private to begin deciding the fate of the Affordable Care Act, and the millions of Americans whose lives and futures stand to be made more secure because of the ACA. It's entirely possible that Anthony Kennedy will discover some place in his heart where integrity and a respect for the true role of the Court are supposed to be and the Act will be upheld, but at the moment you won't find too many people willing to bet on it.
So I'd like to spend a few moments working through what might happen if the Court takes the middle course, which could be the most likely—striking down the individual mandate, but leaving the rest of the law intact—both in the short and long term.
The wise Harold Pollack has argued that health care reform is in some ways the best covered social policy story in the history of American journalism. That isn't to say there hasn't been plenty of crappy coverage, but there has never been the same volume of informed and insightful reporting and analysis available in so many places on a pressing policy debate.
And yet it's easy to get depressed about the impact all that good work didn't have...
I don't know about you, but every time I read the term "Obamacare," I can't help but hear Michele Bachmann's voice saying it, in that singsongy Minnesota accent. But I guess Team Obama thinks I'm in the minority, because they've decided to go ahead and embrace the term. As David Axelrod wrote in an email to supporters, "Can you imagine if the opposition called Social Security 'Roosevelt Security'? Or if Medicare was 'LBJ-Care'? Seriously, have these guys ever heard of the long view?" Which is fine.
When the Supreme Court begins its extraordinary three days of hearings on the constitutionality of the Affordable Care Act, one of the oddities will be an amicus brief challenging the act’s individual mandate from 50 doctors who support national health insurance. They point out the inconvenient truth that, contrary to the administration’s representations, the government did not need to require citizens to purchase insurance from private companies in order to meet its goals of serving the health-care needs of the populace. Congress could have enacted a single-payer law.