RSS

United States National Health Care Act

Why the Fight over Obamacare May Never End

Paul WaldmanMay 01, 2013

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 Paul Ryan Medicare Shuffle

Jamelle BouieMar 11, 2013

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."

When Public Is Better

Robert KuttnerMar 08, 2013
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.

Republican Rationality on Medicaid

Paul WaldmanFeb 21, 2013
Rick Scott, who surprised everyone and did the right thing. (Flickr/Gage Skidmore)

Florida governor Rick Scott, with his skeletal frame, shiny bald pate, 9-figure fortune possibly obtained at least partially through Medicare fraud, and love of humiliating poor people, resembles nothing so much as a comic-book villain. So it was something of a surprise when he announced yesterday that he is reversing his previous position and will allow poor Floridians to receive Medicaid coverage as provided for in the Affordable Care Act. It isn't hard to explain why: the federal government is paying 100 percent of the cost of new enrollees in the first few years, and nearly all the cost thereafter, meaning for a small investment on the state's part it gets a healthier, happier, more productive citizenry. Only a truly despicable politician would turn it down, preferring to see their constituents go without health insurance than get it from the government, as I've argued (OK, "raged" is more like it) before.

After the Supreme Court said it its Obamacare decision that states could opt out of the Medicaid expansion, some people were more optimistic than I was, arguing that though Republican governors might shake their fist at Barack Obama for a while, eventually the Medicaid money would be too difficult to turn down. It's looking like I was wrong and they were right; Scott follows Republican governors in states like Ohio and Michigan in announcing that they'll accept the expansion, and though there are still some holdouts (most notably Rick Perry of Texas, which has more uninsured than any other state), the dominoes are starting to fall.

So what does this tell us? It turns out that even the most ideological politicians respond rationally to the incentives they're presented with—maybe not all the time, but much of the time.

Romney Is Stuck Between Two Terrible Messages on Medicare

Jamelle BouieAug 16, 2012

It’s hard to overstate the muddled message Republicans have had on Medicare since Paul Ryan joined the ticket last weekend. As soon as the announcement was official, Team Romney issued talking points distancing their nominee from Ryan’s budget, including his plan for Medicare. On Monday, however, Romnney took the opposite approach, telling crowds in Miami he was on the “same page” as Ryan.

Medicare Myths, Debunked

Paul WaldmanAug 16, 2012

At the moment, the hot issue of the 2012 presidential campaign is Medicare, with the Obama and Romney campaigns trading charges and counter-charges over the health-insurance program for the elderly. Since we at the Prospect love clarifying the muddy and making the complex understandable, we thought we'd unpack the arguments the two sides are making and provide some context so we can all grasp this a bit better. We'll start with the campaigns' claims.

 

Does Mitt Romney actually want to "end Medicare as we know it"?

That's the charge Democrats are now making; here's a video the Obama campaign just released:

Romney Pivots from Welfare to Lie about Medicare

Jamelle BouieAug 14, 2012

I have a feeling that I’ll be writing this with some regularity over the next three months, but the Romney campaign has released a new, shamelessly dishonest ad attacking President Obama for the Medicare cuts in the Affordable Care Act:


Romney’s ad paints the Medicare cuts as some kind of theft—the money was meant for seniors, but Obama took it away to fund his “government takeover of health care.”

I Know You Are But What Am I? Medicare Edition

Paul WaldmanAug 14, 2012

Republicans' pleasure over Mitt Romney picking Paul Ryan for his running mate is tempered by their nervousness that Democrats will use Ryan's budget to hammer them on Medicare, particularly in Florida. And yes, they will. So how are Republicans going to respond? The answer is that they'll employ the time-honored "I know you are, but what am I?" strategy.

The National Republican Congressional Committee, the House Republicans' campaign arm, is sending out memos to its members telling them to, in the title of one, "Stay on offense on Medicare." And how do you do it? You say, we're not the ones who want to destroy Medicare, the Democrats are the ones who want to destroy Medicare! We're already hearing it from Romney and Ryan, and it'll be coming from all kinds of other places as well; here's the Heritage Foundation saying "Obamacare ends Medicare as we know it." (How? Because it's all governmenty.)

This kind of muddying of the waters has worked before...

Five Things to Know about Paul Ryan's Plan

Jamelle BouieAug 13, 2012
(AP Photo)

Long before he won the Republican presidential nomination, Mitt Romney had enthusiastically endorsed the budget of Wisconsin Representative Paul Ryan as the template for his own proposals. As I detailed in the Prospect's print magazine, Romney promises to extend the Bush tax cuts, cut income-tax and capital-gains rates, and reduce corporate taxes. 

Your Guide to "Ending Medicare As We Know It"

Paul WaldmanJul 20, 2012
Paul Ryan is very sincere.

Yesterday, President Obama went to Florida and told seniors that Mitt Romney wants to end Medicare as we know it, and it appears that this argument (and some related ones) will be a central feature of the Obama campaign's message in the coming days. It's entirely possible, as Jonathan Chait has suggested, that all the Obama campaign's attacks on Romney's finances and record at Bain Capital are the first stage of a two-stage strategy that culminates with an attack on the Ryan budget. Since we'll be talking about this a lot soon, I thought it might be worthwhile to refresh our memories on what this is all about, particularly with regard to Medicare, and how it relates to the current campaign.

First: Is it fair to tar Mitt Romney with the Ryan plan? No question.

Running on Health Care

Jamelle BouieJul 06, 2012

A significant part of the Affordable Care Act’s unpopularity had less to do with the law itself, and everything to do with its contested status. With Democrats unhappy and Republicans furious, voters saw the law as something controversial and potentially terrible. As such, the Supreme Court’s decision to uphold the law was an important signal to low-information voters; it communicated a certain amount of legitimacy, which—as we saw at the beginning of this week—translated to increased support for the bill. According to a poll from CNN, for example, support for Obamacare increased to 50 percent after the Court’s ruling.

Failures of Spin

Paul WaldmanJul 02, 2012
Flickr/Gage Skidmore

Republican Senate leader Mitch McConnell is ordinarily a spinner of unusual skill. He's relentlessly focused on his message and doesn't let any interviewer frame a question in a way he (McConnell) doesn't like. Which is why it was a little odd to see Fox News' Chris Wallace catch him without a handy talking point when it came to covering the uninsured. This excerpt is a little long, but you have to see the whole thing:

Why It's Still in States' Interests to Expand Medicaid

Abby RapoportJun 28, 2012
(Flickr/ernstl)

For supporters of the Affordable Care Act, it was hard to hear—over the cheering—anything besides the fact that the Supreme Court today kept the law almost entirely intact. But the Court did make a slight change to a crucial part of the ACA: Medicaid expansion. Under the law, by 2014, states are supposed to extend their Medicaid programs to cover people under 65 with incomes up to 133 percent of the federal poverty line. An analysis from the Center on Budget and Policy Priorities shows that means 17 million more people would have access to health care over the next 10 years.  Before today, it looked like states didn't have much choice in the matter.

Medicare Is Not Your Savior

Jamelle BouieJun 27, 2012

Vermont Representative Peter Welch says that if the Supreme Court overturns the Affordable Care Act, Democrats should begin to push for universal Medicare:

“If the Supreme Court rules against Obamacare, we have to have a substantive policy and political response — in my view, that’s Medicare for All,” Welch said. “Medicare is very popular. People understand it.” […]

“If we argue for Medicare for All, it would reinforce our commitment to Medicare and highlight the Republican plan to turn it into a voucher system and unravel it,” Welch continued.

The Fate of Health-Care Reform

In anticipation of the Supreme Court's historic ruling on the Affordable Care Act tomorrow, we've collected the Prospect's most important pieces about the law and its fate at the Supreme Court.

The EditorsJun 27, 2012
  • Ten Reasons American Health Care is So Bad, Ezra Klein (November 2007)
    Of all the countries surveyed in a recent poll, Americans were the least likely to report relative satisfaction with their health care. Here are ten major ways our system is failing us.

  • The Cost of Delayed Reform, Harold Pollack (July 2010)
    The temporary federal high-risk pools won't reach most of the medically uninsured.

Pages