It was simple, once. Now not so simple.
In the beginning; when the Patient Protection and Affordable Care Act (Obamacare) was debated and after it was passed one got the impression from Republicans opposed to the bill that they either didn’t know what was in it or had some visceral opposition that, frankly, made them say stupid things about the bill. What comes to mind was the debate and passage of the bill while I was living in Florida. Rep Bill Posey (R-FL-8) asserted to his constituents that the bill takes $500 billion from Medicare and he misstated the facts. Rep Tom Rooney (R-FL-17), a former constitutional law professor at West Point insisted the law was unconstitutional. He was wrong but apparently unabashed at his error and continued through most of his career, as seen by a constituent, to spend much more time lambasting President Obama and his policies rather than doing the business of the district he represented. Add Florida Governor Rick Scott and the Republican legislature’s refusal to accept the Medicaid expansion. The list goes on from state to state and includes an expensive ride to the Supreme Court where the law was found to be constitutional along with other court cases and over 60 political messaging bills that would dissemble in part or in whole but were never expected to make it to the president’s desk.
A complicated and far-reaching law, at its heart it does one thing; provides health insurance subsidies to those who could not afford the coverage. From that basis the law itself successfully disputes other claims that it is a job killer under the logic that any law bringing over 20 million consumers to any market will create the jobs necessary to process their involvement and provide the services they would normally get at an emergency room at a great expense to the taxpayer.
So this ‘disaster’ know as Obamacare (Donald Trump), a failed law (House Speaker Paul Ryan) and a ‘train wreck’ (several Republicans) must go but go where?
Nobody liked the individual mandate to buy coverage or pay a fine but that was necessary to balance the requirement of insurance companies to cover the cost of having to take customers with preexisting conditions. That condition would stay but how to make any deal palatable to insurers must make up that money to cover the premium subsidies which also will remain but are likely to be reduced or transformed into a tax credit rather than a reduction in premium at the pump.
We hear now that a provision to continue subsidies to coal miners with black lung disease would go out with the bath water leaving those recipients with a promise not met so that provision must stay and will cost money.
And that is where the repeal rubber hits the road; it’s about the cost of health insurance. People with income that prohibit them from receiving subsidies now complain that their premiums are too high but that is the fault of insurers, not the federal government. In fact the cost of health insurance in whatever plan replaces Obamacare will be the hurdle and one that Republicans by nature if not by reality will not want to get over. Insurance rates never seemed to be a problem worth addressing.
So what do we have here? A health insurance program originally created at the Heritage Foundation, a conservative think tank, and a similar plan in Massachusetts created by then Governor Mitt Romney (R) we have a position created by Republicans that only they must deal with and likely will find the only path is to allow for a rise in the cost of insurance as dictated by the insurers themselves. After the Republican diatribes against this bill which became less and less in detail and more and more generally vitriolic and the insistence that it is the main problem with our economy the Republicans have a mess on their hands that, if the likelihood of maintaining the law for a year or more to get its changes done right is what happens, they will not come up with something better because if there was something better it would be on the table already.
“Of course, if the ACA were to be repealed, not only as it was pointed out, would tens of millions of Americans lose their coverage – tens of millions of others would see their health care costs skyrocket. I know that Mr. [Richard] Neal, Mr. [Frank] Pallone, and Mr. [Bobby] Scott are going to speak to that.
“According to the Tax Policy Center, repealing the ACA would significantly raise taxes for around seven million Americans, who would lose their tax credits to purchase insurance through the marketplace—a devastating effect for them.
“And according to the Brookings Institution, repealing the Affordable Care Act would increase premiums by 20 percent or more. That’s a startling figure, and Republicans, I’m sure, won’t speak to that. House Minority Whip Steny Hoyer.
Hamilton on Congress
Our System Comes With No Guarantees
By Lee H. Hamilton
There are a lot of dire predictions about our representative democracy out there. We’re just past a presidential election campaign in which candidates complained about a rigged political system. Now, commentators worry about the imminent failure of the American experiment.
I don’t agree with these predictions of calamity. Our representative democracy is not on the verge of collapse. But I do see stresses and tensions that should concern anyone who cares about our system of self-government. Our representative democracy has been remarkably stable and successful for over two hundred years, but that is no guarantee it will survive and prosper.
The mere fact that this nation is filled with so many citizens who have lost confidence in key institutions is worrisome. The Gallup organization’s ongoing polling has found declines in public confidence over the past few decades in everything from the Supreme Court and Congress to the police and even the military. It shows a pervasive drop in public regard for the institutions that undergird American life.
The reasons stem in part from a declining willingness among the people who inhabit those institutions to observe the norms of behavior that evoke public confidence. This is notable especially on Capitol Hill and in political life, where the parties seem to have abandoned fair play and taken to using institutions to maximize partisan advantage. In the Senate, the recent refusal even to hold hearings on the President’s nominee to the Supreme Court brought the lack of comity between branches to a new low.
Politicians engage in a degree of partisanship that a few decades ago would have disqualified them in the eyes of the voting public. They attack opposing politicians’ patriotism, impugn their loyalty, accuse them of criminal activity, question the fairness of the election process itself – with virtually no evidence – and seek to undermine their effectiveness in office. Small wonder that elected officials’ legitimacy is increasingly called into question among the public at large.
If we had a media that prized both the vigilance and impartiality it displayed during its heyday, these tendencies might not run so rampant. Similarly, if politicians were willing to negotiate, compromise, and search for remedies to the nation’s challenges, then our current dysfunctional inability to get things done would be less of a hallmark of these times.
Yet too many politicians seem fine with dysfunction. They appear more interested in holding power than in using it to solve problems. They reject the norms of behavior in a civil society – for example, the New York politician who wished President Obama dead of Mad Cow Disease. They sidestep accountability and transparency: tweeting their stances rather than facing hard questions, avoiding press conferences that would give reporters a chance to hold them to account, preferring public rallies to the give and take that allows the public to examine and scrutinize their stances.
All of this poses real challenges to the system. So what might be done to restore public faith in its fairness, justness and decency?
Paul Light, a professor of public service at New York University, recently came out with a paper, “What Americans Want from Government Reform,” that reinforces the proposals many reformers have been pushing in recent years. His list of fixes that would enjoy support among ordinary Americans in both parties includes reducing the role of money in elections, boosting ethical constraints on elected officials, reducing waste and inefficiency, finding ways to increase the voices of ordinary citizens, and ensuring that civil servants and political appointees are qualified and competent.
Americans don’t expect miracles. They just want the basic features of government to work. But here’s the thing: making this happen is up to us. Politicians may be directly responsible for the problems above, but you and I as voters allow them to get away with it. We voted them into office, kept them there, and paid little attention to their shenanigans.
The problem is not just the politicians. It’s us, too. The first words of the Constitution read, “We the People,” not “We the Government.” It’s up to us to strive for a more perfect union, and to be vigilant about these adverse tendencies that threaten to undermine our representative democracy.
Lee Hamilton is a Senior Advisor for the Indiana University Center on Representative Government; a Distinguished Scholar, IU School of Global and International Studies; and a Professor of Practice, IU School of Public and Environmental Affairs. He was a member of the U.S. House of Representatives for 34 years.
“The top U.S. intelligence official said on Thursday he was “even more resolute” in his belief that Russia staged cyber attacks on Democrats during the 2016 election campaign, rebuking persistent skepticism from Republican President-elect Donald Trump about whether Moscow was involved.” Reuters.
“The president-elect’s dismissal of intelligence assessments may say less about the facts they offer than about a conclusion he’s loath to accept.” ‘…as his adviser Kellyanne Conway suggests, Trump is receiving information from other sources…it’s unclear why it would be more credible. The At;antic
Trump on Assange
“Gearing up for a high-profile briefing on claims that Russia hacked Democratic officials during last year’s election, President-elect Donald Trump is apparently taking the word of WikiLeaks founder Julian Assange over that of U.S. intelligence officials who will brief him.” USA Today
“The United States must either stop accusing Russia of meddling in its elections or prove it, a spokesman for Russian President Vladimir Putin said Friday. Presidential spokesman Dmitry Peskov said it was “indecent” of the United States to “groundlessly” accuse Russia of intervention in the US election campaign, Russian state news agency Tass reported.” CNN.Com
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