Commentary Magazine


Topic: health insurance

ObamaCare Has Another Bad Week

The issue on which President Obama is currently fixated on silencing dissent (the debate is “over”) is ObamaCare. This is understandable: the public still hates the law, and for good reason. Obama’s because-I-said-so routine has not, unsurprisingly, fooled the many Americans who had their doctors and health care taken away from them into forgetting the basic cruelty of the president’s health-care reform. But the hope of ObamaCare supporters was that the worst was behind them. Unfortunately for them, the bad news just keeps on coming.

Last week, the Washington Post editorial board declared that “ObamaCare’s critics have had a bad week.” They have not replicated that again this week. The truth is that there is plenty of bad news for the suffocating regulatory beast that is the ACA, but two stories this week stood out. The first was what may herald the next wave of insurance cancellations. The Obama administration is considering largely banning what’s known as “fixed indemnity insurance.” Peter Suderman reported a few days ago:

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The issue on which President Obama is currently fixated on silencing dissent (the debate is “over”) is ObamaCare. This is understandable: the public still hates the law, and for good reason. Obama’s because-I-said-so routine has not, unsurprisingly, fooled the many Americans who had their doctors and health care taken away from them into forgetting the basic cruelty of the president’s health-care reform. But the hope of ObamaCare supporters was that the worst was behind them. Unfortunately for them, the bad news just keeps on coming.

Last week, the Washington Post editorial board declared that “ObamaCare’s critics have had a bad week.” They have not replicated that again this week. The truth is that there is plenty of bad news for the suffocating regulatory beast that is the ACA, but two stories this week stood out. The first was what may herald the next wave of insurance cancellations. The Obama administration is considering largely banning what’s known as “fixed indemnity insurance.” Peter Suderman reported a few days ago:

Fixed indemnity coverage is a form of limited, low-cost insurance that pays out a flat rate in response to certain prescribed events—say $75 for a doctor’s visit or $15 for a prescription—regardless of the cost. Because the coverage payouts aren’t variable, and because some major medical costs aren’t covered at all, monthly premiums are often quite low, meaning that it offers a way for people to have some coverage at relatively affordable rates.

It may not be an option for much longer. The proposed regulation would essentially outlaw standalone indemnity policies, making it illegal to sell them except as an addendum to the more robust, more expensive plans that meet the law’s minimum essential benefits requirements.  Under the proposed rules, indemnity insurance sold by itself would be classified in such a way that it has to meet all the requirements for “major medical coverage.”

It’s as if regulators suddenly decided that anyone selling scooters had to make sure those scooters were as powerful (and thus expensive) as motorcycles. Otherwise, scooters could only be sold as sidecars to people who already owned motorcycles.

Suderman notes that this would be at cross-purposes with the idea that ObamaCare seeks to increase the ranks of the insured, since such plans could be purchased along with the mandate penalty to at least have some insurance. But, as he points out in answering his own question, ObamaCare is about controlling what kind of insurance plans the government’s confused bureaucrats want you to have. ObamaCare, then, seems likely to continue to kick the insured off their plans and leave many more without coverage. This was by design, but the Obama administration hoped to avoid this kind of story getting much attention. Given the outcry over the last round of millions of cancellation notices, that seems unlikely.

The second story hit yesterday, but needs a brief bit of background. Last year Sarah Kliff, at the time writing for the Washington Post but who has since joined Vox.com, wrote a piece headlined “Oregon may be the White House’s favorite health exchange,” touting the Cover Oregon ObamaCare exchange’s potential for proving the overall reform law’s worth. The federal government sunk $250 million into it to ensure it would thrive. Instead, it has been a complete disaster, and now the Washington Post explains:

The Obama administration is poised to take over Oregon’s broken health insurance exchange, according to officials familiar with the decision who say that it reflects federal officials’ conclusion that several state-run marketplaces may be too dysfunctional to fix.

In public, the board overseeing Cover Oregon is scheduled to vote Friday whether to join the federal insurance marketplace that sells health plans in most of the country under the Affordable Care Act. Behind the scenes, the officials say, federal and Oregon officials already have agreed that closing down the state marketplace is the best path to rescue what has been the country’s only one to fail so spectacularly that no resident has been able to sign up for coverage online since it opened early last fall.

Unfixable, “fail so spectacularly”–these are not descriptions the White House was hoping to hear. But that’s the reality, and not just for Oregon. As the Post notes, the utter failure in Oregon is directing attention to other “faltering exchanges” in places like Massachusetts and Maryland. Beyond the obvious speciousness of the ObamaCare promises, this also shows the fallacy of one of the ObamaCare defenders’ treasured tropes.

As the New York Times wrote last month, the disparity in state exchanges led to the spin that “Obamacare looks less like a sweeping federal overhaul than a collection of individual ventures playing out unevenly, state to state, in the laboratories of democracy.” It’s easy to see the attraction in this claim, but it’s also delusional, as both of this week’s stories make clear.

Were the states left to experiment with the needs and preferences of their residents, the administration wouldn’t be on a steady march to eliminate the very insurance plans these residents chose. And the failure of the Oregon exchange, and the looming disasters in other exchanges, demonstrate the ObamaCare problems that persist across state lines and the taxpayer dollars the federal government sinks into hopeless programs in a futile attempt to stave off collapse before taking them over outright.

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ACA? ObamaCare Not So Affordable

As some pollsters and late-night comedian Jimmy Kimmel have proved, ordinary Americans don’t like ObamaCare but they like the idea of an Affordable Care Act, especially if they don’t know the two are the same thing. That’s led the White House and Democrats to try to train the voters to call the president’s signature health-care legislation the ACA rather than the more popular handle that links the increasingly unpopular incumbent to the issue. But like the attempt to minimize the problems of the ObamaCare rollout as a merely the fault of a glitchy website, the notion that ObamaCare really is about affordable health care turns out to be as false as the president’s promise that people could keep their insurance if they liked it. As the New York Times reports this morning, the premiums being offered via the ObamaCare insurance exchanges may be low, but the deductibles and the other out-of-pocket costs associated with actually using the plans are actually far more expensive than those being offered elsewhere in the market.

Apparently it was no accident that until last week, the healthcare.gov website didn’t offer consumers (or at least those who can successfully log in to it) the ability to discover what the deductibles on the plans being offered cost. That the premiums on these plans are often cheap is not in dispute, though many of those who were forced off existing plans that they liked have now found themselves saddled with much more expensive plans. But the point about insurance is not just what it costs to have it, but what it will cost you when you have to use it. If, as the Times reports, the deductible on some of these plans is $5,000 for an individual and $10,000 for a couple, then as far as many Americans are concerned, pretty much everything short of a hospital stay or surgery is going to mean that they are going to have to pay all medical costs out of their own pockets. Which means, as far as most of the Americans who are being forced onto the state exchanges are concerned, short of a catastrophic event, ObamaCare is the moral equivalent of having no insurance at all.

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As some pollsters and late-night comedian Jimmy Kimmel have proved, ordinary Americans don’t like ObamaCare but they like the idea of an Affordable Care Act, especially if they don’t know the two are the same thing. That’s led the White House and Democrats to try to train the voters to call the president’s signature health-care legislation the ACA rather than the more popular handle that links the increasingly unpopular incumbent to the issue. But like the attempt to minimize the problems of the ObamaCare rollout as a merely the fault of a glitchy website, the notion that ObamaCare really is about affordable health care turns out to be as false as the president’s promise that people could keep their insurance if they liked it. As the New York Times reports this morning, the premiums being offered via the ObamaCare insurance exchanges may be low, but the deductibles and the other out-of-pocket costs associated with actually using the plans are actually far more expensive than those being offered elsewhere in the market.

Apparently it was no accident that until last week, the healthcare.gov website didn’t offer consumers (or at least those who can successfully log in to it) the ability to discover what the deductibles on the plans being offered cost. That the premiums on these plans are often cheap is not in dispute, though many of those who were forced off existing plans that they liked have now found themselves saddled with much more expensive plans. But the point about insurance is not just what it costs to have it, but what it will cost you when you have to use it. If, as the Times reports, the deductible on some of these plans is $5,000 for an individual and $10,000 for a couple, then as far as many Americans are concerned, pretty much everything short of a hospital stay or surgery is going to mean that they are going to have to pay all medical costs out of their own pockets. Which means, as far as most of the Americans who are being forced onto the state exchanges are concerned, short of a catastrophic event, ObamaCare is the moral equivalent of having no insurance at all.

When pressed about the high costs of the Affordable Care Act, its defenders have answered that most of those saddled with higher premiums and deductibles will actually not be hurt because they will be given subsidies. But as the Times points out, the idea that the ACA will be dishing out widespread subsidies is a myth:

Many people buying insurance on the federal and state exchanges are expected to qualify for subsidies. But in the first month, for reasons that are not clear, only 30 percent qualified. The others must pay the full premium and will be subject to the full deductible.

Most people shopping in the exchanges are expected to choose bronze or silver plans, which provide less generous coverage than most employer-sponsored plans.

A study by Jon R. Gabel and colleagues at NORC, a research organization affiliated with the University of Chicago, found that 65 percent of employees in group health plans had higher-value coverage that would be classified as gold or platinum under the Affordable Care Act.

That means that, contrary to the justifications that were offered for the violation of the president’s promise about keeping policies that consumers liked, many of the choices they are being offered are not as good as what was previously available. Throw in the factor of costs from sky-high deductibles and you have an ObamaCare formula that combines both mediocre-to-lousy coverage with costs that make it dangerous for anyone relying on the ACA to get sick.

As the Times explained:

Higher deductibles are one tool that insurers can use to hold down premiums. Many have also held down premiums on the exchanges by limiting the choices of doctors and hospitals available to consumers in their provider networks.

That brings up the third damaging element of ObamaCare: the fact that many Americans are not only going to lose their coverage they liked but will also be unable to keep the doctors they liked and trusted.

There are Americans who are, as the Times points out, grateful to get any kind of insurance at all and will suffer with ObamaCare’s costs due to its allowing those with pre-existing conditions to be covered. But the numbers of those who are benefiting from the new health-care regime appear to be heavily outnumbered by those who are being either inconvenienced or gouged by the Affordable Care Act. That’s why the expectation that once it is implemented it will be popular appears to be based on some faulty assumptions. As the ranks of the ObamaCare losers grows, the burden of “affordable care” that turns out to be not so affordable is turning the ACA into an albatross sinking President Obama’s second term.

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G’town Keeping Policy on Birth Control

Georgetown University’s student insurance program came under fire a few months ago during an unofficial congressional hearing after student and activist Sandra Fluke criticized its lack of birth control coverage. Since Fluke’s testimony, the university has been under mounting pressure to change its birth control coverage policy immediately. But today, Georgetown University President John J. DeGioia confirmed in a letter to students that the university will not change its policy until it’s required to by law:

As you know, like most universities, Georgetown requires that students have health insurance. Students are not required to purchase their health insurance through Georgetown University and are free to acquire health insurance through a third party. The student plan offered by Georgetown is consistent with our Catholic and Jesuit identity and does not cover prescription contraceptives for birth control. It does provide coverage for these prescriptions for students who require them for health reasons unrelated to birth control, as determined by a physician.

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Georgetown University’s student insurance program came under fire a few months ago during an unofficial congressional hearing after student and activist Sandra Fluke criticized its lack of birth control coverage. Since Fluke’s testimony, the university has been under mounting pressure to change its birth control coverage policy immediately. But today, Georgetown University President John J. DeGioia confirmed in a letter to students that the university will not change its policy until it’s required to by law:

As you know, like most universities, Georgetown requires that students have health insurance. Students are not required to purchase their health insurance through Georgetown University and are free to acquire health insurance through a third party. The student plan offered by Georgetown is consistent with our Catholic and Jesuit identity and does not cover prescription contraceptives for birth control. It does provide coverage for these prescriptions for students who require them for health reasons unrelated to birth control, as determined by a physician.

While the letter doesn’t mention Fluke directly, DeGioia clearly responds to several of her claims. In her testimony, Fluke argued that contraception coverage is necessary for health care reasons, and recounted a story about one fellow student who was allegedly forced to have an ovary removed after the university health insurance refused to cover the contraception that would have treated her polycystic disorder. DeGioia reiterated that Georgetown’s health insurance covers contraception as long as it is for medical reasons unrelated to birth control.

DeGioia also pointed out that students aren’t required to purchase the Georgetown health insurance and have the option to buy outside plans instead.

While DeGioia’s letter didn’t indicate that the university would take a public stance against President Obama’s rule requiring religious institutions to provide birth control coverage in their insurance plans, he did say he would be monitoring related developments. The U.S. Council of Catholic Bishops has called for protests of the law this summer.

Full letter from President DeGioia below:

Dear Ladies and Gentlemen:

I write to you regarding Georgetown’s health insurance and contraceptive coverage in our plans.  Many members of our community have expressed different perspectives on this issue.  I am grateful for the respectful ways in which you have shared your opinions.

As you know, like most universities, Georgetown requires that students have health insurance. Students are not required to purchase their health insurance through Georgetown University and are free to acquire health insurance through a third party. The student plan offered by Georgetown is consistent with our Catholic and Jesuit identity and does not cover prescription contraceptives for birth control.  It does provide coverage for these prescriptions for students who require them for health reasons unrelated to birth control, as determined by a physician.

After thoughtful and careful consideration, we will continue our current practice for contraceptive coverage in our student health insurance for the coming year, as allowed for under the current rules issued by the United States Department of Health and Human Services.

There will also be no change to the University’s approach to contraceptive coverage for employees for 2013.

We will be monitoring further regulatory and judicial developments related to the Affordable Care Act. I hope this is helpful in clarifying a matter of concern to many of you.

You have my very best wishes as we conclude our academic year.

Sincerely,
John J. DeGioia

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ObamaCare Continues to Unravel

According to the AP, two of the central promises of President Barack Obama’s health-care overhaul law are unlikely to be fulfilled, Medicare’s independent economic expert told Congress today.

The landmark legislation probably won’t hold costs down, and it won’t let everybody keep their current health insurance if they like it, Chief Actuary Richard Foster told the House Budget Committee. (Foster’s office is responsible for independent long-range cost estimates.)

Mr. Foster was asked by Republican Tom McClintock for a simple true or false response on two of the main assertions made by supporters of the law: that it will bring down unsustainable medical costs and it will let people keep their current health insurance if they like it.

On the costs issue, “I would say false, more so than true,” Foster responded. As for people getting to keep their coverage, “not true in all cases.”

Foster also sided with those who argue that moving toward a defined contribution model is much more likely to keep health-care costs down than the kind of centralized, top-down price controls that are in ObamaCare.

Finally, in an exchange with Representative John Campbell of California, Foster blew up the claim that the Patient Protection and Affordable Care Act’s Medicare provisions could both reduce the deficit and extend the solvency of Medicare, as President Obama has claimed. Mr. Foster pointed out the obvious: this isn’t possible unless you double-count the savings.

“Is it legitimate to say,” Campbell asked, “that you can add a dozen years to the solvency of Medicare or that you can reduce the deficit, but it is not correct to say both simultaneously?”

“Both will happen as a result of the same one set of savings, under Medicare,” Foster said. “But it takes two sets of money to make it happen. It happens directly for the budget deficit, from the Medicare savings, and then when we need the money to extend the Hospital Insurance Trust Fund, we have a promissory note — it’s an IOU, not a worthless IOU, but it is an IOU — and Treasury has to pay that money back. But they have to get it from somewhere. That’s the missing link.”

Unraveling the false claims of ObamaCare continues apace.

According to the AP, two of the central promises of President Barack Obama’s health-care overhaul law are unlikely to be fulfilled, Medicare’s independent economic expert told Congress today.

The landmark legislation probably won’t hold costs down, and it won’t let everybody keep their current health insurance if they like it, Chief Actuary Richard Foster told the House Budget Committee. (Foster’s office is responsible for independent long-range cost estimates.)

Mr. Foster was asked by Republican Tom McClintock for a simple true or false response on two of the main assertions made by supporters of the law: that it will bring down unsustainable medical costs and it will let people keep their current health insurance if they like it.

On the costs issue, “I would say false, more so than true,” Foster responded. As for people getting to keep their coverage, “not true in all cases.”

Foster also sided with those who argue that moving toward a defined contribution model is much more likely to keep health-care costs down than the kind of centralized, top-down price controls that are in ObamaCare.

Finally, in an exchange with Representative John Campbell of California, Foster blew up the claim that the Patient Protection and Affordable Care Act’s Medicare provisions could both reduce the deficit and extend the solvency of Medicare, as President Obama has claimed. Mr. Foster pointed out the obvious: this isn’t possible unless you double-count the savings.

“Is it legitimate to say,” Campbell asked, “that you can add a dozen years to the solvency of Medicare or that you can reduce the deficit, but it is not correct to say both simultaneously?”

“Both will happen as a result of the same one set of savings, under Medicare,” Foster said. “But it takes two sets of money to make it happen. It happens directly for the budget deficit, from the Medicare savings, and then when we need the money to extend the Hospital Insurance Trust Fund, we have a promissory note — it’s an IOU, not a worthless IOU, but it is an IOU — and Treasury has to pay that money back. But they have to get it from somewhere. That’s the missing link.”

Unraveling the false claims of ObamaCare continues apace.

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ObamaCare and Political Insanity

According to the New York Times:

Soon after the 112th Congress convenes Wednesday, Republicans in the House plan to make good on a campaign promise that helped vault many new members to victory: voting to repeal President Obama’s health care overhaul.

The vote, which Republican leaders pledged would occur before the president’s State of the Union address later this month, is intended both to appeal to the Tea-Party-influenced factions of the House Republican base and to emphasize the muscle of the new party in power. But it could also produce an unintended consequence: a chance for Democrats once again to try their case in support of the health care overhaul before the American public.

Democrats, who in many cases looked on the law as a rabid beast best avoided in the fall elections, are reversing course, gearing up for a coordinated all-out effort to preserve and defend it. Under the law, they say, consumers are already receiving tangible benefits that Republicans would snatch away.

The story goes on to report this:

Representative Robert E. Andrews, Democrat of New Jersey, challenged the Republicans to bring it on. “We will respond by pointing out the impact of repeal on people’s lives,” Mr. Andrews said. “On women with cancer who could be denied insurance because of a pre-existing condition. On senior citizens who would lose the help they are receiving to pay for prescriptions.”

Democrats argue that repeal would increase the number of uninsured; put insurers back in control of health insurance, allowing them to increase premiums at will; and lead to explosive growth in the federal budget deficit.

It’s hard to know if Democrats are serious about pursuing this course. If so, they are heading down a perilous political path. Here’s why: the more the public learns about the Patient Protection and Affordable Care Act, the more they dislike it — and they dislike it plenty right now.

In addition, the thinking that continues to animate many Democrats — namely, that the only reason Obama’s health-care overhaul isn’t wildly popular is because of a “communications problem” by the White House and congressional Democrats — is wholly in error.

The problem is that ObamaCare is a monstrous, incoherent piece of legislation that is/will (among other things) increase premiums, force millions of people off their existing coverage (which many of them are happy with), and increase, not decrease, the federal-budget deficit. It will harm, not improve, our health-care system. In almost every respect, it compounds rather than ameliorates our problems.

If Democrats want to relitigate ObamaCare, they will find a Republican Party plenty eager to join them.

It’s been said that the definition of insanity is to do the same thing over and over again and expect different results. With that definition in mind, it is fair to say that on health care at least, the Democratic Party’s strategy is bordering on insanity. If Mr. Obama and his party want the political debate of 2011 to center on health care, they will pay a huge political price for it.

According to the New York Times:

Soon after the 112th Congress convenes Wednesday, Republicans in the House plan to make good on a campaign promise that helped vault many new members to victory: voting to repeal President Obama’s health care overhaul.

The vote, which Republican leaders pledged would occur before the president’s State of the Union address later this month, is intended both to appeal to the Tea-Party-influenced factions of the House Republican base and to emphasize the muscle of the new party in power. But it could also produce an unintended consequence: a chance for Democrats once again to try their case in support of the health care overhaul before the American public.

Democrats, who in many cases looked on the law as a rabid beast best avoided in the fall elections, are reversing course, gearing up for a coordinated all-out effort to preserve and defend it. Under the law, they say, consumers are already receiving tangible benefits that Republicans would snatch away.

The story goes on to report this:

Representative Robert E. Andrews, Democrat of New Jersey, challenged the Republicans to bring it on. “We will respond by pointing out the impact of repeal on people’s lives,” Mr. Andrews said. “On women with cancer who could be denied insurance because of a pre-existing condition. On senior citizens who would lose the help they are receiving to pay for prescriptions.”

Democrats argue that repeal would increase the number of uninsured; put insurers back in control of health insurance, allowing them to increase premiums at will; and lead to explosive growth in the federal budget deficit.

It’s hard to know if Democrats are serious about pursuing this course. If so, they are heading down a perilous political path. Here’s why: the more the public learns about the Patient Protection and Affordable Care Act, the more they dislike it — and they dislike it plenty right now.

In addition, the thinking that continues to animate many Democrats — namely, that the only reason Obama’s health-care overhaul isn’t wildly popular is because of a “communications problem” by the White House and congressional Democrats — is wholly in error.

The problem is that ObamaCare is a monstrous, incoherent piece of legislation that is/will (among other things) increase premiums, force millions of people off their existing coverage (which many of them are happy with), and increase, not decrease, the federal-budget deficit. It will harm, not improve, our health-care system. In almost every respect, it compounds rather than ameliorates our problems.

If Democrats want to relitigate ObamaCare, they will find a Republican Party plenty eager to join them.

It’s been said that the definition of insanity is to do the same thing over and over again and expect different results. With that definition in mind, it is fair to say that on health care at least, the Democratic Party’s strategy is bordering on insanity. If Mr. Obama and his party want the political debate of 2011 to center on health care, they will pay a huge political price for it.

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Federal Judge Rules ObamaCare Provision Unconstitutional

A Virginia federal judge has ruled that a key provision of ObamaCare is unconstitutional. “U.S. District Court Judge Henry E. Hudson found that Congress could not order individuals to buy health insurance,” the Washington Post reports. Yes, this was somewhat inevitable. And there will likely be similar rulings in the near future. The Supreme Court will eventually resolve the question of ObamaCare’s constitutionality one way or another.

But today’s ruling, coming when it did, is important beyond its implications for the fate of the health-care overhaul. For it is one more data point in a seemingly endless narrative of administration setbacks. Every failure is now a compounded failure. Furthermore, this is yet another setback about which Obama can do precious little. After a term of ferocious activism, this administration is stuck watching its own deficiencies play out along with the rest of us.

Bill Clinton couldn’t be reached for comment.

A Virginia federal judge has ruled that a key provision of ObamaCare is unconstitutional. “U.S. District Court Judge Henry E. Hudson found that Congress could not order individuals to buy health insurance,” the Washington Post reports. Yes, this was somewhat inevitable. And there will likely be similar rulings in the near future. The Supreme Court will eventually resolve the question of ObamaCare’s constitutionality one way or another.

But today’s ruling, coming when it did, is important beyond its implications for the fate of the health-care overhaul. For it is one more data point in a seemingly endless narrative of administration setbacks. Every failure is now a compounded failure. Furthermore, this is yet another setback about which Obama can do precious little. After a term of ferocious activism, this administration is stuck watching its own deficiencies play out along with the rest of us.

Bill Clinton couldn’t be reached for comment.

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Flotsam and Jetsam

Could the 2012 GOP presidential primary start closer to 2012? “Former Massachusetts Gov. Mitt Romney is letting donors know it’ll be a while before he looks to 2012 — and that any presidential campaign he builds will have a much smaller staff than in 2008 … and no one is in a big hurry. Indiana Gov. Mitch Daniels has said he’ll wait until after the Indiana legislative term ends in the spring before he decides, and South Dakota Sen. John Thune hasn’t laid out a timeline. Former Alaska Gov. Sarah Palin told The New York Times that she’s considering a bid but didn’t elaborate on timing. Minnesota Gov. Tim Pawlenty’s team has alluded to an announcement in the spring.”

Could there be a better formulation of the GOP’s approach than this by Speaker-to-be John Boehner? “We think that Obamacare ruined the best healthcare in the country, we believe it will bankrupt our nation, we believe it needs to be repealed and replaced with commonsense reforms to bring down the cost of health insurance and you’ll see us move quickly enough.” The “how” is still to be determined, but the goal is crystal clear.

Could the Dems be any more tone-deaf? “House Democrats on Thursday shot down a G.O.P. attempt to roll back federal funding to NPR, a move that many Republicans have called for since the  public radio network  fired the analyst Juan Williams last month.” I guess we’ll find out when they vote — or not — on the Bush tax cuts.

Could Haley Barbour be a 2012 contender? A “formidable” one, says the Gray Lady: “Mr. Barbour’s political might was on full display at the Hilton Bayside Hotel here in San Diego this week, where Republican governors met for the first time since the elections. He strode like a popular small-town mayor through the hotel’s wide concourses, attracting a steady crush of corporate contributors, political operatives and reporters. In public sessions and private conversations, his fellow governors lavished praise on him.”

Could they have drained the swamp a little earlier? “A House ethics panel Thursday said senior Democratic Rep. Charles Rangel deserved to be censured — the most severe form of punishment short of expulsion from Congress — for nearly a dozen instances of misconduct as a lawmaker.”

Could there be any reason to give the mullahs assurance that we won’t use force? The Washington Post‘s editors don’t think so: “We agree that the administration should continue to focus for now on non-military strategies such as sanctions and support for the Iranian opposition. But that does not require publicly talking down military action. Mr. Gates’s prediction of how Iranians would react to an attack is speculative, but what we do know for sure is that the last decision Iran made to curb its nuclear program, in 2003, came when the regime feared – reasonably or not – that it could be a target of the U.S. forces that had just destroyed the Iraqi army. As for the effect of the sanctions, Tehran has not shown itself ready to begin serious bargaining about its uranium enrichment.” It is one of their more inexplicable foreign policy fetishes.

Could the Dems benefit from listening to William Galston? You betcha. He tells them that they should have dumped Pelosi: “What’s the logic of patiently rebuilding a Democratic majority—for which Pelosi deserves a considerable share of the credit—only to embark on a strategy seemingly calculated to destroy it? And why should the kinds of Democrats without whom no Democratic majority is possible expect anything better in the future? This decision was the victory of inside baseball over common sense, and no amount of spin can change that.”

Could the 2012 GOP presidential primary start closer to 2012? “Former Massachusetts Gov. Mitt Romney is letting donors know it’ll be a while before he looks to 2012 — and that any presidential campaign he builds will have a much smaller staff than in 2008 … and no one is in a big hurry. Indiana Gov. Mitch Daniels has said he’ll wait until after the Indiana legislative term ends in the spring before he decides, and South Dakota Sen. John Thune hasn’t laid out a timeline. Former Alaska Gov. Sarah Palin told The New York Times that she’s considering a bid but didn’t elaborate on timing. Minnesota Gov. Tim Pawlenty’s team has alluded to an announcement in the spring.”

Could there be a better formulation of the GOP’s approach than this by Speaker-to-be John Boehner? “We think that Obamacare ruined the best healthcare in the country, we believe it will bankrupt our nation, we believe it needs to be repealed and replaced with commonsense reforms to bring down the cost of health insurance and you’ll see us move quickly enough.” The “how” is still to be determined, but the goal is crystal clear.

Could the Dems be any more tone-deaf? “House Democrats on Thursday shot down a G.O.P. attempt to roll back federal funding to NPR, a move that many Republicans have called for since the  public radio network  fired the analyst Juan Williams last month.” I guess we’ll find out when they vote — or not — on the Bush tax cuts.

Could Haley Barbour be a 2012 contender? A “formidable” one, says the Gray Lady: “Mr. Barbour’s political might was on full display at the Hilton Bayside Hotel here in San Diego this week, where Republican governors met for the first time since the elections. He strode like a popular small-town mayor through the hotel’s wide concourses, attracting a steady crush of corporate contributors, political operatives and reporters. In public sessions and private conversations, his fellow governors lavished praise on him.”

Could they have drained the swamp a little earlier? “A House ethics panel Thursday said senior Democratic Rep. Charles Rangel deserved to be censured — the most severe form of punishment short of expulsion from Congress — for nearly a dozen instances of misconduct as a lawmaker.”

Could there be any reason to give the mullahs assurance that we won’t use force? The Washington Post‘s editors don’t think so: “We agree that the administration should continue to focus for now on non-military strategies such as sanctions and support for the Iranian opposition. But that does not require publicly talking down military action. Mr. Gates’s prediction of how Iranians would react to an attack is speculative, but what we do know for sure is that the last decision Iran made to curb its nuclear program, in 2003, came when the regime feared – reasonably or not – that it could be a target of the U.S. forces that had just destroyed the Iraqi army. As for the effect of the sanctions, Tehran has not shown itself ready to begin serious bargaining about its uranium enrichment.” It is one of their more inexplicable foreign policy fetishes.

Could the Dems benefit from listening to William Galston? You betcha. He tells them that they should have dumped Pelosi: “What’s the logic of patiently rebuilding a Democratic majority—for which Pelosi deserves a considerable share of the credit—only to embark on a strategy seemingly calculated to destroy it? And why should the kinds of Democrats without whom no Democratic majority is possible expect anything better in the future? This decision was the victory of inside baseball over common sense, and no amount of spin can change that.”

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Finding Out What Is in ObamaCare

Obama said he is only interested in tweaking ObamaCare. But what if it doesn’t do what it’s supposed to do? What if employers start dumping people from their existing health care, premiums go up, and the cost projections — shockingly! — are proved to have been entirely fraudulent? Well, no never mind as far as the president is concerned. He’s not an evidence man. He didn’t want the generals coming back to tell him more troops were needed in Afghanistan. He doesn’t want to alter his failed approach to the Middle East. And he’s not about to mess with his “historic” achievement.

Obama supporters, and those concerned that there own reputations may be at risk, are rushing forth to defend ObamaCare. However, the facts aren’t on their side. Veronique de Rugy takes issue with former OMB chief Peter Orszag, who declares that it is imperative to keep ObamaCare in order to control health-care costs. But de Rugy says that this is nonsense. Using CBO’s own data, she explains that ObamaCare will leave “the cost curve of federal healthcare spending virtually unchanged over the next 25 years.” In fact, ObamaCare makes things a whole lot worse:

The CBO finds that the effect of the healthcare legislation has been to increase government spending by $3.8 trillion between 2010 and 2020. From 2020 to 2035, federal spending under the two projections [ObamaCare and no ObamaCare] are equal percentages of GDP. If Orszag is arguing that the real cost-containment provisions kick in around 2036, such futuristic projections are simply not worth taking seriously. …

What we can be certain of is that this legislation increases the amount of money taxpayers will be forced by law to pay for health insurance to the tune of $420 billion over the next 10 years. Claims about ObamaCare’s deficit-reduction effects depend on new taxes growing even faster than new spending. Read More

Obama said he is only interested in tweaking ObamaCare. But what if it doesn’t do what it’s supposed to do? What if employers start dumping people from their existing health care, premiums go up, and the cost projections — shockingly! — are proved to have been entirely fraudulent? Well, no never mind as far as the president is concerned. He’s not an evidence man. He didn’t want the generals coming back to tell him more troops were needed in Afghanistan. He doesn’t want to alter his failed approach to the Middle East. And he’s not about to mess with his “historic” achievement.

Obama supporters, and those concerned that there own reputations may be at risk, are rushing forth to defend ObamaCare. However, the facts aren’t on their side. Veronique de Rugy takes issue with former OMB chief Peter Orszag, who declares that it is imperative to keep ObamaCare in order to control health-care costs. But de Rugy says that this is nonsense. Using CBO’s own data, she explains that ObamaCare will leave “the cost curve of federal healthcare spending virtually unchanged over the next 25 years.” In fact, ObamaCare makes things a whole lot worse:

The CBO finds that the effect of the healthcare legislation has been to increase government spending by $3.8 trillion between 2010 and 2020. From 2020 to 2035, federal spending under the two projections [ObamaCare and no ObamaCare] are equal percentages of GDP. If Orszag is arguing that the real cost-containment provisions kick in around 2036, such futuristic projections are simply not worth taking seriously. …

What we can be certain of is that this legislation increases the amount of money taxpayers will be forced by law to pay for health insurance to the tune of $420 billion over the next 10 years. Claims about ObamaCare’s deficit-reduction effects depend on new taxes growing even faster than new spending.

One benefit of the GOP House majority is that there can now be hearings on exactly the impact of ObamaCare. Nancy Pelosi said we’d have to pass it to find out what’s in it. Now we can. James Capretta gives us a peek at what we will find. No “death panels,” the Democrats insist?

But Obamacare does create the Independent Payment Advisory Board, or IPAB. … [T]he fifteen-member IPAB has the authority to implement cost-cutting mechanisms in Medicare without further congressional approval. Indeed, IPAB’s proponents have been quite explicit in their hope that the panel will use government-funded “comparative effectiveness research” as the basis to terminate Medicare reimbursement for items and services deemed not “cost effective” by budget cutters. So, here we have an unelected board of so-called experts with the authority to unilaterally decide that certain treatments should not be funded by Medicare.

Medicare will be just fine, they say? Capretta explains:

But Medicare’s chief actuary — who works for the president of the United States — has stated repeatedly that these cuts are so deep and arbitrary that they will force many hospitals and other institutions to stop seeing Medicare patients. In fact, the cuts in Obamacare would drive Medicare’s payment rates for services below those of Medicaid by 2019, and Medicaid’s network of willing suppliers of care and services is already very constrained. It’s quite clear that pushing Medicare’s rates to such low levels would drastically reduce access to care for many beneficiaries.

But don’t take de Rugy’s and Caparetta’s word for it. Beginning in January, the GOP Congress should explain exactly what is in the bill, how much it’s going to cost, how high the tax hike will be ($700B, most agree), and the short- and long-term impact on Americans’ health care. Will Democrats rush forth to defend their handiwork? Or will the evidence be compelling, and embarrassing? Pelosi’s rump liberal caucus in the House will never abandon ObamaCare, but will the Red State senators? Don’t bet on them going down with the ObamaCare ship. Especially after we find out what is in it.

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Democratic Governor Dissects ObamaCare

Tennessee Gov. Philip Bredesen in an op-ed today explains:

Our federal deficit is already at unsustainable levels, and most Americans understand that we can ill afford another entitlement program that adds substantially to it. But our recent health reform has created a situation where there are strong economic incentives for employers to drop health coverage altogether. The consequence will be to drive many more people than projected—and with them, much greater cost—into the reform’s federally subsidized system. This will happen because the subsidies that become available to people purchasing insurance through exchanges are extraordinarily attractive. …

For a person starting a business in 2014, it will be logical and responsible simply to plan from the outset never to offer health benefits. Employees, thanks to the exchanges, can easily purchase excellent, fairly priced insurance, without pre-existing condition limitations, through the exchanges. As it grows, the business can avoid a great deal of cost because the federal government will now pay much of what the business would have incurred for its share of health insurance. The small business tax credits included in health reform are limited and short-term, and the eventual penalty for not providing coverage, of $2,000 per employee, is still far less than the cost of insurance it replaces.

As more Americans flood into the public system, the cost of all those additional highly subsidized patients will skyrocket. The cost of the new entitlement will balloon, as will our deficit.

Now, this is smart analysis by a Democrat. Could not senators and congressmen have seen precisely this result? Of course they could have — conservative analysts predicted this precise phenomenon. But the rush was on to pass something — anything — and call it “historic.” The result is not only politically distasteful but fiscally untenable. The move to repeal ObamaCare will, I think, have many Democratic advocates as Bredesen’s take becomes the new conventional wisdom. Well, that and the 2010 election returns should do the trick.

Tennessee Gov. Philip Bredesen in an op-ed today explains:

Our federal deficit is already at unsustainable levels, and most Americans understand that we can ill afford another entitlement program that adds substantially to it. But our recent health reform has created a situation where there are strong economic incentives for employers to drop health coverage altogether. The consequence will be to drive many more people than projected—and with them, much greater cost—into the reform’s federally subsidized system. This will happen because the subsidies that become available to people purchasing insurance through exchanges are extraordinarily attractive. …

For a person starting a business in 2014, it will be logical and responsible simply to plan from the outset never to offer health benefits. Employees, thanks to the exchanges, can easily purchase excellent, fairly priced insurance, without pre-existing condition limitations, through the exchanges. As it grows, the business can avoid a great deal of cost because the federal government will now pay much of what the business would have incurred for its share of health insurance. The small business tax credits included in health reform are limited and short-term, and the eventual penalty for not providing coverage, of $2,000 per employee, is still far less than the cost of insurance it replaces.

As more Americans flood into the public system, the cost of all those additional highly subsidized patients will skyrocket. The cost of the new entitlement will balloon, as will our deficit.

Now, this is smart analysis by a Democrat. Could not senators and congressmen have seen precisely this result? Of course they could have — conservative analysts predicted this precise phenomenon. But the rush was on to pass something — anything — and call it “historic.” The result is not only politically distasteful but fiscally untenable. The move to repeal ObamaCare will, I think, have many Democratic advocates as Bredesen’s take becomes the new conventional wisdom. Well, that and the 2010 election returns should do the trick.

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ObamaCare Bending Up the Cost Curve

During his press conference on Friday, Jake Tapper, ABC’s excellent senior White House correspondent, asked President Obama about a new CMS (Centers for Medicare and Medicaid Services) report that shows that the health-care cost curve is actually bending up — not down, as during the health-care debate Obama had promised it would. In response, Obama said this:

With respect to health care, what I said during the debate is the same thing I’m saying now and it’s the same thing I will say three or four years from now. Bending the cost curve on health care is hard to do. We’ve got hundreds of thousands of providers and doctors and systems and insurers. And what we did was we took every idea out there about how to reduce or at least slow the costs of health care over time.

But I said at the time, it wasn’t going to happen tomorrow, it wasn’t going to happen next year. It took us decades to get into a position where our health care costs were going up 6, 7, 10 percent a year. And so our goal is to slowly bring down those costs. … I haven’t read the entire study. Maybe you have. But if you — if what — the reports are true, what they’re saying is, is that as a consequence of us getting 30 million additional people health care, at the margins that’s going to increase our costs, we knew that. We didn’t think that we were going to cover 30 million people for free, but that the long-term trend in terms of how much the average family is going to be paying for health insurance is going to be improved as a consequence of health care.

And so our goal on health care is, if we can get, instead of health care costs going up 6 percent a year, it’s going up at the level of inflation, maybe just slightly above inflation, we’ve made huge progress.

The president should read the report, which can be found here. It incorporates the effects of health-care reform and estimates annual spending growth to be 0.2 percentage points higher than its February 2010 estimate, increasing from 6.1 percent to 6.3 percent. According to the Wall Street Journal, “The report by federal number-crunchers casts fresh doubt on Democrats’ argument that the health-care law would curb the sharp increase in costs over the long term.”

In 2009, the report reads, national health-care spending, public and private, totaled $2.5 trillion and accounted for 17.3 percent of the economy. The report predicts that health-care spending will rise to $4.6 trillion and account for 19.6 percent of the economy in 2019. By contrast, in February — before the passage of ObamaCare — the same team of government experts, using the same economic and demographic assumptions, predicted that national health-care spending would reach $4.5 trillion, or 19.3 percent of the gross domestic product, in 2019. The report also anticipates a big increase in health-care spending in 2014, when major provisions of the new law, including a requirement for most Americans to have insurance, take effect. From 2013 to 2014, for example, overall health-care spending is expected to increase by 9.2 percent, which is significantly more than the 6.6 percent increase predicted before ObamaCare became law. (For more, see this story.)

Beyond that, the report assumes that the law’s sweeping reduction in Medicare payments to doctors — 30 percent over the next three years — will actually take place. As Grace-Marie Turner points out, “Congress will not let payment rates be reduced to these levels, so health spending will increase further.”

And former CBO director Douglas Holtz-Eakin has written a paper arguing that ObamaCare provides strong incentives for employers to drop employer-sponsored health insurance for as many as 35 million Americans, funneling far more workers into taxpayer-funded health insurance, thereby raising the gross taxpayer cost of the subsidies by roughly $1.4 trillion in the first 10 years.

A core promise of the president’s signature legislative achievement, then, has been exposed as false. And for Obama, in light of the CMS report, to be talking about the cost of health care going up at or just above the level of inflation, which is running below 2 percent this year, is utterly fanciful. Moreover, the American people can be excused if during the health-care debate they didn’t pick up Obama’s warning that “bending the cost curve on health care is hard to do” and that he knew ObamaCare would increase costs in the short run. Those warnings were omitted, for example, in the president’s September 10, 2009 health-care speech to Congress, when Obama claimed that his plan “will slow the growth of health-care costs for our families, our businesses, and our government.” Obama even pointed out that “if we are able to slow the growth of health-care costs by just one-tenth of one percent each year, it will actually reduce the deficit by $4 trillion over the long term.” To reiterate: the new CMS report predicts an annual increase by two-tenths of one percent each year over the status quo — even accepting the Obama administration’s own ludicrously optimistic assumptions. The reality will be a good deal worse than the CMS report anticipates.

This is all of a piece. Claim after claim the president has made — on the stimulus package, on unemployment, on the deficit and the debt, on the “recovery summer,” on ObamaCare, and on so much more — is being shattered by events. The expectations he set were extraordinarily high and his performance so far is inept. That is one reason why Obama and his party will suffer enormous electoral losses seven weeks from now.

During his press conference on Friday, Jake Tapper, ABC’s excellent senior White House correspondent, asked President Obama about a new CMS (Centers for Medicare and Medicaid Services) report that shows that the health-care cost curve is actually bending up — not down, as during the health-care debate Obama had promised it would. In response, Obama said this:

With respect to health care, what I said during the debate is the same thing I’m saying now and it’s the same thing I will say three or four years from now. Bending the cost curve on health care is hard to do. We’ve got hundreds of thousands of providers and doctors and systems and insurers. And what we did was we took every idea out there about how to reduce or at least slow the costs of health care over time.

But I said at the time, it wasn’t going to happen tomorrow, it wasn’t going to happen next year. It took us decades to get into a position where our health care costs were going up 6, 7, 10 percent a year. And so our goal is to slowly bring down those costs. … I haven’t read the entire study. Maybe you have. But if you — if what — the reports are true, what they’re saying is, is that as a consequence of us getting 30 million additional people health care, at the margins that’s going to increase our costs, we knew that. We didn’t think that we were going to cover 30 million people for free, but that the long-term trend in terms of how much the average family is going to be paying for health insurance is going to be improved as a consequence of health care.

And so our goal on health care is, if we can get, instead of health care costs going up 6 percent a year, it’s going up at the level of inflation, maybe just slightly above inflation, we’ve made huge progress.

The president should read the report, which can be found here. It incorporates the effects of health-care reform and estimates annual spending growth to be 0.2 percentage points higher than its February 2010 estimate, increasing from 6.1 percent to 6.3 percent. According to the Wall Street Journal, “The report by federal number-crunchers casts fresh doubt on Democrats’ argument that the health-care law would curb the sharp increase in costs over the long term.”

In 2009, the report reads, national health-care spending, public and private, totaled $2.5 trillion and accounted for 17.3 percent of the economy. The report predicts that health-care spending will rise to $4.6 trillion and account for 19.6 percent of the economy in 2019. By contrast, in February — before the passage of ObamaCare — the same team of government experts, using the same economic and demographic assumptions, predicted that national health-care spending would reach $4.5 trillion, or 19.3 percent of the gross domestic product, in 2019. The report also anticipates a big increase in health-care spending in 2014, when major provisions of the new law, including a requirement for most Americans to have insurance, take effect. From 2013 to 2014, for example, overall health-care spending is expected to increase by 9.2 percent, which is significantly more than the 6.6 percent increase predicted before ObamaCare became law. (For more, see this story.)

Beyond that, the report assumes that the law’s sweeping reduction in Medicare payments to doctors — 30 percent over the next three years — will actually take place. As Grace-Marie Turner points out, “Congress will not let payment rates be reduced to these levels, so health spending will increase further.”

And former CBO director Douglas Holtz-Eakin has written a paper arguing that ObamaCare provides strong incentives for employers to drop employer-sponsored health insurance for as many as 35 million Americans, funneling far more workers into taxpayer-funded health insurance, thereby raising the gross taxpayer cost of the subsidies by roughly $1.4 trillion in the first 10 years.

A core promise of the president’s signature legislative achievement, then, has been exposed as false. And for Obama, in light of the CMS report, to be talking about the cost of health care going up at or just above the level of inflation, which is running below 2 percent this year, is utterly fanciful. Moreover, the American people can be excused if during the health-care debate they didn’t pick up Obama’s warning that “bending the cost curve on health care is hard to do” and that he knew ObamaCare would increase costs in the short run. Those warnings were omitted, for example, in the president’s September 10, 2009 health-care speech to Congress, when Obama claimed that his plan “will slow the growth of health-care costs for our families, our businesses, and our government.” Obama even pointed out that “if we are able to slow the growth of health-care costs by just one-tenth of one percent each year, it will actually reduce the deficit by $4 trillion over the long term.” To reiterate: the new CMS report predicts an annual increase by two-tenths of one percent each year over the status quo — even accepting the Obama administration’s own ludicrously optimistic assumptions. The reality will be a good deal worse than the CMS report anticipates.

This is all of a piece. Claim after claim the president has made — on the stimulus package, on unemployment, on the deficit and the debt, on the “recovery summer,” on ObamaCare, and on so much more — is being shattered by events. The expectations he set were extraordinarily high and his performance so far is inept. That is one reason why Obama and his party will suffer enormous electoral losses seven weeks from now.

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ObamaCare, Missouri, and the Coming Inflection Point

What happened in Missouri yesterday is quite remarkable. By nearly a 3-to-1 margin, voters rejected a key provision of President Obama’s health-care law. More than 70 percent of Missouri voters backed a ballot measure, Proposition C, that would prohibit the government from requiring people to have health insurance or from penalizing them for not having it.

“It is likely to give Republicans a chance to brag about the unpopularity of ObamaCare,” Karen Ball of Time reports, “but the vote will be largely symbolic.” (Courts will decide whether Missouri and other states can legally trump federal law and exempt citizens from the mandate to buy insurance.)

Symbolic is one way to describe Tuesday’s vote; ominous (for the Democrats) is another.

This is yet one more electoral manifestation of the dismal polling numbers the Democrats have been facing for many months now. We saw rising popular opposition to ObamaCare throughout last summer, which many liberals ignored or ridiculed. Then came the gubernatorial elections in Virginia and New Jersey and the Senate election Massachusetts. Since then the opposition to ObamaCare specifically, and to Obama more generally, has increased; as a result we saw the 40-plus point trouncing in Missouri, a margin far higher than most people anticipated.

It is hard to overstate the toxicity of the Obama agenda. Losing a net total of 65 or more Democratic House seats is now possible (if not yet likely). We are less than 100 days away from what looks to be an inflection point, one of those rare mid-term elections that alter the trajectory of American politics.

What happened in Missouri yesterday is quite remarkable. By nearly a 3-to-1 margin, voters rejected a key provision of President Obama’s health-care law. More than 70 percent of Missouri voters backed a ballot measure, Proposition C, that would prohibit the government from requiring people to have health insurance or from penalizing them for not having it.

“It is likely to give Republicans a chance to brag about the unpopularity of ObamaCare,” Karen Ball of Time reports, “but the vote will be largely symbolic.” (Courts will decide whether Missouri and other states can legally trump federal law and exempt citizens from the mandate to buy insurance.)

Symbolic is one way to describe Tuesday’s vote; ominous (for the Democrats) is another.

This is yet one more electoral manifestation of the dismal polling numbers the Democrats have been facing for many months now. We saw rising popular opposition to ObamaCare throughout last summer, which many liberals ignored or ridiculed. Then came the gubernatorial elections in Virginia and New Jersey and the Senate election Massachusetts. Since then the opposition to ObamaCare specifically, and to Obama more generally, has increased; as a result we saw the 40-plus point trouncing in Missouri, a margin far higher than most people anticipated.

It is hard to overstate the toxicity of the Obama agenda. Losing a net total of 65 or more Democratic House seats is now possible (if not yet likely). We are less than 100 days away from what looks to be an inflection point, one of those rare mid-term elections that alter the trajectory of American politics.

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The Incredibly Unpopular Individual Mandate

It doesn’t have the force of law, but this is a telling rebuke of the president:

Missouri voters on Tuesday overwhelmingly rejected a key provision of President Barack Obama’s health care law, sending a clear message of discontent to Washington and Democrats less than 100 days before the midterm elections.

With about 70 percent of the vote counted late Tuesday, nearly three-quarters of voters threw their support behind a ballot measure, Proposition C, that would prohibit the government from requiring people to have health insurance or from penalizing them for not having it. … Tuesday’s vote was seen as largely symbolic because federal law generally trumps state law. But it was also seen as a sign of growing voter disillusionment with federal policies and a show of strength by conservatives and the tea party movement.

Three-quarters? It is astounding, really, in a country divided bitterly over so many things that the most popular and unifying issue may be repeal of ObamaCare’s central feature. Other states have or will pass similar measures. Will all this magically disappear by 2012, or will the Republican nominee — whoever he or she may be (and it won’t be Mitt Romney if he doesn’t get on board) — have a huge, broad coalition of support for ripping out Obama’s “historic achievement”?

The individual mandate is for many on the left (Don’t force me to buy a plan from Big Insurance!) and the right (Don’t force me to buy what I don’t want!) a sore point, a reminder of Obama’s statist-corporatist agenda. We are now seeing just how many Americans across the political spectrum want it abolished before it goes into effect. It’s almost like “Repeal and Reform!” could be a popular campaign slogan.

It doesn’t have the force of law, but this is a telling rebuke of the president:

Missouri voters on Tuesday overwhelmingly rejected a key provision of President Barack Obama’s health care law, sending a clear message of discontent to Washington and Democrats less than 100 days before the midterm elections.

With about 70 percent of the vote counted late Tuesday, nearly three-quarters of voters threw their support behind a ballot measure, Proposition C, that would prohibit the government from requiring people to have health insurance or from penalizing them for not having it. … Tuesday’s vote was seen as largely symbolic because federal law generally trumps state law. But it was also seen as a sign of growing voter disillusionment with federal policies and a show of strength by conservatives and the tea party movement.

Three-quarters? It is astounding, really, in a country divided bitterly over so many things that the most popular and unifying issue may be repeal of ObamaCare’s central feature. Other states have or will pass similar measures. Will all this magically disappear by 2012, or will the Republican nominee — whoever he or she may be (and it won’t be Mitt Romney if he doesn’t get on board) — have a huge, broad coalition of support for ripping out Obama’s “historic achievement”?

The individual mandate is for many on the left (Don’t force me to buy a plan from Big Insurance!) and the right (Don’t force me to buy what I don’t want!) a sore point, a reminder of Obama’s statist-corporatist agenda. We are now seeing just how many Americans across the political spectrum want it abolished before it goes into effect. It’s almost like “Repeal and Reform!” could be a popular campaign slogan.

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Misinformation, Disinformation, and ObamaCare

In a recent story in the New York Times, we learned this:

When Congress required most Americans to obtain health insurance or pay a penalty, Democrats denied that they were creating a new tax. But in court, the Obama administration and its allies now defend the requirement as an exercise of the government’s “power to lay and collect taxes.”

And that power, they say, is even more sweeping than the federal power to regulate interstate commerce.

Administration officials say the tax argument is a linchpin of their legal case in defense of the health care overhaul and its individual mandate, now being challenged in court by more than 20 states and several private organizations.

The story goes on to explain that under the legislation signed by President Obama in March, most Americans will have to maintain “minimum essential coverage” starting in 2014. In a brief defending the law, the Justice Department says the requirement for people to carry insurance or pay the penalty is “a valid exercise” of Congress’s power to impose taxes.

DOJ argues that the penalty is a tax because it will raise substantial revenue: $4 billion a year by 2017, according to the Congressional Budget Office. And according to the Times, the penalty is imposed and collected under the Internal Revenue Code, and people must report it on their tax returns “as an addition to income tax liability.” Because the penalty is a tax, the department says, no one can challenge it in court before paying it and seeking a refund.

Well, well, well, this does pose a problem for our president, doesn’t it?

In addition to being yet one more violation of his pledge not to tax families making less than $250,000, Obama, during the health-care debate, insisted that a mandate to buy insurance, enforced by financial penalties, was not a tax.

In an exchange with ABC’s George Stephanopoulos last September (h/t Ed Morrisey), Stephanopoulos pressed Obama on admitting that what he was advocating was a tax increase. “For us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase,” Obama assured us. Elsewhere in the interview, Obama said, “George, you — you can’t just make up that language and decide that that’s called a tax increase.” And when Stephanopoulos read the definition of a tax increase from Merriam Webster’s Dictionary, Obama came back with this condescending and foolish response:

George, the fact that you looked up Merriam’s Dictionary, the definition of tax increase, indicates to me that you’re stretching a little bit right now. Otherwise, you wouldn’t have gone to the dictionary to check on the definition.

It turns out the truth is exactly the opposite of what Obama said. Jack M. Balkin, a professor at Yale Law School who supports the new health-care law, stated the obvious at a meeting last month: “[Mr. Obama] has not been honest with the American people about the nature of this bill. This bill is a tax.”

This is just one example of a systematic pattern of misinformation and disinformation related to the health-care campaign. We have seen similarly dishonest claims related to funding abortion (ObamaCare is doing exactly that), bending the cost curve down (it will bend it up), lowering premiums (they will rise), and to allowing Americans to keep the coverage they currently have (many won’t).

In many respects, the Obama administration has shown itself to be thoroughly postmodern; words have no objective meaning. Reality can be molded to the whims of the most powerful. We can each construct our own narrative.

In the case of the president, the narrative is fairly simply: whatever advances his own aims and objectives is defensible. The ends justify the means. If false claims have to be used to advance a larger truth, so be it.

This attitude pervades the Obama administration and appears to be especially concentrated in the chief executive. He thinks he can get away with almost anything, including the corruption of language. He can’t, and if he isn’t careful, this kind of distortion of truth and reality is going to cost him a very great deal.

In a recent story in the New York Times, we learned this:

When Congress required most Americans to obtain health insurance or pay a penalty, Democrats denied that they were creating a new tax. But in court, the Obama administration and its allies now defend the requirement as an exercise of the government’s “power to lay and collect taxes.”

And that power, they say, is even more sweeping than the federal power to regulate interstate commerce.

Administration officials say the tax argument is a linchpin of their legal case in defense of the health care overhaul and its individual mandate, now being challenged in court by more than 20 states and several private organizations.

The story goes on to explain that under the legislation signed by President Obama in March, most Americans will have to maintain “minimum essential coverage” starting in 2014. In a brief defending the law, the Justice Department says the requirement for people to carry insurance or pay the penalty is “a valid exercise” of Congress’s power to impose taxes.

DOJ argues that the penalty is a tax because it will raise substantial revenue: $4 billion a year by 2017, according to the Congressional Budget Office. And according to the Times, the penalty is imposed and collected under the Internal Revenue Code, and people must report it on their tax returns “as an addition to income tax liability.” Because the penalty is a tax, the department says, no one can challenge it in court before paying it and seeking a refund.

Well, well, well, this does pose a problem for our president, doesn’t it?

In addition to being yet one more violation of his pledge not to tax families making less than $250,000, Obama, during the health-care debate, insisted that a mandate to buy insurance, enforced by financial penalties, was not a tax.

In an exchange with ABC’s George Stephanopoulos last September (h/t Ed Morrisey), Stephanopoulos pressed Obama on admitting that what he was advocating was a tax increase. “For us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase,” Obama assured us. Elsewhere in the interview, Obama said, “George, you — you can’t just make up that language and decide that that’s called a tax increase.” And when Stephanopoulos read the definition of a tax increase from Merriam Webster’s Dictionary, Obama came back with this condescending and foolish response:

George, the fact that you looked up Merriam’s Dictionary, the definition of tax increase, indicates to me that you’re stretching a little bit right now. Otherwise, you wouldn’t have gone to the dictionary to check on the definition.

It turns out the truth is exactly the opposite of what Obama said. Jack M. Balkin, a professor at Yale Law School who supports the new health-care law, stated the obvious at a meeting last month: “[Mr. Obama] has not been honest with the American people about the nature of this bill. This bill is a tax.”

This is just one example of a systematic pattern of misinformation and disinformation related to the health-care campaign. We have seen similarly dishonest claims related to funding abortion (ObamaCare is doing exactly that), bending the cost curve down (it will bend it up), lowering premiums (they will rise), and to allowing Americans to keep the coverage they currently have (many won’t).

In many respects, the Obama administration has shown itself to be thoroughly postmodern; words have no objective meaning. Reality can be molded to the whims of the most powerful. We can each construct our own narrative.

In the case of the president, the narrative is fairly simply: whatever advances his own aims and objectives is defensible. The ends justify the means. If false claims have to be used to advance a larger truth, so be it.

This attitude pervades the Obama administration and appears to be especially concentrated in the chief executive. He thinks he can get away with almost anything, including the corruption of language. He can’t, and if he isn’t careful, this kind of distortion of truth and reality is going to cost him a very great deal.

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Obama’s Reality Gap

Morton Kondracke writes:

From BP to banks, health insurance companies to special interest lobbyists, Obama & Co. pass up no opportunity to slash and bash — except when they are asking for industry cooperation or appealing for national unity.

The dichotomy between one rhetorical mood and the other is so pronounced, you almost suspect that the administration and its leader are bipolar. …

President Barack Obama certainly is not a socialist — let alone a communist — as some of his far-out detractors claim. But he and his aides certainly are in populist, “whack industry” mode.

From BP to banks, health insurance companies to special interest lobbyists, Obama & Co. pass up no opportunity to slash and bash — except when they are asking for industry cooperation or appealing for national unity.

The dichotomy between one rhetorical mood and the other is so pronounced, you almost suspect that the administration and its leader are bipolar.

Kondrake wonders if Obama is just a liberal with a deep suspicion of free enterprise. Perhaps — but that does not explain the rank hypocrisy that permeates not only his tone with businesses but also with an array of adversaries and critics.

Here’s another theory: the Obama self-created image — practiced in the Ivy League, cultivated in memoirs, nurtured on the campaign trail, and enhanced by the media — of an intellectual, a moderate, a unifier, and most of all a charismatic figure whose mere presence is transformative has a life of its own, unrelated to Obama’s actual political agenda and beliefs. To discover the latter one need only look at his pre-senatorial associations (from Rev. Wright to Bill Ayers), his record in the Senate (the most liberal among many liberals), his legislative goals (a mix of special-interest trinkets and monstrously complicated statist measures), and his staff’s fetish for bullying (from Bibi to Fox News to Rush Limbaugh). So naturally the result is what Kondrake calls “bipolar” and others call “hypocrisy.” It is also why Obama is so expert — perhaps the only thing in which he is expert — in campaigning. For campaigning is the art of spinning a discrete image, a reality that may or may not coincide with the outside world, and selling it relentlessly to the public. That, after all, is what Obama does and has done throughout his adult life. Unfortunately, eventually the public catches on — and then poll numbers sink, a wave election builds, and the facade crumbles. But it takes a while for people to catch on.

Morton Kondracke writes:

From BP to banks, health insurance companies to special interest lobbyists, Obama & Co. pass up no opportunity to slash and bash — except when they are asking for industry cooperation or appealing for national unity.

The dichotomy between one rhetorical mood and the other is so pronounced, you almost suspect that the administration and its leader are bipolar. …

President Barack Obama certainly is not a socialist — let alone a communist — as some of his far-out detractors claim. But he and his aides certainly are in populist, “whack industry” mode.

From BP to banks, health insurance companies to special interest lobbyists, Obama & Co. pass up no opportunity to slash and bash — except when they are asking for industry cooperation or appealing for national unity.

The dichotomy between one rhetorical mood and the other is so pronounced, you almost suspect that the administration and its leader are bipolar.

Kondrake wonders if Obama is just a liberal with a deep suspicion of free enterprise. Perhaps — but that does not explain the rank hypocrisy that permeates not only his tone with businesses but also with an array of adversaries and critics.

Here’s another theory: the Obama self-created image — practiced in the Ivy League, cultivated in memoirs, nurtured on the campaign trail, and enhanced by the media — of an intellectual, a moderate, a unifier, and most of all a charismatic figure whose mere presence is transformative has a life of its own, unrelated to Obama’s actual political agenda and beliefs. To discover the latter one need only look at his pre-senatorial associations (from Rev. Wright to Bill Ayers), his record in the Senate (the most liberal among many liberals), his legislative goals (a mix of special-interest trinkets and monstrously complicated statist measures), and his staff’s fetish for bullying (from Bibi to Fox News to Rush Limbaugh). So naturally the result is what Kondrake calls “bipolar” and others call “hypocrisy.” It is also why Obama is so expert — perhaps the only thing in which he is expert — in campaigning. For campaigning is the art of spinning a discrete image, a reality that may or may not coincide with the outside world, and selling it relentlessly to the public. That, after all, is what Obama does and has done throughout his adult life. Unfortunately, eventually the public catches on — and then poll numbers sink, a wave election builds, and the facade crumbles. But it takes a while for people to catch on.

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Rubber-Stamping Obama’s Agenda Can Be Hazardous to Democrats

This report on the prospects for Republicans’ gains in the House in suburban districts features my home district, the 11th in northern Virginia. Represented for years by moderate Republican Tom Davis, Gerry Connolly now occupies the seat. He’s brimming with confidence — sort of:

Rep. Gerry Connolly, a liberal Democrat who won the seat by a wide margin in 2008, agrees—up to a point. “Seeing it go Republican again would be big,” he said, before adding, “I don’t expect that to happen.”

But unlike his immediate predecessor, who hewed a moderate line and often confounded the conservative base, Connolly has been a rubber stamp for Nancy Pelosi and the Obama agenda. And his constituents are none too pleased. At a health-care town hall, they vented their frustration:

He touted the hundreds of millions he had won for his district to expand its congested highways and intersections. He defended the president’s stimulus package, noting that $77 million was going to help build a rail line to Dulles Airport, which lies partly in Fairfax County.

He then gave a detailed defense of the health bill. “I voted for it and am proud to have voted for it,” he said.

What followed was a barrage of negative comments and questions on health care. Did he really read the whole bill? Why is my doctor now telling me that he’ll check my pacemaker only four times a year instead of monthly? What in the Constitution gives you the power to demand people pay for health insurance?

Mr. Connolly cut off questioning after 20 minutes, saying he has to get home to his wife. A knot of constituents gathered to shake his hand and to invite him to various events. One asked about his daughter, who’s now in college.

Outside, he waved off the hostility. “Yeah, they were critical in there,” he said. “But I’ve known these folks for years. You saw how they were asking about my daughter. I’ll win this precinct.”

Perhaps. Or maybe the voter was being polite. The two Republicans vying to oppose Connolly have figured out his weak spot: he’s gone far left in a moderate district. (“‘He’s been acting as Nancy Pelosi’s personal lieutenant,’ Mr. [Pat] Herrity said to a chorus of boos, speaking one morning to several hundred party faithful in the gym of West Springfield High School. ‘I call him Gerry Pelosi.’”) Keith Fimian is focusing on the deficit that the Democrats have piled up, accusing them of “preparing for the next generation a life of servitude and mediocrity.”

It is noteworthy that Obama crushed John McCain in 2008 in Fairfax County, winning by more than 20 points. But it is a different story now. Bob McDonnell won the county in the 2009 gubernatorial race. It seems that the voters have gotten a good look at Obamaism and don’t like what they see. Connolly — like Obama — took a risk that voters had moved left and would welcome a huge  expansion of federal power and shrug off the taxes to pay for it. We’ll find out in November if that was a smart bet.

This report on the prospects for Republicans’ gains in the House in suburban districts features my home district, the 11th in northern Virginia. Represented for years by moderate Republican Tom Davis, Gerry Connolly now occupies the seat. He’s brimming with confidence — sort of:

Rep. Gerry Connolly, a liberal Democrat who won the seat by a wide margin in 2008, agrees—up to a point. “Seeing it go Republican again would be big,” he said, before adding, “I don’t expect that to happen.”

But unlike his immediate predecessor, who hewed a moderate line and often confounded the conservative base, Connolly has been a rubber stamp for Nancy Pelosi and the Obama agenda. And his constituents are none too pleased. At a health-care town hall, they vented their frustration:

He touted the hundreds of millions he had won for his district to expand its congested highways and intersections. He defended the president’s stimulus package, noting that $77 million was going to help build a rail line to Dulles Airport, which lies partly in Fairfax County.

He then gave a detailed defense of the health bill. “I voted for it and am proud to have voted for it,” he said.

What followed was a barrage of negative comments and questions on health care. Did he really read the whole bill? Why is my doctor now telling me that he’ll check my pacemaker only four times a year instead of monthly? What in the Constitution gives you the power to demand people pay for health insurance?

Mr. Connolly cut off questioning after 20 minutes, saying he has to get home to his wife. A knot of constituents gathered to shake his hand and to invite him to various events. One asked about his daughter, who’s now in college.

Outside, he waved off the hostility. “Yeah, they were critical in there,” he said. “But I’ve known these folks for years. You saw how they were asking about my daughter. I’ll win this precinct.”

Perhaps. Or maybe the voter was being polite. The two Republicans vying to oppose Connolly have figured out his weak spot: he’s gone far left in a moderate district. (“‘He’s been acting as Nancy Pelosi’s personal lieutenant,’ Mr. [Pat] Herrity said to a chorus of boos, speaking one morning to several hundred party faithful in the gym of West Springfield High School. ‘I call him Gerry Pelosi.’”) Keith Fimian is focusing on the deficit that the Democrats have piled up, accusing them of “preparing for the next generation a life of servitude and mediocrity.”

It is noteworthy that Obama crushed John McCain in 2008 in Fairfax County, winning by more than 20 points. But it is a different story now. Bob McDonnell won the county in the 2009 gubernatorial race. It seems that the voters have gotten a good look at Obamaism and don’t like what they see. Connolly — like Obama — took a risk that voters had moved left and would welcome a huge  expansion of federal power and shrug off the taxes to pay for it. We’ll find out in November if that was a smart bet.

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Christie Targets Public-Employee Unions

George Will, like a lot of us, is impressed with Chris Christie. He won the gubernatorial race in one of the Bluest states and is now governing like a tough fiscal conservative. Will explains:

He inherited a $2.2 billion deficit, and next year’s projected deficit of $10.7 billion is, relative to the state’s $29.3 billion budget, the nation’s worst. Democrats, with the verbal tic — “Tax the rich!” — that passes for progressive thinking, demanded that he reinstate the “millionaire’s tax,” which hit “millionaires” earning $400,000 until it expired Dec. 31. Instead, Christie noted that between 2004 and 2008 there was a net outflow of $70 billion in wealth as “the rich,” including small businesses, fled. And he said previous administrations had “raised taxes 115 times in the last eight years alone.”

So he closed the $2.2 billion gap by accepting 375 of 378 suggested spending freezes and cuts. In two weeks. By executive actions. In eight weeks he cut $13 billion — $232 million a day, $9 million an hour. Now comes the hard part.

But that’s not going to get New Jersey back to fiscal sanity. So Christie is going after public-employee unions’ gold-plated benefits:

Government employees’ health benefits are, he says, “41 percent more expensive” than those of the average Fortune 500 company. Without changes in current law, “spending will have increased 322 percent in 20 years — over 16 percent a year.” There is, he says, a connection between the state’s being No. 1 in total tax burden and being No. 1 in the proportion of college students who, after graduating, leave the state.

Partly to pay for teachers’ benefits — most contribute nothing to pay for their health insurance — property taxes have increased 70 percent in 10 years, to an average annual cost to homeowners of $7,281. Christie proposes a 2.5 percent cap on annual increases.

In the past, the “solution” to all this was to raise taxes, which created an exodus of the “rich” and small businesses to neighboring states. But Christie is taking a page from another northeastern Republican (and another former federal prosecutor) who when he came into office was told he had to raise taxes, but proceeded to show that budget discipline and tax cuts could revive the greatest of American cities. Rudy Giuliani became a conservative rock star and New York came roaring back. If Christie pulls this off, he will not only elevate himself to the top tier of Republican politicians; he will also point the way to taming state budgets (California, are you paying attention?). As Will notes:

In the state that has the nation’s fourth-highest percentage (66) of public employees who are unionized, he has joined the struggle that will dominate the nation’s domestic policymaking in this decade — to break the ruinous collaboration between elected officials and unionized state and local workers whose affections the officials purchase with taxpayers’ money.

No wonder labor leaders are going berserk. If Christie wins, Big Labor will get its comeuppance, New Jersey will prosper, and once again liberal governance will be replaced by something better — responsible fiscal conservatism.

George Will, like a lot of us, is impressed with Chris Christie. He won the gubernatorial race in one of the Bluest states and is now governing like a tough fiscal conservative. Will explains:

He inherited a $2.2 billion deficit, and next year’s projected deficit of $10.7 billion is, relative to the state’s $29.3 billion budget, the nation’s worst. Democrats, with the verbal tic — “Tax the rich!” — that passes for progressive thinking, demanded that he reinstate the “millionaire’s tax,” which hit “millionaires” earning $400,000 until it expired Dec. 31. Instead, Christie noted that between 2004 and 2008 there was a net outflow of $70 billion in wealth as “the rich,” including small businesses, fled. And he said previous administrations had “raised taxes 115 times in the last eight years alone.”

So he closed the $2.2 billion gap by accepting 375 of 378 suggested spending freezes and cuts. In two weeks. By executive actions. In eight weeks he cut $13 billion — $232 million a day, $9 million an hour. Now comes the hard part.

But that’s not going to get New Jersey back to fiscal sanity. So Christie is going after public-employee unions’ gold-plated benefits:

Government employees’ health benefits are, he says, “41 percent more expensive” than those of the average Fortune 500 company. Without changes in current law, “spending will have increased 322 percent in 20 years — over 16 percent a year.” There is, he says, a connection between the state’s being No. 1 in total tax burden and being No. 1 in the proportion of college students who, after graduating, leave the state.

Partly to pay for teachers’ benefits — most contribute nothing to pay for their health insurance — property taxes have increased 70 percent in 10 years, to an average annual cost to homeowners of $7,281. Christie proposes a 2.5 percent cap on annual increases.

In the past, the “solution” to all this was to raise taxes, which created an exodus of the “rich” and small businesses to neighboring states. But Christie is taking a page from another northeastern Republican (and another former federal prosecutor) who when he came into office was told he had to raise taxes, but proceeded to show that budget discipline and tax cuts could revive the greatest of American cities. Rudy Giuliani became a conservative rock star and New York came roaring back. If Christie pulls this off, he will not only elevate himself to the top tier of Republican politicians; he will also point the way to taming state budgets (California, are you paying attention?). As Will notes:

In the state that has the nation’s fourth-highest percentage (66) of public employees who are unionized, he has joined the struggle that will dominate the nation’s domestic policymaking in this decade — to break the ruinous collaboration between elected officials and unionized state and local workers whose affections the officials purchase with taxpayers’ money.

No wonder labor leaders are going berserk. If Christie wins, Big Labor will get its comeuppance, New Jersey will prosper, and once again liberal governance will be replaced by something better — responsible fiscal conservatism.

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ObamaCare Bedevils Romney

Mitt Romney is the most experienced presidential candidate of the 2012 aspirants, having slogged through the 2008 primary and pre-primary campaigns. He has written a book and developed an easier, less stilted demeanor and public persona. He speaks authoritatively on foreign policy. But he has a big problem: ObamaCare looks a good deal like the ex-governor’s RomneyCare, his signature health-care legislation. A former advisor and MIT economist Jonathan Gruber remarks: “If any one person in the world deserves credit for where we are now (with the passage of the new federal law) it’s Mitt Romney.” Yikes.

Romney’s plan includes mandatory insurance for individuals — an anathema to conservatives. And the plan faces hard realities, which conservatives predict will befall ObamaCare too. The Wall Street Journal editors explain:

Three of largest four — Blue Cross Blue Shield, Tufts Health Plan and Fallon Community Health — posted operating losses in 2009. In an emergency suit heard in Boston superior court yesterday, they argued that the arbitrary rate cap will result in another $100 million in collective losses this year and make it impossible to pay the anticipated cost of claims. It may even threaten the near-term solvency of some companies.

So until the matter is resolved, the insurers have simply stopped selling new policies. A court decision is expected by Monday, but state officials have demanded that the insurers — under the threat of fines and other regulatory punishments — resume offering quotes by today and to revert to year-old base premiums. Let that one sink in: Mr. Patrick has made the health insurance business so painful the government actually has to order private companies to sell their products (albeit at sub-market costs). . . .

On top of that, like ObamaCare, integral to the Massachusetts overhaul are mandates that require insurers to cover anyone who applies regardless of health status or pre-existing conditions and to charge everyone about the same rates. This allows people to wait until they’re about to incur major medical expenses before buying insurance and transfer the costs to everyone else. This week Blue Cross Blue Shield reported a big uptick in short-term customers who ran up costs more than four times the average, only to drop the coverage within three months.

Romney cites the differences between the bills — his contained no massive tax hike and didn’t savage Medicare. Mostly, he’s focused on the Tenth Amendment — the argument that the federal government shouldn’t and can’t constitutionally occupy the health-care field, which has been subject to state regulation. It’s far from clear that this will be enough to satisfy the Republican primary electorate, which is going to hear Romney’s opponents attack him for passing ObamaCare-lite. They likely will be proposing market-based plans akin to those which the GOP proposed in Congress. But for whatever reason — perhaps concern about reviving the flip-flop label — Romney isn’t disowning his past effort and he’ll have to withstand the onslaught if he’s going to do better than second place this time around. Every candidate has handicaps but in an election in which the Republicans are trying to elect a president to rip out ObamaCare before it takes root, Romney will have his work cut out for him, living down what was once a selling point for his candidacy.

Mitt Romney is the most experienced presidential candidate of the 2012 aspirants, having slogged through the 2008 primary and pre-primary campaigns. He has written a book and developed an easier, less stilted demeanor and public persona. He speaks authoritatively on foreign policy. But he has a big problem: ObamaCare looks a good deal like the ex-governor’s RomneyCare, his signature health-care legislation. A former advisor and MIT economist Jonathan Gruber remarks: “If any one person in the world deserves credit for where we are now (with the passage of the new federal law) it’s Mitt Romney.” Yikes.

Romney’s plan includes mandatory insurance for individuals — an anathema to conservatives. And the plan faces hard realities, which conservatives predict will befall ObamaCare too. The Wall Street Journal editors explain:

Three of largest four — Blue Cross Blue Shield, Tufts Health Plan and Fallon Community Health — posted operating losses in 2009. In an emergency suit heard in Boston superior court yesterday, they argued that the arbitrary rate cap will result in another $100 million in collective losses this year and make it impossible to pay the anticipated cost of claims. It may even threaten the near-term solvency of some companies.

So until the matter is resolved, the insurers have simply stopped selling new policies. A court decision is expected by Monday, but state officials have demanded that the insurers — under the threat of fines and other regulatory punishments — resume offering quotes by today and to revert to year-old base premiums. Let that one sink in: Mr. Patrick has made the health insurance business so painful the government actually has to order private companies to sell their products (albeit at sub-market costs). . . .

On top of that, like ObamaCare, integral to the Massachusetts overhaul are mandates that require insurers to cover anyone who applies regardless of health status or pre-existing conditions and to charge everyone about the same rates. This allows people to wait until they’re about to incur major medical expenses before buying insurance and transfer the costs to everyone else. This week Blue Cross Blue Shield reported a big uptick in short-term customers who ran up costs more than four times the average, only to drop the coverage within three months.

Romney cites the differences between the bills — his contained no massive tax hike and didn’t savage Medicare. Mostly, he’s focused on the Tenth Amendment — the argument that the federal government shouldn’t and can’t constitutionally occupy the health-care field, which has been subject to state regulation. It’s far from clear that this will be enough to satisfy the Republican primary electorate, which is going to hear Romney’s opponents attack him for passing ObamaCare-lite. They likely will be proposing market-based plans akin to those which the GOP proposed in Congress. But for whatever reason — perhaps concern about reviving the flip-flop label — Romney isn’t disowning his past effort and he’ll have to withstand the onslaught if he’s going to do better than second place this time around. Every candidate has handicaps but in an election in which the Republicans are trying to elect a president to rip out ObamaCare before it takes root, Romney will have his work cut out for him, living down what was once a selling point for his candidacy.

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America Is Not on Autopilot

David Brooks surveys the American scene and finds the future bright — a population boom to produce young  workers, immigration to attract skilled workers, a dynamic economy to satisfy the world’s ever-growing demand for U.S. products, and a thriving popular culture. He concludes:

The U.S. is on the verge of a demographic, economic and social revival, built on its historic strengths. The U.S. has always been good at disruptive change. It’s always excelled at decentralized community-building. It’s always had that moral materialism that creates meaning-rich products. Surely a country with this much going for it is not going to wait around passively and let a rotten political culture drag it down.

That’s a comforting thought, but, of course, the political culture – and the policy choices it produces – can retard or shut off the very trends and phenomena that Brooks praises. Immigration could be choked off  — as it was in previous eras of economic uncertainty. That economic dynamism that Brooks touts is not impervious to the regulatory, tax, and legal framework that political elites produce. In fact, it is the enormous uptick in debt, the growth of the public sector, the tax hikes, and the financial micromanagement that the Obama administration is pushing that threaten to make America a less productive, less dynamic, and less wealthy nation. That “decentralized community-building” that Brooks likes can be subverted by an overreaching federal government that seeks to regulate everything from the type of health insurance we must buy to the emissions that the local electric company can put out to the sorts of infrastructure projects that are funded.

In sum, the American social and economic culture that has produced tremendous wealth, upward mobility, and opportunity can be eroded by foolish policies. Similarly, our national security — which is a prerequisite for that blissful domestic environment — can be imperiled by a reckless approach that ignores looming threats, imagines our foes share common values, and alienates allies.

America is not a nation on autopilot. It remains to be seen whether we can prosper and remain safe despite the misguided domestic and foreign-policy agenda of a president who lacks a fundamental understanding of how wealth is created and how America projects its strength and defends its vital interests.

David Brooks surveys the American scene and finds the future bright — a population boom to produce young  workers, immigration to attract skilled workers, a dynamic economy to satisfy the world’s ever-growing demand for U.S. products, and a thriving popular culture. He concludes:

The U.S. is on the verge of a demographic, economic and social revival, built on its historic strengths. The U.S. has always been good at disruptive change. It’s always excelled at decentralized community-building. It’s always had that moral materialism that creates meaning-rich products. Surely a country with this much going for it is not going to wait around passively and let a rotten political culture drag it down.

That’s a comforting thought, but, of course, the political culture – and the policy choices it produces – can retard or shut off the very trends and phenomena that Brooks praises. Immigration could be choked off  — as it was in previous eras of economic uncertainty. That economic dynamism that Brooks touts is not impervious to the regulatory, tax, and legal framework that political elites produce. In fact, it is the enormous uptick in debt, the growth of the public sector, the tax hikes, and the financial micromanagement that the Obama administration is pushing that threaten to make America a less productive, less dynamic, and less wealthy nation. That “decentralized community-building” that Brooks likes can be subverted by an overreaching federal government that seeks to regulate everything from the type of health insurance we must buy to the emissions that the local electric company can put out to the sorts of infrastructure projects that are funded.

In sum, the American social and economic culture that has produced tremendous wealth, upward mobility, and opportunity can be eroded by foolish policies. Similarly, our national security — which is a prerequisite for that blissful domestic environment — can be imperiled by a reckless approach that ignores looming threats, imagines our foes share common values, and alienates allies.

America is not a nation on autopilot. It remains to be seen whether we can prosper and remain safe despite the misguided domestic and foreign-policy agenda of a president who lacks a fundamental understanding of how wealth is created and how America projects its strength and defends its vital interests.

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We Still Don’t Know What’s in It

Bill McGurn helps highlight two defects in ObamaCare — its uncertainty and its potential to bully the American people. They come together in the provision for an individual mandate, something Obama ran against during the campaign (when he was also promising not to raise taxes on those making less than $250,000).

How could there be uncertainty about this key feature? Nancy Pelosi promised, after all, that if we passed it, we’d find out what was in it. Well, this is what comes of racing through a largely secretive legislative process. McGurn explains “one of the murkiest bits of this legislation”:

In testimony before a House Ways and Means subcommittee last Thursday, the IRS commissioner deflected questions about the agency’s precise role vis-à-vis health care. Mr. Shulman reassured citizens that this bill does not “fundamentally alter” their relationship with the IRS, and said the IRS would not be snooping into their health records. About the penalties associated with the mandate, he was less clear.

Partly that’s because the law is unclear. The original House bill opened the door for criminal sanctions against Americans who didn’t buy health insurance and pay the penalty. The Senate bill did the same until Sen. John Ensign (R., Nev.) successfully pushed to amend the bill. Even so, the final language begs the question that Mr. Shulman and Mr. Weiner avoided: Who’s going to enforce the mandate, and how?

You might wonder how we can possibly predict costs if we don’t know how many people, if any, are going to herded into the arms of Big Insurance. You might wonder how we are going to achieve compliance with a law that many already resent if it’s not even clear whether the IRS will go after people. Both are good questions, revealing just how uninterested the Democrats were in thinking through and crafting effective legislation. They simply wanted a notch in their belt and to silence the hollering from their base. Getting a coherent, understandable legislative scheme just wasn’t a priority for them.

And then there is the bullying if, in fact, the mandate exists and will be enforced with the full power of the federal government:

Almost by definition, those hit by the mandate will be either young people starting out, or those working for smaller businesses that do not provide employees with health coverage. Back in November, a report by the Congressional Budget Office and Joint Committee on Taxation estimated that nearly half (46%) of the mandate penalties will be paid by Americans under 300% of the poverty line. In today’s dollars, that works out to $32,500 for an individual. For a family of four, it’s $66,150. …

In his appearance before Congress, Mr. Shulman stated he was still working on “the proper resources” the IRS would need to handle the tax provisions of the health-care act. Maybe that won’t mean 16,500 new agents. If the Republicans do manage to take back Congress come November, however, it should mean hearings in which Mr. Shulman provides the American people with specific answers about how much bigger the IRS is going to get because of this bill—and how exactly the IRS will deal with Americans who don’t pay the penalty tax.

So we will, as McGurn points out, either witness the IRS hassling modest-income Americans into buying insurance they don’t want, or the law will be “unenforced.” If it is the latter, all the estimated cost “savings” supposedly achieved by expanding the risk pool of the newly insured can be tossed onto the heap of misrepresentations and fiscal fantasies deployed to pass the bill despite the dire warnings of those like Rep. Paul Ryan. This is the personification of the ever-growing bureaucratic state — incomprehensible, threatening, and very, very expensive.

Bill McGurn helps highlight two defects in ObamaCare — its uncertainty and its potential to bully the American people. They come together in the provision for an individual mandate, something Obama ran against during the campaign (when he was also promising not to raise taxes on those making less than $250,000).

How could there be uncertainty about this key feature? Nancy Pelosi promised, after all, that if we passed it, we’d find out what was in it. Well, this is what comes of racing through a largely secretive legislative process. McGurn explains “one of the murkiest bits of this legislation”:

In testimony before a House Ways and Means subcommittee last Thursday, the IRS commissioner deflected questions about the agency’s precise role vis-à-vis health care. Mr. Shulman reassured citizens that this bill does not “fundamentally alter” their relationship with the IRS, and said the IRS would not be snooping into their health records. About the penalties associated with the mandate, he was less clear.

Partly that’s because the law is unclear. The original House bill opened the door for criminal sanctions against Americans who didn’t buy health insurance and pay the penalty. The Senate bill did the same until Sen. John Ensign (R., Nev.) successfully pushed to amend the bill. Even so, the final language begs the question that Mr. Shulman and Mr. Weiner avoided: Who’s going to enforce the mandate, and how?

You might wonder how we can possibly predict costs if we don’t know how many people, if any, are going to herded into the arms of Big Insurance. You might wonder how we are going to achieve compliance with a law that many already resent if it’s not even clear whether the IRS will go after people. Both are good questions, revealing just how uninterested the Democrats were in thinking through and crafting effective legislation. They simply wanted a notch in their belt and to silence the hollering from their base. Getting a coherent, understandable legislative scheme just wasn’t a priority for them.

And then there is the bullying if, in fact, the mandate exists and will be enforced with the full power of the federal government:

Almost by definition, those hit by the mandate will be either young people starting out, or those working for smaller businesses that do not provide employees with health coverage. Back in November, a report by the Congressional Budget Office and Joint Committee on Taxation estimated that nearly half (46%) of the mandate penalties will be paid by Americans under 300% of the poverty line. In today’s dollars, that works out to $32,500 for an individual. For a family of four, it’s $66,150. …

In his appearance before Congress, Mr. Shulman stated he was still working on “the proper resources” the IRS would need to handle the tax provisions of the health-care act. Maybe that won’t mean 16,500 new agents. If the Republicans do manage to take back Congress come November, however, it should mean hearings in which Mr. Shulman provides the American people with specific answers about how much bigger the IRS is going to get because of this bill—and how exactly the IRS will deal with Americans who don’t pay the penalty tax.

So we will, as McGurn points out, either witness the IRS hassling modest-income Americans into buying insurance they don’t want, or the law will be “unenforced.” If it is the latter, all the estimated cost “savings” supposedly achieved by expanding the risk pool of the newly insured can be tossed onto the heap of misrepresentations and fiscal fantasies deployed to pass the bill despite the dire warnings of those like Rep. Paul Ryan. This is the personification of the ever-growing bureaucratic state — incomprehensible, threatening, and very, very expensive.

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Who Will Run Defending ObamaCare?

There are a number of polls out on ObamaCare. Democrats have seized upon a Gallup poll of all adults, showing a plurality favoring ObamaCare; Republicans point to other polls, showing a majority of voters oppose it. But this might be the most troubling of all for Democrats:

As Florida’s attorney general, Bill McCollum is suing the federal government to prevent implementation of the newly passed health-care plan. As a candidate for governor, McCollum may have found a popular campaign position.

Fifty-four percent (54%) of Florida voters favor their state suing the federal government to challenge the requirement in the new plan that every American must get health insurance. Thirty-six percent (36%) oppose such a lawsuit.

This was a state that Obama carried in 2008. By a huge margin voters not only don’t want ObamaCare but expect elected officials to sue the government to get rid of it. (Nationwide, 49 percent favor suing to get rid of ObamaCare while 37 percent do not.) That should be a warning sign to attorneys general and gubernatorial candidates as well as House and Senate contenders. And it raises an interesting question: which Democrats in competitive races will want to appear on the same stage with Obama, defending ObamaCare?

There are a number of polls out on ObamaCare. Democrats have seized upon a Gallup poll of all adults, showing a plurality favoring ObamaCare; Republicans point to other polls, showing a majority of voters oppose it. But this might be the most troubling of all for Democrats:

As Florida’s attorney general, Bill McCollum is suing the federal government to prevent implementation of the newly passed health-care plan. As a candidate for governor, McCollum may have found a popular campaign position.

Fifty-four percent (54%) of Florida voters favor their state suing the federal government to challenge the requirement in the new plan that every American must get health insurance. Thirty-six percent (36%) oppose such a lawsuit.

This was a state that Obama carried in 2008. By a huge margin voters not only don’t want ObamaCare but expect elected officials to sue the government to get rid of it. (Nationwide, 49 percent favor suing to get rid of ObamaCare while 37 percent do not.) That should be a warning sign to attorneys general and gubernatorial candidates as well as House and Senate contenders. And it raises an interesting question: which Democrats in competitive races will want to appear on the same stage with Obama, defending ObamaCare?

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