Commentary Magazine


Topic: insurance reforms

Replace and Reform but First Vote

A new Rasmussen poll reveals that ObamaCare is, in fact, a winning issue — for those who want to repeal it:

The latest Rasmussen Reports national telephone survey, conducted on the first two nights after the president signed the bill, shows that 55% favor repealing the legislation. Forty-two percent (42%) oppose repeal. Those figures include 46% who Strongly Favor repeal and 35% who Strongly Oppose it.

And this is the message on which Minority Leader Mitch McConnell says Republicans are going to run on. Politico reports:

Refusing to concede permanent defeat on health reform, Senate Republican leader Mitch McConnell wants to “repeal the whole bill” and replace it with insurance reforms and other measures that could get bipartisan agreement.

“They got health care,” McConnell told POLITICO with a mischievous glint in his eye. “We’ll see whether that’s a gift worth receiving.”

McConnell said that if Republicans were to win back the Senate majority in November, “at the top of our list would be to repeal and replace this health care bill.”

Politico’s reporter concedes the Republicans aren’t going to get 67 votes needed to override an Obama veto that would greet repeal attempts, but it’s no longer inconceivable that the Senate could flip, leaving the remaining Democrats (especially those up for re-election in 2012) quaking. Republicans have excellent to good shots at picking up Pennsylvania, Delaware, Colorado, Arkansas, North Dakota, Nevada, and Illinois. Throw in Wisconsin (if former governor Tommy Thompson runs) and California as competitive states, and you see a pathway to a GOP Senate takeover. (I suspect both sides are going to be very nice to Independent Joe Lieberman, who may once again be in the catbird seat after the November election.) Certainly there will be other issues — repeal of the Bush tax cuts in 2011, unemployment, and national security. But if you have a large base of active support on one key issue — which the other side obsessively emphasizes — it’s hard to resist making that issue the central focus of the campaign.

If Republicans run and win big on a “Repeal ObamaCare” message, Democrats will once again face a choice: continue to ignore the will of the voters, or take another look at the monstrous health-care entitlement (and the additional mounds of debt accumulated by then). We know Obama’s answer — he’d rather have just one term than give up his grand achievement. But by then, Democrats may have a different answer.

A new Rasmussen poll reveals that ObamaCare is, in fact, a winning issue — for those who want to repeal it:

The latest Rasmussen Reports national telephone survey, conducted on the first two nights after the president signed the bill, shows that 55% favor repealing the legislation. Forty-two percent (42%) oppose repeal. Those figures include 46% who Strongly Favor repeal and 35% who Strongly Oppose it.

And this is the message on which Minority Leader Mitch McConnell says Republicans are going to run on. Politico reports:

Refusing to concede permanent defeat on health reform, Senate Republican leader Mitch McConnell wants to “repeal the whole bill” and replace it with insurance reforms and other measures that could get bipartisan agreement.

“They got health care,” McConnell told POLITICO with a mischievous glint in his eye. “We’ll see whether that’s a gift worth receiving.”

McConnell said that if Republicans were to win back the Senate majority in November, “at the top of our list would be to repeal and replace this health care bill.”

Politico’s reporter concedes the Republicans aren’t going to get 67 votes needed to override an Obama veto that would greet repeal attempts, but it’s no longer inconceivable that the Senate could flip, leaving the remaining Democrats (especially those up for re-election in 2012) quaking. Republicans have excellent to good shots at picking up Pennsylvania, Delaware, Colorado, Arkansas, North Dakota, Nevada, and Illinois. Throw in Wisconsin (if former governor Tommy Thompson runs) and California as competitive states, and you see a pathway to a GOP Senate takeover. (I suspect both sides are going to be very nice to Independent Joe Lieberman, who may once again be in the catbird seat after the November election.) Certainly there will be other issues — repeal of the Bush tax cuts in 2011, unemployment, and national security. But if you have a large base of active support on one key issue — which the other side obsessively emphasizes — it’s hard to resist making that issue the central focus of the campaign.

If Republicans run and win big on a “Repeal ObamaCare” message, Democrats will once again face a choice: continue to ignore the will of the voters, or take another look at the monstrous health-care entitlement (and the additional mounds of debt accumulated by then). We know Obama’s answer — he’d rather have just one term than give up his grand achievement. But by then, Democrats may have a different answer.

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But Why Should House Democrats Listen to Nonsense?

Gary Andres summarizes the reasons why congressional leaders feel compelled to try to cram through a massive health-care bill the public hates:

Passing health care reform is a bit of a Holy Grail for Democrats.  It is one of the most important debates and potential accomplishments for the party’s most ardent partisans — and has been for many years.  Failure to enact this legislation would render a crippling blow to those most apt to volunteer, talk to their friends about politics, give money and vote in the upcoming midterm election.  These base voters may not always guarantee the party’s victory, but without them defeat is assured.

Oh, and they’ll sell the dupes — the voters, that is, who don’t know what’s best for them — on it later, convincing them how wrong they were to oppose the heroic efforts of  lawmakers. Or something like that.

This and complete cluelessness about what the public’s objections are to the bill and a pattern of ultra-liberal excess explain a lot. As Democratic consultant Dan Gerstein put it, “the Democrats have seemed to be operating in a hermetically sealed political vacuum, impervious to the public’s changing post-crash priorities and diminishing tolerance for big government solutions.” He thinks its political madness to plunge ahead:

Those hell-or-high-water Democrats are banking on the context to change again once they pass their bill. Their theory is that once the program benefits kick in, the political benefits will soon do the same. Public support will grow over time, the system will become as ingrained and untouchable as Medicare and Medicaid, and this year’s election liability will gradually become a campaign asset. It might be a plausible argument–if this were any other year, if health care were the only issue dragging down the Democrats’ credibility, if the anti-government Tea Party movement had not gotten such traction, and of course, if the bill ends up working reasonably well. …

The best course for Democrats would be to skip the all-or-nothing trap and pass a center-out bill that contains the 80% of insurance reforms on which both sides already agree. But that’s a moot point: The Democrats are going for broke (in more ways than one). The more salient question is when will the Democrats start connecting the dots–and recognize that the American people are not going to accept a government that is not willing to heed their doubts.

Now Pelosi-Reid-Obama are plainly not taking Gerstein’s advice, but that’s not what matters at this point. (Well, for many who will meekly accept their assignment to walk the plank for the greater good of Obama’s ego, I suppose it matters.) What really matters to the outcome is whether those one or two dozen House Democrats whose votes are still in play connect the dots and assess the arguments of their leadership in light of their own constituents.

Pelosi’s liberal donors may have been pining away for socialized medicine since the days of their nuclear-free-zone sit-ins at Berkeley, but that doesn’t mean a Michigan or Arkansas congressman’s constituents harbor the same dreams. Pelosi may think she can explain it all later, but those congressmen on the fence saw her explain things at the summit and likely had the same reaction as Gerstein — oh my. (“Led by Pelosi, they repeated their same unpersuasive arguments for universal coverage, recycled the same hollow CBO numbers as a crutch and too often resorted to the same partisan defenses in responding to what sounded like substantive Republican criticisms.”) Pelosi may worry about turning off  Democratic activists, but a Democratic congressman from a district that voted for John McCain in 2008 knows it’s the independents and the Republicans he needs to mollify.

The motives and interests of the congressional leadership and their members have diverged sharply. Before Scott Brown’s election, the Obama-Reid-Pelosi troika was successful in getting members to disregard that divergence. Now it’s a lot harder to get Democratic House members to overlook the obvious: a vote for ObamaCare will cost them their seats. Pelosi will try, but her members have seen just how ineffective Obama is, both in convincing the public of the bill’s merits and in providing cover for Democratic candidates (e.g., Creigh Deeds, John Corzine, Martha Coakley). Now they need to decide whether it’s worth sacrificing their careers for the sake of an awful bill — which Republicans will spend the rest of the year (and years to come, if need be) trying to repeal.

Gary Andres summarizes the reasons why congressional leaders feel compelled to try to cram through a massive health-care bill the public hates:

Passing health care reform is a bit of a Holy Grail for Democrats.  It is one of the most important debates and potential accomplishments for the party’s most ardent partisans — and has been for many years.  Failure to enact this legislation would render a crippling blow to those most apt to volunteer, talk to their friends about politics, give money and vote in the upcoming midterm election.  These base voters may not always guarantee the party’s victory, but without them defeat is assured.

Oh, and they’ll sell the dupes — the voters, that is, who don’t know what’s best for them — on it later, convincing them how wrong they were to oppose the heroic efforts of  lawmakers. Or something like that.

This and complete cluelessness about what the public’s objections are to the bill and a pattern of ultra-liberal excess explain a lot. As Democratic consultant Dan Gerstein put it, “the Democrats have seemed to be operating in a hermetically sealed political vacuum, impervious to the public’s changing post-crash priorities and diminishing tolerance for big government solutions.” He thinks its political madness to plunge ahead:

Those hell-or-high-water Democrats are banking on the context to change again once they pass their bill. Their theory is that once the program benefits kick in, the political benefits will soon do the same. Public support will grow over time, the system will become as ingrained and untouchable as Medicare and Medicaid, and this year’s election liability will gradually become a campaign asset. It might be a plausible argument–if this were any other year, if health care were the only issue dragging down the Democrats’ credibility, if the anti-government Tea Party movement had not gotten such traction, and of course, if the bill ends up working reasonably well. …

The best course for Democrats would be to skip the all-or-nothing trap and pass a center-out bill that contains the 80% of insurance reforms on which both sides already agree. But that’s a moot point: The Democrats are going for broke (in more ways than one). The more salient question is when will the Democrats start connecting the dots–and recognize that the American people are not going to accept a government that is not willing to heed their doubts.

Now Pelosi-Reid-Obama are plainly not taking Gerstein’s advice, but that’s not what matters at this point. (Well, for many who will meekly accept their assignment to walk the plank for the greater good of Obama’s ego, I suppose it matters.) What really matters to the outcome is whether those one or two dozen House Democrats whose votes are still in play connect the dots and assess the arguments of their leadership in light of their own constituents.

Pelosi’s liberal donors may have been pining away for socialized medicine since the days of their nuclear-free-zone sit-ins at Berkeley, but that doesn’t mean a Michigan or Arkansas congressman’s constituents harbor the same dreams. Pelosi may think she can explain it all later, but those congressmen on the fence saw her explain things at the summit and likely had the same reaction as Gerstein — oh my. (“Led by Pelosi, they repeated their same unpersuasive arguments for universal coverage, recycled the same hollow CBO numbers as a crutch and too often resorted to the same partisan defenses in responding to what sounded like substantive Republican criticisms.”) Pelosi may worry about turning off  Democratic activists, but a Democratic congressman from a district that voted for John McCain in 2008 knows it’s the independents and the Republicans he needs to mollify.

The motives and interests of the congressional leadership and their members have diverged sharply. Before Scott Brown’s election, the Obama-Reid-Pelosi troika was successful in getting members to disregard that divergence. Now it’s a lot harder to get Democratic House members to overlook the obvious: a vote for ObamaCare will cost them their seats. Pelosi will try, but her members have seen just how ineffective Obama is, both in convincing the public of the bill’s merits and in providing cover for Democratic candidates (e.g., Creigh Deeds, John Corzine, Martha Coakley). Now they need to decide whether it’s worth sacrificing their careers for the sake of an awful bill — which Republicans will spend the rest of the year (and years to come, if need be) trying to repeal.

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Bad Policy, Worse Politics

James Capretta and Yuval Levin make a key point about the health-care bill snaking its way through Congress:

This timeline of tax and spending implementation corresponds rather awkwardly to the political calendar confronting the Democrats. The new entitlement, insurance rules, and other elements of the plan will not go into effect until well after the 2010 congressional elections and even the next presidential election, but some serious tax hikes will take place by then.

Meanwhile, again to make for a palatable CBO score, the bill envisions radical cuts in Medicare beginning quite soon. For instance, steep cuts in Medicare Advantage start in 2011, which means millions of seniors will begin hearing the bad news in 2010 as their plans withdraw from the program, cut their benefits, or raise their premiums.

So how exactly does this play out in the 2010 elections? Republicans will be holding up the Medicare cuts and urging seniors to run to the polls and vote the Democrats out. The Democrats will either savage their own bill by undoing the cuts or defend it as is, while explaining that other voters should be happy because by 2014 they will get subsidized health care. (“Essentially all of the spending provisions and insurance reforms–including the individual mandate to purchase health insurance, the employer mandate to provide it, the state insurance exchanges, the federal subsidies for coverage, and the Medicaid expansion–would only go into operation in 2014.”) Gosh, who has the better argument?

Then let’s break that down on a race-by-race level. In states where voters overwhelmingly oppose ObamaCare, Republicans running against incumbents like Byron Dorgan, Blanche Lincoln, and Harry Reid will run against the taxes, mandates, fees, and corruption. Republicans running in Blue states like California will question why someone like Barbara Boxer didn’t do a “better job” and allowed Nebraska or Iowa to get Medicare carve-outs, leaving their seniors to scrounge for doctors (who won’t make ends meet on Medicare’s reduced fees) and to live without their much-loved Medicare Advantage benefits. What exactly are the Democrats going to say to voters in an off-year election who are generally older, more conservative, and more politically savvy than the masses who turn out for a presidential election? I’m sure aggrieved voters will be delighted to hear that the bill is “historic.” But that means nothing to most of them, who have insurance and whose benefits and taxes are going to be impacted in a huge government power grab.

So if the bill makes no sense on the merits, it makes even less sense politically. The only question remains whether nervous incumbents figure this out and grudgingly agree to return to the drawing board. If not, they better figure out how they are going to defend this in front of enraged voters.

James Capretta and Yuval Levin make a key point about the health-care bill snaking its way through Congress:

This timeline of tax and spending implementation corresponds rather awkwardly to the political calendar confronting the Democrats. The new entitlement, insurance rules, and other elements of the plan will not go into effect until well after the 2010 congressional elections and even the next presidential election, but some serious tax hikes will take place by then.

Meanwhile, again to make for a palatable CBO score, the bill envisions radical cuts in Medicare beginning quite soon. For instance, steep cuts in Medicare Advantage start in 2011, which means millions of seniors will begin hearing the bad news in 2010 as their plans withdraw from the program, cut their benefits, or raise their premiums.

So how exactly does this play out in the 2010 elections? Republicans will be holding up the Medicare cuts and urging seniors to run to the polls and vote the Democrats out. The Democrats will either savage their own bill by undoing the cuts or defend it as is, while explaining that other voters should be happy because by 2014 they will get subsidized health care. (“Essentially all of the spending provisions and insurance reforms–including the individual mandate to purchase health insurance, the employer mandate to provide it, the state insurance exchanges, the federal subsidies for coverage, and the Medicaid expansion–would only go into operation in 2014.”) Gosh, who has the better argument?

Then let’s break that down on a race-by-race level. In states where voters overwhelmingly oppose ObamaCare, Republicans running against incumbents like Byron Dorgan, Blanche Lincoln, and Harry Reid will run against the taxes, mandates, fees, and corruption. Republicans running in Blue states like California will question why someone like Barbara Boxer didn’t do a “better job” and allowed Nebraska or Iowa to get Medicare carve-outs, leaving their seniors to scrounge for doctors (who won’t make ends meet on Medicare’s reduced fees) and to live without their much-loved Medicare Advantage benefits. What exactly are the Democrats going to say to voters in an off-year election who are generally older, more conservative, and more politically savvy than the masses who turn out for a presidential election? I’m sure aggrieved voters will be delighted to hear that the bill is “historic.” But that means nothing to most of them, who have insurance and whose benefits and taxes are going to be impacted in a huge government power grab.

So if the bill makes no sense on the merits, it makes even less sense politically. The only question remains whether nervous incumbents figure this out and grudgingly agree to return to the drawing board. If not, they better figure out how they are going to defend this in front of enraged voters.

Read Less




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