Monday Reads

Good Morning!

Most of the news today is about the looming shutdown of the Federal Government.  Our government is truly dysfunctional.  The states have gerrymandered us into a Congress that doesn’t care about the country at all.  They just take care of their base and their personal pork.  We’ve also got a krewe of congress critterz that’s about as dumb as they come.   Why are some of them gleeful over the idea of a shutdown?  What do they think they have to gain and why would they hurt so many people?

Why have House Republicans pursued their effort to defund, and now to delay, Obamacare so relentlessly, even though they have almost zero chance of success in the face of a rapidly-approaching deadline for shutting down the government? And why have they done so when many in their party have warned that a shutdown would be suicidal for the GOP?

I talked with one of the most vocal of the defund/delay advocates, Minnesota Rep. Michele Bachmann, on Friday night, as she waited to hear what path the House Republican leadership would take. It’s safe to say her views reflected those of many of her conservative colleagues, and her reasoning was this: One, Obamacare as a policy is so far-reaching, so consequential, and so damaging that members of Congress should do everything they can — everything — to stop it before it fully goes into effect. Two, lesser measures to fight Obamacare — repealing the medical device tax or making Congress purchase coverage through the exchanges without special subsidies — are just not big enough to address the problem. And three, there have been government shutdowns in the past over far less urgent reasons that did not result in doom for Republicans.

“There is a very large group of us who believe that this is it, this isn’t just another year, this isn’t just another CR fight,” Bachmann told me. “This is historic, and it’s a historic shift that’s about to happen, and if we’re going to fight, we need to fight now.”

“This isn’t just another bill,” Bachmann continued. “This isn’t load limits on turnip trucks that we’re talking about. This is consequential. And I think the reason why you’ve come to this flash point is that this is an extremely consequential bill that will impact every American, and that’s why you have such passionate opinions. And we’re not giving up and we’re not caving in that easily.”

For Bachmann and many of her colleagues, the enormity of the issue serves to highlight the problem with less extensive anti-Obamacare measures. “The Vitter Amendment isn’t going to help real people,” Bachmann told me. “It’s going to be a political move, but it’s not going to help real people. Obamacare will continue to destroy the economy. Now, repealing the medical device tax does help the economy. Here in the Beltway, we get the medical device tax issue. And in my state of Minnesota, we get the medical device tax issue. That’s our industry. And I’m all for [repealing] it, but for most Americans, that is not something that they see that they want to get.”

It’s really strange to see the apoplexy shown by Republicans when they call the American Heritage’s Dole/Chaffey Care alternative to Hillarycare some kind of socialist plot. What happens under the law if implementation is slowed down even one year? Many states, businesses, insurance companies and health care providers have already started their transition.

So what does this “compromise” actually look like? For a party that has centered their platform around reducing spending and the deficit, it’s surprisingly bad economics.

First of all, repealing the medical device tax would actually add $30 billion to the deficit. That provision, which imposes a 2.3 percent tax on medical devices, is one of the funding sources for Obamacare’s coverage expansions. Proponents say that the tax will be balanced out by the influx of new Americans entering the insurance market. But getting rid of it now without finding another way to finance health reform would simply increase health reform’s price tag.

Furthermore, delaying Obamacare’s individual mandate — a central tenet of the health law that requires everyone to purchase insurance — would have catastrophic effects. The Congressional Budget Office (CBO) projects it would end up forcing Americans to pay higher premiums for their health coverage. Healthier people would be discouraged from buying insurance, resulting in an older and sicker pool of people in the individual market and encouraging insurers to submit higher rates. The delay would ultimately hike premiums by an estimated 15 to 20 percent.

And according to the CBO, a one-year delay would leave about 11 million Americans uninsured, ultimately reducing the expected coverage gains under the health reform law by nearly 85 percent. As those uninsured Americans end up seeking care in hospitals, the cost of providing that uncompensated care will offset any costs that are achieved by delaying Obamacare’s coverage expansion. Ultimately, delaying the mandate doesn’t actually save the government any money.

As Wonkblog reports, delaying the individual mandate would have a “ripple effect” throughout the health insurance industry. That sector has been preparing for impending changes under Obamacare, and a last-minute decision to delay the law would be a huge drain on the companies that have already spent millions of dollars on advertising and outreach campaigns. “It’s just too late,” Joe Antos, a health policy researcher at the American Enterprise Institute,told Wonkblog. “Everybody who is involved, insurance companies and hospitals and any other big entity, they’re ready to go. They really can’t make any changes.”

When the Affordable Care Act was winding its way through the court system last summer, a conservative federal judge made the point that suddenly striking down health reform would create “economic chaos.” And at this point, as many of Obamacare’s consumer protections have already taken effect, the individual mandate is inextricably linked to making the health reform law work in practice. A new paper from the Urban Institute notes that delaying the individual mandate would “seriously disrupt overall implementation” of health reform.

Most folks believe that the GOP will get the blame for the shutdown.

The federal government swerved toward a shutdown on Saturday when House Republicans demanded to hold a vote to delay Obamacare by one year instead of cooperating with the Senate to pass a “clean” spending bill. It’s now practically assured that parts of the government will go dark on Tuesday for the first time in 17 years.

From a Republican point of view, there are three possible happy endings to the looming catastrophe.

Happy Ending #1: The president blinks. He’s blinked before after all—notably when he agreed to sequestration in 2011—and who knows? He might blink again.

Problem with Happy Ending #1: This time, though, “blinking” means blowing up the president’s most important legacy: his health-care plan. That’s more than a blink. He might as well hand in his resignation after that.

Happy Ending #2: The country blames the Democrats for the shutdown. After all, the GOP is only asking for the president to negotiate. It’s the president who refuses to yield.

Problem with Happy Ending #2: Republicans actually shut down the government in 1995. They took the country to the brink of debt default in 2011. Their caucus is reacting to this shutdown with enthusiasm, not regret. It’s going to be hard to sell the claim that it’s the Democrats who brought about this latest outcome when Republicans come out of caucus looking so happy about it.

Happy Ending #3: Even if the president does not blink, and even if Democrats don’t get blamed, perhaps Republican activists will be so motivated and mobilized by the shutdown that their excitement will loft the party to big wins in the 2014 races.
Problem with Happy Ending #3: Because Happy Endings 1 and 2 look so unlikely, the shutdown is likely to end in a Republican retreat. Party activists will be demotivated—and may waste their energy recriminating against their own leadership rather than organizing to fight Democrats.

There is also the usual Republican slap to women included in the budget.

Typical of the privileged, entitled spoiled brats that they collectively are, the House Republicans threw everything but the kitchen sink into their government funding bill. The bill, which purportedly was to stave off a government shutdown, was instead a big, fat sloppy kiss to all of the special interests that want to curtail average Americans’ lives while enriching the top one percent even further.

Telling, perhaps, that they were unable to do it without drinking heavily enough to be noticeable from the gallery. Putzes.

The “funding” bill included a clause that for the puritanical and/or science ignorant Republicans, may be the king of unintended consequences: delaying funding for contraceptive care under ACA:

House Republicans included a so-called “conscience clause” in the government funding billin a plan they approved early Sunday.

The House voted 231-192 on a bill that would delay much of the 2010 health care overhaul for a year. It would also repeal a tax on medical devices that helps finance the health care law. The measure would allow employers and insurers to opt out of providing health care services that they find morally or religiously objectionable. The addition reignites the debate over a portion of the health care reform law that requires most insurers to cover women’s preventative health care, including contraception.

It’s enough to make me want to nut punch a Republican member of Congress. Need I remind them once again that in addition to preventing unwanted pregnancies, contraceptives are used therapeutically as well for a host of women’s health issues? Those “family-friendly” idiots will not be satisfied until Americans see an increase of abortions (oh, wait…), an increase in people applying for federal assistance due to the forced births (oh, wait…) or a bunch of motherless children,

However, the Exchanges set up by the Affordable Healthcare Act are being set up.  It’s interesting that the Republican plan to shut down the Government isn’t really shutting down Obamacare.

Many pieces of the health care law, the Affordable Care Act, aren’t tied to the annual spending bills. Much of the health law is mandatory spending — a kind of fiscal autopilot that’s not part of the annual appropriations battle that has Congress tied in knots. The mandatory components of the health law include the subsidies to help people buy private health plans as well as the expansion of Medicaid in many states. Both of those functions will be handled through the new health insurance markets or exchanges.

Because those programs are mandatory, the Department of Health and Human Services has a lot of leeway to say whether Obamacare activities can continue — and HHS officials have made clear they’re going to use it.

On Friday, the HHS quietly posted its shutdown contingency plan. The bottom line is clear: Obamacare would continue, including the health exchanges and their coordination with Medicaid. It also said Medicare coverage “will continue largely without disruption.” True, lots of HHS workers would be furloughed — but those who would be told to stay home are concentrated in agencies that are not driving the launch of the health law.

HHS says its plan is consistent with legal advice that allows activities that “do not rely on annual appropriations, and activities that involve the safety of human life and protection of property” to keep running even if much of the government shuts down. And that means the staff that carry out mandatory programs like those in the health law can keep working — even if their positions are funded through the annual spending bills

I’ll let you know how the process is going to work down here in one of the states that’s fighting the law every way it can.  I was told Friday that the adjunct health care plan that I’ve had for the past few years doesn’t meet the minimum standards for the Act and won’t be offered.  I am going to head to the exchange next week and find out what my options are going to be.  I’m glad to be out of my subpar health insurance plan, but wondering if the federal exchange is going to have many choices here in a state with a hostile governor.

So, I know this was a little oriented to the one topic of the day, but I thought we needed to spend some time on it.  Feel free to share your thoughts on this or any other links on any other subjects that made your reading and blogging list today!!!