Romney's Audacious Romneycare Claim: Good for MA, Bad for America

Oct 17, 2012Richard Kirsch

Romney touts the expansion of health coverage in Massachusetts as a great achievement, but he'd deny that same guarantee to millions of Americans.

Romney touts the expansion of health coverage in Massachusetts as a great achievement, but he'd deny that same guarantee to millions of Americans.

As Romney aimed to prove that he cared about the 100 percent in last night's debate, part of the stream of accomplishments he listed in his final answer was his audacious claim that “as governor of my state, I was able to get a hundred percent of my people insured -- all my kids; about 98 percent of the adults.” What’s audacious is not that’s its untrue – it is true. But it takes a lot of brass to trumpet as evidence of your compassion something that you are planning to deny to the 98 percent of Americans who don’t live in Massachusetts. That is of course what Romney plans to do with his pledge to repeal Obamacare.

Last week, Romney told the editors of the Columbus Dispatch that “We don't have people that become ill, who die in their apartment because they don't have insurance.” Romney is right again, but in a very perverted way. Most of the time people who die because they are denied health insurance spend their last days in the hospital after getting very sick in their houses or apartments.

Take, for example, Tifanny Owens, the mother of Marcelas Owens, the young boy who stood next to President Obama when he signed the Affordable Care Act into law. Tifanny was fired by Jack in the Box, where she worked as a manager, because her serious illness was causing her to miss work. With her job went her health insurance, and Tifanny could no longer afford to get the care she needed. She died in a Seattle hospital, leaving Marcelas, age seven, and his two younger sisters behind.

Of course, sometimes people don’t make it to the hospital to die. Like Billy Koehler of Pittsburgh, who had a heart attack in his car when his cardiac defibrillator failed. Koehler, who had lost his job when the company he worked for in Pittsburgh failed, could not afford the $10,000 to get the device replaced. A doctor told him to come back when he had the cash.

Tifanny and Billy's stories are drawn from my book, Fighting for Our Health, but they're far from alone. A recent report by Families USA estimates that 26,000 people die each year in the United States because they don’t have health coverage.

Last night Romney told America, “I believe we're all children of the same God.” But not, it appears, when it comes to saving the lives of God’s children who don’t live in Massachusetts.

Richard Kirsch is a Senior Fellow at the Roosevelt Institute, a Senior Adviser to USAction, and the author of Fighting for Our Health. He was National Campaign Manager of Health Care for America Now during the legislative battle to pass reform.

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Obama Failed to Defend Government from Romney's Bluster

Oct 4, 2012Jeff Madrick

Obama failed to defend his policies or the positive role of government. But next time he'll be ready.

President Obama lost the dabate. A night’s bad sleep did not change my mind about that. But let’s be clear that, if more relaxed and clear, Romney was the same as ever. There is no new Romney. He dissimulated, did not address details, and refused to answer what few charges Obama brought up.

Obama failed to defend his policies or the positive role of government. But next time he'll be ready.

President Obama lost the dabate. A night’s bad sleep did not change my mind about that. But let’s be clear that, if more relaxed and clear, Romney was the same as ever. There is no new Romney. He dissimulated, did not address details, and refused to answer what few charges Obama brought up.

He opened with a brilliant debating tactic—really a war tactic: open a second front and retreat on the first one. Romney tacked to the middle. No, he won’t cut any taxes he can’t pay for. No, it isn’t a $5 trillion plan. Obama wasn't ready and didn't seem able to adjust. But what is the Romney policy? He never said. More upsettingly, Obama noticed but never truly pressed him on it. 
 
In fact, Romney's is the same old George W. Bush policy, and it didn’t work then. Obama got to this point, too, but didn’t bring it home strongly enough. Job growth was the slowest under Bush of any other postwar president. Obama said it. Doesn’t anyone remember his saying it? But Romney dissimulated again, because he can’t pull this grand four or five point strategy off, just like he couldn't pay off his original tax cut program. Obama could have asked him how much he plans to cut tax rates. He would have dodged it, but in dodging it he would have looked more like the old Romney than the new, bold Romney. Obama could have pressed harder on the details of closing loopholes. He didn’t.
 
Romney ignored the facts time and again, a tried and true debating technique. Obama pointed out that in a Medicare voucher program with choice, the insurance companies will steal the elderly who are healthy and raise costs for Medicare, jeopardizing its future. Romney simply ignored the point and went on to say, as if Obama said nothing, that Medicare would still be there under his voucher program and if it worked better, it would stand. 
 
In his attacks on the role of government, he persistently said the private sector can do better. But private sector health care costs have risen faster than Medicare. Why is that? He pushed the old ideological sticking points. Government is bad, private enterprise good. No facts, mind you. Just shibboleths. Keep the federal government out of health care. Give it to the states. Should we keep the federal government out of Social Security and Medicare, too—both very popular programs?
 
But if Romney’s bluster was strong, Obama lost the debate more than Romney won it. He seemed incapable of defending Obamacare. He couldn’t even counter the alleged Medicare theft of $716 billion well. He didn’t defend his green investments. Ninety billion dollars is not much when you consider Japan will probably spend nearly $500 billion on renewables. He only passingly defended his stimulus bill, repeating the error of neglect he has made for most of his administration. In fact, he hardly defended his record at all, for fear it reminds people that unemployment is stil high, as is the deficit. The point is they'd both be higher under a Romney plan.  
 
And what of the policies for 2013? Where was talk of Obama's American Jobs Act? Why not say that Romney’s policies will bring you a recession, sure as you’re sitting there?
 
And what about bipartisanship, of which Romney bragged during his governorship in Massachusetts? Could Obama have pointed out that he couldn't deal with Republicans who proclaim their first priority is to stop his reelection? Did any prominent Massachusetts Democrats threaten Romney that way?
 
Now, the media will start analyzing the Romney promises, and therein will lie some justice. He won’t be able to defend them except in the same general, non-detailed ways. The Democrats have to counter-attack. There will be plenty of room to do so. 
 
And one other point: I think Obama will be ready next time. He went into the ring cold. Every boxer knows you have to warm up and break a sweat before the first bell. I think he learned. He almost got knocked out in the first round. Not again, I don't think. 
 

Roosevelt Institute Senior Fellow Jeff Madrick is the Director of the Roosevelt Institute’s Rediscovering Government initiative and author of Age of Greed.

 

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Roosevelt Reacts: At the Presidential Debate, Mitt Misleads and Obama Omits

Oct 4, 2012

After the first presidential debate last night, which focused entirely on domestic policy, Fellows and staff from the Four Freedoms Center, Campus Network, and Pipeline weigh in with what was said, what was left out, and what was just an outright fib.

After the first presidential debate last night, which focused entirely on domestic policy, Fellows and staff from the Four Freedoms Center, Campus Network, and Pipeline weigh in with what was said, what was left out, and what was just an outright fib.

Thomas Ferguson, Senior Fellow, Roosevelt Institute; Professor of Political Science, University of Massachusetts, Boston; Contributing Editor, AlterNet:

My first reaction is simple: These guys have some nerve talking so cavalierly about teachers. Virtually from their first words, both the president and Governor Romney got lost in a fog of details. They begged questions, frequently argued from different premises, tossed off too many details without context, and rarely held a focus long enough for many in the audience to discern what they were talking about. The effort was a case study in how not to illuminate very much.

So what? I’d guess that Romney’s endless talk about “jobs” may persuade a few of his listeners that somehow his arithmetic actually does add up, but that number probably will not be large. I suspect, too, that the president’s highlighting how Romney’s voucher plans might change Medicare even for Americans now in their fifties probably was widely understood, too, and will work in the opposite direction. Possibly Romney, by not looking wooden, might pick up some tiny increment of public support. But my guess is that this debate changed few minds for all the talk of a Romney “victory.” My own takeaway is that both candidates’ harping on the genius of the American people and the virtues of the market system made it easy to lose sight of virtually all the important points at issue. I’d say the candidates battled to close to a draw, while America lost.

Dorian Warren, Fellow, Roosevelt Institute; Associate Professor of Political Science & School of International & Public Affairs, Columbia University:

Debates are rarely game-changers in presidential elections, and last night's debate was no different. The quick assessments of Romney's more aggressive performance compared to President Obama's weak and sleepy responses are correct, as far as they go. But we should remember that incumbents always do poorly in the first debate. As political scientist Sam Popkin argues, sitting presidents don't have time for debate prep, and they aren't used to being challenged the way Romney challenged Obama last night. Clearly, the Obama team's strategy was for the president to play it safe and not come across as an angry black man. We also know that Obama has never been a good debater -- recall the 2007 Democratic Primary debates where both Hilary Clinton and John Edwards put in consistently better performances. Obviously, we know who won the nomination despite his weak performance relative to his adversaries. What will happen now through the next debate will be fact-checking the claims made by both candidates followed by obsessive poll watching to see if and how the numbers move. In the end, of the small number of voters uncommitted, last night's debate wasn't decisive nor did it sway potential voters one way or the other. 

Joelle Gamble, Deputy National Field Director, Roosevelt Institute | Campus Network:

What was noticeably absent in last night’s debate was the mention of the role of everyday Americans in the economy, health care, and governance. Candidates talked about making strong investments in the future, but they did not elaborate on the role future Americans play in making their promises a reality. The bottom line for both campaigns was essentially this: “Vote for me and everything will be (or continue to be) better. Nothing bad will happen to people who are comfortable with their lives. Those who are unhappy with things will only see immediate benefits because of my policies.”

But this is a quintessential flaw in our current electoral political system. Citizens are simply voters and nothing more. We show up to the polls and mark our calendars for the next major election. For this reasons, political candidates have resigned themselves to only telling us what we want to hear before an election instead of what we need to hear to be invested in their policies afterwards. For either candidate to execute their plan well, a fully engaged citizenry is needed throughout their entire four years in office. Their success is dependent upon our continued participation on November 7th.

This participation requires a shared responsibility for the efficacy of our economic recovery. Some people will have to waste less gas or change their habits if we want to be more energy-efficient in the future. Others will have to adjust to a new system of health care if we want to be healthy as a country in the future and lower costs. The fact of the matter is, in order to keep moving in a positive direction, things will change for everyday Americans. The presidential candidates need to make it clear that we will have to be participants in that change if we want to be a better nation.

Jeanne Tilley, Roosevelt Institute | Pipeline, Greater Boston:
 
Millennials, if you went to bed after the debate feeling disheartened, that’s okay. You weren't alone. That debate was not for us. I love that Dodd-Frank got so much play, but President Obama and Governor Romney each missed the mark on talking to younger generations -- particularly on education.
 
President Obama mentioned twice that he wants funding to hire “100,000 math and science teachers,” and Governor Romney gave schools here in Massachusetts a mostly deserved tip of the hat for being among the best in the country. But while these statements came during a discussion of the role of the federal government, they failed to drill down on the role of education and thus the role of educated citizens in the American social framework.
 
I was disappointed that the candidates avoided discussing two key aspects of education policy last night. First of all, I wish that the DREAM Act had been raised. It’s plausible that this will come up as part of the foreign policy debate in the coming weeks, and I try to maintain hope that eventually we can have a comprehensive immigration reform debate. But the DREAM Act is not really about foreign policy and national security. It is about creating opportunity for young, undocumented Americans to enter the hallowed demographics of “small business owners” and “middle-income families” that everyone courts so strongly during election season. American demographics are changing, and in order to remain competitive on the global stage, we need to embrace the talented, committed young people who are already here and give them every opportunity to succeed.
 
Teachers’ unions were also roundly ignored -- perhaps not surprising given recent controversies, but still unfortunate. (In fact, unions as a whole were not mentioned once, and even the ever-popular auto industry got but one brief line.) Millennials are teaching in droves, typically through structured service programs, before graduate school or entering the broader job market. This teaching bent is mainly temporary, however; most programs last only two to three years. 
 
I think President Obama’s idea to hire 100,000 STEM teachers is a great one. But once schools have recruited and trained all these teachers, the trick is to keep them in the classroom working their magic with American school children and to make sure they feel supported by their parents, schools, and government outside the classroom. The unions may well have a powerful and positive role to play in striking this balance. The time to talk it over and find out is now. American education statistics no longer top the world. For candidates who talk about global competitiveness and making sure small businesses have someone to hire, leaving education out of this debate is a huge oversight.
 

Rahul Rheki, Roosevelt Institute | Campus Network Senior Fellow for Health Care; Senior, Rice University: 

To me, the philosophical difference between the president and Governor Romney -- the visions they put forth for the role of government in America -- could not have been more stark. The barbs traded over healthcare were particularly emblematic of this dichotomy. Whereas Romney lambasted the ACA's "unelected board" for rationing care -- the IPAB is only advisory, mind you -- while distancing himself from his own signature health reform achievements in Massachusetts and proposed Medicare voucherization, President Obama embraced the provisions of the ACA that provided universal coverage, ended pre-existing conditions clauses, and ensured a thriving American social safety net for the coming decades. The competing choice, in my mind, was evident: the challenger's "every man for himself" versus the incumbent's "we're all in this together."

Tim Price, Deputy Editor, Next New Deal:
 

Given how much time the candidates spent talking past each other last night, it’s odd that some of their biggest flubs came in areas where they actually agreed, or at least claimed to. For Romney, it was health care reform – his most significant achievement as governor, and the one he’s barely been able to mention during this campaign for fear of conservative revolt. Though he was able to dodge most of the president’s criticisms throughout the debate by adopting new policy positions on the fly, his hair-splitting about whether Romneycare should be a model for national legislation was the least convincing part of his performance. Pressed to explain why he’d repeal the Affordable Care Act given that it’s essentially a scaled-up version of the plan he adopted in Massachusetts, Romney seemed to argue that Romneycare might be an appropriate model for every state, but not all of them at the same time. If states are the laboratories of democracy, he apparently wants Massachusetts to keep a tight hold on its patents.

As for President Obama, when he wasn’t wandering through a fog of obscure policy details, he was conceding far too much ground to conservatives. One of the most eyebrow-raising moments of the night was when Obama began the discussion of entitlements by declaring that he and Romney share a similar position on Social Security. Do they really? If so, progressives have a lot more to worry about than we thought, since Romney’s running mate is the author of a plan that would privatize it. Then there was the question about the need to cut deficits, where instead of rejecting the premise and making the case that we need a bigger deficit to create jobs, Obama defended his budget plans as Bowles-Simpson with a cherry on top. Instead of articulating a bold progressive vision for the economy and a strong defense of the social safety net, he often sounded like a moderate running in a Republican primary.

Rajiv Narayan, Roosevelt Institute | Pipeline, California:

We bring as much of our own perception to the debates as the presidential candidates add with their responses and rebuttals. Having recently landed my first job out of college, I understand the importance of building a labor force with diverse skills and an economy rich with opportunities. But what I understand to be even more important is the community of support that got me from my diploma to my first paycheck. That means teachers. Tonight I saw one candidate who praised teachers, but was unwilling to keep intact those programs supporting classrooms for political reasons. Likewise, I was disappointed by the political “strategery” at work on health care reform. When we reach a point where Governor Romney is threatening to dismantle the (unspecified, seemingly unpopular) parts of a health program cloned from his health program, in order to reinstate from the states, where "democracy's experiments take place," the most successful version of that program, I'm afraid we've become audience to Dadaist political theater.

Hannah Locke, Roosevelt Institute | Campus Network Senior Fellow for Energy and Environment; Senior, Goucher College:

C-SPAN, Fox News, Twitter, Facebook---tax policy, Big Bird, educational vouchers, zingers. The Internet was alive with puns, expressions of disgust, tired and overused commentary, and the usual spin. Is this what the battle for the soul of our country looks like? Boiled down to cherry-picked numbers, to stuttering sentences of little substance, to talking over the moderator? What does our Millennial generation garner from such a discussion? We laugh and point and tweet and snark, but I’ve started to wonder whether that level of  “political engagement” is worth bragging about.

Meanwhile in Venezuela, the people are taking to the streets, risking their own lives to demand a fair and transparent democracy. The challenger, Henrique Capriles, heads a coalition of opposition groups who contest not only the continuation of Chavez’s isolating economic practices, but the proliferation of violence and fear in Venezuela. What started as state-sanctioned Robin Hood behavior quickly bred into a festering, sprawling disease of chaotic violence where anyone—poor, rich, liberal, conservative—runs the risk of getting in trouble with the street gangs or the military.

So next time we bemoan our elections, let’s take a step back and put things into perspective. We aren’t on a black list for going to an opposition leader’s website. We aren’t risking a bullet in the head every time we step out to a rally, stump speech or fundraiser. We aren’t risking our families’ future on the hope that our country can be something better than one of the most violent nations on this planet.

We go to the polls, and we vote. Sometimes, we should take a moment to recognize how much we’ve got, just as much as we recognize what we don’t have yet.

Kyle Shepherd, Roosevelt Institute | Pipeline:

My favorite passage of the night came from the candidates' back and forth on federal regulation of the economy. "You couldn't have people opening up banks in their garage and making loans," Romney said. "Every free economy has good regulation. At the same time, regulation can become excessive."

I love imagining people loaning money out of their garage. For all the talk of the American people's ingenuity, it seems like someone on the right must think this is a good idea. But this statement also points to the key differences between the two candidates on regulation, albeit in broad strokes. And as a progressive, this is a big deal to me, because Romney wants to eliminate important financial protections that don't have enough teeth to begin with.

Dodd-Frank, like much government oversight of the economy, can be easy to criticize. Detractors say it’s unwieldy, opaque, and brings unintended consequences. It's also not immediately apparent how it has solved the problem of banks being "too big to fail." Romney played on this by saying he wants to repeal and replace it with more intelligent regulation that will create jobs. This was a somewhat new proposal from him, as he has previously stated he just wants to repeal it, but it's also important to note he remains characteristically vague on the subject, making deeper analysis of his policies difficult. It's safe to say, however, that it would probably involve decreases in regulation on derivatives and relaxing the restrictions that have been imposed on the large, systematically important firms. This would debatably result in more jobs, but would certainly result in more banking profits.

Obama didn't do much to advance any new policy initiatives. He instead defended Dodd-Frank, mentioning the "reckless behavior" of Wall Street and touting the capital requirements and bank "living wills" imposed by the legislation he supported. There are some good things in Dodd-Frank, and it's much needed legislation that will hopefully strengthen over time as regulators adapt and enforce its stipulations.

The discussion of the role of government in regulating financial institutions is a vital one. These are important issues that get to the heart of inequality, corporate welfare, and consumer protection in our country. We need people to be able to borrow money with confidence they are not being taken advantage of, and the banks need to understand their risk is real and can't be passed over to someone else along the financial daisy chain. The debate on this issue needs to more fully acknowledge the risks inherent in the economy, who should assume responsibility for those risks, and what policies can make that happen.

Unfortunately, the debate as framed last night presented only two options. Either Dodd-Frank, a bill mercilessly attacked by lobbyists, only supported by key financial interests in order to prevent a stronger bill from passing, and only partially enforced -- or weaker regulations and restrictions as offered up by Romney.

Lydia Austin, Roosevelt Institute | Campus Network Senior Fellow for Economic Development; Senior, University of Michigan:

It seems that the hype surrounding this debate -- the numerous news articles and coverage dedicated to it -- was greater than the actual event. Both candidates held their own, both threw out a lot of facts related to tax policy and Medicare, and both were on the defensive for some amount of time. Romney had the most at stake coming into tonight: he desperately needed to rebrand himself as someone who understands the middle class and is responsive to Americans' frustrations. I think he effectively did that. Not an outstanding performance by either candidate, but in terms of who shifted the public discourse, it was definitely Romney (though now the Internet is blowing up with Big Bird photos).

Ken Lefebvre, Roosevelt Institute | Campus Network member; Senior, University of Massachusetts:

Last night we witnessed two opposing narratives clash, unmitigated in their stances, and mostly unmoderated in their discourse. We saw a president tired from four years of entrenchment in the daily minutiae of national politics, and we saw an ever-eager opponent going into this fight with the gloves off. It could be said that Mitt Romney won this debate through his writers and an ability to look presidential. At the same time, Obama did what he had to to maintain his steady ground and consistent policies. Little was accomplished in this debate, and both candidates made the same talking points together that they had for months before. No new details were offered. You really could take segments of their commercials and edit them as if they were the debate. Emotional responses may tip the polls toward Romney for the time, but voters learned little from either candidate in this display.

Jean-Ann Kubler, Roosevelt Institute | Campus Network member; Senior, Skidmore College:

After sifting through the talking points and empty rhetoric of last night’s debate (we get it, 5 trillion is a big number), the American public is left with very little substance on which to compare the incumbent Obama and challenger Romney. The two candidates made bold attempts, particularly during the economic segment of the debate, to appear as if they were presenting facts and specifics about tax plans, the deficit, and creating jobs. But in the end, what did viewers learn other than that Romney and Obama have starkly different opinions on how theoretical math works? Can Obama decrease the deficit by spending more and taxing more? Romney said no, but demonstrated no evidence other than his lack of faith. Can Romney spend $2 trillion extra on defense without raising taxes on the middle class to pay for it? Obama said no, and the math seems to back him up, but he was unable to present his argument in a manner that would be digestible by a common viewer. What the common viewer could easily discern, however, was that two presidential candidates with four Ivy League degrees between them, who both claim that the key to their governing style is bipartisan leadership, were unable to put aside polarizing, partisan rhetoric long enough to provide the American people enough information to make an educated decision about the future of our country.

Michelle Tham, Roosevelt Institute | Campus Network member; Sophomore, American University:

The presidential debate had a lot more number-crunching than I expected. However, this didn't mean that all the numbers were correct. One ironic rhetorical point Romney has been using throughout his campaign (and continued at the debate) was "disregard the fact-checker and studies." Yet Romney's tax plan is defended by the Heritage Foundation. Furthermore, Romney mentioned clean coal. Since 2009, clean coal has already been identified as more of a misleading political frame than actual clean energy. Currently, there's no economical way to capture and eliminate carbon emissions from coal itself -- dirty or clean. On the same note, as Romney praises the idea of clean coal, he also misunderstands the collapse of the solar company Solyndra. There is no Solyndra scandal. Solyndra was simply a startup solar-power equipment manufacturer that was funded under the Bush administration. Solyndra fell because of the lack of demand and overseas competition. It has nothing to do with Obama's initiative for higher clean energy funds. Finally, the idea of investing in Solyndra itself adheres to Romney's idea of economic growth. 

Mawish Raza, Roosevelt | Institute Campus Network member:

The start of the presidential debates last night had stirred up much more excitement than the debate itself was able to offer. Governor Romney presented an aggressive side that clamored over President Obama’s passiveness, but aside from the candidates' demeanor, the debates didn’t touch on many key issues, including women’s rights or immigration reform. Even during the dialogue on education and health care, neither candidate even mentioned the right for a woman to make her own decisions with her body or education being a right for all individuals. 

Governor Romney repeated his commitment to education several times, along with his plan to allow parents to choose where to send their children. That’s great, but what about kids coming from broken families and being raised in poverty? What about human trafficking victims who are sold to the streets until disposed of? What about the failing education systems in inner cities? Because commitment to the education system doesn’t provide kids in these communities with instantaneous financial support, education often isn’t an answer for them. In these environments, the only plausible option for them may be to turn to drugs or crime. And when we focus on the family, where the emphasis on education will be placed on the parent’s engagement with their child, we are neglecting entire populations of youth around the country. This creates a cyclic culture of poverty for young people.

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The Romney-Ryan Medicare Plan is Bad for Students and Seniors

Sep 21, 2012Rahul Rekhi

Shifting health care costs onto seniors will break a social compact that all Americans rely on.

Shifting health care costs onto seniors will break a social compact that all Americans rely on.

With Election Day finally in sight, the last few weeks have been brimming with slogans, speeches, and sound bites. But while Republicans and Democrats are working from a similar playbook, there’s a gaping chasm between their competing visions of the social safety net, and the future of Medicare hangs in the balance. In short, the Republicans claim their voucher plan would reduce health care costs, but the truth is that the seniors who depend on Medicare would be forced to pay the price.

The policy clash boils down to a single notion: vouchers. Mitt Romney and Paul Ryan are proposing a voucher-based Medicare system—one in which seniors are given vouchers to trade for insurance plans on a national exchange or market. The value of these vouchers is capped at a specific value, with the aim of curbing rising health care costs. And in fact, it is completely true that the Romney-Ryan voucher system will reduce Medicare costs, as promised. But it will do so by pushing those expenses onto Medicare enrollees, by forcing them to pay more out of pocket to cover their medical expenses as health care costs rise. What the GOP is proposing, in other words, is not exactly cost-cutting, but rather cost-shifting from government to seniors. If the yearly national allowance of vouchers has expired and your heart begins to fail, well, at least take solace in the fact that Mr. Ryan’s plan lowers Medicare costs by 20 percent.

If you’re only looking at the arithmetic, voucherizing Medicare is a clear and easy solution to bending the health care cost curve. Unlike, say, prevention and wellness campaigns, it’s not hard to project the level of cuts such vouchers will allow for. But this policy simplicity and straightforwardness mask an equally straightforward truth. Rather than attempt to extract amorphous, messy savings through biomedical innovation, electronic records, waste reduction, comparative effectiveness research, or incentivizing quality of care—in other words, achieving collective savings through progressive reforms—Romney and Ryan propose to gut Medicare and hand senior citizens the entrails. And this is hardly hyperbole; the nonpartisan CBO itself stated that the plan “could lead to reduced access to health care; diminished quality of care for Medicare beneficiaries…[and] less investment in new, high-cost technologies.”

That’s not to say that changes to the structure of Medicare are not needed, or will not require tradeoffs; they will. Real discussions, for instance, will have to be had over such hot-button topics as end-of-life care, or limits on the use of expensive, clinically unproven medical technologies. Refinements to these policies would bring Medicare into the 21st century, making it more nimble and in tune with technological advancement and social change. But they also preserve its central guarantee: that our nation’s retirees, having put in a lifetime of hard work and civic service, will receive quality, affordable health care to support them through their later years.

Fifty years ago, with the creation of Medicare under LBJ, thousands of soon-to-be enrollees—aunts, uncles, professors, my friends’ parents and my own—grew up trusting in this promise. And though, as a student, it will be nearly half a century before I qualify for the program, I recognize all too well the gravity of the decision we now face. It is one, after all, that will be borne most heavily by my peers, since the costs that are shifted to seniors today will be thrust upon us tomorrow as health care costs continue to rise. And young Americans will feel the consequences of voucherization well before we reach the age of eligibility, for the security that Medicare provides allows us to take risks when we're younger, to try to create the next Facebook or Instagram, rather than play it safe for fear that we'll be left destitute or denied care in our later years. To chip away at the heart and soul of our social safety net is, in a sense, to hinder innovation itself.

Ultimately, the choice we face is simple: to uphold this mandate or reject it fundamentally; to maintain the promise of health care access for our elderly or begin chipping away at the coverage we provide in the name of budget-balancing. This debate is about a decades-old American social compact, and its effects will reverberate, shaping the futures of not only my own generation but also the ones to come. For the health of our citizens and our safety net, there is only one right answer.

Rahul Rekhi is a student at Rice University and the Senior Fellow in Health Care Policy for the Roosevelt Institute | Campus Network.

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What Does Obama Really Stand For: Community or Small Government?

Sep 10, 2012Jeff Madrick

The president's convention speech focused on the power of community, but the details of his future policies remain sketchy at best.

The president’s acceptance speech in Charlotte last week emphasized his new theme of community and "being in this together." For all its mushy sentiment, this is a major victory for those like us at Rediscovering Government who have been talking about the need to revitalize the discourse about government for quite some time.

The president's convention speech focused on the power of community, but the details of his future policies remain sketchy at best.

The president’s acceptance speech in Charlotte last week emphasized his new theme of community and "being in this together." For all its mushy sentiment, this is a major victory for those like us at Rediscovering Government who have been talking about the need to revitalize the discourse about government for quite some time.

Obama hesitated to sound such a theme in the past. He seemed to run from potential charges of class warfare or favoring big government. He failed to boast about his stimulus plan and some of his investment programs. He hardly talked about his health care program. The conversation in America has changed, of course, partly because of the vice presidential nomination of an extremist, Paul Ryan, who wants to cut government spending to 16 percent of GDP. That’s about the 1950s level. 

But Obama has been moving in this direction for quite a while now. He still avoids the word "government," preferring "community." But he also nicely introduced the word "citizenship." Among Ronald Reagan’s most damaging legacies was, I think, that he undermined the meaning of being a citizen in America. To him, we did not belong to a nation. We belonged only to ourselves. It would be nice to bring the concept of citizen back.

I can’t overemphasize how useful it was for Obama to lay out this old but now new vision. Bill Clinton, who had proudly proclaimed the end of big government in 1996, also said similar things. There is now a distinct us versus them as the election season begins. “Us” is those who want to work together. "Them” is those who treat community as a drug we'll become dependent on. It is probably no accident that the Republican ticket is composed of men descended from rich parents. Lots of rich kids become effective leaders, but many don’t understand how tough it can be to have no one to lean on, to borrow from (as Mitt now famously suggested), or even to be taught by.

But having listened closely to the Obama speech, I am still hungry for more candor. Even a few days later, I have no idea what Obama plans to do over the next four years. We know he will care, and we know he will not take a pound of flesh from the poor or strivers to the middle class if he can help it, but what do we know about his future programs?

He was about as careful as Romney and Ryan were in Tampa to avoid any specifics. Will he propose a new stimulus if the economy teeters, or will he remain dedicated to a narrow deficit-cutting plan even during a weak economy? Does he think there is anything truly commendable about the Simpson-Bowles deficit-cutting plan he had sponsored (if then mostly ignored)? The plan disastrously aims to limit federal spending to 21 percent of GDP, its 40 year- average, even as the population ages, health costs rise, and we know pre-K education is urgently needed. It would cut Social Security sharply. But Obama mentioned it in his speech, and it has become the widely cited “bipartisan” model for fiscal responsibility. The public relations program in its favor is a stunner. It is not really bipartisan at all, of course. Both the Democrat Bowles and the Republican Simpson are devoted and extreme deficit hawks.

What line will Obama hold on Social Security? Will he significantly upgrade his proposals to invest in infrastructure? How about a higher minimum wage? Better labor laws? Is there a potential jobs program in the works? Serious education reform? Will he encourage a lower dollar to help manufacturing and propose ways to create a more level playing field in global trade? Will he propose a serious tax increase to pay for needed public investment and buttress entitlements programs once the economy is righted?

I can’t say it’s bad politics to ignore the details for now. The best case for Obama is that as his health reform law helps more people, he will build American confidence in government. Mitt Romney has already conceded as much, saying he will retain some of Obamacare. With some proof that governmnet helps under his belt, perhaps Obama can move forward. He can add to his health care program with a true public option and perhaps expansion of Medicaid reimbursements to providers, which are too low. He can also adopt more rigid cost controls, drug negotiating procedures, and firmer preventive medicine incentives. A more positive attitude toward government might awaken fresh ideas about educational reform. Perhaps we can put art and music programs back into schools and tackle universal access to the web. Maybe we can even build a universal pre-K system that is cheap and good, one of our most important needs.

I know Romney has only one major idea in his head: tax cuts. If at first they don’t succeed, try again. But of course, tax cuts did succeed for the wealthy, just not for the “community” of America.

What’s really in Obama’s head? Is he a limited government man at bottom, just another Third Way New Democrat? Or is he really a community government man? I don’t know, and that bugs me. Moreover, I am not sure we will find out before Election Day.

Roosevelt Institute Senior Fellow Jeff Madrick is the Director of the Roosevelt Institute’s Rediscovering Government initiative and author of Age of Greed.

 

Barack Obama image via Shutterstock.com.

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Memo to RNC Delegates: You Didn't Build It, But Feel Free to Pay Up

Aug 28, 2012Jordan FraadeSarah Pfeifer VandekerckhoveJeff Madrick

“We built this” is the phrase ringing throughout the (largely publicly funded) Tampa Bay Times Forum this week at the Republican National Convention. Though it is meant as a rebuttal to President Obama’s remarks earlier this summer emphasizing that government is the dynamic foundation and support system upon which all Americans rely, its use as a theme of the RNC is actually a critical illustration of the president’s point.

“We built this” is the phrase ringing throughout the (largely publicly funded) Tampa Bay Times Forum this week at the Republican National Convention. Though it is meant as a rebuttal to President Obama’s remarks earlier this summer emphasizing that government is the dynamic foundation and support system upon which all Americans rely, its use as a theme of the RNC is actually a critical illustration of the president’s point. To be clear, Obama was saying that “there are some things (like fighting fires or building infrastructure) that we (the government and its people) do better together,” such as constructing a multi-million dollar professional sports facility in downtown Tampa or, say, rebuilding the infrastructure and restoring public services to an entire city in the wake of a (relatively small) hurricane to the tune of millions of dollars. But if the 50,000-plus people visiting Tampa for the RNC this week really want to take credit for these enormous feats of collectively funded and supported work, we have helped them figure out just how big a check they’ll need to write.

As Media Matters pointed out last week, the Tampa Bay Times Forum was built in 1996 by the Tampa Bay Sports Authority, a public entity. Of the $139 million construction cost, 62 percent, or $84 million, was paid with public money – bonds backed by the City of Tampa and Hillsborough County, paid back through sales taxes, tourist development taxes, and ticket surcharges. More recently,  the Republican National Committee, which received over $18 million from the federally supported Presidential Election Campaign Fund, shared costs of over $500,000 with the Tampa Bay Lightning just to upgrade the arena’s sound system.

Additional preparation for the RNC cost the City of Tampa upwards of $2.7 million in beautification projects and infrastructure upgrades, like improving highways, redesigning signage, planting palm trees, and bringing a locally loved fountain back into use. Commuting from up to 90 miles away, RNC delegates will surely find these upgrades to be pleasant as they are introduced to the hallowed Tampa tradition of long, grinding commutes. Some delegates may even be transported around by a fleet of 400 city-chartered buses. Those same delegates who, like Florida Governor Rick Scott, are adamant about blocking any further government expenditures on mass transit are more than welcome to walk to the Forum (although a 2007 survey of cities found that Tampa has no walkable destinations, and 50 percent of the urban core is set aside for parking).

Downtown Tampa offers delegates benefits that come as a result of public investment in the city’s urban core (unless, of course, they choose to avert their eyes out of principled opposition to wasteful government spending on things like public art and higher education). The Riverwalk, a two-mile green space along the Hillsborough River, has already enticed the Tampa Museum of Art to relocate and freed up space for public events. The city received $11 million from the Obama administration to put the finishing touches on the project, and is spending $3 million to turn downtown’s Zack Street into a pedestrian thoroughfare with benches, landscaping, and street art. Finally, along the downtown riverfront, the University of South Florida’s new Center for Advanced Medical Learning and Simulation is the world’s largest medical facility that allows medical students to practice surgery without a patient. The center was built at a cost of $38 million and was partially paid for by Build America Bonds, an Obama administration program that provides capital for infrastructure projects and issued over $100 billion in bonds in its first year of operation. More wasteful government spending!

Of course, no event in Florida in August would be possible without hurricane season preparation. In anticipation of Tropical Storm Isaac’s imminent development into a hurricane, the RNC cancelled Monday’s convention activities. Though it’s not clear yet what cleanup the storm will require, similar strength storms generally cost FEMA millions in statewide recovery. When Tropical Storm Debby hit Florida earlier this summer, FEMA spent over $15 million on individual assistance.

For the 2,286 RNC delegates eager to claim they “built this” – whether it’s the Tampa Bay area infrastructure or social services, Tropical Storm recovery included, provided by the host town – we’ve done some math to help them determine just how much money they would have to personally shell out to validate such a claim. Diffusing a $15 million cleanup cost among 2,286 delegates would lead to a total of about $6,562 per delegate—a small price to pay to make sure the party can actually nominate a candidate for president. If we ask everyone visiting Tampa for the convention to pitch in—roughly 50,000 people, according to the RNC website (and yes, 15,000 members of the press, that includes you too)—each person would pay $300 to help clean up. Natural disasters aren’t cheap. Without coordinated government efforts to manage and clean them up, they would be even less so. To cover the roughly $100 million in Tampa Bay area beautification and service and infrastructure improvements, including the construction and upgrades of the Tampa Bay Times Forum, each delegate would need to pitch in an extra $43,745, or an extra $2,000 per visitor, and that doesn’t include myriad other costs going into this week’s events, including the nearly $50 million federal grant covering RNC security.

With this $15 million tucked away and set aside for hurricane cleanup and over $100 million secured for RNC-related infrastructure and beautification, Tampa and Florida taxpayers could go back to taking care of day-to-day expenses, like improving Medicare coverage in a city and state where the need for it is acute. Florida’s health care costs are well above the national average—it ranks 18th in per-capita health spending overall—but the state rockets to second place nationwide in Medicare spending with $11,893 spent per enrollee. The state also ranks second behind California in gross Medicare spending, with just over $39 million spent on the program. And while the Tampa and St. Petersburg hospital referral regions do not contain Florida’s highest per-enrollee Medicare expenditures, nor are the cities among Florida’s most elderly, the city’s age 50-64 population grew by 40 percent between 2000 and 2010. A city whose largest-growing age group is on the cusp of Medicare eligibility is hosting the convention of a party that has dedicated itself to ending the program as we know it.

There’s a larger-than-usual chance that your average Republican delegate will be a Medicare recipient, too. While the convention does not officially release information on the age of its delegates, several states do. North Carolina, Texas, and Connecticut, for example, are all sending delegations whose median age is 57 or 58. Any delegates who require medical care during the convention, hurricane or no, will have the option of visiting Tampa General Hospital, a downtown hospital affiliated with the public University of South Florida—but not, alas, with the for-profit hospital chain managed by Florida Governor Rick Scott in the 1990s and later found guilty of Medicare fraud. Tampa General is the city’s largest hospital, with an operating revenue of $1.1 billion in fiscal year 2011—a year before it was voted the best hospital in Florida by U.S. News and World Report. No doubt at least one Republican delegate, for some reason or another, will find a reason to visit the hospital and help contribute to this nonprofit, government-funded success story.

As for the delegates who stay healthy, we hope you’ll enjoy your stay and that your cheers of “we built this!” are worth the $50,307 you’ll have to refund the government for all the work it did to prepare the city on your behalf. And remember to set a little extra aside for tourist activities!

Jordan Fraade is a former member of the Roosevelt Institute | Campus Network.

Sarah Pfeifer is Manager of Programs for the Roosevelt Institute.

Roosevelt Institute Senior Fellow Jeff Madrick is the Director of the Roosevelt Institute’s Rediscovering Government initiative and author of Age of Greed.

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Ignore the Deficit Hawks. Social Security is Easy to Fix.

Aug 14, 2012Jeff Madrick

On the 77th anniversary of Social Security, we're celebrating what has made the program so important and why it remains vital today. Jeff Madrick explains why Social Security's so-called fiscal crisis has been overblown and looks at the many simple solutions on the table. Read the rest of our coverage here.

On the 77th anniversary of Social Security, we're celebrating what has made the program so important and why it remains vital today. Jeff Madrick explains why Social Security's so-called fiscal crisis has been overblown and looks at the many simple solutions on the table. Read the rest of our coverage here.

Little is as distressing in the public discourse as the linking of the financial problems of Social Security and Medicare. It is a favorite ploy of the deficit hawks to claim we must reform our entitlement programs without distinguishing between the two. I am at a loss to explain this. It is clearly ideological -- small government no matter who gets hurt. But Social Security payouts will rise from roughly 5 percent of GDP to 6 percent at worst down the road, while Medicare will rise by much more.

Nevertheless, poorly educated pundits, willing to believe the self-proclaimed centrist view that we cannot tax our way to solvency, demand Social Security reforms from selfish baby boomers. Monique Morrisey of the Economic Policy Institute does good work on this. Moreover, there is even a detailed Senate report on the issues that requires only a little updating. Maybe journalists should read it before they write about the subject. Its title is rather self-explanatory: “Social Security Modernization: Options to Address Social Security Solvency and Benefit Adequacy from the Senate.” 

First, remember that Social Security provides nearly 60 percent of the elderly more than half of their income. Seventeen percent receive all their income from Social Security, mostly households headed by elderly women. Most remarkably, and it would be nice for young people to register this, the poverty rate measured by the federal government for the elderly was 35 percent in 1959. As Social Security became more generous, it was reduced to 10 percent, about where it stands today. This is one of the great social achievements of our time.

Now for that future financing gap. It's true that payroll taxes won’t cover all the benefits to be paid in 25 years or so, as the ratio of the elderly to workers rises and life expectancy grows. But a more important and lesser known cause of this future gap is inequality of income. Tax revenues are reduced because incomes have stagnated for so many. Due to an earnings cap above which taxes are not collected, now about $110,000 a year, combined with the rapid rise of incomes for high-end earners, some 17 percent of aggregate earnings are not covered by the payroll tax. In 1980, only 10 percent were not covered.

But the solvency gap, as we might call it, is not very large, amounting to only 2.67 percent of GDP. How can that be closed? Pretty darned easily. For example, the cap can be eliminated. This would close almost the entire gap if high-end earners do not receive higher benefits. It will still close four-fifths of the gap if they do.

Another way to close the gap would be to raise payroll taxes by 1.1 percentage points, from 6.3 percent to 7.6 percent. This would entirely close the solvency gap. Or the tax could be raised by a little more than 1 percentage point in 2020 and another percentage point in 2052, also eliminating the solvency gap.

A combination would also work. If the cap were raised to cover 90 percent of all workers, for example, it would close about 25 percent of the gap. Thus, a tax increase to close the rest would be smaller. Alternatively, the payroll cap on employees could be limited to 90 percent and eliminated altogether for employers. This would just about eliminate the gap.

There are many other options and permutations, but any claim that a pragmatic increase in taxes cannot close the gap is utterly wrong. 

Let’s also keep in mind that Social Security solvency is based on a 75-year forecast. Any increase in the rate of growth over what is expected will reduce the gap significantly. Now to really be pie in the sky, there is also the possibility of investing in the economy to enable it to grow faster—investing in infrastructure, education, and so on. More equality of income would also reduce the solvency gap. For those eager for major benefit cuts because we can’t be sure about growth, well, they can be quite modest if coupled with tax increases. But they are not necessary now!

Medicare is a different issue. In sum, the nation pays about twice as much for what it gets from health care than it should compared to other countries. This is the domestic problem of our time. I think Obamacare may start us down the road to control these costs, especially if we ultimately add a public option at something like Medicare rates. That’s where pundits and deficit hawks should focus their attention. Instead, they like picking on Social Security, our single greatest achievement. Why?

Roosevelt Institute Senior Fellow Jeff Madrick is the Director of the Roosevelt Institute’s Rediscovering Government initiative and author of Age of Greed.

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The Aurora Victims (and the Rest of Us) Deserve a Health Care Safety Net

Jul 31, 2012Tim Price

The Aurora shooting has sparked debates over gun control, but health care reform is just as important for the uninsured victims.

The Aurora shooting has sparked debates over gun control, but health care reform is just as important for the uninsured victims.

Just 11 days ago, a shooter opened fire in a movie theater in Aurora, Colorado, killing 12 and injuring 58 others who had gathered for the midnight premiere of The Dark Knight Rises. In the wake of these tragic events, a debate has erupted over gun control. (This happens every now and then when we’re reminded that the authors of the Second Amendment might not have meant for someone to be able to buy 6,000 bullets online with no questions asked.) But as we mourn those who were lost and extend our sympathies to their grieving families, we shouldn’t forget that the suffering continues for many who survived the shooting. As Dashiell Bennett of The Atlantic Wire notes, “Most of the wounded are expected to have medical costs in the hundreds of thousands, if not millions, of dollars and many appear to have inadequate or non-existent coverage.” This burden could add more tragedy to the lives of those who have already experienced too much. But while we may wonder if more sensible gun laws or better mental health care could have prevented the shooter’s rampage, we know for sure that a stronger social safety net could have prevented the financial catastrophe that has followed in its wake.

As hospital bills pile up, uninsured and under-insured survivors of the shooting are being forced to rely on the kindness of strangers. The Associated Press reports that three of the five hospitals treating the Aurora victims are capping their fees or offering them free care. But that still leaves many to bear a heavy financial burden, including Caleb Medley, an uninsured man who was shot in the eye and placed in a medically induced coma. His family is raising private donations to cover what already amounts to over $2 million in medical bills.

The charity of those who have donated is certainly commendable, but while we wish Medley and his family all the best, we have to ask ourselves whether this is any way to run a country. If there’s a crime spree, we don’t pass the hat around to hire a private security firm to defend us. We have the police for that. If our homes catch on fire, we don’t just cross our fingers and hope one of neighbors will be nice enough to lend us their garden hose. We know firefighters will be there to help. So when it comes to medical emergencies, including random events like this one and also the kind that all of us will face at some point in our lives, why should the 50 million uninsured Americans be reduced to begging for help? If the Affordable Care Act is allowed to fully take effect, providing guaranteed coverage, expanded Medicaid coverage, and insurance subsidies for those who need them, that may no longer be the case. But that’s a big “if.”

There’s a story conservatives like to tell about our health care system, and as with so many of their stories, it involves their peculiar definition of personal responsibility. The story goes that if you’re a responsible person, as physically and mentally healthy as you are morally upright, you can obtain health insurance by working hard so that you can either be covered by your employer’s plan or purchase an individual plan. If you don’t have insurance, there are two likely explanations. The first is that you’re an irresponsible bum who wants everyone else to pick up the tab for your medical care. The other is that you’re a Galtian Übermensch who has planned ahead and saved up for your own private medical staff and organ-cloning lab in case of emergency. If you can’t obtain insurance because you’ve been denied due to a preexisting condition or because your employer doesn’t offer it and doesn’t pay you enough to buy it yourself, you don’t fit into this narrative, so please politely excuse yourself and go complain about it in a quiet room.

I last wrote about this argument and the problems with it when I discussed my own brush with death. That experience didn’t just deepen my appreciation for health insurance and my belief that everyone should be guaranteed coverage. It also made me aware of just how flimsy the GOP’s argument is. If I hadn’t had health insurance at the time of my accident, would I have been “responsible” for a driver blowing a red light and running me over as I was crossing the street? Should the firefighters and paramedics who saved me have instead patted me on the (broken) shoulder and said “Good luck with all that”? Are the uninsured victims of the Aurora shooting at fault because they didn’t set aside some rainy day money on the off-chance that a psychopath in SWAT gear would try to murder them while they were enjoying a night out at the movies?

Claims like these clash with common sense and basic human empathy, which is why they’re rarely made explicit. But it may take events like the Aurora shooting to highlight the extent to which they undergird the Republican approach to health care. To be fair, many conservatives would argue that they agree with the principle that everyone should have access to affordable health care but believe the best way to accomplish that is through the free market rather than government mandates. And many on the left would rightly point out that the Affordable Care Act is only a half-measure, a compromise with private insurers that won’t truly guarantee equal access to health care for all. But none of those criticisms are reflected in the policy agenda of the Republican Party, which has now repealed the Affordable Care Act 33 times and offered an alternative proposal zero times. Senate Minority Leader Mitch McConnell has explicitly said that covering the uninsured is “not the issue,” while Senator Orrin Hatch admits that the number of uninsured is disgraceful but maintains that “we cannot succumb to the pressure to argue on the left’s terms.” Indeed, why should the debate about health insurance focus on people who need health insurance? We should talk about something more fun, like our favorite vacation destinations or Mitt Romney’s dancing horse.

The Aurora victims may have been gathered to watch a movie about a benevolent billionaire who dedicates his life and fortune to righting society’s wrongs, but there’s a reason such stories are best left to fiction, and it’s not just that Warren Buffett wouldn’t look good in a bat costume. In the real world, we understand that there are vast and complex problems that we can’t solve through private charity alone, and for those problems we require strong public institutions and a reliable social safety net. People shouldn’t have to fear that they’ll be shot dead when they walk into a movie theater, but neither should they have to fear that they won’t be able to afford the cost of survival.

Tim Price is Deputy Editor of Next New Deal. Follow him on Twitter at @txprice.

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Mark Schmitt: GOP Has "Less Than No Reason" to Repeal the Individual Mandate

Jul 10, 2012

In the latest episode of the Roosevelt Institute's weekly Bloggingheads series, "Fireside Chats," Senior Fellow Mark Schmitt talks to Scott Lemieux of Lawyers, Guns, and Money and The American Prospect about th

In the latest episode of the Roosevelt Institute's weekly Bloggingheads series, "Fireside Chats," Senior Fellow Mark Schmitt talks to Scott Lemieux of Lawyers, Guns, and Money and The American Prospect about the machinations behind the Supreme Court's recent health care ruling and what challenges lie ahead for the Affordable Care Act. Mark notes that while Republicans have tried to spin the ruling by claiming that they can use reconciliation to repeal the individual mandate if it's a tax, the truth is that they always could have but never will. Echoing his recent post on this subject, he maintains that they have "less than no reason" to repeal the individual mandate as long as insurance companies are lining their pockets.

Mark thinks the recent revelation of Aetna's $7 million donation to conservative groups is significant given that "overall the health insurance industry basically has staked out with the Republican Party," but insurers were forced to work with Democrats during the health care reform negotiations to get a seat at the table. He explains that the conflict for insurers has always been that "they would love to have as many customers as possible, so if you create a mandate, that's a great thing for them," but it also means that they'll have to put up with more regulation as part of an overall reform package. "If it was all regulation, no mandate, they wouldn't want it; if it was all mandate, no regulation, they'd love it; and then there's two acceptable positions. One is the status quo... pre-2010, and then ACA they were basically fine with."

Now that the Supreme Court has upheld the law, Mark notes that the worst outcome for insurers would be that "only the mandate gets struck," since they would get all of the new regulations and none of the new customers. He says that "now that these companies are fully back at the table with Republicans, the Republicans simply are not going to just repeal the mandate. It's just not an option they have with their cash constituents." As for repealing the entire law, he notes that there is plenty of internal division among Republicans about preserving the more popular provisions, like guaranteed issue and the ability for young adults to stay on their parents' insurance plan until age 26. "I think they're really stuck, and I think we should really just draw the line and say, 'Here it is, we have the Affordable Care Act. It's not going anywhere, nobody's repealing it, now it's time to make it work.'"

For much more, including Mark and Scott's take on how the Supreme Court reached its surprising verdict and why it's been leaking like a sieve ever since, watch the full video below:

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Mark Schmitt: GOP Has "Less Than No Reason" to Repeal the Individual Mandate

Jul 10, 2012

In the latest episode of the Roosevelt Institute's weekly Bloggingheads series, "Fireside Chats," Senior Fellow Mark Schmitt talks to Scott Lemieux of Lawyers, Guns, and Money and The American Prospect about the machinations behind the Supreme Court's recent health care ruling and what challenges lie ahead for the Affordable Care Act.

In the latest episode of the Roosevelt Institute's weekly Bloggingheads series, "Fireside Chats," Senior Fellow Mark Schmitt talks to Scott Lemieux of Lawyers, Guns, and Money and The American Prospect about the machinations behind the Supreme Court's recent health care ruling and what challenges lie ahead for the Affordable Care Act. Mark notes that while Republicans have tried to spin the ruling by claiming that they can use reconciliation to repeal the individual mandate if it's a tax, the truth is that they always could have but never will. Echoing his recent post on this subject, he maintains that they have "less than no reason" to repeal the individual mandate as long as insurance companies are lining their pockets.

Mark thinks the recent revelation of Aetna's $7 million donation to conservative groups is significant given that "overall the health insurance industry basically has staked out with the Republican Party," but insurers were forced to work with Democrats during the health care reform negotiations to get a seat at the table. He explains that the conflict for insurers has always been that "they would love to have as many customers as possible, so if you create a mandate, that's a great thing for them," but it also means that they'll have to put up with more regulation as part of an overall reform package. "If it was all regulation, no mandate, they wouldn't want it; if it was all mandate, no regulation, they'd love it; and then there's two acceptable positions. One is the status quo... pre-2010, and then ACA they were basically fine with."

Now that the Supreme Court has upheld the law, Mark notes that the worst outcome for insurers would be that "only the mandate gets struck," since they would get all of the new regulations and none of the new customers. He says that "now that these companies are fully back at the table with Republicans, the Republicans simply are not going to just repeal the mandate. It's just not an option they have with their cash constituents." As for repealing the entire law, he notes that there is plenty of internal division among Republicans about preserving the more popular provisions, like guaranteed issue and the ability for young adults to stay on their parents' insurance plan until age 26. "I think they're really stuck, and I think we should really just draw the line and say, 'Here it is, we have the Affordable Care Act. It's not going anywhere, nobody's repealing it, now it's time to make it work.'"

For much more, including Mark and Scott's take on how the Supreme Court reached its surprising verdict and why it's been leaking like a sieve ever since, watch the full video below:

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