Tag: Freedom Caucus

Will the GOP Be Forced to Work with the Democrats on Health Care?

George S LedyardFrom the article –
Second, McConnell will press the argument that if this bill does not pass, Republicans will have no choice but to negotiate over the future of the Affordable Care Act with Democrats. Multiple reports have said that McConnell has privately warned Republicans that failure would mean they must enter into talks with Democrats on ways to shore up the individual markets, which would effectively mean that a chance to pass a partisan repeal bill is gone.”
It is abundantly clear that the GOP has not wanted to work with Democrats on health care. They have seen this chance to dismantle big government programs and cut taxes as a unique opportunity. The battle has revealed fault lines in the GOP between the real ultra right libertarian extremists, who fundamentally don’t really believe that government should have any role at all in providing benefits and protections to private citizens and more traditional style Republican moderates who are willing to support some level of Federal involvement in health care.
While in theory, the GOP has total control of both houses of Congress, the ideological divide between the Tea Party, Koch brothers sponsored extremists, whose goal is to roll back government to pre-New Deal levels and the more traditional moderates is wider than that between the moderates and establishment Democrats.
The ACA, better known as Obama Care, was really a Heritage Foundation, conservative plan created in order to head off Liberal efforts to establish a single payer system. It was successfully put into place in Massachusetts under Governor Mitt Romney. In other words, this was a conservative plan, not some Liberal creation.
President Obama went with is plan, as did the Dems at the time, because they felt it was the best they could do. Anything closer to single payer seemed to be a non-starter at the time. So the ACA was passed with its supporters fully knowing that it had issues that they expected to address as they revealed themselves over time.
What they had not anticipated was the unrelenting, concerted, disinformation attack on the ACA by the GOP. Conservatives made opposition to the ACA the single most important element in their opposition to the entire Obama administration. Republicans met and determined that their strategy would be to block any and all efforts by the Obama administration to do anything. They wished to deny Obama anything that could be considered to be a win and to force him out of office after one term.
Of course that backfired completely and Obama successfully completed two terms. But GOP obstructionism made any tinkering with the ACA to fix apparent issues impossible. Instead, the GOP repeatedly and unsuccessfully tried to repeal the legislation as a way to play to their base. So they publicly excoriated Obama and the ACA while refusing to do anything that might improve it. Their hope was that it would implode and they could replace it with their own legislation.
But now those same Republicans are faced with putting their money where their mouths have been. It is abundantly clear that while they were great at criticizing the ACA for eight years, they didn’t actually have a plan in place that they could agree on to replace it. Their replacement plan floundered in the House and they finally were forced to kick the can down the line by passing a version they knew wouldn’t fly, hoping that the Senate would be able to fix it.
Mitch McConnell decided to minimize public outrage over their developing plan by appointing thirteen GOP Senators, all white males, to meet in closed session to draft the bill. No public hearings, no input from the opposition party, no input from women, no input from the minority community, and no input from the health care provider community.
Even many GOP Senators have been offended by this process, rightly feeling that they had been left out of the process and were being rushed to approve the plan that emerged without really understanding its implications.
Now that the Congressional Budget Office has released its analysis of the draft legislation, it has become apparent that the extremist libertarians in the Senate, the so-called Freedom Caucus, feel it does not go far enough to dismantle Federally supported health care. And the moderates, looking at benefit cuts, rising deductibles, drastic cuts to Medicaid, etc. which will devastate health care for the poor and raise costs dramatically for everyone else, in order to give a tax break to the top 1% are finding that they just can’t go there.
This is REALLY not about health care at all. It is the result on a 35+ year effort on the part of a group of extreme right wing billionaires, like the Koch brothers, to dismantle the Federal government. It’s not just health care they wish to dismantle. It is the entire Federal regulatory structure and involvement on providing the social safety net. Like the Democrats with the ACA, they see this legislation as just the first round. Their eventual goal isn’t just cutting Medicaid. It is dismantling both Medicaid and Medicare. It is the privatization of almost everything we currently view as public goods.
While these extremists have a serious power base within the GOP and have largely, through excellent organization and vast financial support from the radical point one percenter billionaires, like the Koch brothers and Robert Mercer, been able to drive the GOP agenda, they are not the majority. Most of the GOP are not the extreme ideologues that these people are. They are more opportunists. They’ve gone along with the extremists when it seemed politically expedient but now that they are seeing the public reaction to the health bill for instance, they are wavering in their support. And the true moderates, of whom there are still a few, are not willing to follow the extremists in their desire to dismantle government at the expense of their constituents.
The moderates concede that there is a legitimate role for Government in administering areas deemed public goods as well as providing some sort of regulation to protect clean air, clean water, the environment in general, etc. This places them closer to establishment Democrats than it does to the more right wing members of their party. This is a serious culture war in our country and it is reflected within the GOP itself.  Mitch McConnell was barely able to restrain a pro-Trump super pac from running attack ads on one of their own GOP Senators who was refusing to vote for the health care bill as it stands.
So, given the impasse that may result from this ideological battle which may just result in the inability of Mitch McConnell to enforce party discipline and pass the legislation, he has informed his GOP comrades that their failure will force them to do the unthinkable and reach across the aisle and work with the Democrats to keep the current system functioning. It would mean the defeat of the GOP promised efforts to repeal Obama Care and require them to do what they have refused to do, fix the broken elements of the current system.
And the Democratic Party they will be forced to deal with will be a newly energized group. The resistance effort that has been mobilized within the Dem community has actually reinvigorated talk of single payer, Medicare for all proposals. If the GOP is forced to accept a colossal fail on their repeal and replace effort, the reaction from the public may just push health care reform farther in the other direction than it has been. If the GOP is forced to deal with the Democrats, they will be negotiating with a Democratic party newly energized to go farther in expanding Federal coverage than has been the case to date.

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The Health Insurance Debate

George S LedyardThe issue of health insurance in America should be a lot simpler than it’s made out to be. All the way back in the 1930’s our country made the decision to go a different way that every other major democratic nation by opting for an employer based health insurance system. This decision was entirely ideological in nature. Right wing opposition to anything that even hinted at the great bugaboo “Socialism” made it impossible for us to have a national health care system like every other major nation.
This decision made major problems with our health care in the US inevitable right from that moment. Our system virtually ensures that millions of citizens have no insurance whatever. First of all, there are the unemployed. No job, no insurance. Add to that, our massive number of “underemployed”. Congress rightly decided that small businesses couldn’t afford to provide insurance to their employees so they were exempted. Additionally, only full time workers generally received benefits so larger corp[orations used as many part time workers as was feasible to avoid paying benefits. The chronically “|underemployed” could be working two, even three part time jobs, just to pay the bills and receive zero benefits.

Eventually a patchwork system of work-arounds brought the number of uninsured down. Medicare covered the citizens over retirement age. Medicaid was set up at the state level to cover the poor who otherwise couldn’t afford to be covered. Of course this left large disparities between the states as to how well they took care of their poor.

So, even with the additional programs filling in some of the gaps, as many as 48 million citizens were still uninsured (a 2012 figure). These many millions tended to end up using the emergency care infrastructure for their basic health care which was, by far, the most expensive way to provide health care services. Additionally, we got to the point at which even for those who had coverage of some sort, many had plans that denied coverage for existing conditions, had huge deductibles which made it impossible for the unwell to afford to get care. The result was that under our system, the number one cause for personal bankruptcies in the US is medical costs.

So now, the Republicans are in power. They have steadfastly opposed the provisions of the ACA, also known as Obamacare, since it was passed. But the effort to repeal and replace the ACA is revealing an ideological divide on the right. The Trump / Ryan plan does a massive tax cut that goes mostly to the wealthiest Americans, puts up to 26 million people back into the ranks of the unemployed, pushes more costs onto the consumer and also places a heavier burden on the states, which probably do not have the tax base to fill in the void.

But, the repeal is running into problems, not from the outnumbered Democrats who appear to be 100% against the repeal on principle, but from the ultra right wing of the party. These folks are the radical “libertarian” wing known as the Freedom Caucus in the House. These people, if left completely to their own devices, would have almost no government role in health care at all.

health care reform, Ryancare, Trumpcare, uninsured

So, what the Republicans are struggling with is a choice between two plans, one of which screws the poor, the elderly, disadvantaged women, and so on and reduces the share the wealthiest pay to support the system and a complete devastation of the health care system that would pretty much screw everyone not able to afford his own insurance at free market rates. This is a fight that totally leaves out GOP moderates… It is between far right  Congressional representatives who wish to shrink the government role in providing health care but are mindful of voter back lash and are worried about pushing the effort so far that they get demolished in the 2018 mid-terms and the ultra right libertarian fanatics who simply do not care about the voters at all and see themselves as fighting for small government and maximum privatization, screw the folks who can’t afford it. These are the folks that see any and all government benefits as removing the incentives of the poor to get jobs and get to work.

In other words, Democrats may rejoice that the GOP is divided and this temporarily is delaying the repeal of the ACA, but the negotiations about how to compromise on the Trump / Ryan plan and get the Freedom Caucus people on board will not result in any improvement but rather result in a compromise plan that is even worse, if possible, than the original. It will result in tens of millions losing coverage, sky high deductibles, more excluded conditions, the middle class covering more of the costs relative to the super rich, and so on. It is an unmitigated disaster for health care in the US and will result in far higher medical costs for the country in the end.
Once again we see the Republican commitment to take from the poor and give to the rich fully revealed. It is a morally bankrupt effort and we as a country should be ashamed that this is the direction we are choosing to go.
Check out:
How We Ended Up with Employer Based Healthy Care

Five Charts Which Explain the Ryan Plan

House Vote to Repeal is Delayed