Wednesday, October 29, 2014

What Happened To Repealing Obamacare?

It's the biggest mystery of the 2014 GOP campaign season: what happened to repealing Obamacare as the top issue for the Republican Party in 2014 as it was in 2010?

Two big things happened, actually.  One, Obamacare is working, as evidenced by a major NY Times study of the Affordable Care Act.  In seven categories, the law is working, but could be doing better with some help instead of constant opposition.  But for the most part, it is doing what it has promised:

  1. Has the percentage of uninsured people been reduced? Yes, the number of uninsured has fallen significantly.
  2. Has insurance under the law been affordable? For many, yes, but not for all.
  3. Did the Affordable Care Act improve health outcomes? Data remains sparse except for one group, the young.
  4. Will the online exchanges work better this year than last? Most experts expect they will, but they will be tested by new challenges.
  5. Has the health care industry been helped or hurt by the law? The law mostly helped, by providing new paying patients and insurance customers.
  6. How has the expansion of Medicaid fared? Twenty-three states have opposed expansion, though several of them are reconsidering.
  7. Has the law contributed to a slowdown in health care spending? Perhaps, but mainly around the edges.

And that brings us to our Republican friends, who are no longer calling for the repeal of the law and are getting away with it.

If 2010 was the year when Democrats backed away from their votes to establish Obamacare, 2014 is the year when Republicans back away from their crusade to repeal President Barack Obama's signature domestic achievement.

With the law benefiting many voters in their states, Republican candidates in key Senate races are tacitly supporting core Obamacare provisions, most notably the Medicaid expansion. 
But shhh, don't call it Obamacare. "Obamacare" remains a dirty word in Republican politics, and so these candidates are rhetorically toeing the party line for repeal. Scratch beneath the surface and they're making a logically strained implication that they can eliminate Obamacare without taking away its benefits.

That's impossible, and yet nobody seems to be attacking the GOP on such a ridiculous position.

One revealing example is North Carolina Republican Thom Tillis. During the primary, the state house speaker boasted in a TV ad that he "stopped Obama's Medicaid expansion cold." But last week he flipped his position and argued that North Carolina is "trending in a direction where we should consider potential expansion." He told Time Warner Cable News, "I would encourage the state legislature and the governor to consider it."

This is a massive flip-flop on a key plank of Tillis's position, and yet Tillis is still considered a serious candidate and may very well become NC's next senator.

Iowa's Joni Ernst, who holds a narrow lead in the race, illustrates the dilemma for Republican Senate candidates caught between a conservative base that despises Obamacare and their constituents who are benefiting from the Medicaid expansion — an estimated 100,000 Iowans. Ernst has repeatedly called for repealing Obamacare, but she has also said Congress must "protect those that are on Medicaid now."

Again, you can't do both.  Repealing Obamacare would take Medicaid away from millions, full stop, point blank, do not pass Go.

The dilemma has vexed Senate Minority Leader Mitch McConnell of Kentucky, where the state-based Obamacare portal, Kynect, has signed up some 520,000 residents under Medicaid expansion and the subsidized market exchanges. What's the Republican leader to do? Throw them off? That's too risky, especially when he's facing an unexpectedly strong reelection challenge from a Democrat who promises to protect that coverage.

McConnell has sought to distinguish Kynect from Obamacare, arguing that Kentucky should be allowed to keep Kynect if Obamacare is repealed, and saying Kynect is merely a "website" that he's "fine" with continuing. His position on the health care law was pilloried as "bizarre" by theLouisville Courier-Journal and an "outlandish deception" by the Lexington Herald-Leader, the state's two largest papers.

As I said earlier, this idiocy is one of the big reasons both papers endorsed Alison Grimes.

Republicans are absolutely ridiculous, and believe their voters must be stupid to pull this.  They're certainly counting on a compliant media to keep them stupid, it seems.

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