Wednesday, July 23, 2014

Last Call For More Help Less Republicans

Like myself, Steve M is somewhat uneasy about the blase' attitude of liberal pundits towards the Halbig decision earlier this week.  Somehow it's going to end up at the Supreme Court, and there's no guarantee that the government would prevail.

But Republican governors, especially from the tea party class of 2010, have been harming large numbers of people quite openly -- depriving unionized workers of collective bargaining rights, curtailing voting rights, dismantling democratically elected local governments in Michigan, curbing reproductive rights ... and, apart from Pennsylvania's Tom Corbett, they all have a shot at reelection. Voters who aren't specifically targeted by these governors sure don't seem to be displaying much empathy for those who are.

The prevailing sentiment is that somehow, there's a bridge too far that the GOP will cross, and when that happens, voters will punish them resoundingly.

Empirical evidence so far doesn't show that we've reached that point.

A lot of the people harmed by a Supreme Court evisceration of Obamacare will be Democratic voters who wouldn't have voted GOP anyway. Others will be the same people who were subjects of the early Obamacare scare stories -- people who had pre-Obamacare insurance and didn't have their policies renewed. If they replaced those old policies with subsidized Obamacare policies and now can't afford those policies, who are they going to blame, over and over and over again in the right-wing media? They're going to blame Obama, accusing him of tyrannically taking away their old policies in the first place and thus being the guy who left them uninsured.

You can count on this happening, followed by "both sides are responsible" and then "It's President Obama's job to fix this" when it would be Congress's job to fix it, and they won't.  Voters have completely forgotten the fact that the GOP shut down the government, remember?  Of course it'll be Obama's fault.  It always is.

Maybe the Court's Republicans are going to game this out and conclude that a ruling against the law will be too much for the GOP and conservative movement to handle. But I wouldn't bet the rent money on that.

But a lot of Americans are betting the rent money on that, about six million of them, in fact.  There will not be "tremendous pressure for Congress to fix it" any more than there was Congress to fix anything in the last six years.  The result is the GOP now controls the House for the foreseeable future and has a clear shot at getting the Senate in November.

At some point voters may punish the GOP.  Will that number exceed the voters who want to punish Obama in November?

We'll see shortly.  If you haven't noticed, the voters haven't exactly been punishing the GOP so far.

Somebody Else's Problem Field In Action

People going without health care because red states rejected funding for Medicaid expansion is a perfect example of the "Somebody Else's Problem" effect.  But the ugly truth underneath the GOP's efforts to make sure Obamacare doesn't work in their states is that without that funding, hospitals are closing, putting the population of those states at risk.

Reports out in the last week indicate the gap between those with health care coverage is widening between states that agreed to go along with the health law’s Medicaid expansion and those generally led by Republican legislatures and GOP governors that are balking at the expansion. 
The moves against expansion are “beginning to hurt hospitals in states that opted out,” a report last week from Fitch Ratings said. The U.S. Department of Health and Human services has said Medicaid enrollment in the 26 states and the District of Columbia that agreed to go along with and implemented the expansion by the end of May “rose by 17 percent, while states that have not expanded reported only a 3 percent increase,” HHS said in an enrollment update for the Medicaid program. 
We expect providers in states that have chosen not to participate in expanded Medicaid eligibility to face increasing financial challenges in 2014 and beyond,Fitch said in its July 16 report. “Nonprofit hospitals and healthcare systems in states that have expanded their Medicaid coverage under the Patient Protection and Affordable Care Act have begun to realize the benefit from increased insurance coverage.” 
Already, the financial ratings agency said it has downgraded 10 health care entities so far this year and five of those were in states that have not gone along with the Medicaid expansion. Fitch didn’t specify the entities that have been hurt financially. 
“Several of those downgrades were driven by operating performance declines related to funding and reimbursement pressures, which may have been lessened by Medicaid expansion,” the Fitch report said. “Conversely, of the nine upgrades since Jan. 1, eight were hospitals in states that have expanded Medicaid.”

So yes, this is starting to affect the bottom lines of many hospital systems. That in turn affects availability of health care, and of course the economic well being of hospital employees.  If it seems like Republican governors are doing billions of dollars in damage to their own economies in order to get red state voters to blame Obama for the resulting mess, that's because this is exactly what's going on.

A report last week from the Robert Wood Johnson Foundation and the Urban Institute described the coverage difference as a “gulf in percentage of people without health insurance” that is growing larger between states that expanded Medicaid and those that did not. 
As of June, the report said 60 percent of the nation’s uninsured residents live in states that did not expand Medicaid. That figure was up from 49.7 percent in September of last year. 
Analysts expect that gap to only worsen. Unlike private coverage under the health law that is generally purchased during a specified open enrollment period, Americans can sign up for Medicaid at anytime.

In states that expanded Medicaid, an estimated 71 percent of the uninsured likely qualify for some type of financial assistance for health insurance, compared with 44 percent of the uninsured in the states that did not expand Medicaid,” the Robert Wood Johnson Foundation and Urban Institute report said.

So these are the states that are going to have higher taxpayer costs dealing with uninsured Americans, and Republicans, instead of taking responsibility for their direct actions to keep people uninsured,  are just going to blame Obama.

And in most cases, that'll work just fine.

Hope you don't live in a red state.

Republicans Help Less Over Obamacare

Greg Sargent makes this catch on CNN's latest Obamacare poll:

With the political world still pondering what yesterday’s court rulings mean for the future of Obamacare, CNN has published a fascinating new poll that asks a question I haven’t seen before. It asks whether the law has personally helped respondents, but then follows up and asks whether respondents think the law has helped others. 
And guess what: A huge majority of Republicans and conservatives don’t think the law has helped anybody in this country. 
Among all Americans, the poll finds that 18 percent say the law has made them and their families better off. But another 35 percent say the law has made other families better off, for a total of 54 percent who say they or others are being helped. Meanwhile, 44 percent say the law hasn’t helped anybody — a lot, but still a minority. 
Crucially, an astonishing 72 percent of Republicans, and 64 percent of conservatives, say the law hasn’t helped anyone. (Only one percent of Republicans say the law has helped them!) By contrast, 57 percent of moderates say the law has helped them or others. Independents are evenly divided.

This makes complete sense in terms of the pathology of the Republican mind:  if Obamacare has helped Americans in any way, then repealing it would hurt Americans.  Since roughly 3 out of 4 Republicans believe that nobody has been helped by Obamacare, repealing it will only help everyone.  What Republicans really mean when they say that "nobody" has been helped by Obamacare is that no Republicans have been helped by Obamacare.

It's screaming denial that ignores millions, if not tens of millions of Americans seeing a change for the better in affordable health care, but all of those people are probably Democrats anyway, so why not hurt them?  As far as they're concerned, Obamacare is taking fro hard-working, patriotic Republicans to give to awful, parasitic Democrats.  Of course nobody that counts is being helped by it.

So yes, only one percent of Republicans say Obamacare has personally helped them.  That's ludicrous, but then again, we're talking about completely ridiculous Republican voters.  It helps Democrats, and especially those people, so the law has to go.


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