Tag Archives: affordable care act

Watermelon, Meet Hammer

I bet you don’t all agree on how amusing Gallagher is, with his giant, whacking sledgehammer and immobile, squishy vegetable/fruit targets.

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But between the hammer and the watermelon, I bet you agree on which one’s the Republican and which one’s the Democrat. Right? The Republican hammer has been pounding away at the Democratic Affordable Care Act watermelon for the last 6 mos until finally this week, Kathleen Sebelius popped out. Meanwhilst, Democrats—in and out of the White House—have just been sitting in the front row, silently draped in their plastic sheets, somewhat offended by the waste of good food yet strangely attracted to the spectacle.

So what. Sebelius IS a watermelon, right? Botched that website rollout! Give her a whack for me!

Well, any of you ever been involved in a really big, innovative, IT project? And no, I don’t mean changing your FB profile photo or starting a blog. I mean something large that’s never been done before and requiring multiple vendors and multiple years. I didn’t think so. Well I have (certainly not on the scale of the ACA, but still in the multi-million range). So let me remind you the IMPORTANT things that happened with this rollout. The project LAUNCHED ON ITS GO-LIVE DATE in October. And it MET ITS FIRST MAJOR TARGET (7 million registrants by 3/31/14). These are the metrics that matter, not whether there were bugs along the way. Meeting a launch date set over a year in advance and a pre-specified metric in a project this complex is a big deal. And if you think you can do innovative tech (ie, building something that didn’t exist rather than just duplicating current functionality) and NOT have bugs, problems and glitches, well then you don’t know what you’re talking about or have an axe to grind. That is, you’re a Republican.

So why do we insist on being watermelons? Why do we just lie there, taking whack after whack from the Republican hammers being wielded by grinning loons? We reformed health coverage in this country! We made it impossible for insurance companies to deny medical coverage to people who (gasp) actually NEED medical coverage! We made it impossible for them to throw you out once you got sick! We arranged for subsidies to help people who cannot afford the full cost of coverage and expanded access to Medicaid! These are good things. These are great things. What did the Republicans do? Well, they split their seams and shouted themselves hoarse trying to block all this and deny people health care. And most Republican governors are still blocking access by refusing to participate in the Medicaid expansion, which ALONE will cause thousands of otherwise preventable deaths each year (see Paul Krugman in NYT, and the original research article in Health Affairs Blog).

From now on, every time you hear some dunderhead fuming about the “botched” ACA, pull out the hammer:

  • Launched on time
  • Met its targets
  • Why are you killing people?

Capitol Hill is full of fat frogs croaking “Benghazi, Benghazi” who need a good whack and I want to see people in the administration haul off and take a swing for once.

Republicans Continue Attempts to Thwart Republican Health Plan

So, the Republicans in Congress continue to strain every fiber of their being and every last cent of the Koch brothers’ carbon-based loot in their valiant effort to fight off—the Republican Health Care Plan. Yes, the evil Obamacare, its nefarious schemes unmasked to all in a Web video recently that showed a leering Uncle Sam preparing to do a pelvic exam, was for the past TWO DECADES—the Republican Health Care Plan. Yes, it’s a Republican baby, paternity confirmed on public record, conceived in response to the Clinton health care plan of 1993, and built on the foundation of an individual mandate to purchase insurance from private insurance companies. A Republican governor (what was his name again?) actually implemented this plan and Republicans continued to advocate for it—right up until the time a Democratic president proposed it in the apparently mistaken belief that Congressional Republicans could at least be persuaded to vote for a Congressional Republican program. “Hah! Consistency? We spit on consistency! Though foolish consistency is the hobgoblin of small minds, and we have small minds, and are foolish, we reject consistency as it is much less important than denying health care to the poor and a victory to the Muslim president whose socialist plan will result in a windfall of profits for private insurance companies and…Never mind! Remember what we said about consistency!”

The history of the Republican plan was described by Ezra Klein in the New Yorker. Briefly, in 1989 the Heritage Foundation published “Assuring Affordable Health Care for All Americans,” which suggested that all individuals be required to purchase health insurance (like they must auto insurance). Then in 1993, as an alternative to the Clinton plan, the Republicans included the individual mandate in their Health Equity and Access Reform Today Act (sponsored by John Chafee, RI and co-sponsored by 18 Republicans). In 2006, Sen. Ron Wyden (D, OR) and Bob Bennett (R, UT) sponsored the Healthy Americans Act (11 R and 9 D co-sponsors). Broad Republican support. No Uncle Sam ob/gyn videos…until president Obama changed his mind in 2009 and used the Republican plan to design the Patient Protection and Affordable Care Act. Then the blue-blooded, rock-ribbed Republican baby morphed into the evil Obamacare.

So what exactly is in Obamacare that inspires such vitriol and hatred from Republicans? What makes Georgia state insurance commissioner, Ralph T. Hudgens, say he will do “everything in our power to be an obstructionist.” Well, Obamacare tries to help poor people, and that ought to be enough right there, don’t you think? But besides that, what’s in the plan? Fasten your seatbelts, folks, and raise the blast shields, because here’s a straight look into the maw of hell that is Obamacare, which proposes to:

  • Prevent insurers from denying coverage or charging higher premiums to those with preexisting conditions, and from rescinding coverage after people have required expensive care
  • Require plans to cover preventive services without cost-sharing (deductibles)
  • Allow children to remain on their parents’ insurance up to age 26
  • Eliminate lifetime limits on coverage
  • Raise Medicaid eligibility to 138% of federal poverty level
  • Create health insurance exchanges in which people without employer or Medicaid coverage can buy insurance (and cost-sharing for some of those who need help paying for it)
  • Require everyone to have health insurance beginning in 2014 (the individual mandate)
  • Require plans to spend at least 80% of premiums on actual medical costs
  • Penalize employers that do not offer affordable coverage to their employees (with exceptions for small employers)

OMG! OMG! Insurers can’t drop you when you get sick or get so sick that you cost too much! They can’t deny you coverage because you had asthma when you were young? They have to spend 80% of the premium money you pay them on actual medical care (note that Medicare spends 96% on medical care)? Help, help! Call the Thought Police!

You know, I’ve looked at more detailed summaries of Obamacare (see this summary from the Kaiser Foundation) and I’m still looking for the evil. The only evil I can come up with is that it’s not Medicare for All—but that’s because it’s a Republican plan, now isn’t it?

Grover’s Gonna Gitcha, Mitt

First, I guess a shout out to Chief Justice John Roberts for his completely out of character decision to step away from the side of the knuckle-dragging apologists for the plutocracy and do the right thing by upholding Obamacare*. And if you disagree that this was uncharacteristic of him, show me a Republican who was not surprised by it. Good on him. Won’t hold my breath waiting for a repeat performance, but I’m willing to be pleasantly surprised. One more like this and maybe Scalia will have an actual seizure, rather than just simulating one in his dissenting opinion.

But given the reasoning behind the court’s decision, to wit, that the individual mandate was constitutional because it is technically a tax (and of course Congress does still retain the power to tax), I’m really wondering about the effect of this on Mitt. Why? Because Mitt established a similar insurance mandate in Massachusetts, and that means he’s in violation of his pledge to Grover Norquist not to raise taxes. Now that evil, ankle-biting gnome is going to have to run honking after his party’s standard bearer like an angry goose, demanding penance (or perhaps one of Mitt’s overseas bank accounts).

Which reminds me. All these Congresspeople who signed Grover’s pledge. How, exactly, does a pledge to a someone who doesn’t even live in your district somehow take priority over your responsibilities to your job? “Oh, I promised!” Oh, right, like your other promises ever meant squat. And what sense does it make to promise to anyone that you’ll never, ever do anything? I mean, I’m about as anti-war and anti-foreign-misadventure as it gets, and I’d certainly like my leaders to promise to try to avoid war, but I wouldn’t for a minute think it was sensible to promise never, ever to go to war no matter what.

Oh, and when Grover drowns the government in his bathtub, if Mitt is president then, will he go swirling down the drain along with Social Security and Medicare? Or will those 2 good programs reject his presence and allow him to float to the surface like water was supposed to reject a witch in medieval times?

*As per a previous post, I think President Obama should get full credit for this very important (but still preliminary) step in reforming American health care. Let his name stay attached so everyone who now has access to health care and wouldn’t’ve before knows exactly who to thank.

Obamacare

So, I read that the hero of the South, Rick Perry, has as one of his main platforms repeal of the Affordable Care Act, which he charitably refers to as “Obamacare.” He and all the other Republicans who bandy this term about seem to think it’s a smart move on their part to link President Obama very tightly to health care reform. That way, all the people who would’ve gotten thrown off their health insurance plan for getting too sick, or who got too sick to work and then couldn’t buy coverage at any price would know who to blame for them still being able to get medical care. Good idea, Republicans. For once I agree with you. Mr. Obama deserves full credit for being the first president in American history to get a majority (barely) of Congress to agree that civilized countries ensure their citizens are cared for when they are hurt or sick, rather than the “survival of the richest” medical plan that is the essence of Republican health care policy. Yes, this is Obama’s care plan and I thank him for it. You will too if you lose your job and then get sick.

 Oh, we can’t afford it? I say we can’t afford foreign wars that attempt to reform the unreformable and a war machine that can fight any country anywhere anytime that we say threatens our “interests”. We can’t afford to have multi-billion dollar corporations pay little or no taxes just so their leaders and owners will donate to right-wing candidates (to be fair, they’d donate to left wing candidates that would also maintain their breaks). Let’s take care of Americans for a while.