Digby's Hullabaloo Posts

How Democrats fall into the welfare trap

by David Atkins

Digby and Dave Dayen have been doing a tremendous job of highlighting the ridiculous conventional wisdom that all of the GOP governors will opt in to the Medicaid expansion in ACA simply because the hospitals want them to. The CW assumes that Republican governors are driven purely by corporate greed, rather than a deep ideological commitment to the idea that the undeserving poor should be left to suffer out of a sense of Calvinist cosmic justice. For GOP governors and their base, there are two kinds of people: those who deserve to prosper and be happy and those who don’t. For them, the greatest injustice in the world is the taking of their tax dollars to assist the undeserving, and the removal of their private authority to abuse and exploit the undeserving.

Sometimes the definition of “undeserving” is based on race. Sometimes on gender. Sometimes on sexual orientation. Sometimes simply based on how much money one has, which in circular fashion is itself proof of one’s worth. Sometimes it’s all of the above. But for modern Republicans, it’s about much more than just the money. It’s about ideology.

Which in turn leads to a very important point that Digby made earlier:

But then that was always going to be a problem when they decided to continue to have a taxpayer funded program for the poor rather than a taxpayer funded program for everyone.

This is the heart of the problem. The reason that Social Security and Medicare are so popular is because they’re for everyone over the age of 65. From a financial and economic justice standpoint it would make sense to means test social security so that multimillionaires aren’t getting those government checks. But from a political standpoint it would be a disastrous conversion of a popular universal program into a welfare program for the less fortunate. Social Security works functionally and politically because everyone over a certain age is eligible for it. The same goes for Medicare.

By making Medicaid subsidies and targeted secondary populations like young adults and those with pre-existing conditions the liberal core of the Affordable Care act, we have once again taken what should be a universal program (Medicare for All) and made it less politically palatable by converting it into a safety net patch for the less fortunate. That in turn opens progressives up to the old liberal stereotype of someone who wants to take “normal” Americans’ money and give it to degenerate ne’er-do-wells, and also makes it easy for ideologically conservative governors to slash the most important part of the program, leaving only a few crumbs and a mandate to buy private health insurance for everyone else.

I’ve said it before: what made the New Deal so popular and effective was the fact that most of its programs benefited everyone (well, at least everyone white.) The Civil Rights Era alienated a huge number of Americans who weren’t yet prepared to see women and minorities as equally deserving human beings. For liberalism to be politically palatable for enough of the public, the benefits of liberalism cannot be seen as going overwhelmingly to people that suburban and rural whites consider to be less than fully deserving of the same empathy and basic rights that they themselves enjoy.

As the Affordable Care Act becomes increasingly associated with Medicaid, and as Republicans continue to demonize it as taking away Medicare money to give to “undeserving” people, the Affordable Care Act itself will be unpopular.

Democrats need not be shocked by Republican governors’ refusal to accept Medicaid funds, and they need not feel that the experience of the Affordable Care Act means that Americans don’t like “socialized medicine.” What Democrats need to learn from this experience is that Democrats need to avoid the welfare trap, and need to embrace the power of universal social insurance.

Universal social insurance has always been popular and will remain popular when implemented. It’s just a matter of having the courage to enact it in the first place.

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Talking the talk on Medicaid opt-out

by digby

Douglas Holz-Eakin, who I understand used to be a sane person, has written an early rundown of Republican talking points for the Medicaid expansion refusal:

Obamacare included a provision requiring that states expand Medicaid to cover everyone up to 133 percent of the poverty line. States that refused would lose all federal funding for the state’s program. The Supreme Court ruled that this was an unconstitutional federal coercion of the states, a decision that mirrors the fiscal reality. Instead of states’ losing all Medicaid funding if they refuse to comply, the Court restricted the federal government to withholding only the federal funding for a state’s expansion. In short, the expansion is now voluntary.

The question that immediately arises is: “If this is such a good deal, why did Obamacare have to mandate it in the first place and enforce it with a draconian penalty?” Common sense suggests that if the expansion were such a good idea, then it would have been voluntary to begin with.

It goes downhill from there.

I don’t suppose one has to actually make the point that the idea of expanding health care in America, even when it costs the states next to nothing, does not have a consensus. After all, we have a fair number of people who either believe that health care is paid for by the medicine fairy or that people who can’t afford the overwhelming costs should just die:

Blitzer: You’re a physician, Ron Paul, you’re a doctor. You know something about this subject. Let me ask you this hypothetical question. A healthy 30-year-old young man has a good job, makes a good living, but decides I’m not going to spend $200 or $300 a month because I’m healthy, I don’t need it. But something terrible happens, all of a sudden he needs it. Who will pay if he goes into a coma, who pays for that?

Paul: In a society that you accept welfarism and socialism, he expects the government to take care of him.

Blitzer: What do you want?

Paul: What he should do is whatever he wants to do and assume responsibility for himself. My advice to him would have a major medical policy.

Blitzer: He doesn’t have that and he needs intensive care for six months. Who pays?

Paul: That’s what freedom is all about, taking your own risks. This whole idea that you have to prepare and take care of everybody —

Audience: [applause]

Blitzer: but congressman, are you saying that society should just let him die?

Audience:[shouts of “yeah!”]

Those are the people who are driving the political train in the red states right now.

The Democratic response to this seems to be that the hospitals will force the states to take the money because they need it. The only problem with this is that hospitals have been getting gouged for decades and haven’t been successful at getting more money for Medicaid. In fact, the pie has been steadily shrinking.

Which brings us to another of Holz-Eakins points:

Advocates of the law point out that the federal government initially picks up 100 percent of the cost, and commits to 90 percent of the cost at the end of ten years. For a state, that is attractive but far from a guarantee, so it has to figure into the calculation the probability that a cash-strapped federal government will choose in the future to shift costs to the states.

I would be sympathetic to this argument — indeed, I think it is a very real threat to the future health of the program — except for the fact that it will be these very same people cutting the funding (yes, with the help of Democratic useful idiots.) So, you know, it is a problem. But then that was always going to be a problem when they decided to continue to have a taxpayer funded program for the poor rather than taxpayer funded program for everyone.

He goes on to say that if states opt out the Medicaid population will be eligible for the subsidies, but that’s not true. Jared Bernstein explains:

[T]hose between 100-133% of poverty–who would have been covered under the Medicaid expansion–will now be eligible for the federal subsidies to buy insurance from the state exchanges, coverage which Paul VdW says “may be more costly than Medicaid.”

The problem for Doug, Sen. Coburn and other who are making this case is that there are about four times more people potentially eligible for Medicaid below 100% than between 100 and 133%. As the figure below—from some very timely Urban Institute research—reveals, there are 22.3 million uninsured poor and near-poor people who would be eligible for coverage under the Medicaid expansion. But about 80% of them—17.8 million—are below 100% of poverty and therefore not eligible for subsidies.

All the people in the left category are going to be out of luck.

And, once more, Holz-Eakin makes the diabolical argument that the overall costs will now bust the budget because that smaller number will get the more expensive subsidies. The only reason that would happen, of course, is that the Republican Governors refuse the Medicaid money and therefore put them into the subsidy pool!

And then there’s the usual nonsense:

A superior option would be the flexibility to address the needs of the sub-poverty populations on a state-by-state basis in ways consistent with each state’s norms.

Right. And if a state’s “norms” is to let people die it would be wrong to interfere. People are different! We shouldn’t inflict our values on them. Letting some Americans languish in poverty and illness and die early preventable deaths while others are allowed to have health care and security — all on the basis of some arbitrary lines drawn up long ago — is a perfectly respectable moral position. No biggie.

I can’t tell the future. It’s certainly possible that the hospitals will turn the screws on the Governors and force them to take the money. (You have to wonder why they haven’t exercised this clout before as the current system has been draining them for several decades, but …) This is one case where I hope the corporate powers that be are (accidentally) on the side of the angels. But if I had to guess, the politics of our time are such that it’s perfectly realistic to imagine that a whole bunch of states will opt-out and that Democrats will stand there, shocked and paralyzed, when it turns out that they actually believe the bullshit they spew. Again.

Update: Dday makes the important point that this is not about logic:

I don’t know why, given shared history, anyone would believe that logic will rule the day, and red state governors will go against their entire ideological worldview and spend taxpayer dollars – however small – to cover poor people, in many states largely people of color. And if you rely on this numbers game, if you never make a moral argument for WHY poor people shouldn’t have to choose between food or medical care, you have a whole bunch more problems than just this Medicaid expansion.

That’s right. This is the moral center of the ACA. The case must be made for these people. If it isn’t and everybody keeps being smug and indifferent to the fact that millions of poor people are going to get nothing in this deal — and especially if we are all exhorted to keep clapping because of the technocratic genius of the subsidies and the exchanges — I think we’ll know once and for all that the moral case was never the point.

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Who would Jesus taser?

I’m sure there was absolutely no other way to deal with this:

The religious ruckus happened at Victory Church at 1515 N. Kelly Ave in Edmond.

A woman was apparently playing a tambourine too loudly during Wednesday night services.

When she refused to stop, the woman was escorted out by an off duty Oklahoma County Sheriff’s Deputy.

Myers said, “He had to physically escort her outside the church. Once outside, she broke free from the deputy and tried to go back inside, there became a physical confrontation.”

According to the arrest report, the deputy was forced to pepper spray and tase the unruly woman.

Myers said, “She was not filled with the Holy spirit. She was not being very Christianly and this is why the folks decided to get her out as soon as possible.”

It’s a good thing that deputy had a taser because it was either that or shoot her.

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Via Think Progress:

Not a single Republican governor has pledged to accept the new Medicaid funds and three Democrats are also considering turning down the money. In total, these states would give up $291.4 billion in federal funds and leave 10,297,221 Americans uninsured.

Keep in mind that the federal government is picking up the entire tab in the beginning and will only require states to pick up a nominal amount after that. And since the whole point is to “bend the cost curve”, states will end up paying less than they are today. And since I don’t believe these people are completely ignorant of that, the only explanation is ideology. They do not want to implement a new “entitlement” for the working poor — people they believe are undeserving. And we know who they think those people are.

As Emptywheel points out:

The GOP frame for the Medicaid argument will not focus at all on insuring the uninsured. It will not breathe a word of how insured people subsidize uninsured people who use emergency rooms for care. Rather, it will extend and enlarge on this argument about a black President giving free stuff to black people (or Latinos in states like Texas). And I believe that will remain true even if Obama loses in November.

How could radical Republican governors not love engaging in that fight? It’s a damn good way to keep working class whites in the GOP party. It’s a damn good way to keep the base enthused. It’s a damn good way to distract from larger economic failures. It’s the same logic, of course, that has already led some of these firebreathers to embrace “Papers Please” laws that lose their states a lot of money.

Moreover, these same governors are already hard at work shrinking the number of people of color who will be able to cast their legal votes. Thus, the idea that these governors will have to respond non-Republican votes is weak, given that this fight will be accompanied by an effort to limit the number of non-Republican voters who can vote at all.

Finally, while I don’t think the TeaParty arose primarily out of racist resentment, I do think it has fed on it in the last three years. Given that fact, the likelihood its fight against Medicaid would get racist and ugly quickly is quite high.

Of course it will. That’s the underlying reason for many Americans’ obsessive hatred for the welfare state.

I really hope that the Democrats wake up to the fact that real human beings are going to suffer because of this and launch a counter-attack instead of smugly assuming that the states will come around in the long run so no need to do anything. In the long run a bunch of people will be dead who didn’t have to be.

I realize that the shiny exchanges are the technocratic centerpiece of the bill and the only thing that many wonks care about, but the Medicaid expansion is the liberal heart of this thing. So it’s a little bit hard to understand why all these Democrats are acting as if it’s a given that these governors will (eventually) sign on and in the meantime: shut up and clap louder. (Oh hell, I guess I just answered my own question, didn’t I?)

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Words To Remember

by tristero

From the NY Times:

By Saturday, John Yoo, a former Bush administration lawyer, was suggesting in The Wall Street Journal that there had been a catastrophic vetting failure in 2005 when the administration was considering Chief Justice Roberts’s nomination.

“If a Republican is elected president,” said Professor Yoo, who teaches law at the University of California, Berkeley, “he will have to be more careful than the last.”

Let’s remember that the next time some Republican con artist starts piously bleating about how Obama should make “ideologically neutral” judicial appointments.

Incidentally, Yoo, as always, is a criminally incompetent thinker. Again, from Adam Liptak’s Times article:

“The right is declaring defeat in the short term, and the left is declaring defeat in the long term,” said Pamela S. Karlan, a law professor at Stanford. She said parts of Chief Justice Roberts’s opinion in the health care case had laid the groundwork for legal doctrines that could roll back liberal programs.

Exactly, through his ruling, Roberts handed the far right gift-wrapped dynamite with which to demolish the New Deal. And he knows it, even if his less cunning or intelligent pals don’t realize it yet.

California’s Homeowners’ Bill of Rights: the power of progressive leadership

by David Atkins

Reading progressive blogs can be a depressing experience. There is so much bad news out there that it’s easy to get discouraged.

That’s why it’s important for us to highlight bright spots like California’s recently passed

I honestly don’t know how we can survive as a country with leadership this absurd:

“We’re opposed to it and we’re not going to have any part of it,” Branstad said. “But we’re taking our own approach. We want to put our own effort together to be the healthiest state, and we’re willing to help people who are willing to help themselves. But we’re certainly not going to buy into this federal effort. We’re going to fight it in every way we can.”

“We don’t believe the federal government when they say they’re going to pay the whole cost of this for the next three years,” Branstad added, “because the federal government is dead broke.”

Really? Well, I guess he’s assuming a Romney win, in which case the feds probably will repeal the plan or he’s talking to his own pals in the Party who are promising to squeeze it the first chance they get. Either way, the federal government is not dead broke — it can’t be dead broke — but the Republicans (and some very stupid Democrats) are acting like it is. Maybe he could have a word with them about it on the QT.

This is why they keep kids away from book learnin’

by digby

I love this story. Remember this kid?

Well guess what?

Jonathan Krohn took the political world by storm at 2009’s Conservative Political Action Conference when, at just 13 years old, he delivered an impromptu rallying cry for conservatism that became a viral hit and had some pegging him as a future star of the Republican Party.

Now 17, Krohn — who went on to write a book, “Defining Conservatism,” that was blurbed by the likes of Newt Gingrich and Bill Bennett — still watches that speech from time to time, but it mostly makes him cringe because, well, he’s not a conservative anymore.

“I think it was naive,” Krohn now says of the speech. “It’s a 13-year-old kid saying stuff that he had heard for a long time.… I live in Georgia. We’re inundated with conservative talk in Georgia.… The speech was something that a 13-year-old does. You haven’t formed all your opinions. You’re really defeating yourself if you think you have all of your ideas in your head when you were 12 or 13. It’s impossible. You haven’t done enough.”

Krohn won’t go so far as to say he’s liberal, in part because his move away from conservatism was a move away from ideological boxes in general.

“I want to be Jonathan Krohn,” he said, “and I’m tired of being an ideology, and it’s not fun and it gets boring and it’s not who we are as individuals.”

But a quick rundown of his current political stances suggests a serious pendulum swing away from the right.

Gay marriage? In favor. Obamacare? “It’s a good idea.” Who would he vote for (if he could) in November? “Probably Barack Obama.” His favorite TV shows? “The Daily Show” and “The Colbert Report.” His favorite magazine? The New Yorker. And, perhaps telling of all, Krohn is enrolling this fall at a college not exactly known for its conservatism: New York University.

“One of the first things that changed was that I stopped being a social conservative,” said Krohn. “It just didn’t seem right to me anymore. From there, it branched into other issues, everything from health care to economic issues.… I think I’ve changed a lot, and it’s not because I’ve become a liberal from being a conservative — it’s just that I thought about it more. The issues are so complex, you can’t just go with some ideological mantra for each substantive issue.”

The article says that he’s bucking the CW by becoming more liberal as he ages instead of more conservative, but that silly. When you’re a little kid you reflect your parents views. And many people, perhaps most, never question that and continue with that identification for the rest of their lives. A lot of us however, reach the age that this kid does, read a few books, talk to a few people and start to question what we’ve been told.

I suppose there are some Alex P Keatons out there who rebel against their liberal parents, but I think it’s more likely to be a right to left phenomenon. Maybe some of these kids go back into the fold after a while, but more stay with the liberal side.

This kid’s very smart. If they wanted him to stay conservative they should have kept him away from books:

“I started reflecting on a lot of what I wrote, just thinking about what I had said and what I had done and started reading a lot of other stuff, and not just political stuff,” Krohn said. “I started getting into philosophy — Nietzsche, Wittgenstein, Kant and lots of other German philosophers. And then into present philosophers — Saul Kripke, David Chalmers. It was really reading philosophy that didn’t have anything to do with politics that gave me a breather and made me realize that a lot of what I said was ideological blather that really wasn’t meaningful. It wasn’t me thinking. It was just me saying things I had heard so long from people I thought were interesting and just came to believe for some reason, without really understanding it. I understood it enough to talk about it but not really enough to have a conversation about it.”

This is why the 2012 Texas GOP platform comes out against teaching critical thinking.

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Polling shows Republicans fighting a losing battle on ACA repeal

by David Atkins

Greg Sargent has an excellent analysis of the polling on the Affordable Care Act today. The basic summary is that public opinion is nearly evenly split on the Supreme Court’s decision (and moderates are slightly in favor of it.) And as we’ve known for a long while, a majority of people want to repeal the law but keep most of its provisions. The mandate, of course, is the least popular part of the law, while making insurance affordable for those with pre-existing conditions and allowing those under 26 to remain on their parents’ coverage are highly popular.

But perhaps the most problematic polling number for Republicans is this:

This poll fielded following the Supreme Court’s decision upholding the heart of the Affordable Care Act (ACA) finds a majority of Americans (56 percent) now say they would like to see the law’s detractors stop their efforts to block its implementation and move on to other national problems…

Solid majorities of voters of every political stripe say the decision won’t impact whether or not they vote this November – though Republicans are more likely than Democrats (31 percent compared to 18 percent) to say the result makes them more likely to turn out.

The economy and jobs are top of mind for voters this election, not the intricacies of healthcare law. But the Republicans have spent so much time inflaming their base by painting the Affordable Care Act as a Communist takeover, that they don’t have much choice but to make full repeal of the law a rallying cry through November. The more they talk about it, the more voters will see Republicans as unfocused on their principal concerns.

As a policy matter, the fight will really be over implementation of Medicaid expansion. But as a political matter, that too is a losing battle for Republicans. Bright red states where Romney is already assured of victory won’t have any problem with letting poor people die due to lack of access to healthcare, but that won’t fly well with more morally sane parts of the country where the election will be decided.

Creating a fictional, terrifying alternate reality for rubes can be very useful for mobilizing one’s base and stopping key reforms. But it also has very negative political consequences and backfires over the long run as that base of rubes continues to shrink.

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Dispatch from Gilead

by digby

Via RH Reality check:

A Tampa woman whom we only know as R.W., was raped. She was treated by the rape crisis center, who gave her two emergency contraception pills, one to be taken immediately and one to be taken 12 hours later. When she reported the rape to the police, they uncovered an arrest warrant on R.W. for failure to pay restitution and failure to appear. After she was arrested, a Hillsborough County guard confiscated her second pill, claiming it was against her religious beliefs.

I can hardly get past the arrest. A rape victim reports her rape and is arrested on an old warrant for failure to pay restitution? Really? That’s the priority?

As for the allegedly “religious” guard, let’s just call her what she really is: a fascist.

If this is true, it’s an obscenity. But it’s a natural extension of what’s been happening with this hideous “conscience” exception to the law of the land. Taken to its natural extension anyone in authority can cite their religion to do whatever he or she wants , regardless of the law. When you look back in history you can see where that leads. In fact, America was formed by people who were desperate to get away from that horror.

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