Affordable Care Act: What's The Real Problem?

Economist Brad DeLong calls attention to a piece by Jim Tankerslee in Ezra Klein's Blog. Tankerslee explains the problems poor workers in Rome, Georgia have with the ACA as "due to a quirk in the law."

DeLong makes it very plain that it is NOT due to the law. It IS due to a decision by Justice Roberts and his cohorts on the US Supreme Court, coupled with efforts by Republican Governors and State Legislators who intentionally sabotaged the law.

Here is how DeLong explains it:

"The phrases "because of a quirk in the health-care law, and the fact that Georgia declined to expand Medicaid coverage for low-income people like him, Rizer can’t qualify for a subsidy to buy coverage" are not adequate. What Tankersley means is:

1. The ACA provides subsidies for people with incomes more than 1/3 above the poverty level to afford insurance via the exchange-marketplace.
2. The ACA provides coverage for people with lower incomes via the expanded Medicaid program.
3. Chief Justice John Roberts and the other four right-wing justices broke this system by giving individual states the option not to accept the federal money to pay for the expansion of Medicaid.
4. This was a lawless and unforeseen action: no precedent for it in previous court decisions and no warrant for it in the constitution.
5. Because it was a lawless and unforeseen action, it had never struck the minds of anybody drafting the ACA that the John Roberts, C.J., and his Four Horsemen of the Constitution-in-Exile would do such a thing.
6. Thus people with incomes less than 1 1/3 times the poverty level are left high and dry: since they are supposed to be covered by expanded Medicaid, there is no language in the ACA allowing them to claim subsidies.
7. If Roberts, C.J., had been a public-spirited an intelligent man, he would have realized that if he was going to rewrite the ACA to break its Medicaid expansion provision, he also needed to rewrite the exchange subsidy provision to provide people with incomes less than 1 1/3 times the poverty level with access to subsidies.
8. Roberts, C.J., did not do this.
9. Perhaps Roberts simply wanted to harm people with incomes lower than 1 1/3 times poverty who lived in states that would pick up the ball not to expand Medicaid he had given them and run with it, on the theory that creating an aggrieved class for whom the ACA is clearly not working would redound to the political benefit of the Republican Party.
10. Perhaps Roberts did not understand what he was doing.
11. In any event, Roberts rewrote the ACA from the bunch--and so left people with incomes like Donald Rizen's in red states with governors and legislatures who fear the Tea Party out in the cold. All of numbers (1) through (11) are inside Tankersley's "quirk in the health-care law". I know that that is what is inside Tankersley's "quirk in the health-care law". But how many of Tankersley's readers will know that?
12. The state of Georgia did, indeed--in spite of the protests of doctors and hospitals that want Medicaid expansion so they don't have to keep playing the shell-game of cost-shifting in order to raise the resources to cover the treatment of the uninsured--did indeed refuse to expand Medicaid.
13. And that is how the Governor Nathan Deal, the legislature of Georgia, John Roberts, C.J., and the Four Horsemen of the Constitution-in-Exile casually #@#&^ed Donald Rizen, a fifty-something with a bad shoulder, and many other Americans as well. All of numbers (1) through (13) are inside Tankersley's "quirk in the health-care law, and the fact that Georgia declined to expand Medicaid". I know that's what those clauses in Tankersley's article are really saying. But how many of Tankersley's readers will know?
14. And then comes the end of Tankersley's article: "When he visited the federal health insurance exchange Web site, he found the cheapest policy available to him cost $200 a month — one quarter of his current salary. 'Obama', he said, 'he thinks that he’s helping things, but he ain’t'. He fished out a bruised green apple and tossed it aside. Only a few boxes were left." Could there be a crueler irony? The original ACA--the one that Pelosi and Reid passed and that Obama signed--provides Donald Rizen with health-insurance coverage (Medicaid, admittedly, but coverage) for free. It is Republicans John Roberts, Nathan Deal, the legislature, and the Four Horsemen who have casually #@#&^ed him. But who does he blame? He blames Barack Obama."

Make no mistake. That is the Republican scheme.

Some Thoughts On Oriental's Future - From A Candidate

Ben Cox has posted some thoughts on his facebook page. If you are thinking about supporting him, take a look here. If you aren't thinking about supporting him, you should think about changing your mind. What does he think should be done? The information is here.

You should also write in Lili Stern and Barbara Stockton. If you want things done to improve the future of Oriental, Barbara Stockton is the only Barbara to vote for.

While you are at it, cast a vote for Lori Wagner for mayor. You'll be glad you did.

Oriental Town Board Special Meeting

Without getting into all the details (you can read about it on Town Dock), yesterday's special meeting of the Town Board confirmed that not a single incumbent, including the mayor, should be reelected.

In a nutshell, the four members of the Town Board who attended refused to adopt the mayor's proposed motion to sell Town water to Wal-Mart with no conditions. Then they appointed a committee to "negotiate" with Wal-Mart  before they capitulate. Committees spread the responsibility around.

I intend to vote for Lori Wagoner for mayor, Ben Cox for commissioner, and to write in votes for Lili Stern and Barbara Stockton for commissioner.

For those concerned about "wasting" a write-in vote, I remind you that one current incumbent, Warren Johnson, won his seat on a write-in vote. A vote for a candidate who either can't or is unwilling to do the job is truly a wasted vote.

Oriental Race For Commissioner

As Ben Cox announced at last week's candidate forum, he has started a facebook page for his campaign. He has just added an important note relating to the Town's law suit concerning South Avenue.

The issues concerning rights of way may seem complicated, but they really aren't. Those who are curious and also who understand that commissioners should focus on the future of the Town as well as the present can read his fuller explanation here. I recommend it.

2013 Oriental NC Candidate Forum On Line

Now that Town Dock has put the audio recording of last Wednesday's candidate forum on line here, I no longer have to rely on reports by attendees. I can hear for myself how the candidates responded.

That being said, I have heard nothing that changes my judgement. I support Benjamin Cox for Commissioner and Lori Wagoner for Mayor.

It's all about the future of the town.

2013 Oriental NC Candidate Forum

I received a pretty complete report from Wednesday night's Candidate Forum.

No surprises.

Nothing happened to change my judgments in my last post. I will vote for Lori Wagoner for mayor and Benjamin Cox for Commissioner.

Voting shouldn't be about charisma or other personality attributes - what matters is policy. Who has the best chance of leading Oriental into a better future?

Not the incumbents.

Town Of Oriental Elections

Out of town this week, so no posts so far. But tonight is a big event in Oriental - the candidate's forum. And voting starts tomorrow.

With ten candidates for five seats on the Town Board, voters will face some difficult choices. My advice: don't reelect any incumbents. I thought about posting my reasons, but decided against it. My reasons have to do with policy, not personalities, though in some cases it is hard to separate the two.

I don't know anyone who follows town affairs who believes the present Board has done well.

I will vote for Benjamin Cox. He has the knowledge and skills to contribute valuable insights to the Board.

Something to bear in mind is, voters don't have to vote for all five commissioner seats. There are good reasons to vote for the one or two that you support and no others. There is also the option of casting write-in votes. I could be tempted, for example, to write in Lilli Stern's name. I think she is going to contribute a great deal to the Town, whether in office or not.

I intend to vote for Lori Wagoner for mayor.

Time for a new broom.

Effect Of ACA On Different States: Those Expanding Medicaid Do Much Better

Here is an excellent report examining how different states do under the Affordable Care Act. The report has a good summary graph of the difference between states expanding Medicaid and those not expanding Medicaid. If state governments are concerned for the welfare of their citizens, expanding Medicaid is a no-brainer.

More On The History Of Republican Election Strategy

Yesterday I provided a link to an article by Michael Lind shedding light on Republican strategy. A strategy, by the way, that has been pretty successful as well as destructive.

Today I offer a link to an article in Salon.com by Salon's editor, Joan Walsh: http://www.salon.com/2013/10/01/the_real_story_of_the_shutdown_50_years_of_gop_race_baiting/

This new article complements the piece by Michael Lind.

I have been following the developments described by both authors for about seventy years. They pretty much hit the nail on the head.

Bruce Bartlett Predicts: Shutdown Will Defeat Republicans In 2014

Writing for the Fiscal Times,  Republican pundit Bruce Bartlett sees a possible Republican defeat in 2014 because of the government shutdown. His analysis is here.

Speaking Of Ponderous Matter

Yesterday's New York Times reported the award of the Nobel Prize in physics for the Higgs Boson, that gives mass to particles in space, or something like that. When experimenters at the Large Hadron Collider in Switzerland detected the Higgs Boson, it completed the verification of the Standard Model, which is a very big thing in physics.

The article explained the function of the Higgs: "According to this model, the universe brims with energy that acts like a cosmic molasses, imbuing the particles that move through it with mass, the way a bill moving through Congress attracts riders and amendments, becoming more and more ponderous and controversial."

What most needs explaining now is the origin of the New York Times' tortured analogy. My theory is that the Times had no science writer to do the article, but because of the shutdown of the US government, there was a political reporter available - one who usually covers Congress and to whom such an analogy makes sense. Otherwise, there is no rational explanation.

NC Health Insurance And Medicaid

Information is accumulating that the McRory Administration war on Medicaid and the General Assembly's refusal to expand Medicaid is fraudulent from beginning to end. And North Carolinians are suffering as a result.

Here is what NC Health News has uncovered. The bottom line is that NC Medicaid has one of the nation's lowest administrative costs instead of being 30% higher than similar states. But the incoming administration suppressed that information. They wanted an excuse to reject Medicaid expansion, which is a central element in keeping overall health care costs down.

Then the General Assembly prohibited the Insurance Commissioner from providing any assistance to Insurance companies interested in taking part in an insurance exchange. The News and Observer explains.

For ideological and partisan reasons, the Republicans in charge of North Carolina have intentionally sabotaged the Affordable Health Care Act and increased profits for Blue Cross/Blue Shield.

Expanding Medicaid would reduce costs and increase competition.

Lincoln On Political Extortion

“A highwayman holds a pistol to my ear, and mutters through his teeth, ‘Stand and deliver, or I shall kill you, and then you will be a murderer!’ ”

Abraham Lincoln, 1860

Tea Party Radicalism: Just A Bit More Extreme?

Much current commentary tends to describe the Tea Party phenomenon as just a bit more extreme than mainstream Republicanism, but within the American tradition. Francis Fukuyama recently tied the Tea Party efforts to the parts of the US Constitution that make it hard for anything to get done.

Michael Lind thinks it is more than that. It may have roots going back to Jefferson and Jackson (and to the Anti-Federalists, but Lind doesn't bring that up), but it represents a fundamentally anti-democratic undertaking. Think Downton Abbey.

Here is Lind's article. It is the best analysis I have read lately, putting it in the context of the American Civil War, the failure of reconstruction, and the reaction to the Voting Rights Act and Civil Rights Act.

There are a lot of different ways to look at current American politics. The different angles overlap, and they all seem to involve race to some degree.

I strongly recommend reading Lind's article.

On Rigging Elections In The West

How often would you vote if you had to drive 157 miles round trip to exercise the franchise? Not to mention being faced with racist harassment at the county seat?

Tomorrow at the ninth circuit court of appeals in Montana, the great-grandson of a Cheyenne who fought against and defeated George Armstrong Custer at the Battle of the Little Bighorn appears against the wife of one of Custer's descendants in a case over Native American voting rights.

The Guardian provides an account of what is at stake here.

It appears pretty clear that the dominant white residents of Montana (and South Dakota) have rigged the electoral system to make it virtually impossible for Native Americans to vote.

The plaintiff is a Northern Cheyenne and Vietnam veteran, wounded in defense of his country.

Personal note: my grandsons are Native Americans, and my wife and I have attended many Pow-Wows across the land. The opening ceremonies always accord special honor to both veterans and those currently serving in the US armed forces. In fact, I know no more patriotic Americans than those of Native ancestry.

Another personal note: in 1876, my great grandfather served in the U.S. 4th Cavalry Regiment in Texas. After Little Big Horn, the regiment was sent north to "round up" a band of Cheyenne and return them to their reservation. He subsequently rode with Billy the Kid in the Lincoln County Wars and is said to have served in the Indian Scout Service. I don't know the truth of that.

But I do know that across the West, Native Americans have been systematically impeded in exercising their right to vote.

The doctrine of White Supremacy is not confined to the states of the former Confederacy.

The Tipping Syndrome

One of the pleasures from browsing through blog sites on the web is the occasional discovery of a new and unexpected insight. The insight that "Republicans are the dissatisfied and angry diners at the table of life." is something that never occurred to me. I keep puzzling over the irrationality of their economic ideas, their rejection of science and facts, and their evident disdain for people who actually work for a living, but I never thought about their general dissatisfaction with the world as it is.

The blog post by Aimai goes on: "We've seen a lot of weird reactions on the right wing to the Government Shut down. These range from "it doesn't matter" to "its terrible" but one thing that really strikes me is the rage and antipathy that has been displayed towards Federal Workers themselves.  It doesn't strike me as unusual, but it does strike me as significant.  Yesterday's on air rant by Stuart Varney makes it pretty explicit: Federal Workers and, indeed, the entire Government are failing Stuart Varney. They cost too much and they do too little.  In fact: they are so awful they don't even deserve to be paid for the work they have already done. Contracts, agreements, and labor be damned. If Stuart Varney isn't happy then they deserve to be fired."

And it all relates to tipping. You have to read the post to uncover the connection, but it calls to mind North Carolina Governor Pat McRory's announcement that he wants the state bureaucracy to adopt a "customer service" mentality. I never knew what he meant. Now I understand. He wants the bureaucracy to act like "wait staff" in a restaurant angling for a tip.

If they can't take bribes, they can at least take orders, and "the customer is always right" - if, that is, he has enough wealth, power or other high status.

Seventy Years Ago On The Eastern Front: The Holocaust Is Discovered

Soviet forces advancing against the German Army enter the region of Khazary, a Jewish region, and find all the inhabitants dead.

The eyewitness account here paints a vivid picture of just what that means.

The horror.

Water For Wal Mart

At last week's Town Board meeting, Oriental Town Manager Wyatt Cutler claimed that selling Town water to customers outside the Town (i.e. Wal-Mart) is good, because we make money for the Town. Reference was also made to the fact that the Town agreed to provide water to the Dollar General store, which is also out of Town. Commissioner Venturi pushed the same line.

It is true that the Town has been providing water to Dollar General since they opened.

It is not true that the Town made money from providing water.

It's like the old joke: "we lose money on every sale, but make up for it in volume."

In fact, during the decade from 2001 to 2011, the General Fund (Oriental taxpayers) was subsidizing the Water Fund (water users, including Dollar General) an average of from $35,000 to $50,000 a year.

It could happen again if the Town isn't careful to keep rates high enough to cover ALL of the expenses of operating the water plant, including depreciation.

Town Of Oriental Municipal Elections Begin In Thirteen Days

Early one-stop voting for Oriental municipal offices begins at the County Board of Elections in Bayboro in thirteen days.

German Elections

Interesting article in Atlantic about German elections. It describes a very different form of democracy. I think it has great advantages over ours. Germany's system is one form of proportional representation, where the voters vote for the party whose candidates they wish to see in office. It isn't about individual candidates. Parties select their own candidate list. The number of candidates from each party who win office in parliament depends on how many votes each party receives. Those candidates higher on their party's list have a higher probability of gaining office.

I think there are many advantages to the proportional representation system. One advantage is that it almost inevitably creates more than two parties and to form a government requires forming a coalition. To some extent, parties have to make nice with each other.

Here is a link to the article.

There are differences from country to country in the details, but proportional representation systems have much in common. The political dynamics are very different from "first past the post" or "winner take all" systems like ours.

Economist Brad DeLong on "Three Kansases"

I'm not sure why economist Brad DeLong is writing from Kansas City, but he has posted some comments on the economics and politics of government in Kansas. I would like to say, "Toto, we're not in Kansas anymore - we're in North Carolina," but I'm not so sure.

Here is what he says:

"As best as I can see it, the majority political coalitions in these three different Kansas are as follows:

• In the Petropolis [Wichita area] right now, the majority coalition votes for lower taxes because the petrocrats have convinced the voters (correctly) that state taxes transfer money out of Greater Wichita to the Prairie and to the Blue Triangle [Kansas City area], and (incorrectly) that the citizens of Greater Wichita as a group benefit from more money in the hands of the petrocrats.
• On the Prairie right now, the majority coalition votes for lower taxes because the voters believe (incorrectly) that their state tax money goes to keep the African-American poor of Kansas City in idleness, and (correctly) that their tax money goes to support state colleges, universities, and high schools that teach evolution and "liberalism".
• In the Blue Kansas City Social-Democratic Triangle right now, the majority coalition votes for lower taxes because the voters believe (correctly) that their state tax money goes to support the Prairie, and (correctly) that they could get better value if they kept their state tax money at home, redirected it to lower levels of government to support their schools, roads, and parks, and so had social democracy in seven counties.
• Underpinning everything in all three areas, the majority coalition suffers from Fear of a Black President: Lots of people in Kansas's three regional majority coalitions appear to be thinking: "For 500 years we kept the Black Man down. Now somehow one of them is in charge. What would we do if the Black Man had kept us down for 500 years, and now one of us was in charge? That's right--we would try to disadvantage them, and so he is trying to disadvantage us, and we must oppose everything he wants to do, for if we cannot figure out how it is intended to disadvantage us that only shows that he is clever, and we must oppose everything he plans even more strongly."

I really wish I were joking. But that really appears to be how it is right now--really appears to be What Is the Matter with Kansas"

J. Bradford DeLong on October 01, 2013 at 10:34 AM | Permalink

Throw The Bums Out

The clear conclusion that any citizen of the Town of Oriental can draw from last night's Town Board meeting is that none of the incumbent candidates should be returned to office.

Not a single one has shown anything other than contempt or disdain for concerns of the citizens. None has shown any interest in seeking advice from citizens, many of whom have more knowledge and experience than those in office.

It was not always so. Those who held office from 2005 to 2009 were far more open to inputs from citizens than those currently holding office.

What can we do? A good start would be to replace the whole crew - lock, stock and barrel. In the vernacular - throw the bums out. All of them.

Elections start two weeks from tomorrow. Oriental voters begin casting early votes during one-stop on October 17 at the County Board of Elections in Bayboro.

Anarchist Extortionists Shut Down Government, Intimidate Fellow Legislators

On this day in which a handful of willful extortionists intimidated fellow party members and acted to shut down the US Government, it is worth remembering: we live in a democracy.

The government is us. We are the sovereign. The Tea Party zealots driving this action are not patriots, they are terrorists. They hate the United States. They fear and hate fellow Americans.

They despise democracy. They are having a prolonged tantrum.

Time to give them a time out.