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.