The Republican response to healthcare exchanges – oblivious and shameless

Oblivious and shameless – two observations about Tea Party Republicans and healthcare exchanges.

I’ve had two minor epiphanies recently, both brought to me by (mostly) Republican-led states and the Tea Party-dominated Republicans in Congress.

First, many Republican governors and/or state legislatures refused to implement health care exchanges in their own states. As a result, these conservatives gave up their state’s right to form a healthcare exchange and forced their citizens to use a big government federal program, all supposedly in the name of “small government” and “states’ rights.” Irony or hypocrisy? You decide.

Second, if you look at individual state healthcare exchanges vs. the big federal exchange, the state exchanges are doing pretty well. There have been the usual startup issues, but nothing like the SNAFU that the federal exchange had, and very early indications (subject to change, of course) are that the healthcare exchanges will do just fine in states that implemented their own. Part of the problem with the federal exchange is that it’s so large and has to cover so many different states that it’s a very complicated beast. And it has to cover so many different states precisely because those previously mentioned Republican-led states refused to implement statewide exchanges.

And now Congressional Republicans are holding hearings demanding to know why the federal exchange is so screwed up – after their own state parties helped create the exact conditions that led to the screw up in the first place.

What this whole sordid affair demonstrates to me is that a) the present Republican Party is oblivious to irony and/or hypocrisy, and b) that they are without shame.

25 replies »

  1. Blaming the Republicans for the ObamaCare fiasco is lame. ObamaCare was passed with 100% Democrat Party votes and 0% Republican votes.

    This stinker is all Democrat.

    When are Progressives ever going to start taking responsibility for the utter disaster wrought by their own political philosophy?

    ObamaCare like all Progressive social programs are developed not for the sick and needy, but for politicians.

    It’s time for all good citizens to understand that they can’t outsource their Christian duty to the poor, to greedy power mongering politicians.

      • Samuel,

        Right, it’s GOP program.

        That’s why it’s called ObamaCare and no Republicans voted for it and the Democrats will not allow anyone but President Obama to change it.

        Liberals live in an alternative universe that is the opposite of reality.

        • Brian,

          Who cares?

          And if it’s a GOP thing why is the GOP trying to get rid of it and the Democrat Party trying to impose it on an unwilling public?

          As usual, you’d have to be a complete imbecile to believe any of the Democrat Party blame games because reality tells a totally different story.

          My God, millions of Democrat village idiots are still blaming Bush for things even after Obama has been screwing things up all by himself for the last 5 years.

          The Democrats wrote ObamaCare.

          It’s primary architect, Democrat Senator Max Baucus even admits it’s a “train wreck.”

          Yes, the Democrat author of ObamaCare called it a “train wreck.”

          Maybe that scoundrel, GOP Speaker of the House John Boehner threatened old Max with abuse from IRS.

          Oh, wait! That’s what Obama did to average US citizens who disagreed with him.

        • Sam pretty succinctly answered your question, silenceofmind, but I’d like to add a point.

          The Republicans are trying to get rid of the ACA because they have been yanked far to the right by a vocal Tea Party minority, so far that what was originally a conservative version of universal healthcare is now considered too liberal.

          The Republican party leadership is far more conservative than the vast majority of their membership, much as the Democratic party leadership is more conservative than the vast majority of its membership.

          As for your “train wreck” quote, I’m afraid that you don’t know the whole story. Here’s what Max Baucus actually said, in context, from Slate:

          “A lot of people have no idea about all of this,” [Baucus] said. “People just don’t know a lot about it, and the Kaiser poll pointed that out. I understand you’ve hired a contractor. I’m just worried that that’s gonna be money down the drain because contractors like to make money … I just tell ya, I just see a huge train wreck coming down.”

          What would cause the “train wreck”? Insufficient awareness of how the law worked. Not the law itself. Neither at that hearing nor in the month since has the (always pretty mush-mushed) Baucus said the law itself would be a disaster if implemented.

        • Silence, I’m trying to get past how uninformed you are about even the basics of the ACA. You can have your own opinions, but you don’t get your own facts. “Obamacare” is largely the same as Romneycare and the GOP didn’t vote against it because they hate the idea, they voted against it because their prime directive is to oppose Obama on anything he attempts to do.

        • Sam,

          Did ObamaCare or did it not pass both houses of Congress with 100% Democrat votes and 0% Republican votes?

          Did its Democrat Party architect Senator Max Baucus not say that ObamaCare was a “train wreck?”

          You calling me uninformed is like a fart saying it doesn’t stink. It’s a lie.

          The entire ObamaCare mess is a cluster f#ck of Democrat Party lies. Obama promised that everyone could keep their own coverage under ObamaCare.

          That’s a lie.

          Only Obama’s union buddies and Congress and whoever else he favors, gets to escape the ravages of ObamaCare.

          Law that doesn’t apply equally to everyone is oppression.

          You people are defending oppression. What in God’s name is wrong with you?

        • silenceofmind, as Sam and I have both demonstrated, you are uniformed. It’s not a lie – we’ve demonstrated that it’s a fact. I understand that you may not like being told that, but getting defensive about it doesn’t help you correct it.

          I’ve got a friend who had his personal insurance policy canceled on him a couple of days ago, in fact. But ask yourself this question – was that the fault of the ACA (or Obama) or the insurance company who chose to cancel the policy rather than add the new coverage required by the ACA (pre-existing conditions, no lifetime maximums, contraception coverage, et al) but not charge for the new coverage?

          Obama did promise that everyone could keep their own coverage, and that’s turned out not to be the case. But was that a lie, or an unanticipated consequence? I think either could be reasonably claimed.

          I personally expect that my friend can probably find an alternative on the Colorado exchange (the state exchange is working pretty well) that will work well for him at a very similar cost to what he was previously paying. And if he chooses to stick with the policy that his prior insurance company was recommending as a replacement and that costs a little more than he was paying previously, that’s also his choice.

    • Where do I blame the Republicans for the Affordable Care Act? I blame them for helping create the problem with the federal healthcare exchange (ironically and/or hypocritically) and then shamelessly taking political advantage of it.

      And frankly, if I have to take responsibility for food stamps, Medicare, Medicaid, Social Security, and so on, I’m just fine with that. Just like I was OK with my own insurance costs increasing (I had, and probably still have, on of those “gold plated” insurance policies) as a way to ensure that others less fortunate than me can get health insurance at all. Knowing someone who died in part because he didn’t have health insurance and having family members who probably would have died young without insurance means I have some personal experience with this issue.

      And we’ve tried it your way in the past. We have the grand progressive social programs precisely because your way failed, and miserably. After all, people give charity to those within their own “tribe” and have historically been perfectly happy to let those outside their tribe starve and freeze. This way there is a minimum baseline that everyone, in tribe and out, is provided.

      I fail to see what’s wrong with that.

      • Brian,

        The Democrats created the federal exchanges all by themselves. Not one Republican in the Senate or the House voted for ObamaCare.

        Blaming ObamaCare on the Heritage Foundation or the Republicans is just plain stupid because they had nothing whatsoever to do with making it the law of the land.

        The Democrats did that all by themselves.

  2. The real horror Brian is not the exchanges state or fed. Go-lives are almost always temporary fiascoes, then things magically smooth out.

    The real horror is Republican state governors who have refused to allow the Medicaid expansion for their poorest residents. Purposely refusing to allow primarily federal funds to be used to provide basic healthcare for the indigent and needy is unfuckingconscionable.

    I am a Republican but never so dense as not to realize that we all pay for each others healthcare now. The ACA and Medicaid are just offering a more efficient delivery mechanism
    and better outcomes than emergency room visits with no followup care.

    • Frank,

      ObamaCare is not going to smooth out. It can’t because it is a total disaster by design.

      Then Speaker of the House Nancy Pelosi proved that when she said, “We’ll have to pass it (ObamaCare) to find out what’s in it.”

      If a Republican had made such an horribly imbecilic statement they would have been laughed to scorn.

      But liberals love imbecility from their own people.

      • Anyone laughing at that kind of statement from any political leader is ignorant of how legislation and rulemaking actually works.

        In the case of big laws like this, the legislation lays out broad principles and a few key provisions that cannot be violated. Everything else is regulation and rulemaking done by the Executive. Congress doesn’t get down into the gory details of how an exchange should function, but the Department of Health and Human Services does exactly that. And it’s those gory details that often determine exactly what a given piece of legislation does and means. Or, to paraphrase Pelosi, it’s the rules and regulations that determine “what’s in it.”

        This process is similar to product development. Congress is like a customer who wants a product made. The description of what that product does is the specification, and that’s analogous to the legislation passed by Congress. The rules and regulations are analogous to the details of how the product meets the specification – the individual circuits and gears of the product.

        • Brian,

          Legislative power is exclusive to the Congress. That’s what the Constitution says.

          Rule making by the executive branch combines all three branches of government and gives that power to the President.

          According to Enlightenment philosopher Charles Montesquieu, the definition of tyranny is combining executive, legislative and judicial powers into one man, group of men or institution created by men.

          ObamaCare and all Progressive social programs are tyranny because they depend on federal bureaucratic rule making which is the consolidation of government power into the executive branch.

          That means the Democrats only want social programs in order to commit oppression, that is impose their will on society.

          Please help the Tea Party in their efforts to repeal ObamaCare. It is truly a monster, a terrible threat to us all.

        • I think you are misunderstanding the Constitution a bit, silenceofmind. Allow me to quote the applicable passages:

          The Congress shall have Power… To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof. (Article 1, Section 8)

          The executive Power shall be vested in a President of the United States of America. (Article 2, Section1)

          Basically, once Congress determines that a Department is required, they write legislation that in turn vests the power of executing the applicable laws with that department. As the President is the head of the Executive branch, the execution of those laws is the President’s responsibility. Rulemaking is execution.

          If Congress wants to, they have every right to dive into individual rules and regulations, writing or overruling them directly. And they did so with respect to abortion in the ACA. But if Congress chooses not to go down to that level, then it’s the Executive’s Constitutional responsibility to do it.

      • I suspect I’m feeding trolls but I’m always willing to give benefit of the doubt to first meetings.

        First, you do realize the ACA is not an insurance policy but rather a framework of laws defining basic policy minimums and requiring that every citizen with minor exceptions will have a current policy in force or face tax penalties? Obamacare is an unfortunate misnomer since as Sam and Brian have pointed out Obama neither wrote it nor passed it. It’s not Obama’s program it’s the American people’s program.

        Second, our current model of business provided healthcare is a huge and horrible failure. I am a businessman and I do provide 100% gold plated coverage for all my employees because we’re worth it and we need it. That is an exception not the rule as more and more businesses cut back sponsored coverage or remove it altogether. Changes have needed to be made for 30 years or more. Try to disassociate your hatred of Obama whom I will happily loathe with you, from the Affordable Care Act. They are _not_ the same.

        Lastly, we have been arguing healthcare reform nationally since at least the 1960’s. Tens of thousands of manhours if not manlives, and billions upon billions of dollars wasted in endless debate. Time to shit or get off the pot. The ACA is going to need a tremendous amount of tweaking before it settles down and becomes the norm, just as Social Security required in the last century. Settle down though it will and normal it will become regardless of how much impotent shrieking and wailing and rending of cloth occurs during the process.

    • I was appalled with the SCOTUS decision that let states refuse the Medicaid expansion. It was a travesty of epic proportions, and IMO one of the most ideological decisions that the SCOTUS has made in a long time. The Roberts Court has set progress back decades (and I don’t mean that in a liberal, ideological sense – I mean in a “moving the country forward toward a better future” sense).

      • Exactly Brian, take Sam’s beloved North Carolina. All of it’s citizens are paying federal income tax which could be partially going to support healthcare for the poor and indigent in their state.

        However by refusing the Medicaid expansion Governor McCrory has allowed his citizen’s taxes to be shared by other states for this purpose while North Carolinians will have to pay additionally for the local costs incurred.

        That is not only evil, it is ignorant is well.

      • Brain,

        The Constitution gives the states the right to refuse Medicaid expansion.

        The Supreme Court savaged human rights by calling ObamaCare penalties, taxes.

        So be patient, the Supreme Court is doing its best to destroy the Constitution but they do it a little at a time.

        • I happen to agree that the SCOTUS screwed up when it called the ACA taxes – it should have been ruled Constitutional on the basis of the Commerce Clause instead. It appears that Roberts is trying to slowly weaken decades of Commerce Clause precedents, and the ACA was his opening salvo.

  3. The best case scenario for the ACA was for it to work like it did in Massachusetts. The only problem is that the Massachusetts model doesn’t really work unless you want more expensive health care and longer wait times for appointments.

    Complaining about partisanship now after the way the bill was passed is a waste of time. Bills like this have to be passed in a bipartisan fashion.

    • Henshaw,

      Massachusetts health care is financed by the federal government. Otherwise it would cause Massachusetts to become insolvent.

      Federal ObamaCare has no outside source of revenue to keep from causing federal government insolvency.

      ObamaCare is not only a disaster for health care, it is also a fiscal disaster.

      Only the free market can control costs. Government involvement in the markets and social programs ALWAYS causes complete ruin.

      • silenceofmind, do you truly, seriously believe that “Only the free market can control costs. Government involvement in the markets and social programs ALWAYS causes complete ruin?” I ask because I can’t tell anymore if you’re an uniformed tea partier or you’re a troll pretending to be an uniformed tea partier (aka a Poe).

        The free market is the most efficient way to control costs, but it’s hardly the only way. Tariffs, taxes, subsidies, even price caps are all ways to distort the market in order to increase or decrease costs, and they each have their advantages and disadvantages. History has shown that, generally speaking, protectionist measures put in place by governments are good for economies while they’re developing, and it’s only after developing a reasonably advanced economy and largely eliminating corruption that those protectionist measures become a serious drag on the economy.

        And that’s not even taking into account the fact that sometimes “lowest cost” isn’t the relevant metric.

  4. “these conservatives gave up their state‚Äôs right to form a healthcare exchange and forced their citizens to use a big government federal program” Good point. Hadn’t noticed that.