I woke up New Year's morning with a nervous stomach. It was finally 2012, the year that I'd been talking about casually since people started asking me, "will the Affordable Care Act survive?" As I wrote in the epilogue to my new book, Fighting for Our Health: The Epic Battle to Make Health Care a Right in the United States, health reform has to jump two big hurdles in 2012 to survive. The first is the Supreme Court ruling on its constitutionality, with three days of oral arguments in March now just a few weeks away. The second, of course, is the election for President.
On the campaign trail in Iowa, Rick Santorum baldly revealed why the right is so intent on killing the promise of good health care for all: Santorum said it would make people "dependent" on the government. As I write in my book: "The right understands that if the Affordable Care Act is implemented, it will create a bond between the American people and government, just as Social Security and Medicare have done. The last thing that the corporate and ideological right want is for a new health care pillar to be added to the foundations of government social insurance."
The battle over the Affordable Care Act needs to be understood in its historic context. While the legislation that passed was certainly compromised from an ideal law, it will for the first time - when its key measures are implemented in 2014 -establish a government responsibility to make decent health care affordable to almost everyone. Following a century of failure, during which the United States emerged as the only developed nation to guarantee health care, the passage of the ACA needs to be understood as a remarkable accomplishment.
That history weighed over the battle that began in 2008, when I helped found Health Care for America Now (HCAN), a coalition that as health care historian Paul Starr told me, was the first time that there was a major grassroots, field campaign to pass reform. Fighting for Our Health is the story of that campaign, starting from its early roots in 2003, when Yale professor Jacob Hacker (pdf) and I (pdf) separately developed a new policy approach, the public option. We each envisioned the public option as a way to bridge the gap between those who championed single-payer government health insurance and reforms based on expanding private health coverage. As I write: "It is impossible to overstate how important the idea of the public option was to creating the powerful unified coalition that became HCAN."
One of the major goals of the Affordable Care Act is to close the Medicare prescription drug coverage gap, better known to most as the "donut hole." The law will fill that hole over a decade, and in 2010, that meant many seniors received a $250 rebate check.
"Richard Foster, the Chief Actuary for the Centers for Medicare and Medicaid Services (CMS), has said that "in theory," seniors would have to return the checks if repeal becomes law," the letter reads.
Yes, Leonard Lance, Jon Runyan, Frank LoBiondo et al. literally just voted to take $250 from seniors with large prescription drug bills. And since the elders of their party -- LoBiondo, Smith, Frelinghuysen et al. -- created the "donut hole" system in the first place it's obvious they really do want those seniors to owe the $250.
Here's Cantor's unreassuring response:
"If a repeal bill passes and there's any uncertainty as to whether those checks would have to be recaptured, we can speak to that then,"
I don't see how they will "recapture" 2010's check, but they sure want the ones for 2011, 2012, and especially 2013.
I wonder how many of the people shot at the 8 January assasignation attempt on Rep Gabby Giffords have the insurance coverage to pay for the care they received.
The Cook Report has shifted NJ-6 from Solid Democrat to Likely Democrat, as Frank Pallone's lead on Tea Party approved Republican Anna Little dropped from 12 points to 7 with a week to go.
Now comes Chris Christie hard-charging for Pallone, calling him "the sponsor of Obamacare". Obamacare being pure dogwhistle pitched to get people who may be without health care coverage themselves to agitate against what may be their own best interests. Yet another signal that Chris Christie's take on New Jersey is temporary.
With this ad, Christie allies himself with the shriekers, screamers and name-callers of last summer's Town Halls on health care reform. With this ad, he chooses a Tea Party candidate to pump, defusing some of the lingering resentment from the uber-right that Christie isn't 'conservative' enough, that Steve Lonegan was better.
Most importantly, Christie becomes a huckster for the national stink bomb that is the far-right's gross distortion of health care reform; not that it's problematic because it doesn't go far enough or fast enough, but for them that it dares to tie any responsibility or requirement at all to insurance companies making vast sums. Worse, with New Jersey having the 9th-largest number of uninsured people in America, quite a few of those 1.2 million living in Middlesex, Monmouth, Somerset & Union counties that comprise NJ's 6th congressional district, we now have a Governor huckstering for the right-wing on their national issues - not his state issues - flying around the country doing favors for Republicans he can collect on later, and screwing up just about everything at home. Good plan!
It's been a little over 24 hours since the Patient Protection and Affordable Care Act went into effect. Now, we have real reform that lowers costs, holds insurance companies accountable and guarantees more choice for consumers. Together, we fought against and beat back powerful special interests and partisan extremists to deliver real results and meaningful reform for Central Jersey's middle-class families. Not only were we able to ensure that this reform would be deficit neutral, it will even lower the debt by slowing the growth rate of health care costs. And this was all done in an effort to bring about better, more-accessible, high-quality health care for all.
more below the fold
"I certainly in my legislative district feel comfortable making the case healthcare reform - for the reform the House adopted," Wisniewski added. "I believe John Adler made the right decision for his district. He knows his district."
Obviously, Wisnewski wants us to understand this as just another vote. It's not unusual, after all, to see members feel pressure. Democrats have picked up Republican votes in swing districts this way from time to time. So we hear that it is just necessary politics, and it's the voters' fault after all. Adler is admirable for siding with the Republicans in his district. Even if Wisnewski doesn't really believe this, he surely thinks his job to publicly support his incumbents. Political parties, after all, are as much about a group gathering and holding onto power as they are about advancing some noble principles.
But principles do come into it, especially for ordinary voters and the activists who make up "the base." The Democratic base is very unhappy with John Adler, because this wasn't just another vote. We all know the Republicans decided to oppose a moderate bill to destroy Barack Obama's Presidency and the Democratic Congress, openly admitting that they aimed to make it his "Waterloo." Meanwhile, Democrats, as Ted Kennedy's beautiful memoir reminded us, have been fighting for universal health care for over a generation, and Obama and Adler promised health care reform in their campaigns. In this context, for Adler to join the other side and attack the bill was an astonishing betrayal. (Let me say, too, that his announcements in both votes came while we know frantic negotiations with Stupak et al. to round up votes were still going on; I believe Adler was not "released" by leadership.)
Perhaps Wisniewski would think we're worrying too much about a bill, that after all, passed anyway. But I would remind him, and any other party leaders, of the tremendous disasters of the last decade. You see, to the people who vote and volunteer Democratic, from 2000-2008, and even earlier, the disasters were not solely due to Republicans. Democrats acquiesced as Republicans lead us into those disasters. Some Democrats in Congress voted to invade Iraq, not only due to their "districts" but many because they thought it would help their presidential campaigns! Some Democrats voted for the Bush tax cuts that wrecked our finances. Some Democrats voted to dismantle the system of financial regulation that had served us since the New Deal (I include the 1990s votes here) returning us to the pre-FDR world of financial panics every decade. Democrats voted to curtail civil liberties. They agreed to torture detainees and bypass the court system. In short, Republican administrations have easily found Democrats to go along with every lousy, disastrous, extreme conservative idea they could dream up. (Only on privatizing Social Security in 2005 did Nancy Pelosi finally keep Democrats together to say no, or rather, "Never. Is never good enough for you?")
And so, I fear, and I suspect many in the base fear, that John Adler has shown that the lessons he learned from the Bush (43) Administration is that the cowardly Democrats, the Democrats who voted with the conservatives, were the smart ones. This is why, I think, Adler's no vote on health care reform is even worse than a vote to abandon one core principle and undermine his party's President. if John Adler remains in Congress long enough, and finds himself in Congress with a Republican Administration, for all I know he'll be voting to invade Iran, end the inheritance tax, deregulate the banks, or give Social Security to Wall Street. It could be any crazy conservative idea, because "It's the right thing for his district." I definitely don't want Republican Jon Runyan to win. I'm even putting my time into that. But the truth is, I no longer really want Adler to win.
Blue Jersey readers, what do you think? Am I too harsh? Do you feel otherwise? Should Wisniewski defend Adler's vote?
The House has just approved the Senate bill 219-212 (roll call), but as we wait for the House to act on the Reconciliation Bill, we will start to post (excerpts of) official reactions as they come in. Feel free to share your own reaction and responses. I understand President Obama will make a short statement later tonight and I have embedded the player after the jump, or you can go to White House Live.
"For me, the debate about health insurance reform always has been about the families who struggle to secure the coverage they need. It's about the small business owners who face rising premiums. It's about the seniors who can't pay for their prescription drugs," Holt said. "In supporting reform of our broken health insurance system, I stand with the families, seniors, and small businesses who I represent and who will soon have greater control over their health care."
"Health care reform has been a long time coming - almost 100 years in the making. Yet, as soon as the President signs this into law, benefits will be felt immediately," Holt said. "Small businesses will be able to receive tax credits to purchase insurance, insurance companies will be banned from dropping coverage when someone gets sick, and seniors confronting the 'donut hole' will receive $250 to pay for prescription drugs."
Frank Pallone:
"The history of failed attempts at health care reform reaches back decades," said Pallone. "But more important than the historical achievement is what the reformed system will do for everyday Americans. We aren't just making history, we are making a better health care system."
"Our health care system is in crisis, millions of Americans are going without insurance, and rising health care costs are bankrupting many American families, said Pallone. "The reform bill will stop insurance company abuses, lower health care costs and give almost all Americans quality health care coverage, the same as members of congress."
Bob Menendez:
"From the beginning, we approached this historic legislation with one simple truth in mind: good, affordable health insurance should be a right, not a privilege for the wealthy. The health of American families should never be viewed simply as a commodity used to maximize profits. Yet, millions of families struggle every single day with health insurance that is unaffordable, unreliable or unavailable. Today, we have accomplished insurance reforms sought for generations that will protect the health and economic security of our families and our nation in three main categories.
President Obama's remarks to the nation:
Good evening, everybody. Tonight, after nearly 100 years of talk and frustration, after decades of trying, and a year of sustained effort and debate, the United States Congress finally declared that America's workers and America's families and America's small businesses deserve the security of knowing that here, in this country, neither illness nor accident should endanger the dreams they've worked a lifetime to achieve. (continued in full, in Comments)
I was in D.C. yesterday at the Code Red Rally to Kill the Bill on Capitol Hill. You've already heard the most egregious news:
Congressmen John Lewis called a nigger. Congressman Barney Frank called a faggot. Congressman Emanuel Cleaver spat on.
An afternoon in the sun with my overwrought, but politically/historically illiterate, countrymen is an eye-opener. Reasonable arguments can be made against this bill - from both sides - but I heard none of them yesterday. What I heard convinced me more that the Tea Party, out in force in our nation's capital, is likely to do more harm to the GOP than it may do to us. From a civic perspective, I have to like that the Tea Party brings out masses previously disengaged, but as yet they haven't moved beyond fist-waving. They generate noise, but so does a tantruming 3-year-old, with as much historical perspective.
We encountered mostly non-voters (I asked) who wanted to "take over" Congress with no recognition of the irony that they already have the power to do that, but fail to exercise it. The rhetoric was 100% spewage from Glenn Beck in a universe where talk show hosts are deemed 100% credible.
These people simply didn't know stuff. Old guys on Medicare "horrified" at government health care. A lady: this "takes away my Medicare." Her friend: "no, it means we have to take Medicare whether we want to or not." Reconciliation demonized, but eyes glaze with the news that all major changes in health care in 3 decades came via reconciliation ... and Republicans use it too.
Tea Party tries to liberate
Rayburn Office Bldg. (click to enlarge) After a couple hours rallyers were supposed to lobby. But it was a nice day, and lobbying's not fun like a lawn party. So, as conservative star power like Michele Bachmann (R-Minnesota), Mike Pence (R-Indiana), Tom Price (R-Georgia) and Marcia Blackburn (R-TN), and a coiffed, shiny Jon Voight moved among adoring white people, rallyers re-applied sunscreen and looked for trouble. A mob tried to liberate the Rayburn House Office Building, bewildered as to why Capitol Police denied them overtake of the building.
It's mind-numbing how many of these people are uninsured themselves and can't do the math that they're working against their own interests. Joey Novick got great video of the confused. This is your opposition:
Zero health coverage, doesn't want the govt to euthanize him
Lady Liberty wants her freedoms (but has no zero health coverage)
The bill is imperfect, the process bloody and the stakes high. At the end of the day, we'll know where we stand. This is what democracy - and the crafting of sausage - looks like today:
Ronald C. Rice: Message To Wavering Congressional DEMS: With this information, please grow a backbone and pass what we sent you to DC to do in the first place. Rep. Adler, we are watching, please don't let NJ and those that supported you when you supported President Obama down [snip]
Ronald C. Rice:... and that's why you can start calling his opponent Congressman Runyan. I rather have a Republican in that seat that I know is a an actual Republican than one that supports Obama and progressive politics to get elected and then acts like a Repug. Good riddance to him and all fair weather DEMS, we hardly knew ye all.
What the hell does it say about the re-election chances of the hard-won candidacy of Rep. John Adler, when an almost comically insubstantial candidate like Football Republican Jon Runyan can issue a testosterone-charged message like You can run but you can't hide as he did when he formally got into the race last night. And have it all be taken seriously. Which, it is - and should be - but only because of how Adler squandered his own chances, and poorly served the people who needed him most.
Runyan? Really? Burlington County voting records show he registered as a Republican November 10, 2009, 1 day before the news that he was his county's choice to lead the charge against Adler. Between 2000, the year Runyan registered to vote in Burlington, and 2008,
Runyan only voted in 5 general elections, sitting out 4. He has no record of money contributed to political candidates. Some football players are very smart - my father was - so this isn't about football-players-are-dimwits. But there's nothing in this guy's record or history that suggests he's even a particularly civic-minded citizen, let alone a man who should be deciding national policy.
And yet, this is who the Burlington and Ocean GOP (who are not as lost as last time) and the GOP in that little slice of Camden County have put their faith in to beat Adler.
And - wow - if that wasn't enough, it is Adler who's earning high praise from the Tea Party people. And now Americans for Prosperity, led in NJ by Steve Lonegan, is taking credit for Adler's stubborn refusal to enact health care reform, citing AFP-led rallies in Toms River and Marlton supporting Adler for not changing his vote.
Great. We've got Tea Party and AFP activists overjoyed with Adler, and the incumbent himself thumbing his nose at his party. And stronger politicians - like Newark's Councilman Rice - openly challenging him.
John Adler, you walked away from your responsibility to the people who needed you most in your District (Adam will have more on this) and played right into the hands of the far-right. I don't know who's going to knock themselves out for you this time, congressman. I do know quite a few people who were there for you last time, who will not be there for you again. Nicely played.
I've taken enough shots here at how the new health insurance exchanges don't start until years from now that I felt I should post on these benefits. Frank Pallone gave us a similar list last year. The main points are the temporary high-risk pool until the exchanges go into effect, thereby helping those who can't get insurance now, and a number of insurance reforms that protect people who already have insurance. Also, relief on the "Donut Hole" for seniors in the Medicare drug plans. In summary, there are significant benefits that John Adler should vote for even though major portions of the reform are not implemented immediately.
Youtube user ctrimarchi has just posted a fragment of John Adler townhall which is labeled as being from March 13 in Toms River. He is facing a crowd that sounds hostile to health care reform.
An audience member asks him about the Senate health care reform bill, correctly pointing out that if the bill is approved by the House it can be signed by the President and become law. There's no need for reconcilation or any other votes. So, he asks, will you vote for the Senate Bill?
Adler's answer sounds like a no and gets cheers, but I actually think it was evasive. (It may be that he said more, but the video "conveniently" cuts off and indeed may be deliberately misleading if he said more.) He says he would not vote for the Senate bill "if that were the final bill." But of course it is not the final bill, the point of having a second bill pushed through reconcilation is that some provisions will be changed. So Adler implicitly left open the chance of voting for the Senate bill, because he knows it will be changed in reconciliation. Needless to say, such positive votes would be welcomed at Blue Jersey and by most of the people who voted for Adler and Obama, and are opposed largely by people who will not vote for Adler anyway. I've expressed my skepticism that Adler will vote the right way but he has not closed the door. In his recent interviews he has insisted on seeing the actual reconcilation bill before deciding on his vote. We expect to see this bill this weekend, or Monday at the latest. The right wing is spreading some absurd propaganda that the bill will be passed without a vote, and I suppose if you think Saddam had nuclear weapons and W. was a good President you might be dumb enough to believe it.
Politico has posted a memo from Chris Van Hollen which went to Adler's district director amongst others laying out the timelime this week and giving some advice.:
I continue to encourage all of you not to get into debates about process and to try and persuade your Member not to get into process arguments either. At this point, we have to just rip the band-aid off and have a vote -- up or down; yes or no? Things like reconciliation and what the rules committee does is INSIDE BASEBALL. People who try and start arguments about process on this are almost always against the actual policy substance too, often times for purely political reasons.
John Adler has posted his appearance on Fox News Sunday to discuss health care reform. He appeared today with another "no" vote on the House bill, Jason Altmire (D-PA), who despite representing a district McCain won by 11 points, sounded considerably more positive about the possibility of voting "yes" this time instead of voting to "do nothing." Both Democrats say they've not made a final decision.
The highlights that in my opinion lead to a pretty clear conclusion:
Adler is again on Fox News.
Adler is still saying he needs to "read the bill first" which in this case, since the Senate bill has been available for months, means see the final deal for a reconciliation fix. But can any reconciliation deal truly be final before the House votes on the Senate bill?
Adler keeps talking about the needs of "my businesses" and cost containment, and not at all about the health needs of his residents. Indeed, if you visited from Mars, you would never imagine from the interview that he is elected by citizens rather than selected by business owners.
He wants to change the fee-for-service system, and isn't satisfied with the pilot projects in the bill. He wants to "mandate" that the "good pilot projects" (with good patient outcomes that save money) automatically go national. That's fine, but does it fit in reconciliation, and does a more radical program lose votes with more cautious members? As Wallace says, this was talked about for a year but didn't get traction. Also, usually reconciliation measures expire after ten years, so how could you wait to see how the pilot projects do and then mandate something for a year or two?
Adler is supposedly "pro-choice" but sits by silently as the "pro-lifers" openly hold the bill hostage. He's enabling them. If he cared in the slightest, he would at least say something, much less cancel out Stupak's switched vote personally.
Adler says he's had good recent conversations with the President and the Speaker, but she is "looking elsewhere" for yes votes.
Do you agree that adds up to a no? It infuriates me but that's what I see.
First up, President Barack Obama is at a 53% job approval rating (an improvement on the sub-50 showing last time). Disapproval is at 38%, so the the net +15 matches the margin he beat McCain by in 2008. His numbers with independents are 53-33.
On the other hand, the right track/wrong track numbers for the country are at 38-52, hardly surprising with 10% unemployment, massive deficits, and victory-less wars.
Democrats lead the generic ballot for U.S. Congress 47-39 with leaners. That doesn't exactly suggest many Democratic incumbents will be swept away, though I don't doubt NJ3 is a battlefield.
If the election were held today, Senator Bob Menendez would get 38%, a (hypothetical candidate) Tom Kean Jr would get 39%, Someone else gets 6%. Not the numbers we'd like to see, but not unfamiliar either. The pollster notes that Menendez did worse with the subgroup that was asked about him closer to the questions about health care reforms.
Senator Menendez is at 29-25, favorable-unfavorable, and Senator Frank Lautenberg is at 42-29. The negative ads of 2006 have been forgotten as Kean Jr is at 28-11. Kean was at 33-32 at the end of the last campaign, so you can see that campaigns matter.
As for health care reform, the numbers are lousy but not disastrous, as you know if you follow it in national polls. 37% think they will be better off and 42% think they will be worse off if health care reform passes. On the other hand, for the "country as a whole," "better" leaads "worse" 45-40. No doubt the numbers are dragged down by strong Republican opposition, but the two sets for independents are 31-35 and 41-33. The numbers are very striking by race, because only 28% of "Whites" think they'll be better off. Overall, 35% say they'd advise their memver of Congress to vote for a health care reform bill, 40% against, and 25% don't know. That 25% is more Democrats and Independents, so they need to be won over, perhaps by the reality of the bill helping them. (Cough, cough, too bad some genius designed most of the benefits to start years from now.)
Well, we're on the final push for health care reform and Democrats are rounding up every last vote they need. Here's the Wall Street Journal on John Adler:
Rep. John Adler (D., N.J.), a freshman who won a Republican-leaning district in 2008, is also undecided, after voting no last fall. He said the Senate bill did a better job containing health costs.
In an interview, he said he had spoken directly to the president about the issue and was not worried about Republican arguments that Democrats would pay a political price for supporting the health bill. "I think people shouldn't be worried about their careers. They should be worried about doing what's right."
He did emphasize cost controls in his previous criticism so it's pretty consistent. If you live in the district it might be good to phone. The Senate bill is well short of what progressives wanted, but I think we'd regret not having in ten years. There's also this interview with Fox News (I don't think this is same interview) where he is undecided, but he keeps emphasizing the viewpoint of business.
The grassroots movement that swept Obama into office sat back and relaxed following 2008's historic presidential victory, wrongly believing the job was done.
Oh ... really? I will acknowledge some post-election exhale, which I imagine they both enjoyed themselves. But, really, who sat back here? We elected a President who told us if we brought the hope, he'd deliver change. And yet, who sat back? Obama, and his people did. The activists have been calling for public option for months - hosting public forums, writing letters, lobbying. And the president is walking on the sticky paper of bi-partisanship, unwilling or unable to lead a majority-Dem Congress to reform, unable to inspire, unable for most of the time even to articulate his position. Or worse, making stirring public option speeches while undermining the effort by sending Rahm Emanuel and Kathleen Sebelius to whisper to legislators, No worries, he doesn't really mean it. The prez gets a partial-save for deftly maneuvering the truculent GOP into the party of NO wall recently. But it's too little, too late.
We called for repeal of ENDA and DADT, and he has not used his power.
A smart friend of mine said of this, The activists used their tools and power, to identify issues that need reform and elect those in support. The President has to use his tools and power - which is to make like LBJ and twist arms and drive strong legislation. We did our part, he didn't.
The players: President Obama, Vice-President Obama, and members of the House & Senate from both parties, including Rep. Rob Andrews, who chairs the House Education and Labor subcommittee on health.
The Location: Blair House, across the street from the White House, significantly at the President's end of the national Mall.
Interesting analysis of what the President's after today, from Marc Ambinder at The Atlantic.
Donor information for all the speakers is at Sunlight Foundation (info changes depending on who's at the microphone - turn off the sound at their site, if you're listening to our stream here).
Meeting started 10am, but I just grabbed the feed. Click the arrow to go LIVE.
Andrews, chairman of a health subcommittee of the Education and Labor Committee, is not a fan of the excise tax that's included in the Senate version of the bill and in President Obama's plan he outlined yesterday.
Information about the meeting, and the President's proposal, is at WhiteHouse.gov. The discussion might be interesting and I will try to watch it live Thursday 10AM. It will be streamed online.
As a practical matter, here are the possibilities Democrats face that don't involve completely craven surrender, and you should keep them in mind as the pundits and politicians talk:
A. Pass a comprehensive bill through the House (217 votes) and Senate (51 votes, but 60 to beat the filibuster first), whether starting over or by modifying the existing bills after conference committee.
B. The House passes last December's Senate bill with 217 votes. Not one word could be changed.
C. Pass health reforms that are budget-related through reconciliation, meaning 51 Senate votes (no filibuster) plus 217 House votes.
D. The House and Senate pass a series of smaller bills, each with 217 + 60/51 votes and lots of time used up in the Senate.
Option A seems highly unlikely, since 2009 was already wasted looking for Snowe's vote and a Democrat vote was lost, so we're into Options B+C. Pass the Senate bill (B), and "fix" it (excise tax, cough, cough) via reconciliation (C.) Some elements of Option D may also happen, for example, we're supposed to see a House vote on repealing the health insurance industry's anti-trust exemption.
The White House obviously has a loser mentality -- but America rallies around winners. Polls show that in state after state, voters hate the Senate bill and overwhelmingly want a public option, even if passed with zero Republican votes. More than 50 Senate Democrats and 218 House Democrats were willing to vote for the public option before, and the only way to lose in reconciliation is if losers are leading the fight. That's why Democrats in Congress should ignore the White House and follow those like Chuck Schumer and Robert Menendez who know that the public option is a political and policy winner.
Now that we know he is the one of the first two names that come to mind when you think "winner," I trust Senator Bob Menendez will never think he doesn't get praise from the left.
