Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts

Tuesday, November 11, 2025

Why I am (Mostly) OK with Democrats Caving on the Shutdown

 

One provision in the continuing resolution is completely unacceptable -- a provision allowing Senators to sue the government if their phone records were subpoenaed during the January 6 investigation.  This is part of the ongoing effort to ensure that Republican office holders are above the law -- unless the run afoul of Trump, of course.

As for the rest of the bill, I know it is an unpopular view on my side, but I really don't think it is so bad.  I do understand the argument that you should never reward a hostage taker or you will just encourage them.  At the same time, I also at least partly agree with JV Last that the Democrats are really better off losing this fight than winning it.

Last goes further than I am willing to go.  He says that the real issue at stake is not policy but power -- specifically, Trump's outrageous authoritarian power grabs.  I agree.  But I don't think the American people broadly understand that.  Trump's power grabs are just too remote and abstract for the average low information voter to get too excited about.  What does excite a low information voter is skyrocketing insurance premiums.  

Last proposes that Democrats refuse to open the government unless Congress admits Washington DC as a state.  Needless to say, that is not going to happen.  It will just make Democrats look like outrageous extortionists and sway public opinion heavily in favor of Republicans.  If DC statehood is too extreme, Last suggests some sort of measure to reign in ICE.  While I am all in favor of that, I still don't think it would command the sort of public approval that would translate into support for a government shutdown.  Alternately, he suggests releasing the Epstein files.  That just might sway some voters, Trump supporters included, but still probably not enough to make them support the Democrats in the shutdown.  But saving voters from skyrocketing insurance premiums -- now that is the sort of thing that
 lines up public opinion behind the Democrats.  And it did.  The only problem is that Democrats can only win politically by losing.  In other words, if Republicans had actually agreed to extend the subsidies, the result would have been that people's insurance premiums would not go up and no one would see what the big deal was about.  Voters will never give you credit for averting a disaster if things basically stay unchanged.

So Democrats lost substantively, which means that they won politically.  And we should not underestimate what they gained in the exchange.

The government is only open until January 30.  That means that if the Democrats really want to, they can do a shutdown all over again.

There are exceptions for the Departments of Defense, Veteran's Affairs, and Agriculture which are funded for the fiscal year.  That means if the Democrats do decide to do another government shutdown, Trump will be deprived of some of his most valuable hostages.  The country will not face the prospect of the troops going unpaid, veterans being denied benefits, or people losing their food stamps.  These were all factors in the Democrats' decision to back down.  They will not be issues in January.  Furthermore, the holidays will be over in January, so air traffic snarls will not be as bad.

Furloughed employees will receive back pay and fired employees will be reinstated.  This is highly significant because the whole reason for the shutdown was, quite simply, that Donald Trump and OMB Director Russ Vought wanted the shutdown as cover for a major power grab.  Vought made clear that he intended to use the shutdown to cancel widespread programs, most of them benefitting Democrats, and to engage in widespread firings of federal employees.  Actual number fired: 4,000.  The fact that they are being reinstated and that Trump is signing off on it effectively means that the power grab failed.  Senate Democrats, by shouting and waving their arms about healthcare subsidies and keeping quiet about the power grab gave Trump space to very quietly back down on it.  Of course, this victory will only be successful if people refrain from talking about it!

This just might sour Trump on government shutdowns.  After initially welcoming the shutdown, Trump has become increasingly eager to end it, once it became clear that it was hurting him, and Republicans in general.  Again, this shutdown appears to have been largely orchestrated by Russ Vought, who has been described as a competent version of Elon Musk.  I am not sure he is quite as competent as advertised.  Vought's 4000 firings included 1000 CDC employees monitoring infectious disease, from measles to Ebola.  Once word got out, federal officials assured employees that this had been an error and the firings would be reversed.  That sounds just like Musk.  In any event, Vought's power play appears to have backfired on Trump.  While it is no doubt asking too much to hope that Vought is going anywhere very soon, we can at least hope that Trump will be slower to take his advice in the future.

Trump has clearly violated Rule No. One of Smart Authoritarians, which is to save the unpopular stuff until you have consolidated complete power.  Trump has been doing so many unpopular things lately that I was beginning to be concerned that might be a sign he was confident that he had fully consolidated power.  I think recent events are clear evidence that he is not there yet.

The filibuster survived.  I know there are people on our side like JV Last and Matthew Yglesias favor ending the filibuster.  I agree on the sole issue of continuing resolutions.  It should not require the President, the House of Representatives and a super majority in the Senate to keep the government open.  The last thing we need in our government is the opportunity for the minority party in the Senate to make government shutdowns a routine way of doing business.  Last and Yglesias favor allowing the Senate to pass legislation by a simple majority so that if the dominant party wants to pass something unpopular it will have to live with the results.  Under normal circumstances, I would agree.  Passing legislation by a simple majority of the Senate should not be a radical, extraordinary, shocking measure.  Under normal circumstances, it should be routine.  

But circumstances are not normal.  We have a dangerous authoritarian in the White House and spinelessly compliant party in control of both houses of Congress.  If they want to pass unpopular measures and face a public backlash, I am fine with that.  What I am afraid of is procedurally authoritarian measures that are too abstract and obscure to attract public outcry, but pose a serious threat to democracy and the rule of law.  This threat is not hypothetical.  The One Bonkers Barbaric Bonanza originally contained provisions that would have prevented courts from enjoining government actions that was fortunately rejected by the Senate Parliamentarian as subject to filibuster.  Ted Cruz has proposed a bill that would add "riot" to the list of offenses that could result in RICO prosecutions.  The implications are truly alarming.  For instance, the October "No Kings" protests were almost entirely peaceful -- almost.  In Los Angeles after the bulk of the marchers had gone home, small crowds caused disturbances.  Under Ted Cruz's law, that alone might open every group involved in the "No Kings" protests to prosecution as a criminal enterprise.  The only Republicans I trust to vote against such legislation are Thomas Massie and Rand Paul.  We need to keep the filibuster alive to block such things.

Winning the shutdown give Republicans a Huge Political Headache.  Simply put, Republicans know that soaring insurance premiums will be wildly unpopular and have no idea what to do about it.  The vote is set for December.  That will give plenty of time for the public to see its premiums go up an pressure to build.  And if the vote to extend subsidies fails, Democrats have made completely clear who is to blame.  
Viewing Democratic tactics, a cynic might wonder whether the party, which failed to make the enhanced Obamacare credits permanent during the Biden administration, laid a trap for Republicans on an issue their rivals always failed to solve, especially under Trump.

To which I can only say, "Ya think?" 

PS:  In further good news House Republicans are just as outraged over Senators' giveaways to themselves as anyone else.  Though not prepared to continue the shutdown over this particular provision, they plan to move to strike it in separate legislation.  At last, a measure that will command overwhelming bipartisan support!

Sunday, November 2, 2025

A Brief Comment on the Government Shutdown

 I actually find it encouraging that Donald Trump is urging Senate Republicans to end the filibuster and they are refusing.

First of all, Trump specifically chose this shutdown.  He wanted it because he saw it as an opportunity to make power grabs.  Asking Senate Republicans to end the filibuster and reopen the government means that he no longer sees the shutdown as playing to his advantage.

Second, Republican refusal is doubly encouraging.  It means that Senate Republicans are not wholly subservient to Trump, but still see institutional interests to uphold.  It also means that they believe there may be a time in the future when Democrats hold the triple crown and Republicans may need the filibuster to block them.  I think this assumption is extraordinarily naive, but Senate Republicans are closer to the centers of power than I am.  Maybe they know something I don't.

Assuming there actually is such a chance, there are still good reasons to consider ending the filibuster for continuing resolutions only.  All our previous shutdowns have occurred with divided government, i.e., at least one house of Congress controlled by the party opposed to the President.  In other words, filibustering a continuing resolution is something new and a serious escalation.  I would prefer to see this option disarmed precisely so filibusters of continuing resolutions do not become a routine way of doing business.

I do want to see the filibuster retained other than for continuing resolutions.  We may need it to block who-knows-what insanity Team Trump may propose

Friday, October 24, 2025

Why I Think the Democrats Should Cave on the Government Shutdown

 

Yes, I get that if you make any concession to Donald Trump at all it will simply whet his appetite for more.  And I realize it is a very bad idea to reward hostage taking because you encourage more of it.  And I understand the Trump and Vought are just using the shutdown as an excuse to do things they were going to do anyhow.

But I still think Democrats should extend funding for a few more weeks.   

Why?

Well, first of all, it is not as though they are extending a full year, or even a few months.  It is just a matter of weeks.

Second, I really don't understand the politics underlying the shutdown.  Yes, I get that Democrats have chosen to take their stand on the area where they have the greatest advantage over Republicans -- healthcare subsidies.  That makes some degree of sense.  Only, this approach makes no sense at all.  Democrats are essentially trying to save Republicans from their own folly by extending the subsidies before anyone feels any pain.  Look, guys, you will never get any credit at all for the disaster you stopped from happening.  People will just go on with their lives and wonder what the fuss was about.  If anything, it will make you look like Chicken Little saying that the sky is falling when the subsidies are extended and nothing happens.

Third, I get that you are trying to bring pressure to bear on Republicans.  Hot news flash: It isn't working.  But you know what will put real pressure on Republicans?  People actually seeing their premiums spike. It is my understanding that after Hakim Jeffries and Chuck Schumer talked to Trump, they came away with the impression that he had no idea what is One Big Busted Budget was about to do.  AOC has also said that when she asks Republicans why they aren't concerned about spiking premiums, they say they don't really expect it to happen.  Well, actual premium spikes should clear all that up.  Touch a hot stove and all.

Health insurance premiums also have the advantage of being the issue that is easiest for Trump to cave on.  He won't yield any ground on ICE because they are his secret police.  He won't give way on tariffs because that is how he avoids Congress's power of the purse.  And he won't back down on rescissions and impoundments because that is how he punishes jurisdictions for voting for Democrats (along with ICE blitzes, of course).  While I find Trump's anti-vax approach to be baffling, there is at least some political sense to it.  He is trying to broaden his base by creating a MAGA/MAHA alliance.  I think he will alienate more people than he wins, but apparently Trump has a different calculation.

But Trump gains nothing -- nothing whatever -- by people's health insurance premiums spiking.  It hurts his popularity while doing nothing to advance his power.

A one-year extension would create a great issue for Democrats in the midterms (assuming you believe in the midterms).  They could point to the chaos that broke out when the subsidies lapse and warn that a one-year extension means a repeat unless you elect Democrats to make the extensions permanent.

The interesting question is going to be what happens when premiums jump.  Up till now, we could be sure that the Republicans would splinter, disagreeing on what to do and the more sane members would have to cut a deal with Democrats to get an extension.

What appears to happen now is that Donald Trump decides what to do and cracks the whip and all Republicans will fall into line, no matter how much they hate it.  I have no idea what Donald Trump will decide to do when premiums spike.  I don't think Trump knows either

Saturday, January 25, 2025

The Only Way to Defeat Trump

 

I see that JV Last and I agree that there is only way to defeat Donald Trump.  The secret is to get him on the wrong side of Rule #1 for Smart Authoritarians -- don't do anything unpopular until after you have consolidated power.

If Donald Trump successfully subdues our institutions to his will, then he can do unpopular things at will because there will be no countervening power structures to stop him.  Such is the situation in Venezuela today.  

But if he loses popularity before consolidating power, then our institutions will rediscovery their spines and start restraining him.

Trump is currently the most popular he has ever been -- either minimally under water, or slightly favorable -- and our institutions are cowering before him.  To some extent, this is normal.  Almost all Presidents enjoy a honeymoon of strong popularity and institutional sycophancy at the outset of their terms.  (The first Trump term is a notable exception).  The honeymoon has been a short-lived phase up till now and has always faded.  

But these are not ordinary circumstances.  If Trump is able to remain popular for long enough -- I do not pretend to know how long that is -- he could lock in power in ways that could change the whole dynamic.  For instance, the tech cartel adopt social media algorithms to suppress any story critical of Trump and promote anything favorable to him.  Trump's FCC can pull licenses from any radio or television station that runs adds that displease him.  Big media can understand that getting favorable regulatory decisions will depend on favorable coverage.  The IRS can strip unfriendly non-profits of their tax exempt status.  Government contracts can be made to depend on political donations.  State and local governments, and a wide range of institutions, can lose their federal funding for failing to toe the line.  Courts can be afraid to rule against him for fear that he will disregard the ruling.  Proud Boys can harass and intimidate Trump opponents, confident in a pardon even if they are criminally charged.  State and local governments that prosecute can be denied federal assistance next time a wild fire hits.  And so forth.

But this won't happen if Trump is sufficiently unpopular.  Congressional Republicans just might vote against him if what is proposes is sufficiently unpopular.  Big business will see less advantage in hitching their brand to a leader who is widely hated.  The Supreme Court will find its spine stiffened if it is confident it has public opinion on its side.  State and local governments will become increasingly willing to defy Trump if swing voters broadly swing against him.  Even the Proud Boys will start to see recruiting drop off and enthusiasm decline if Trump makes himself sufficiently unpopular.

So we need to hit early and hard to undermine Trump's popularity.  But how?

Last makes an excellent point -- popularity and unpopularity both tend to be self-reinforcing:

Do people care about the price of eggs? Well, if the president is popular and egg prices are high, then everyone assumes that the public doesn’t care about the price of eggs. And because people assume that, they don’t talk about it.

But if the price of eggs is high and the president is unpopular, then people won’t shut about how terrible it is that egg prices are off the charts.

Perhaps you remember this dynamic?

When a president is popular, nothing sticks and nothing matters. When a president is unpopular, every stupid, random thing is a catastrophe they have to answer for.

Very true!  But how do you attack this self-reinforcing dynamic?  Or, to put it differently, what matters to the American people?  What will hurt Trump's popularity?  

Well, for starters, I would say not any sort of scandal.  Scandals are perhaps the prime example of this dynamic.  If a politician is otherwise popular, no one cares about a scandal.  People being angry about a scandal is a symptom that a politician is unpopular. 

Not the price of eggs, either.  Voters know that egg prices were high before Trump came to power and are unlikely to blame him for high prices now.  And besides, the right wing media are (correctly) explaining that high prices are the result of bird flu.  

Something that makes people's lives noticeably worse would probably move the needle.  I am guessing tariffs that affect mostly clothing or electronics prices will probably not make much difference because clothing and electronics are occasional purchases and people are unlikely to notice increases in price.  On the other hand increased healthcare costs due to reduced Obamacare subsidies are the sort of thing that will affect people's regular expenses and are likely to provoke a backlash.  Other proposed budget cuts may also prove unpopular.

What about things that don't affect people's every day lives, but are likely to be unpopular on principle? Last proposes hammering on the January 6 pardons.  If the American people could forgive Trump for January 6, I would expect them also to forgive the pardons.  Still, graphic videos of violence against police together with condemnations of the pardons may move the needle some, especially among the police.  It may, for instance, make police more willing to arrest any Proud Boys and other militia types who stir up trouble -- a very important consideration!  He also proposes making hay out of Trump's pardon of Ross Ulbricht, a large-scale online drug dealer.  That also sounds likely to be unpopular, especially if accompanied by detailed descriptions of Ulbricht's crimes, which are not all that widely known.

I can think of other things to use as well, but they have to be made accessible to a typical low information voter.  A VA hiring freeze sounds like something that would be extremely unpopular.  Yes, the VA can assure people of exemptions but, as the saying goes, if you are explaining, it means you're losing.  

Talking about the National Institute of Health (NIH) communications and grants freeze is too abstract to interest most people.  Talking about cancer patients being frozen out of studies or hospitals forbidden from purchasing supplies sounds like the sort of thing that could stir public outrage.

The foreign aid freeze will no doubt be popular.  That it is cutting off treatment for AIDS overseas will probably be greeted with a shrug because the beneficiaries of the program are not American.  But maybe we can give it a try.

Of course, the problem with all of these is that they are short term.  The Trump Administration may back down under pressure and the issue may be quickly forgotten.  Proposals to end FEMA, now, sound like political suicide.

Sunday, September 19, 2021

Reasonable Conservatives and Vaccine Mandates


Well, Biden's speech on COVID has now allowed sane and rational conservatives to stake out a position -- in favor of vaccines, but against mandates.  It is depressing to read columns by Jonah Goldberg or George Will because they drive home just how far we are apart.  On the other hand, I do believe that disagreement is healthy for democracy, so let me offer a little healthy disagreement here. Both men agree that Biden's anger and frustration with people who won't take the vaccine is understandable and justified, but does not justify a national mandate.

Will begins by denouncing the idea that rights are granted by government and can be revoked by government and says:
This nation’s Founders thought otherwise: Governments are, as the Declaration of Independence says, instituted to “secure” preexisting rights. To this end, the Constitution’s Framers gave the federal government finite, enumerated powers and reserved police power to the states.
Do I have to point out why that makes no sense at all?  If "governments" secure pre-existing rights, then presumably that rule applies to all government, whether federal or state. Yes, there are plenty of arguments for limiting federal power and leaving plenty of power in the hands of states. Regulations that are appropriate to one area may not be appropriate to another.  People in one area may have different values, different ideas of what is appropriate, etc. 

But the basic idea that any action by the federal government, outside of a few narrowly enumerated powers, is inherently tyrannical, while identical actions taken by states are inherently not tyrannical amounts to a view that the states can do no wrong.  That view has been subjected to extensive testing in the field and decisively proven wrong.  Or, to put it more directly, Will's argument here is exactly the same one segregationists used to oppose civil rights.

Obviously Will is right that it would be lawless for the President to unilaterally order such a  mandate at the snap of his fingers.  But that is not what is happening. The Occupational Safety and Health Administration (OSHA) is going to issue such a regulation through the normal regulatory process.  OSHA has been issuing such regulations since the 1970's.  Workplace safety regulations sound very much like the sort of "police powers" that were originally reserved to the states.  Will does not say that he considers OSHA unconstitutional, only that he considers this particular regulation unconstitutional.  But he never explains why this regulation is different from other workplace regulations.  So Will should have to answer, what makes this regulation different from normal regulation?  Or, if he cannot explain that, does he consider OSHA to be constitutional at all?

As for Goldberg, it is hard to say exactly what he favors. His view appears to be that now that anyone who wants a vaccine can have one, whether to have a vaccine is a personal choice. If people who oppose the vaccine prefer 150,000 new cases and 1,500 new dead per day, that is their business.  There are three problems with this view.  The first is that people under 12 are not yet eligible for the vaccine and somehow have to be protected.  The second is that the vaccine is not 100% effective.  Countries with much higher vaccine rates than ours are having serious secondary outbreaks as a result of breakthrough infections. Pre-delta variant, we could treat the vaccine as close enough to perfect, but with the delta variant that is clearly not the case.  And finally, even if a 100% effective vaccine was available to people of all ages, there is still the problem with an outbreak on the scale we are seeing now overloading the healthcare system and limiting healthcare available for other conditions as well.

Goldberg correctly comments that Biden made a mistake in declaring victory, only to see it swept away by the delta variant, and that we will never fully defeat COVID, that it will be here to stay.  Yet he concludes by criticizing Biden for saying just that. His grounds for criticism appears to be that acknowledging that COVID is here to stay fosters a chronic crisis mode and encourages arbitrary power grabs, a fair concern.  But he also seems to consider treating 150,000 new cases and 1,500 dead per day as a crisis to be mere pandering the crisis-mongers.  "The most pro-vaccine voters and voices are often the most pro-mask, pro-school closure and pro-shutdown."  

Well, yes, but do we have to point out the opposite?  The most anti-shutdown voices became anti-mask when masks became a less intrusive alternative to shutdown, and then went on to be anti-vaccine. Being pro-all of these is a consistent view to take to halt the spread of a dangerous contagious disease.  Being anti-shutdown is to point out very real social and economic costs of the resulting isolation and loss of community.  But any rational anti-shutdown viewpoint would want to find some sort of less intrusive way to curb contagious disease.  Instead, people who are anti-all of these seem to be driven by mindless, reflexive opposition.  Herein lies the problem with denouncing Biden's speech as culture wars.  Of course it is culture war.  Absolutely any action to curb the pandemic is culture war.  

Sunday, September 20, 2020

Supreme Court Appointment and Obamacare

 

Various commentators have been gaming out the effects of a Supreme Court nomination on the election.  The obvious answer, so far as Roe v. Wade goes is that it will raise the stakes, and raise passions, mobilization, and turnout on both sides.  I do not pretend to know which side will benefit more.

But give the Democratic leadership credit, for once, with keen political sense.  They have chosen their message wisely.  They will avoid discussion of abortion, which is divisive, and focus on Obamacare, which is not.

That may be surprising, given how divisive Obamacare has been in the past, but currently the Supreme Court is facing a lawsuit seeking to strike down the entire law.  Consider the implications.  

Obamacare expanded Medicaid.  Pre-pandemic, about 10 million people had health insurance under the Medicaid expansion.  It also set up health insurance exchanges.  Pre-pandemic, about 10 million people bought health insurance on the exchanges. Mass layoffs during the pandemic have presumably raised both figures, but let us assume them for the time being.  Repeal the entire law, and both provisions immediately vanish.  That means the Supreme Court could strip 20 million people of their health insurance overnight!

But that is not what Democrats are focusing on.  Repeal will also remove all Obamacare's requirements that health insurance companies cannot deny coverage for pre-existing conditions.  Given the number of people with pre-existing conditions, or who know someone with a pre-existing condition, this is what Joe Biden called a BFD.

The practical upshot of all of this is that basically no one favors the wholesale repeal of Obamacare. And yet their is a lawsuit to do just that schedules for hearing in front of the Supreme Court shortly after the election.  And Donald Trump has ordered the Department of Justice to argue in favor of repeal, an action that one Republican spokesman described as making as much political sense as diving headfirst into a wood chipper.  The Supreme Court did its best to keep Donald Trump away from the wood chipper by postponing argument until after the election.  But sometimes the unpredictable happens, and suddenly the question of whether a Trump appointee would strike down the protections of Obamacare has become a major election issue.

That raises two other questions.

One is what the Supreme Court would do. There is more or less unanimous agreement, even among people who pressed for repeal in the past, that the argument lacks legal merit.  But when has that ever stopped a determined Supreme Court?  I am reasonably confident that if Trump is reelected, a Republican majority on the Supreme Court will save him from himself and uphold the law.  The country will be exposed to a bunch of outraged tweets, but no other harm will be done.  

If a Democrat is in the White House, I can see a Republican Supreme Court striking down Obamacare. Underlying whatever fancy justifications the Supreme Court can come up with, the real reasons will be simple.  First, they will consider the disastrous fallout to be suitable punishment to Democrats for passing such a monstrosity.  Second, they will trust that Democrats will be unable to come up with a replacement fast enough to prevent disaster and will count on the public to blame the party in the White House for the disaster and vote accordingly.  This may be a miscalculation.  If the Supreme Court is obviously, immediately at fault for the mess, and if the Democrats make skilled use of the bully pulpit (a dubious bet, I realize), the Supreme Court just might be blamed, and suddenly court packing will not seem so radical after all.

The second question is why Donald Trump is doing something that makes as much sense as diving head first into a wood chipper.  So far as I can tell, the answer is simple ignorance.  Republicans attempted to find a replacement for Obamacare, failed, and realized they are not able to do health care policy.  They decided that they were better off leaving well enough (or bad enough) alone.  Donald Trump seems to be the only person in the country not to notice what happened.  He keeps saying Republicans have a great plan that will deliver great care at a fraction of the cost.  Maybe he actually believes it.  Or maybe he believes that if he just says so loud enough, no one will notice the 20 million people who lose their health insurance and the countless people who lose coverage for pre-existing conditions.  

After all, his base has managed not to notice a pandemic that has infected over 6 million Americans and killed some 200,000.

Friday, January 10, 2020

Wood Chipper Averted (Presumably Deliberately)

Look, I know I am late to the game, but the political motive in the latest Obamacare lawsuit is obvious.

Put briefly, Congress repealed all penalty for not having health insurance.  A number of Republicans then sued to have the the individual mandate declared unconstitutional because it was no longer a tax, but an intolerable intrusion.  And, since it had been previously argued that the entire law stood or fell on the individual mandate, they called for the entire law to be struck down.

This legal argument was taken seriously by basically no one.

And so, most alarmingly, the district judge accepted it and struck down the entire law.  The effect would have been to shut down the exchanges where some ten million people buy health insurance, roll back a Medicaid expansion covering some 10 million people, and remove protections for people with pre-existing conditions.  In other words, as one Republican consultant put it, it made as much sense politically as diving head-first into a wood chipper.

Nonetheless, Donald Trump is determined to erase the Obama legacy, and if Obama was against diving headfirst into wood chippers, then Trump as to be for it.  Of course, the losing side appealed, and, in the face of all common sense, Donald Trump insisted that his Justice Department argue in favor of the decision. 

The assumption was that the Court of Appeals (Fifth Circuit) would either uphold or strike down the decision.  The loser would then appeal to the Supreme Court, which would hear the case in the summer of 2020.

In other words, the summer before the election, the American people would witness the Trump Administration argue in favor of stripping 20 million people of their health insurance and remove protections for pre-existing conditions.  Short of something disastrous actually happening, this is one of the most effective ways to commit electoral suicide.  The question would not be whether the wood chipper would get Donald Trump, but how much of the Republican Party he would drag along with him.

And so the three-judge panel in the Fifth Circuit stepped in to save Donald Trump from himself.  By a 2-1 vote, they declared the individual mandate unconstitutional and kicked the case back to the district judge to reconsider his ruling and determine, in detail, what must stand and what must fall. 

The obvious goal here is to postpone argument in front of the Supreme Court until after the 2020 election and thereby keep Donald Trump from diving headfirst into a wood chipper.

Thursday, May 2, 2019

Donald Trump Has Not Lost His Fondness for Wood Chippers

Apparently Donald Trump has not altogether lost his affinity for diving headfirst into a wood chipper.  I thought his letter to the Fifth Circuit Court announcing that the Administration now favors repeal of the entirety of Obamacare might be as impulsive and transient as some of his tweets.  But now the Administration has officially filed a brief calling for the repeal of the whole thing.  No one expect the argument to actually prevail.  But the Administration is now locked into standing out in public and arguing for stripping 20 million people of their health insurance.  Who knows, this might even go to the Supreme Court and force the Administration to argue for stripping 20 million people of their health insurance in front of the whole nation.

Fortunately, he is almost certain to lose.

Pass the popcorn.

Tuesday, March 26, 2019

Donald Trump Proves Devotion to Second Amendment, Celebrates Victory by Shooting Self in Foot

Trump had his moment of triumph.  He had been exonerated.  Democrats were in chaos and despair.  Some people were proclaiming them wounded beyond all recovery, stained with a witch hunt and false conspiracy theory, and that we might was well just skip the 2020 election, since the results had already been called.

But Trump apparently decided that wrapping up the election so early wouldn't be sporting, so he would give the Democrats a sporting chance.  He turned his energies to his new priority -- stripping 20 million people of their health insurance.

A Texas judge has ruled that, since the individual mandate is essential to the functioning of Obamacare, the repeal of the individual mandate means that the whole act must be set aside.  Conservative legal scholars, many of them bitter Obamacare opponents, dismissed the argument as worthless.  Congressional Republicans and members of the Trump Cabinet recognize that stripping people of their healthcare is electoral poison.  So naturally the Trump Administration is supporting this decision on appeal.  I don't know how long the appeal will take.  I don't know what Fifth Circuit will rule.  But I am confident that this will never pass the Supreme Court.  It will fail on a 5-4 vote, with Chief Justice Roberts breaking the tie.  Roberts made clear in his last opinion that if Republicans want this law gone, they can repeal it, but stop asking the Supreme Court to do their dirty work for them.

It will, however, be a great weapon for Democrats to bash Republicans.  Once again, they can scream that Republicans want to take your healthcare.  It will energize party activists like nothing else.  It will be a highly effective way of concentrating the mind on the importance of the Supreme Court -- if Trump gets to replace Ruth Bader Ginsberg, 20 million people really could lose their health insurance. 

Why Trump has chosen this moment for such a completely needless, self-inflicted wound is a mystery to me, and to most Americans of either party.

Oh, and did I mention that much of the Midwest is under water?

Monday, September 3, 2018

Note to Trump on John McCain

It is hardly a secret that Donald Trump and John McCain did not get along.  They had many differences -- each in many ways, stood for what the other most opposed.  But it would appear that Trump's biggest grudge against McCain was for his last vote in the Senate.  McCain cast the truly deciding vote to stop Obamacare repeal and deprived Trump of the opportunity to undo his predecessor's signature domestic initiative.

Instead of resenting McCain, Trump should be thanking McCain for saving the Republican Party from itself.  Suppose McCain had not cast that decisive vote.  The monstrosity would have passed, Republicans would have shut down the exchanges where 10 million people get their health insurance, coverage would become unaffordable for numerous people with pre-existing conditions, and Republicans would be on record celebrating this as a great victory.

So, Republicans in general and Trump in particular, be grateful to McCain for saving you from yourselves.

Saturday, June 9, 2018

On Trump, Healthcare, and Protections for Pre-Existing Condions

So the Trump Administration is now urging the courts to strike down Obamacare's ban on discrimination against people with pre-existing conditions.  I have no idea why they have picked this hill to die on.*  But if they insist on holding this hill, the slaughter will be epic.

________________________________________
*My guess -- Republicans appear to have decided that the most important goal in healthcare policy is assuring cheap rates for the young and the healthy.  And it is true that if insurance companies are allowed to raise their rates on older and sicker applicants, or refuse to insure them altogether, young and health policy holders can get cheap rate.  Republicans have made more than amply clear that covering people who actually need medical care is not important to them.  Besides, as economic royalists, they are confident that whatever outcome the unregulated workings of the free market reach is, by definition, optimal.  If the free market in its infinite wisdom says that sick people should be uninsurable, that must obviously be the best outcome.

Sunday, April 8, 2018

The Most Likely Trump Disaster -- Healthcare

So, I am prepared to concede that in the first year plus of the Trump presidency, nothing disastrous has happened except in Puerto Rico, which no one ultimately cares about.

To supporters, the lesson is obvious.  By wrecking the federal government through corruption and incompetence, Trump has released the economy from its crushing burden and freed it to prosper as never before.  By behaving like a bull in a china shop in foreign policy, Trump has intimidated the rest of the world into doing our bidding.  All is well!

Liberals like me nonetheless remain convinced that you can't keep wrecking the government through corruption and incompetence without running into problems sooner or later.  I will address the subject of foreign policy later.  But in the meantime, what of domestic policy.  What is most likely to go wrong there.

The main focus right now is on tariffs and whether we are at the beginning of a trade war.  Although I fully agree that a trade war will do no one any good, my guess is that it will not be as disastrous as many fear.  Yes, some industries will take a hit, but so long as the economy continues to grow, it should be able to take up the slack.  Estimates of the jobs a trade war will cost are in the six figures -- no more than the number being added monthly right now.

No, by far the most likely disaster in the immediate future is in health care.  Repeated Republican attempts to repeal Obamacare in 2017 failed as Republicans learned to their astonishment that stripping 20 million people of their health insurance overnight is a surefire political loser.  But that does not mean that Republicans reconciled themselves to Obamacare; it merely means that they replace sudden and outright repeal with gradual sabotage.  Such attempts have failed so far, but next year may be the chance to make a real difference.

Already Republicans have repealed the individual mandate, meaning that people are not required to buy health insurance and can refrain from doing so until they develop serious medical conditions.  This goes a long way toward encouraging healthy people to leave the exchanges, thereby forcing insurance companies to raise prices for the sick people who remain and inducing a death spiral.

Furthermore, for people who fear that the death spiral may take too long to materialize, Iowa  and Idaho have come up with a way to accelerate it.  They are allowing companies to issue "health benefit plans" that take monthly premiums to pay for subscribers' medical expenses but are not health insurance and therefore not bound by Obamacare rules, or any other rules, for that matter. This will allow companies offering such plans to achieve what Republicans consider most important -- offer low rates to health customers.  Such plans will also be able to exclude people with preexisting conditions, so sick people will be uninsurable, which has always been one of the effects of Republican plans.  However, as any economic royalist would assure you, completely unregulated plans will, by definition, be optimal, and if that means that sick people are uninsurable, that must be optimal, too.

The result will be that, although Republicans will not succeed in inducing a death spiral everywhere at once and crashing the exchanges altogether, they should be able to crash the exchanges in at least a few states and probably at least begin the death spiral in others.

It should go without saying that if Democrats win control of Congress (or even just one house of Congress) in November, Republicans in general and Trump in particular will blame them for anything bad that happens from then on.  Unfortunately for Trump and Republicans, Obamacare premiums will start skyrocketing before the upcoming election, as sign-ups begin in October.  And it will put Republicans in an awkward spot -- should they start throwing confetti and dancing for joy that Obamacare exchanges are finally crashing, or should they pretend to have regrets.

I suppose at least Republican have finally found an alternative to Obamacare -- totally unregulated plans offered at the state level.  As with all major policy changes, this one will have both winners and losers.  The winners will be healthy people who can pay very low rates for plans that don't cover much, but who don't need much coverage anyhow.  The losers will be sick people, who will become uninsurable.

Unfortunately for Republicans, losers tend to attract a lot more attention than winners.

Sunday, October 29, 2017

How I Imagine Trumpcare Might Go Down

At least we got tax cuts
Here is my imagined scenario of how Donald Trump’s healthcare policy would go.  With the defection of McCain, Corker and Flake, as well as the firm opposition of Collins and Murkowski, no plan to shut down Obamacare can muster even a majority in the Senate, so Trump continues his policy of sabotage.  It succeeds.  Every increase in premiums, every reduction in options, every county that loses all coverage he proclaims victory and announces as proof that Obamacare is failing.  Failure begets failure, reports of failure in one county discourage people in other counties, which cause insurers to flee the exchanges, which discourage sign-ups, and soon the whole system comes crashing down. 

Trump declares victory.  He announces that Obamacare has finally failed and the people are freed from its oppression.  He calls a party of Congressional Republicans and Republican donors to celebrate.  They dance for joy.  They throw confetti.  They shoot off fireworks.  All over the country, Trump supporters join in.  They proclaim freedom of this monstrous oppression.  They dance in the streets for joy.  They throw confetti.  They shoot off fireworks.  They rejoice in their liberation from this monstrosity.

Then reality hits home.  People all over the country who lost their health insurance when the exchanges collapsed can’t find it anywhere else.  Many have serious medical problems.   Without subsidies, people in rural areas and older people, no matter how healthy, find that their premiums skyrocket.   If Trump is also successful in rolling back Medicaid enrollment, many rural hospitals may shut down as economically unviable.  Trump supporters are disproportionately affected.  Perhaps healthy young men, especially in urban areas, and possibly healthy young women with no plans to have a baby any time soon benefit.  But if Congress is unable to repeal the Obamacare regulations, the collapse of the exchanges may bring down the individual insurance market outside the exchanges as well.  

Trump supporters ask where is the much better plan that Republicans assured us they had ready in their pocket.  Where is the plan that will deliver awesome health coverage at a fraction of the cost?  And then they will be shocked to learn what everyone else knew anyhow.  Republicans don’t have a plan.  Or, at most, their plan is to repeal the Obamacare regulations requiring an essential health benefit and forbidding discrimination based on pre-existing conditions, or allowing insurers to compete across state lines.  This will make coverage cheap for anyone who doesn’t need it, but prohibitive for anyone with actual medical problems.  And the Republican leadership overall just won’t see this as a problem.  They will have gotten rid of that evil monstrosity, Obamacare, and nothing further is needed.   Freed of the malign tyranny of the government, the free market will come up with an optimal solution any day now (checks watch).  And if that ultimately means people with pre-existing conditions can’t get coverage and are left to die, well if that is what the free market wants, it must be optimal.

And then things get interesting.  Some Trump supporters continue to support him.  These include ones on Medicare and ones who get coverage through their employers, which is, after all, a majority of the population.   Others lose their health insurance and blame it on Obama and don’t blame Republicans at all for failing to do anything about it.  But others lose their health insurance or have family members or friends who lose their insurance or see their rural hospitals shut down and respond with anger and betrayal. 

Trump will be enraged.  He will lock himself in the bathroom and tweet out petulant, self-pitying  tweets.  He will denounce all reports of people losing coverage as “FAKE NEWS!”  He will blame it on “FAILED OBAMACARE” and a Republican Congress that can’t pass decent legislation.  He will say that it isn’t his fault, how was he supposed to know that deliberately crashing that system that provides healthcare to 10 million people would cause problems.  And he will be utterly unable to imagine that it isn’t all about him.  And in this case, since he was the one who deliberately crashed the exchanges, he will have a point.

I should add that this is a fantasy.  Although this is the logical outcome of the course Donald Trump is on, I don’t think it is what will actually happen.  Why not?  Because the exchanges won’t be here today and gone tomorrow.  Before the exchanges fail altogether, they will start to seriously malfunction.  Premiums will skyrocket.  (That is already beginning).  Entire counties will find themselves without insurers, particularly in rural areas where the most Trump supporters reside.   Some rural hospitals will fail.  And all of this will get ample coverage.  Of course, Trump will denounce this as “FAKE NEWS” and many of his supporters will agree.  (Fox, Breitbart, etc. either won’t cover it or will blame it all on the failings of Obamacare).  But that will be sort of like telling the people of Puerto Rico not to believe the stories about hardship in their country.  Residents of pro-Trump rural counties losing their coverage and possibly seeing their hospitals close will be aware of what is happening.  They may blame it on innate failing of Obamacare rather than deliberate sabotage by Trump, but in the end they will want someone to do something about it.  The pressure on Congress to do something will grow. 

And therein will lie the problem.  Republicans will be ideologically opposed to doing anything about it and, even if forced to act by political reality, won’t have any realistic plan to improve the situation.  Democrats will have plenty of plans, but will be in the minority and unable to pass any of them.  If they retake one house of Congress, they will be unable pass it in the other.  Even if they take both, they won’t be able to get any plan past a Republican filibuster.*   And even if they somehow manage to pass something by budget reconciliation or get enough Republican defectors, Republican donors will probably convince Trump to veto it and there is no way Democrats will have the votes to override. 

In short, Republicans have learned that it is easier to destroy than to build.  They are currently hard at work on it, destroying Obamacare with possibly major collateral damage to the insurance system, wrecking regulatory agencies, causing possibly irreversible damage to the environment, and destroying the State Department and, with it, our ability to engage in diplomacy.  And this is best seen as a warning to voters and Democratic politicians alike – do not elect Democrats and, if you do, don’t even think of doing anything once in power.  Because Republicans WILL destroy whatever Democrats may achieve, and they don’t care about the damage they cause along the way.

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*Democrats currently hold 48 seats in the Senate. Of the seats up for election in 2018, only eight belong to Republicans. That means that even if Democrats win every single seat up for election (a most unlikely outcome), they will only have 56 seats, and will therefore need four Republican votes to pass anything

Monday, October 2, 2017

What if Cassidy Graham Had Passed?

At least it pissed off liberals
The Cassidy-Graham monstrosity has now gone down to defeat, but let us take some time to consider what would have happened if it had passed.  Others have considered the policy effects, I am talking mostly about the political effects.

The policy effects for 2018 would be essentially none.  Insurance companies have put in their bids, proposals are up on the exchanges, and 2018 is locked in place.  That being said, there would be at least some damage, not from the bill, but from the Trump Administration’s attempts at sabotage.  Premiums on Oklahoma have gone up by 30% due to Administration neglect, and other states have seen premiums spike from deliberate uncertainty.  Enrollment times have fallen from three month to six weeks, and the Trump Administration has gone out of its way not to warn anyone.  As things stand now, with Republican legislation having conspicuously failed, Republicans can blame all these things on Obamacare and claim that if their legislation had passed these things would not be happening.  If Cassidy-Graham had passed, no doubt with great ceremony, people would automatically blame it for these problems.* 

I am not clear what would happen in 2019.

But it would be in 2020 that disaster would truly strike.  That would be the year that management of health insurance would be turned over to the states.  It is also, all experts agree, not time enough for states to get a system up and running.  And they would be required to do so at much reduced funding, that would continue to shrink over time.  Think of the mess that accompanied the opening of the exchanges in 2014 and raise it by a factor of many.  And just in time for the 2020 election!  I think it safe to say that the general explosion/implosion of the health insurance system during an election year would be a short-term disaster for Republicans.

The bad news is, I see no reason to believe that it would be a long-term disaster.  After all, one would think that a prolonged, highly unpopular war and the biggest economic crisis since 1929 would be a long-term disaster for Republicans, but it ultimately turned out to be a short-term lost, followed by an roaring comeback and unprecedented domination at all levels of government.  Why not turn disaster into victory once again?

The Republican course of action would be simple.  The minute Democrats won, any concern for the public good or attempt to save the healthcare system would be over.  The Trump Administration would spend the interregnum doing everything in its power to wreck the healthcare system beyond what it was already wrecked. 

The sabotage would continue once the Democratic President was inaugurated.  If Republicans retained enough votes in the Senate to mount a filibuster, they would block every attempt to save the healthcare system.  Republic interest groups everywhere would mount litigation to wreck the system in every way possible, and Trump-appointed federal judges would agree with them on every point.  Since many states time their gubernatorial elections to be in opposite years from Presidential elections, Republican governors would largely be protected from the 2020 wave election and would spend the next two years doing everything short of physically blowing up hospitals to wreck the healthcare system so they could blame the Democratic President.

Approximately two days after the Democrat was inaugurated, Republicans would start angrily demanding to know why he hadn’t fixed the healthcare system yet.  Approximately two weeks later, they would be taking out ads laying problems that clearly began before the election at his feet.  Approximately two months later, they would be angrily denouncing Democrats for introducing the disastrous Cassidy-Graham Act that caused that caused this mess.  And in 2022 they would win an unprecedented wave election by running against the healthcare mess that they had created.

And here is the scary thought.  It appears that every time Republicans lose, they respond by getting crazier.  It has proved a highly effective electoral technique.  When Clinton won in 1992, Republican responded by going crazy and won control of Congress for the first time in 40 years.  Although they lost the Presidential election in 1996, in 2000 they won with a candidate of dubious qualification who led this country into a serious mess.  When the country responded by electing a Democrat in 2008, Republican responded by going even crazier and electing a bunch of Tea Party candidates determined to blow everything up.  It proved highly effective in 2010.  When it failed to swing the Presidency to Republicans in 2012, they responded by shutting down the government and nearly causing a debt ceiling breach and were rewarded by a massive sweep in 2014.  And in 2016 they went for the craziest candidate possible and elected Donald Trump, of all people. 

So if patterns hold true and Republicans had gone down to historic defeat in 2020, they would have responded by coming back in 2024 with winning with someone even crazier than Trump!
 _______________________________

*And they would be only half-wrong.  The legislation not have any affect that year, but the same ideological forces driving the legislation would be behind all the problems in the exchanges, so wrong in the details, but right in the generalities.

Congressional Republicans' First Legislative Achievement

At least it pissed off liberals
Congratulations to the Republicans in Congress!   They finally have a legislative achievement!  Not that they actually passed anything, you understand, but they have made a significant achievement without passing any legislation at all!   

Although their repeated efforts to strip 20 to 30 million people of their health insurance have failed, by putting all their energy into the attempt they have managed to avoid funding the Children's Health Insurance Plan (CHIP) program and thereby at least strip 9 million children of their health insurance.  Furthermore, Trump’s effort at sabotage of the exchanges continues apace.  Granted, he has not managed to crash them altogether, but give him time. Already neglect has managed to raise premiums by 30% in many states.  Any by shortening the enrollment period by half, cutting off all public announcement about it, and cutting off all federal attempts at enrollment, he should manage to significantly reduce the number of people enrolled.  Even if he only manages to cut enrollment in the exchanges by one million, that will raise the total number of uninsured by 10 million, and you will be halfway home in the first year of his administration.  Not bad, when you consider that it took Obama a full eight years to lower the number of uninsured by 20 million!  And if he does manage to crash the exchanges by the end of this term, then without passing any legislation whatever, you will have succeeded in stripping 19 million people of their health insurance, which is just one million short of the minimum goal.  Close enough for government work!

And if any Republicans object that they are not seeking to raise the number of uninsured, I can only answer that by their fruits ye shall know them.  Having universal health coverage has been a longstanding Democratic goal since Truman’s day.   Regardless of what form it has taken, Republicans have inevitably denounced it as an intolerable threat to liberty.  Ronald Reagan crusaded against Medicare as the end of all freedom.  Under the Clinton Administration, Republican strategist Bill Kristol warned Republicans not to agree to any form of universal coverage for fear of making is seem acceptable.  When Democrats finally got their opportunity under the Obama Administration, the moderate Republican Chuck Grassley made clear that Republicans would not vote for the proposal no matter what was in it.  Once Obamacare passed, Republicans made destroying this atrocity their top priority for seven years.  They filed suit to block it.  They voted countless times to repeal it, even though doing so would strip 20 million people of their health insurance.  They refused to set up exchanges.  They took down exchanges Democratic governors had set up.  They did their utmost to interfere with enrollment in the exchanges.  They rejected the Medicaid expansion.  They filed suit to prevent people in states with federally run exchanges from receiving subsidies.  And now that Republicans control all branches of the federal government, they have made repeated attempts to introduced repeal legislation that will strip 20 to 30 million people of their health insurance, while the Trump Administration does everything in its power to crash the exchanges and take insurance from at least 10 million.


After all this, only one conclusion is possible.  Republicans consider having a large uninsured population to be an important matter of moral principle.

Saturday, September 23, 2017

The Anti-Trump Paradox

At least it pissed off liberals
Trump's supporters like him because he shares their values, because he makes all the right enemies, and because they equate his style with "strength" and "toughness."  No complaint about his antics and offensive behavior will affect them because it is precisely his antics and offensive behavior that they like.  As for warnings about how dangerous he is, Trump supporters have an obvious retort.  He hasn't harmed them any.  Trump has been President for nine months now and, for all his opponents' warnings, nothing disastrous has happened.*

Of course, the reason Trump hasn't managed to hurt his supporters any is strong resistance to his harmful actions.  Three times now intense protests have beaten back Obamacare repeals that would strip 20 to 30 million people of their health insurance and disproportionately impact older voter, rural voters, and lower-middle income but not truly poor voters -- in other words, groups that are particularly strong Trump supporters.**  Members of his cabinet have dissuaded him rash or hasty protectionist measures that would disrupt supply chains and harm supporters in agriculture or manufacturing.  The support of Democrats will be essential to avoid a debt ceiling breach with untold damage to the world economy.  And if Trump really does cancel DACA his followers will not be harmed, but the harm to many highly sympathetic people with stir a backlash, perhaps even among his supporters.

Democrats and other Trump opponents have fought him mightily on all these things, and rightly so.  Republican actions, not limited to Trump, threaten to harm numerous innocent people, and we are absolutely right to fight to keep it from happening. 

And yet in the end, the only that will ever crack his support among the hard core is if he is actually allowed to harm them.  Such is the Anti-Trump paradox.

____________________________________________
*I mean, except for the hurricanes, of course.  But the hurricanes strike with utter indifference to who is in the White House, and FEMA seems to have done a good job in responding.  In fact, Republicans may have learned after Katrina that, much as they may want to destroy the federal government (at least in its mommy functions), extending that to FEMA is really bad politics.
**The latest bill is an exception, going out of its way to target states that have accepted the Medicaid expansion and benefit states that have not.  But many Trump supporting states have accepted the Medicaid expansion.

Wednesday, August 2, 2017

Repeal is Dead. Long Live Repeal! (Or at Least Sabotage)

I bet THAT pisses off liberals
I still don't understand Senate Reconciliation procedures.   I have read conflicting accounts as to whether repeal is dead now that it has been formally voted down, whether it is alive until September 30, or whether it stays alive until Congress passes its next budget resolution (which can, of course, include another call for repeal).  So repeal is either definitely dead this year, dead on September 30, or capable of coming back an unlimited number of times, like a horror movie villain.

Certainly, Donald Trump favors that later option.  He has even made clear that he wants Congress to pass a repeal before it even passes a budget or raises the debt ceiling.  And, while the Senate has decided to stay in Washington for the first two weeks in August, the House won't be back until September begins.  And they don't have a plan for a budget or debt ceiling increase yet, so there won't be a lot of time for repeal.

In the meantime, Trump is threatening to crash the exchanges if Congress won't give him a repeal. That makes at least limited political sense.  If Congress had passed a repeal and Trump had staged an elaborate signing ceremony in the White House and then premiums has soared, subsidies had shrunk, and sick people found themselves priced out, I don't see how Trump and the Republicans could possibly avoid blame.  By contrast, if repeal spectacularly fails and Trump then crashes the exchanges, he can then blame it on the Democrats and Obamacare and say that it would never have happened if only the repeal had passed.  It might seem more sensible in that case for him not to run around announcing that he is setting out to crash the exchanges if he wants to avoid blame, but this ignores the right-wing media's success in creating an alternate reality.  If Trump succeeds in crashing the exchanges he will simply dismiss any attempts to blame him, including quotes of his own words, as FAKE NEWS! and his followers will believe him.

When Trump was set to withdraw from NAFTA, Agriculture Secretary Sonny Perdue presented him with a map showing that the places that supported him would be disproportionately harmed in a trade war.  The message got through and Trump changed his mind.  Let's all give Perdue a hand for a job well done!  I suppose it is too much to expect Secretary of Health and Human Services Tom Price to do a similar favor for us on what would happen if Trump crashed the exchanges.

Of course, there is another option.  Congress could pass a legislation with some elaborately contrived name to spell out KILL OBAMACARE Act.  It would begin with a preamble calling Obamacare the worse legislation ever passed in the history of the entire known universe and saying that it must be pulled up by the roots, jumped up and down on till it bursts, then scrubbed down with bleach and the furrows salted to make sure it never again pollutes our body politic.  Follow it by a second preamble praising Donald Trump's wisdom, foresight and persistence and assuring him that it would never have passed without his leadership. Then do a few patches and tweaks, some tax breaks for health savings accounts, and a few more minor changes, and assure him that this will deliver such great healthcare people will get tired of great healthcare.  He'll never know the difference.

Sunday, July 23, 2017

Donald Trump's Flying Circus is Really a Russian Pee Pee Party

I bet THAT pisses off liberals
First of all, just to be clear, I have no idea whether the pee pee tape actually exists.  I have no idea whether Trump’s strong pro-Russian bent is the result of blackmail or something else.  But I am confident that if Trump is being blackmailed by the Russians, it must be over something a whole lot more serious than a piddling little pee pee tape.

That being said, Trump’s alleged Russian pee pee party is actually quite a good metaphor for his (and his followers’) approach to the Presidency.  The Steele memos claim that Trump hired a bunch of Russian prostitutes in the Moscow Ritz Carlton to whizz all over the bed Obama had slept in to show his contempt for the then-President.  This led to an obvious question – where did Trump sleep afterward?  Someone (no idea where to find link) got the schematics of the Moscow Ritz Carlton and determined that the room in question was actually a suite.  After the prostitutes had ruined Obama’s bed and gone home, Trump had another room where he could sleep.

Well, now Donald Trump is President and he (and, to a considerable extent, his followers) are treating the occasion as a giant pee pee party – a chance to whizz all over Obama’s achievements and ruin them.  In this they are running into an awkward fact --- in the real world, there is no other room that they can withdraw to when the party is over.  If they want to whizz all over Obama’s policy bed, they will have to sleep in it afterward. 

Healthcare is the most obvious example.   Trump is absolutely determined to repeal Obamacare, come hell or high water.  What is to replace it?  Trump doesn’t know and there is no evidence whatever that he cares.   All he knows is that it is an Obama policy achievement he is determined to whizz on.  If he can’t repeal Obamacare, he can at least sabotage the exchanges and crash them and thereby ruin Obama’s achievement.   What comes after concerns him less than knowing that he destroyed what Obama built.  Ordinary Americans, including many Obamacare opponents, and even many Republican members of Congress, are starting to have misgivings about whizzing all over the health insurance system and then having to continue to use it.  Confronted with the reality that some 20 to 30 million people could lose their health insurance (depending on whether Congress goes with repeal and replace or just repeal), a lot of people are starting to wonder whether that is worth doing just to spite Obama.

Less immediate to most Americans but no less serious is the Iran accord which seriously restricted Iran’s nuclear program in exchange for sanctions relief.  Trump has called that the worst deal ever made and is determined to destroy it.   In this, it should be added, Trump is doing no more than follow in the footsteps of our last Republican President, George W. Bush.  Bush’s predecessor, Bill Clinton, reached an agreement with North Korea whereby they would seal their plutonium reactor and admit international inspectors to their plutonium reprocessing plant in exchange for a wide range of energy assistance.  This arrangement was deeply offensive to hardline hawks because it amounted to paying protection money to an extortionist thug, but it did keep North Korea’s plutonium locked up and kept them from turning it into a nuclear bomb.  It did not prevent them from attempting to circumvent the deal by building a uranium centrifuge to build a uranium bomb. 

At this point it was somewhat understandable the Bush might be reluctant to repeat the whole business his predecessor had gone through – reach an agreement that gave the North Koreans further bribes for shutting down their next attempt.  It would have the unfortunate result of teaching North Koreans that attempts to build nuclear weapons would be rewarded.  On the other hand, there was a dearth of good options available.   Bill Clinton persuaded the North Koreans to deal on the nuclear reactor because he really was willing to go to war over it, or at least to bomb the plutonium reprocessing plant.  Bush, bent on starting a war in Iraq, did not want to be distracted by a war in North Korea.  And he was ideologically opposed to any diplomatic engagement because, as Vice President Dick Cheney said, “We don’t negotiate with evil; we defeat it.”

So instead Bush withdrew from the non-proliferation agreement with North Korea.  He made clear that he wasn’t interested in talking and nothing would change his mind.  When the North Koreans announced their withdrawal from the Non-Proliferation Treaty, he refused to negotiate.  When they kicked out the UN inspectors, he refused to negotiate.  When they very publicly unsealed the plutonium reactor, he refused to negotiate.  And when they detonated an actual nuclear weapon – well, by then it was too late.  I could not say what the Bush Administration was thinking.  Maybe they thought refusal to negotiate would bring down the North Korean regime.   Maybe they thought invading Iraq would give the North Korean government pause.  Maybe they thought taking an unyielding stance was more important than whether North Korea actually got nukes or not.  Or maybe they just wanted to whizz all over whatever Bill Clinton had done.   But be that as it may, the North Koreans now have nuclear and weapons and missiles that can hit us, not exactly a great outcome.  

Trump seems incapable of considering whether something similar might happen if he scuttles the Iranian accord, or else he thinks a nuclear Iran is a small price to pay for whizzing all over Obama’s achievement.

Least apparent, but potential most catastrophic, are attempts by Republicans in general and Trump in particular, to wreck and attempt to fight global warming.   Cooking the planet is a small price to pay for wrecking Obama’s legacy.

When I am in one of my more cynical moods, I wonder if Republicans intend all these things.  By making clear to Democrats that they will go to any lengths to root out any Democratic policy initiative, no matter how great the damage to the larger society, they may be issuing a clear warning to Democrats next time they may hold the triple crown – don’t try to accomplish anything or we will destroy it, no matter how long it takes, or how much collateral damage it causes.

Donald Trump is rich, powerful, and 70 years old.  All that ultimately means he can afford another room in the suite, so to speak, after defiling the Obama bed.   If he wrecks the health insurance individual market and throws millions off Medicaid, he can still afford the best of care himself.  If Iran gets a nuclear weapon, he can drown out the development in a myriad tweets.  And if the planet cooks, he probably won’t live to see it.   He appears to consider all these things as well worth it, just to extend a big middle finger to the liberals.

The question is whether his supporters will ultimately agree.