Yesterday, Democrats cheered when the Senate filibustered a bill that would have granted approval to construction of the Keystone pipeline. A majority of Senators voted for the bill. In fact 59 senators voted for the bill. But since the Senate has a filibuster rule that allows 41 Senators to keep a bill from coming to the floor the bill was defeated. This vote really presents Democrats with a reality check on the use of the filibuster.
For years, Democrats have decried the use of the filibuster by Republicans, and rightly so. In fact, on the same day that the Senate blocked the Keystone bill, Republicans used the filibuster to block a Democratic proposal to overhaul the NSA's program for the bulk collection of telephone data. During President Obama's years in office countless bills have been blocked by a minority of Senators and Democrats have rightly been critical. But now, the shoe is on the other foot and in the next two years we will see more and more bills proposed by Republicans that the Democrats will filibuster.
Contrary to what some assert, the filibuster was never intended to be used in this way. Yes, the Senate was designed in part to be the "cooling saucer" that would be able to check the "unrestrained passions" of the House by providing each State, no matter how large or small, an equal voice in deciding whether laws should be enacted. To give effect to that intent, Senate rules allowed for unlimited debate, even by a small minority of senators, a process referred to as the filibuster. The filibuster was established to allow a minority of senators to delay legislation. However, the filibuster was not intended to allow a minority of Senators to prohibit the consideration of legislation and thereby block it indefinitely.
Many, such as myself, would like to see the Senate rules changed to allow unlimited debate by a minority but not permit that same minority to indefinitely block the consideration of legislation. It is wrong that a minority of Senators, sometimes representing a very small minority of the United States population can keep popular legislation from moving forward. But in doing so we must also accept that there will be circumstances in which terrible legislation will be advanced by a majority of Republican Senators. We should willing to accept that fact with the knowledge that if there is a Democratic House the bill can be blocked, and if there is a Democratic President the bill can be vetoed. And if not, if all branches of the government are controlled by Republicans, we must accept the outcome.
Wednesday, November 19, 2014
Tuesday, November 18, 2014
Time To Take Action To "Save Our Healthcare"
The Supreme Court is considering a case that could take away health insurance subsidies from working people in thirty-four States. Those are the States whose health insurance exchanges were set up by the Federal government, when those States refused to do so on their own. Seven states have actively sought to have the Supreme Court take away their citizen's health insurance and 27 others have sat on the sidelines, possibly in hope that the same thing happens to their citizens. We are talking about the health insurance of over 5 million people.
The people in those states have the capacity to influence the Court and at the same time bring to light the actions of their Governors, Attorneys General and Legislatures. That influence can be achieved by:
* Informing all those who have subsidized health insurance in each of the 34 states involved that their health insurance is at risk because those subsidies could be taken away by a decision of the Supreme Court.
* Informing these people that the governor and legislature in their state has either asked the Supreme Court to take away their ability to buy health insurance or has not asked the Court to protect their health care.
* Doing this could actually influence the governors and legislators in these 34 states to either retract their support for denying insurance subsidies or cause them to oppose a Supreme Court decision that would have that effect.
* Together, pressure from these states could have a real affect on the ultimate Supreme Court decision.
* At the very least, the hard working people of these states would understand who is on their side, who is looking out for their interests, and why they should hold their elected officials accountable.
The risk to the health insurance of these people began when the Supreme Court decided to hear King v Burwell. In that case a group of ACA opponents sought to undermine the law by arguing that a wording glitch in the law meant that people buying insurance on the Federal exchange could not get any subsidies. They lost the case in the District Court and the Appeals Court and are now seeking Supreme Court review.
In a sane world every state that did not set up an exchange would have supported the King v Burwell decision and would have said that there was no need for Supreme Court review. After all, these States did not have to spend money to set up an exchange. And if there are no subsidies available to their citizens through the Federal Exchange many of those folks will not be able to afford insurance. Also, unlike the issue of Medicaid expansion, this issue does not involve the expenditure of State funds. The States do not pay a cent towards these subsidies.
But it is not a sane world. There are 34 states which refused to set up health insurance exchanges and thus required the federal government to set up exchanges for them. Those exchanges are referred to by the Department of Health and Human Services as Federally Facilitated Exchanges. They cover 5,446,178 people. Of those over 5 million people, 86% receive subsidies enabling them to buy their insurance and the average subsidy is $4700. (This is May 1, 2014 data.)
Seven of those 34 states have actively sought to have the Supreme Court take away the insurance subsidies provided to their citizens. Those states are Oklahoma Alabama Georgia Indiana Nebraska South Carolina and West Virginia. Together, there are 2,573,585 people in those seven states who are receiving health insurance through the federally facilitated exchange for each of those states and 82% of those 2 1/2 million people are receiving subsidies. That means the governors, attorneys general, and/or legislature doors of those states are asking the Supreme Court to deny basic healthcare two over 2 1/2 million residents of those states.
But the sad truth is that many people in those states may be unaware of the actions of their elected officials. Is it conceivable that these people, many of whom have health insurance now for the first time, are aware that not only is their healthcare at risk but also that their elected officials are behind the effort to take it away? No, it is not, and for a simple reason. Most people simply have too much difficulty working their daily jobs, taking care of their families, and trying to keep their financial heads above water to spend time researching the intricacies of state government or health insurance policy, let alone the actions of the Supreme Court. It is not their fault that they may be unaware of what is about to happen to them but it would be our fault if we did not do everything possible to make them aware and give them the information needed to make their voices heard.
Now is theme for the people in these 34 states to become aware of what is being done or not being done in their names. They could start with letters to the editors from hard-working people whose health care is in jeopardy. They could also begin to circulate petitions to their governors, attorneys general, and state representatives. Social media could be used to spread the word and inform everyone of what is at stake.
The reality is the people who would be affected by a negative Supreme Court decision are hard-working people who seek only a modicum of health security for themselves and the members of their families. It is not too much to ask. Hopefully, their efforts could receive the attention of parties who have the financial resources necessary to begin an outreach campaign and even provide advertising in those states.
There is still plenty of time for people to take control of their future. But if they do not, they may find out too late that the health security they always wanted has been taken from them.
* * * * * *
It is not the purpose of this article to get into the merits of the challenge to the King v Burwell decision since that challenge ignores all precedent and all rules of statutory construction. However, for those who think that there is any serious merit to the argument that the Affordable Care Act does not authorize subsidies for state exchanges that are established within a federally facilitated exchange here are two things to consider.
The challengers sole argument is that one section of the law that refers to subsidies says that they are available on "an Exchange established by a State" and that these were established by the Federal Government not by States. The DOJ points out the same law imposes a mandatory requirement for each to set up an exchange, but provides that for any state that elects not to establish an exchange that Federal Government must establish one in its stead, and that for all purpose of the law each of those Federally Facilitated Exchanges is "an exchange established by a State." Here is the summary from the Solicitor General's brief, which eviscerates the challengers' arguments.
The brief goes on to explain these arguments in detail. It is well worth the reading.
Next are the words of Justice Antonin Scalia in the case upholding the ACA, National Federation of Independent Business v Sibelius. He wrote a scathing dissent to the majority opinion upholding the constitutionality of the ACA and in the course of that dissent made clear his understanding that subsidies are available to all people purchasing insurance under the ACA, whether through a state established or federally facilitated state exchange. He makes no distinction between the two, as illustrated by this excerpt discussing the Medicaid portion of the bill. The discussion is a bit convoluted because he is saying that while there is a backup plan for the Federal government to set up an exchange for a state refusing to set up an exchange or cover legal aliens, including subsidies, there is no similar backup for a state refusing to expand Medicaid. And because there is no backup the Medicaid expansion is Unconstitutional. But what is important here is how he describes the statutory structure.
Now, no one expects Justice Scalia to be consistent when it comes to the ACA. He has proven that his decisions are motivated purely by reactionary politics and have little to do with the law. However, it is very clear that he as well as all of the other justices who decided the original challenge to the ACA understood that subsidies were available to people buying insurance whether that insurance was purchased on an exchange established by a state or established for a state by the federal government. If they choose to do the mental gymnastics necessary to get around that simple fact, so be it. But everyone will know exactly what they are doing.
The people in those states have the capacity to influence the Court and at the same time bring to light the actions of their Governors, Attorneys General and Legislatures. That influence can be achieved by:
* Informing all those who have subsidized health insurance in each of the 34 states involved that their health insurance is at risk because those subsidies could be taken away by a decision of the Supreme Court.
* Informing these people that the governor and legislature in their state has either asked the Supreme Court to take away their ability to buy health insurance or has not asked the Court to protect their health care.
* Doing this could actually influence the governors and legislators in these 34 states to either retract their support for denying insurance subsidies or cause them to oppose a Supreme Court decision that would have that effect.
* Together, pressure from these states could have a real affect on the ultimate Supreme Court decision.
* At the very least, the hard working people of these states would understand who is on their side, who is looking out for their interests, and why they should hold their elected officials accountable.
The risk to the health insurance of these people began when the Supreme Court decided to hear King v Burwell. In that case a group of ACA opponents sought to undermine the law by arguing that a wording glitch in the law meant that people buying insurance on the Federal exchange could not get any subsidies. They lost the case in the District Court and the Appeals Court and are now seeking Supreme Court review.
In a sane world every state that did not set up an exchange would have supported the King v Burwell decision and would have said that there was no need for Supreme Court review. After all, these States did not have to spend money to set up an exchange. And if there are no subsidies available to their citizens through the Federal Exchange many of those folks will not be able to afford insurance. Also, unlike the issue of Medicaid expansion, this issue does not involve the expenditure of State funds. The States do not pay a cent towards these subsidies.
But it is not a sane world. There are 34 states which refused to set up health insurance exchanges and thus required the federal government to set up exchanges for them. Those exchanges are referred to by the Department of Health and Human Services as Federally Facilitated Exchanges. They cover 5,446,178 people. Of those over 5 million people, 86% receive subsidies enabling them to buy their insurance and the average subsidy is $4700. (This is May 1, 2014 data.)
Seven of those 34 states have actively sought to have the Supreme Court take away the insurance subsidies provided to their citizens. Those states are Oklahoma Alabama Georgia Indiana Nebraska South Carolina and West Virginia. Together, there are 2,573,585 people in those seven states who are receiving health insurance through the federally facilitated exchange for each of those states and 82% of those 2 1/2 million people are receiving subsidies. That means the governors, attorneys general, and/or legislature doors of those states are asking the Supreme Court to deny basic healthcare two over 2 1/2 million residents of those states.
But the sad truth is that many people in those states may be unaware of the actions of their elected officials. Is it conceivable that these people, many of whom have health insurance now for the first time, are aware that not only is their healthcare at risk but also that their elected officials are behind the effort to take it away? No, it is not, and for a simple reason. Most people simply have too much difficulty working their daily jobs, taking care of their families, and trying to keep their financial heads above water to spend time researching the intricacies of state government or health insurance policy, let alone the actions of the Supreme Court. It is not their fault that they may be unaware of what is about to happen to them but it would be our fault if we did not do everything possible to make them aware and give them the information needed to make their voices heard.
Now is theme for the people in these 34 states to become aware of what is being done or not being done in their names. They could start with letters to the editors from hard-working people whose health care is in jeopardy. They could also begin to circulate petitions to their governors, attorneys general, and state representatives. Social media could be used to spread the word and inform everyone of what is at stake.
The reality is the people who would be affected by a negative Supreme Court decision are hard-working people who seek only a modicum of health security for themselves and the members of their families. It is not too much to ask. Hopefully, their efforts could receive the attention of parties who have the financial resources necessary to begin an outreach campaign and even provide advertising in those states.
There is still plenty of time for people to take control of their future. But if they do not, they may find out too late that the health security they always wanted has been taken from them.
* * * * * *
It is not the purpose of this article to get into the merits of the challenge to the King v Burwell decision since that challenge ignores all precedent and all rules of statutory construction. However, for those who think that there is any serious merit to the argument that the Affordable Care Act does not authorize subsidies for state exchanges that are established within a federally facilitated exchange here are two things to consider.
The challengers sole argument is that one section of the law that refers to subsidies says that they are available on "an Exchange established by a State" and that these were established by the Federal Government not by States. The DOJ points out the same law imposes a mandatory requirement for each to set up an exchange, but provides that for any state that elects not to establish an exchange that Federal Government must establish one in its stead, and that for all purpose of the law each of those Federally Facilitated Exchanges is "an exchange established by a State." Here is the summary from the Solicitor General's brief, which eviscerates the challengers' arguments.
The Act provides that each State “shall * * * establish an American Health Benefits Exchange.” 42 U.S.C. 18031(b)(1). But, in a provision expressly designed to respect the sovereign dignity of each State by affording “State flexibility,” 42 U.S.C. 18041, the Act provides two ways for that requirement to be satisfied. First, a State may elect to create the Exchange on its own. 42 U.S.C. 18041(b). Alternatively, if a State does not elect to establish the “required Exchange” itself, then HHS will “establish and operate such Exchange within the State.” 42 U.S.C. 18041(c)(1). Either choice satisfies Section 18031(b)(1)’s requirement that each State “shall * * * establish an [Exchange].” The text of the Act thus makes clear that an Exchange established by HHS in a State’s stead is, as a matter of law, “an Ex- change established by the State.”
That interpretation harmonizes the Act’s text, structure, and purpose. Petitioners’ reading, in contrast, would transform the Act into a hash of superfluities, absurdities, and internal contradictions. It would obstruct the Act’s express purpose by denying affordable insurance to millions of Americans. It would thwart the operation of the Act’s interdepend- ent reforms and gut the Exchanges through which those reforms are implemented. And it would destroy the Act’s model of cooperative federalism by trans- forming the Act’s promise of “State flexibility” into a threat that a State may forgo establishing an Ex- change for itself only at the price of crippling its insurance market and depriving its citizens of the tax credits at the heart of the Act. The Act unambiguously forecloses that construction. At a minimum, the IRS’s interpretation is a permissible one meriting deference under Chevron.
The brief goes on to explain these arguments in detail. It is well worth the reading.
Next are the words of Justice Antonin Scalia in the case upholding the ACA, National Federation of Independent Business v Sibelius. He wrote a scathing dissent to the majority opinion upholding the constitutionality of the ACA and in the course of that dissent made clear his understanding that subsidies are available to all people purchasing insurance under the ACA, whether through a state established or federally facilitated state exchange. He makes no distinction between the two, as illustrated by this excerpt discussing the Medicaid portion of the bill. The discussion is a bit convoluted because he is saying that while there is a backup plan for the Federal government to set up an exchange for a state refusing to set up an exchange or cover legal aliens, including subsidies, there is no similar backup for a state refusing to expand Medicaid. And because there is no backup the Medicaid expansion is Unconstitutional. But what is important here is how he describes the statutory structure.
If Congress had thought that States might actually refuse to go along with the expansion of Medicaid, Congress would surely have devised a backup scheme so that the most vulnerable groups in our society, those previously eligible for Medicaid, would not be left out in the cold. But nowhere in the over 900-page Act is such a scheme to be found. By contrast, because Congress thought that some States might decline federal funding for the operation of a “health benefit exchange,” Congress provided a backup scheme; if a State declines to participate in the operation of an exchange, the Federal Government will step in and operate an exchange in that State. See 42 U. S. C. §18041(c)(1). Likewise, knowing that States would not necessarily provide affordable health insurance for aliens lawfully present in the United States because Medicaid does not require States to provide such coverage Congress extended the availability of the new federal insurance subsidies to all aliens. See 26 U. S. C. §36B(c)(1)(B)(ii) (excepting from the income limit individualswho are “not eligible for the medicaid program . . . by reason of [their] alien status”). Congress did not make these subsidies available for citizens with incomes below the poverty level because Congress obviously assumed that they would be covered by Medicaid. If Congress had contemplated that some of these citizens would be left without Medicaid coverage as a result of a State’s withdrawal or expulsion from the program, Congress surely would have made them eligible for the tax subsidies provided for.
Now, no one expects Justice Scalia to be consistent when it comes to the ACA. He has proven that his decisions are motivated purely by reactionary politics and have little to do with the law. However, it is very clear that he as well as all of the other justices who decided the original challenge to the ACA understood that subsidies were available to people buying insurance whether that insurance was purchased on an exchange established by a state or established for a state by the federal government. If they choose to do the mental gymnastics necessary to get around that simple fact, so be it. But everyone will know exactly what they are doing.
Friday, November 07, 2014
In A Sane World Oklahoma, Alabama And Five Other Red States Would Be Siding With Obama On The ACA Case
The Supreme Court has decided to hear King v Burwell, the case that rejected a challenge to the ACA by die hard ACA opponents. They had argued that a wording glitch in the law meant that people buying insurance on the Federal exchange could not get any subsidies. They lost the case and are now seeking Supreme Court review.
In a sane world every state that did not set up an exchange would have supported the Burwell decision and would have said that there was no need for Supreme Court review. After all, these States did not have to spend money to set up an exchange. And if subsidies are not available to their citizens through the Federal Exchange many of those folks will not be able to afford insurance. Also, unlike the issue of Medicaid expansion, this issue does not involve the expenditure of State funds. The States do not pay a cent towards these subsidies.
But it is not a sane world, which is why Ok, AL, Ga, IN, NE, SC and WV filed a petition together asking the Supreme Court to review the Burwell decision and strongly hinting it should be overturned. Their stated reason was that the matter needed to be settled so that they would know whether they needed to set up exchanges. But both their words and the tenor of their petition was that they hope that the Court will effectively neuter the ACA in a large part of the country. This is Obama derangement syndrome at its worst.
It is interesting that the Court agreed to take the Burwell even though there is no split among the Circuits on the issue. There had been an earlier conflicting decision in the DC Circuit but that decision was set aside when the full DC Circuit decided to rehear the case. Many observers worry that this does not bode well for the ACA. But the optimist in me hopes that Justice Roberts, who already passed on a chance to kill the ACA when he uphold the individual mandate, is not going to turn around and neuter it by striking down the subsidies. After all, the mandate made people do something but here you are just giving them money and helping them afford insurance. I also hope Kennedy upholds the subsidies as a way to finally get on the right side of the ACA.
As to the merits of the argument against subsidies in the Federal exchange, the Solicitor Generals brief eviscerates the challengers arguments.
The challengers sole argument is that one section of the law that refers to subsidies says that they are available on "an Exchange established by a State" and therefore subsidies are unavailable if the Federal Government sets up an exchange for a State. The DOJ points out that there are numerous other provisions of the law that make clear that for any state that elects not to establish an exchange that Federal Government can establish one in its stead and for all purpose of the law that too is "an exchange established by a State." Here is the summary from DOJ's brief,
The brief goes on to explain these arguments in detail. It is well worth the reading.
But we are left with this. There are States that are led by people who hate the President so much that they will go to any lengths, conjure up any bogus arguments,and pursue any course to attack the President and his Presidency even if it directly harms the lives, health and financial security of their own citizens.
In a sane world every state that did not set up an exchange would have supported the Burwell decision and would have said that there was no need for Supreme Court review. After all, these States did not have to spend money to set up an exchange. And if subsidies are not available to their citizens through the Federal Exchange many of those folks will not be able to afford insurance. Also, unlike the issue of Medicaid expansion, this issue does not involve the expenditure of State funds. The States do not pay a cent towards these subsidies.
But it is not a sane world, which is why Ok, AL, Ga, IN, NE, SC and WV filed a petition together asking the Supreme Court to review the Burwell decision and strongly hinting it should be overturned. Their stated reason was that the matter needed to be settled so that they would know whether they needed to set up exchanges. But both their words and the tenor of their petition was that they hope that the Court will effectively neuter the ACA in a large part of the country. This is Obama derangement syndrome at its worst.
It is interesting that the Court agreed to take the Burwell even though there is no split among the Circuits on the issue. There had been an earlier conflicting decision in the DC Circuit but that decision was set aside when the full DC Circuit decided to rehear the case. Many observers worry that this does not bode well for the ACA. But the optimist in me hopes that Justice Roberts, who already passed on a chance to kill the ACA when he uphold the individual mandate, is not going to turn around and neuter it by striking down the subsidies. After all, the mandate made people do something but here you are just giving them money and helping them afford insurance. I also hope Kennedy upholds the subsidies as a way to finally get on the right side of the ACA.
As to the merits of the argument against subsidies in the Federal exchange, the Solicitor Generals brief eviscerates the challengers arguments.
The challengers sole argument is that one section of the law that refers to subsidies says that they are available on "an Exchange established by a State" and therefore subsidies are unavailable if the Federal Government sets up an exchange for a State. The DOJ points out that there are numerous other provisions of the law that make clear that for any state that elects not to establish an exchange that Federal Government can establish one in its stead and for all purpose of the law that too is "an exchange established by a State." Here is the summary from DOJ's brief,
The Act provides that each State “shall * * * establish an American Health Benefits Exchange.” 42 U.S.C. 18031(b)(1). But, in a provision expressly designed to respect the sovereign dignity of each State by affording “State flexibility,” 42 U.S.C. 18041, the Act provides two ways for that requirement to be satisfied. First, a State may elect to create the Exchange on its own. 42 U.S.C. 18041(b). Alternatively, if a State does not elect to establish the “required Exchange” itself, then HHS will “establish and operate such Exchange within the State.” 42 U.S.C. 18041(c)(1). Either choice satisfies Section 18031(b)(1)’s requirement that each State “shall * * * establish an [Exchange].” The text of the Act thus makes clear that an Exchange established by HHS in a State’s stead is, as a matter of law, “an Ex- change established by the State.”
That interpretation harmonizes the Act’s text, structure, and purpose. Petitioners’ reading, in contrast, would transform the Act into a hash of superfluities, absurdities, and internal contradictions. It would obstruct the Act’s express purpose by denying affordable insurance to millions of Americans. It would thwart the operation of the Act’s interdepend- ent reforms and gut the Exchanges through which those reforms are implemented. And it would destroy the Act’s model of cooperative federalism by trans- forming the Act’s promise of “State flexibility” into a threat that a State may forgo establishing an Ex- change for itself only at the price of crippling its insurance market and depriving its citizens of the tax credits at the heart of the Act. The Act unambiguously forecloses that construction. At a minimum, the IRS’s interpretation is a permissible one meriting deference under Chevron.
The brief goes on to explain these arguments in detail. It is well worth the reading.
But we are left with this. There are States that are led by people who hate the President so much that they will go to any lengths, conjure up any bogus arguments,and pursue any course to attack the President and his Presidency even if it directly harms the lives, health and financial security of their own citizens.
Thursday, July 24, 2014
HHS Reports That The ACA Has Saved Consumers $9 Billion
The Department of Health and Human Services issued a report today explaining that the Affordable Care Act has saved consumers $9 Billion since it was enacted. The bulk of the savings was in reduced premiums. But it also included $330 million of refunds to consumers when their insurance companies spent more than 20% of premiums on overhead. Here is a link to the actual report.
These savings all come from the 80:20 medical loss ration that requires insurers to limit their overhead to 20% of premiums. The effect of this requirement has been premium reductions totaling $3.8 Billion in 2013 alone. And the insurers who did not reduce their premiums were required to issue refunds to their customers. In the first three years the refunds that have been or will be paid totaled $1.9 Billion.
Most significantly, in the individual insurance market the spending on overhead dropped from 15.3% in 2011 to 11.7% in 2013.
The report also charts how refunds are declining each year as insurers reduce their premiums, which is exactly how the law was intended to work. For instance, in the individual market refunds went from $399 Million in 2011 to $192 Million in 2012 and $128 Million in 2013. There were similar reductions in the small group and large group markets. And in the aggregate, for all markets, refunds went from $1.1 Billion in 2011 to $332 Million in 2013. But most significantly those refund reduction were a direct result of insurers reducing their premiums to the point that for 2013 the ACA caused premium reductions in all markets of $3.85 Billion
This is real progress.
An HHS report released today shows that last year alone, consumers nationwide saved $3.8 billion up front on their premiums as insurance companies operated more efficiently. Additionally, consumers nationwide will save $330 million in refunds, with 6.8 million consumers due to receive an average refund benefit of $80 per family. This standard and other Affordable Care Act standards contributed to consumers saving approximately $4.1 billion on premiums in 2013, for a total of $9 billion in savings since the MLR program’s inception.
These savings all come from the 80:20 medical loss ration that requires insurers to limit their overhead to 20% of premiums. The effect of this requirement has been premium reductions totaling $3.8 Billion in 2013 alone. And the insurers who did not reduce their premiums were required to issue refunds to their customers. In the first three years the refunds that have been or will be paid totaled $1.9 Billion.
Most significantly, in the individual insurance market the spending on overhead dropped from 15.3% in 2011 to 11.7% in 2013.
The report also charts how refunds are declining each year as insurers reduce their premiums, which is exactly how the law was intended to work. For instance, in the individual market refunds went from $399 Million in 2011 to $192 Million in 2012 and $128 Million in 2013. There were similar reductions in the small group and large group markets. And in the aggregate, for all markets, refunds went from $1.1 Billion in 2011 to $332 Million in 2013. But most significantly those refund reduction were a direct result of insurers reducing their premiums to the point that for 2013 the ACA caused premium reductions in all markets of $3.85 Billion
This is real progress.
Monday, May 05, 2014
Benghazi Is About The President's Legitimacy Not Just Hillary
The entire premise of the Republican Benghazi fixation is backwards.
All of the Congressional and State Department reports make clear that the Republican Benghazi story is fact free nonsense supported only by delusional drivel. This is all very well detailed in this excellent summary the GOP's disregard of facts. But more importantly, the entire political premise for their Benghazi fixation, the entire foundation upon which it is built, is laughable and completely backwards. In their view Obama is the President only because he lied his way to re-election by pulling the Benghazi wool over peoples eyes. Yes, since the election the focus has shifted to undercut Hillary Clinton if she runs in 2016, but make no mistake it started out and continues to be about the legitimacy of Obama as President of the United States.
The Republican theory is that after the Benghazi attack the President downplayed an al Qaeda/terrorist connection to the attack in order to enhance his election prospects. They say that the Benghazi attack undercut the Administration's position that we were having some success against terrorists intent on doing us harm. They knew that Obama had achieved many successes against terrorists, most notable the killing of Bin Laden. All of these successes had eluded Bush and gave rise to the popular perception that Obama was making advances against terrorism.
The Republicans thought Benghazi would reverse all of that. In their view, if Americans were told that four Americans had been killed in Benghazi by al Qaeda terrorists everything Obama had done in the prior four years would have been for naught and he would go down to stunning defeat. This one event would undo the prior four years.
Of course it wouldn't do if the attack was just part of a sequence of events triggered by a hateful video. It had to be an attack by the big AQ, which would prove that everything else that had been done in the prior four years was meaningless smoke. Benghazi today, Benghazi tomorrow, Benghazi forever.
And so, when Susan Rice read the CIA talking points that suggested this attack was motivated by the same thing that generated protests or attacks in Tunis and Cairo and elsewhere, there had to be a coverup. Even in that telling it was an odd coverup since the President had already said it was terrorism and the story details were revised a week later. It didn't matter, this was a coverup of the Achilles heel of the Obama re-election campaign.
Well, if history is a guide they have it backwards. If Obama wanted to use Benghazi to advance his election prospects he would have hyped the Al Qaeda/terrorist fear and brought back the color coded terror alerts. He would have used the playbook that Bush used for all the years after 9/11, including immediately before the election day. Bush would tout his successes but point to every terrorist attack, or threat of attack, or imagined attack to keep people afraid and manufacture the image he and only he was the one who could "keep us safe."
This cynical use of terror attack and threats real or imagined was long suspected while Bush Was President. And it was eventually acknowledged by his DHS Secretary Tom Ridge who said, as reported by Time,
Similarly, as reported by John Amato in connection with the publication of Ridge's book, The Test of Our Times,
If President Obama wanted to make political hay about Benghazi he would have done exactly what Bush did, and try to scare the living bejeezus out of the American people right before the election. But that's not what he did. He and spokespersons for the Administration went out and told he truth as they knew it at the time. It was an evolving narrative as is always the case in times of conflict. First reports are rarely completely accurate and the facts become clearer after the dust settles.
The funny thing is the Republicans know that the Administration was being candid and was not hyping the incident as they know Bush would have done. They knew that his demeanor during this time was a strength, exuding a combination of confidence, compassion for the victims, and resolve. It was the calmness that the American people needed.
So they did what they always do? They attacked this strength. This is what they have done throughout his Presidency. They know he is a gifted orator so they attack his use of tele-prompters. They know he is brilliant and extraordinarily well read so they raise bogus questions about his educational background. They know he is very popular in one on one settings so they attack him for being aloof.
They did and are continuing to do the same with Benghazi. They know he was truthful and the tone and tenor were spot on so they attach him for not hyping an al Qaeda connection and cynically argue that if he had done so his re-election would have been doomed, when, if anything, it would have been further bolstered.
Well, the American people didn't fall for that in 2012 and four years of age aren't going to make it a more successful line of attack in 2014 or against Hillary in 2016.
But it isn't just about 2014 or Hillary. It started out as an attack on the President's legitimacy and continues to this day. In Republican minds the 2012 election had nothing to do with the forty-seven percent. It hinged on only one issue - Benghazi. If the Benghazi truth had been told he would have lost in a landslide.
In the Republican mind President Obama's first term was illegitimate because he was a Kenyan (not to mention anti-colonialist socialist) who wasn't eligible to hold office. And his second term is doubly illegitimate because he lied his way to re-election by pulling the Benghazi wool over peoples eyes.
All of the Congressional and State Department reports make clear that the Republican Benghazi story is fact free nonsense supported only by delusional drivel. This is all very well detailed in this excellent summary the GOP's disregard of facts. But more importantly, the entire political premise for their Benghazi fixation, the entire foundation upon which it is built, is laughable and completely backwards. In their view Obama is the President only because he lied his way to re-election by pulling the Benghazi wool over peoples eyes. Yes, since the election the focus has shifted to undercut Hillary Clinton if she runs in 2016, but make no mistake it started out and continues to be about the legitimacy of Obama as President of the United States.
The Republican theory is that after the Benghazi attack the President downplayed an al Qaeda/terrorist connection to the attack in order to enhance his election prospects. They say that the Benghazi attack undercut the Administration's position that we were having some success against terrorists intent on doing us harm. They knew that Obama had achieved many successes against terrorists, most notable the killing of Bin Laden. All of these successes had eluded Bush and gave rise to the popular perception that Obama was making advances against terrorism.
The Republicans thought Benghazi would reverse all of that. In their view, if Americans were told that four Americans had been killed in Benghazi by al Qaeda terrorists everything Obama had done in the prior four years would have been for naught and he would go down to stunning defeat. This one event would undo the prior four years.
Of course it wouldn't do if the attack was just part of a sequence of events triggered by a hateful video. It had to be an attack by the big AQ, which would prove that everything else that had been done in the prior four years was meaningless smoke. Benghazi today, Benghazi tomorrow, Benghazi forever.
And so, when Susan Rice read the CIA talking points that suggested this attack was motivated by the same thing that generated protests or attacks in Tunis and Cairo and elsewhere, there had to be a coverup. Even in that telling it was an odd coverup since the President had already said it was terrorism and the story details were revised a week later. It didn't matter, this was a coverup of the Achilles heel of the Obama re-election campaign.
Well, if history is a guide they have it backwards. If Obama wanted to use Benghazi to advance his election prospects he would have hyped the Al Qaeda/terrorist fear and brought back the color coded terror alerts. He would have used the playbook that Bush used for all the years after 9/11, including immediately before the election day. Bush would tout his successes but point to every terrorist attack, or threat of attack, or imagined attack to keep people afraid and manufacture the image he and only he was the one who could "keep us safe."
This cynical use of terror attack and threats real or imagined was long suspected while Bush Was President. And it was eventually acknowledged by his DHS Secretary Tom Ridge who said, as reported by Time,
Ridge says he objected to raising the security level despite the urgings of former Defense Secretary Donald H. Rumsfeld and then-Attorney General John Ashcroft, according to a publicity release from Ridge's publisher. He said the episode convinced him to follow through with his plans to leave the administration; he resigned on Nov. 30, 2004.
Similarly, as reported by John Amato in connection with the publication of Ridge's book, The Test of Our Times,
Former US homeland security chief Tom Ridge charges in a new book that top aides to then-president George W. Bush pressured him to raise the "terror alert" level to sway the November 2004 US election.
Then defense secretary Donald Rumsfeld and attorney general John Ashcroft pushed him to elevate the color-coded threat level, but Ridge refused, according to a summary from his publisher, Thomas Dunne Books.
"After that episode, I knew I had to follow through with my plans to leave the federal government for the private sector," Ridge is quoting as writing in "The Test of Our Times: America Under Siege ... And How We Can Be Safe Again."
Some of Bush's critics had repeatedly questioned whether the administration was using warnings of a possible attack to blunt the political damage from the unpopular Iraq war by shifting the debate to the broader "war on terrorism," which had wide popular appeal.
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He later publicly acknowledged that much of the information underpinning the new alert was three years old, stoking Bush critics' charges of political manipulation.
If President Obama wanted to make political hay about Benghazi he would have done exactly what Bush did, and try to scare the living bejeezus out of the American people right before the election. But that's not what he did. He and spokespersons for the Administration went out and told he truth as they knew it at the time. It was an evolving narrative as is always the case in times of conflict. First reports are rarely completely accurate and the facts become clearer after the dust settles.
The funny thing is the Republicans know that the Administration was being candid and was not hyping the incident as they know Bush would have done. They knew that his demeanor during this time was a strength, exuding a combination of confidence, compassion for the victims, and resolve. It was the calmness that the American people needed.
So they did what they always do? They attacked this strength. This is what they have done throughout his Presidency. They know he is a gifted orator so they attack his use of tele-prompters. They know he is brilliant and extraordinarily well read so they raise bogus questions about his educational background. They know he is very popular in one on one settings so they attack him for being aloof.
They did and are continuing to do the same with Benghazi. They know he was truthful and the tone and tenor were spot on so they attach him for not hyping an al Qaeda connection and cynically argue that if he had done so his re-election would have been doomed, when, if anything, it would have been further bolstered.
Well, the American people didn't fall for that in 2012 and four years of age aren't going to make it a more successful line of attack in 2014 or against Hillary in 2016.
But it isn't just about 2014 or Hillary. It started out as an attack on the President's legitimacy and continues to this day. In Republican minds the 2012 election had nothing to do with the forty-seven percent. It hinged on only one issue - Benghazi. If the Benghazi truth had been told he would have lost in a landslide.
In the Republican mind President Obama's first term was illegitimate because he was a Kenyan (not to mention anti-colonialist socialist) who wasn't eligible to hold office. And his second term is doubly illegitimate because he lied his way to re-election by pulling the Benghazi wool over peoples eyes.
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