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Obamacare

Will GOP Govs Cave on Medicaid?

Several GOP governors turned down federal money to expand their states’ insurance for the poor. Now even some hard-core conservatives are about to take the cash.

When will some states that initially refused federal money to expand Medicaid for their poor citizens pull a flip-flop and accept it? Because it’s inevitable that some will—and as they do, the Republicans’ sabotage of Obamacare will be profoundly undermined, and people’s concomitant opposition to the law will start to vaporize.

This thought is occasioned by the publication yesterday by Theda Skocpol, the esteemed Harvard sociologist and political scientist and head of the excellent Scholars’ Strategy Network, of an eye-popping chart about how health-care coverage is proceeding so far in various states. Skocpol divides the 50 states into five categories: “full-go,” the 14 states that have accepted the Medicaid expansion and set up their own exchanges; “supporters,” the seven states expanding Medicaid and working within the federal exchange; “exchange partners,” the two states working with the federal exchange but not expanding Medicaid; “Medicaid only,” the four states expanding Medicaid but defaulting on the exchanges; and “just say no,” the 23 states that aren’t accepting Medicaid money or working with the exchanges

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Scholars Strategy Network

In each of these five categories, what percentages of previously uninsured are gaining coverage? It’s about what you’d think, but it’s pretty astounding to see.

Profiles in....?

What Liz Cheney Should Say

My colleague Michelle Cottle does a great job today of capturing the Sturgesesque bathos of the Liz Cheney “campaign.” But I have a serious suggestion for La Liz, which is less Sturges than Sidney Lumet.

This campaign was a cynical farce from start to pathetic finish. And I think we’d all agree that nothing was more cynical than her denunciation of same-sex marriage. As her sister’s partner, Heather Poe, said at the time Liz made that statement, "to have her say she doesn't support our right to marry is offensive,” because Liz had always supported the couple.

I’ll be perhaps more generous than one needs to be and grant that Liz is telling the complete and honest truth about this family medical situation, even though something tells me that if she’d been 30 points ahead in the polls instead of 30 points behind, she might have found a way to deal with this situation while still campaigning. But if I’m wrong and it is indeed something much more serious than that, then of course, as a parent myself, I can only wish her and child the best.

But one thing it seems pretty obvious she was not telling the truth about was her position on gay marriage. So why doesn’t she just come clean now?

No, Really

The War on Poverty Worked

On the 50th anniversary of LBJ’s initiative, Marco Rubio says it failed. After all, poverty still exists. But the policies did succeed—Democrats are just afraid to say so.

So now Sen. Marco Rubio is trying to join Rep. Paul Ryan’s conservative bleeding-hearts club band. The Florida senator is releasing a video timed to Wednesday’s 50th anniversary of the launch of the war on poverty to declare said war a failure and launch his own. Woot woot. That isn’t necessarily stupid politics, at least as a general election strategy for 2016. How the guy who’s already alienated the wingers on immigration expects to make it through the primary season trying to get conservatives to care about poor people is another question, but that’s his problem. 

Our problem is when conservatives like Rubio talk gibberish: “Isn’t it time to declare big government’s war on poverty a failure?” No, it isn’t. It’s high time to say the war on poverty was a success. A wild success, indeed, by nearly every meaningful measure. But no one thinks so, and a big part of the reason is that most Democrats are afraid to say so. They’d damn well better start. If we’re really going to be raising the minimum wage and tackling inequality, someone needs to be willing to say to the American people that these kinds of approaches get results.

You may have seen the big Times piece Sunday that looked back over the half-century war on poverty, kicked off by Lyndon Johnson’s 1964 State of the Union address. The article noted that in terms of health and nutrition and numerous other factors, the poor in the United States are immeasurably less immiserated today than they were then. But it did lead by saying the overall poverty rate in all that time has dropped only from 19 to 15 percent, suggesting to the casual reader that all these billions for five decades haven’t accomplished much.

What’s wrong with thinking is that we have not, of course, been fighting any kind of serious war on poverty for five decades. We fought it with truly adequate funding for about one decade. Less, even. Then the backlash started, and by 1981, Ronald Reagan’s government was fighting a war on the war on poverty. The fate of many anti-poverty programs has ebbed and flowed ever since.

Roadblock

The GOP’s ‘Jobs’ Hypocrisy

Conservatives are suddenly hot on measures that Democrats have been touting for years. So why can’t they can’t acknowledge their own party is the biggest obstacle?

I bring good news this new year! Conservatives have a jobs agenda, one that isn’t built around merely cutting taxes and regulations and getting the government out of the way so the free market can strut its stuff.

USA-FISCAL/

© Joshua Roberts / Reuters

No—this includes… are you ready?… infrastructure investment, and a monetary policy less obsessed with keeping inflation under 2 percent. It’s new, it’s exhilarating, it’s brilliant! And it’s the same stuff that Barack Obama and most liberal Democrats have favored for years.

When David Frum, whom I respect a great deal, tweets that a new article should be thought of as “a ‘95 theses’ moment for the reformist right,” he gets my attention. So I clicked immediately and read through “A Jobs Agenda for the Right,” by Michael Strain of the American Enterprise Institute, from the new issue of National Affairs. I liked the essay and even agreed with a respectable percentage of what Strain had to say. But reading it was far more infuriating than reading something by a conservative and disagreeing with every syllable, because articles like Strain’s refuse to acknowledge, let alone try to grapple with, the central and indisputable fact that the contemporary Republican Party—his presumed vehicle for all this pro-jobs reform—has opposed many of these initiatives tooth and nail.

Optimism!

Immigration, Round 2: Still a Reach

The Times is all excited this morning that John Boehner has hired a staffer who used to be John McCain's top immigration aide. This means, the paper reports, that Boehner is serious about immigration reform and fully prepared to tell the tea party to go stuff it.

Boehner would not try to ram through the Senate bill passed last year, which is still alive this year, i.e., for the remainder of the session of Congress during which it was passed. Rather, says the Times, he'd break it into smaller pieces and see if he could get those through: most notably, a possible path to citizenship for young people who came to the country illegally as children with their parents. Obviously, this is well short of the broader Senate bill provisions, which include a path to citizenship for everyone.

I still think even these provisions will be too much for the House GOP, but the X factor here, which the Times doesn't get into, is whether this is Boehner's last year as speaker. He's not going to say of course, because as soon as he says it, he loses whatever tenuous power over his people he has.

But if he has decided in his mind that he's not going to run for speaker again, then he may well allow something to pass the House with lots of Democratic votes and just a handful of Republican ones. Under that circumstance, immigration reforms could pass the House, and maybe even some fairly progressive ones, if Boehner ends up being in a position where he needs the Latino caucus more than the tea party caucus.

What’s Ahead

7 Political Predictions for 2014

Sure, budget brinksmanship and Hillary presidential hints are a given. But millions more sign-ups for health-care coverage and the ousting of Mitch McConnell? They could happen, too.

Whatever else the week between Christmas and New Year’s is, it’s a godsend for columnists who are short on serious ideas, because we get to do things like write predictions columns. Thank you, Pope Gregory. But I promise you a few surprises, and a couple made of concrete so that you can hold me to them and wave them in my face a few months hence.

1. Situation: Budget Deadline. Prediction: Deal reached after 9 p.m. on January 14.

The year will start bleakly—really going out on a limb there, eh?—as January 15 arrives. Remember, the budget deal reached in December did not appropriate any specific dollars toward any specific program. It just raised the ceiling on the amounts that may be appropriated.

So between now and January 15, congressional appropriators have to set those levels. One has to assume that the GOP establishment’s “no more stupid shutdowns” rule will still have force. But there will be enough Tea Party members willing to create enough mischief to make things suspenseful again. I somehow suspect that Sen. Ted Cruz (R-TX), notably sidelined during the December negotiations, won’t be quite so cooperative this time around.

2013 Rewind

America Joins the Developed World

For all its woes, real reform finally got underway in 2013. Some day in the future, this year will be remembered as the one when the U.S. recognized people’s birthright to health care.

I’m sitting here very early Christmas Eve morning staring at a chart from the Organization for Economic Cooperation and Development. You know the OECD—they’re the people who keep all those annoying stats about how the United States is 17th in this and 32nd in that, the kind that alas aren’t very surprising anymore except that they do make us shake our heads and wonder how we managed to come in behind even Belarus.

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Getty

This chart is on an Excel spreadsheet, so I can’t provide a link, but it shows access to “health insurance coverage for a core set of services, 2009.” It then lists the 34 OECD member states, showing percentages of citizens with “total public coverage” and with “primary private health coverage.”

tomasky-insurance-chart

Hard Sell

Pajamaboy, Call Your Boss

Is this some wonk’s idea of a millennial? No one’s buying the awful new health insurance ads. Why Obama himself should be making a—yes—more idealistic pitch to the younger generation.

All right, conservatives, here we are. I’ve found that I agree with conservatives once a year about something.

131220-tomasky-pajamaboy-tease

via barackobama.com

We cut it close this year, this being the 356th day of 2013, but just under the wire, we made it: That “Pajamaboy” ad for Healthcare.gov is indeed terrible, and I’m afraid that it does say something about liberalism and liberals that someone, or several someones, at Organizing for America thought this ad would be in any way effective.

Of course I don’t agree at all with the psycho gay-baiting of the poor guy in the ad (and some of his defenders in the liberal commentariat) that’s emanated from a few voices on the right. I feel badly for the young man, who works at OFA and just decided to let it use his image (probably not knowing that when you assent to having your image become “stock art,” you’ve started asking for blowback like he received, and the law is on their side, not yours). The right just can’t help itself. Still. My side is going to have to do a hell of a lot better than this.

So Chris Christie is going to sign a Dream Act for New Jersey, which would allow undocumented immigrants--not just their children--to receive in-state tuition. Christie had said during his reelection campaign that he'd support this once another provision, one that would have provided state aid in some cases, was removed, and it was. This is Christie's first big taking of a position on an immigration issue.

From a 2016 perspective, this was the smart and basically the only move. If he opposed it he'd look like Mitt Romney used to look: afraid of the howlers on the far right, willing to do anything to placate them. If Christie suddenly started behaving like that, it would be death. The main thing he has going for him is the "he's his own man" narrative, which will contrast very favorably to Romney. I think everyone knows this. Even the way-out-there wingers know it. They will understand that a few heterodoxies are just part of the Christie package. And, of course, they understand that they need to do better with Latino voters.

This will put Christie in the enviable position, come the second half of 2015, of standing up before audiences in Ames and Waterloo and saying defiantly that he is who he is and the Republican Party should be big enough to embrace competing views etc etc etc. The media will eat it up. Eat it up.

If Christie plays his cards right, as he does here, he'll be the clear media darling of 2016 among the Morning Joe In Crowd. Those people don't want Hillary. They want a Hillary slayer. It's a better story. They'll be tired of liberal harpies after eight years of a Democratic administration. They'll fool themselves into thinking that Christie has the potential to unite the country in a way the divisive Hillary doesn't.

Hardly Finished

Obama’s Premature Political Obits

It’s been a messy year, but let’s not him pair him with Nixon just yet. Obama isn’t even as bad off as Bush was after his Social Security debacle—and nothing rules out a rally in 2014.

If President Obama saw the columns and news stories I keep reading lately, he’d probably have half a mind to resign and scurry back to Chicago in time to see the Bears lose a playoff game. “Tanking” approval numbers, no accomplishments, rudderlessness, and of course the website fiasco; they all add up, the conventional wisdom seems to say, to a presidency that is already all but finished, unless John Podesta can somehow save it. The Washington Post reported this week that among second-term presidents in the polling era, only Richard Nixon had a lower approval rating at this point than Obama does now.

Nixon? Is it really that bad? (By the way, there’s still a considerable distance between the two—Obama sits at 43 percent in the Post poll, while Nixon was down at 29.) I can read numbers, and I know what’s happened over the past year. Obama has lost support among core Democratic groups such as women and Latinos, and one suspects that the failure—not his failure; the failure, a distinction not enough people are evidently making—to pass immigration reform was disillusioning for these cohorts. And obviously the HealthCare.gov fiasco is the governing reality here. It’s been a messy year.

At the same time, everything that’s happened can be rebounded from. Let’s look, by way of comparison, at where President Bush was at the end of 2005. He’d started out the year, you might recall, saying, “I have political capital, and I intend to use it.” Actually, he said that right after he beat John Kerry. Bush didn’t yet reveal how he meant to use that capital, but soon enough it became clear that he meant Social Security privatization, or partial privatization.

Bush staked a lot on that project. If you were around then, you remember those endless town halls, filled with plants and ringers offering their most plangent testimonials about how they couldn’t wait to get Uncle Sam’s heavy hand out of their purses and invest their own retirement money as they saw fit, as any real Murican would insist. This was how Bush and Karl Rove were going to create the permanent Republican majority, through the new ownership society.

Francis and Capitalism

Darks Days for Bill Donohue

I got to wondering yeserday what Bill Donohue, the head of the Catholic League of America who's been a reliably reactionary defender of the Vatican for two decades as long as the Pope was denouncing gays and baby killers and trying to brush child-molestation stories under the rug, made of Pope Francis.

What a conundrum this must be! A Pope who shows some progressive inclinations. Here, on his group's web site, Donohue tries about two-thirds-heartedly to defend Francis's oft-quoted remarks about gay people ("who am I to judge?") by noting that il papa's remarks were "directly consistent" with the catechism, which says in essence hate the sin but love the sinner.

That's technically true, one supposes, but it doesn't grapple with the message that Francis's comment (and certain subsequent actions, like canning the outspoken social conservative Cardinal Burke from that council) was obviously meant to send out into the world, that he wants his Church to cool its heels a bit on this question.

But the tell came when Dononue was asked about Rush Limbaugh's denuncation of the pope as a "Marxist." Bear in mind here that if, oh, Rachel Maddow (not to say she's remotely comparable to that lying gasbag, but just for the sake of argument) had used similar language about Pope Benedict, Donohue would surely have reacted in the manner you'd expect. Picture Maddow having said at some point that Benedict was "a capitalist lickspittle." He'd have gone mad with apoplexy.

Inequality

What Obama Can Learn From Warren

For the first time in his presidency, Obama seems truly committed to tackling inequality. Here’s how he should do it.

Is 2014 going to be the year that Barack Obama tacks—and stays—left?

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Stephan Savoia/AP

He’s given big economic populism speeches before, but he has tended to raise the subject and then just quietly let it disappear for a few months at a time. Things feel a little different this time. I’d love to see Obama emphasize inequality, but there are good and bad ways to do it, both substantively and politically, and rather than take sides in an acrimonious debate that’s divided liberals and centrists for a couple of decades now, Obama ought to try to find a rhetoric and a set of ideas that both sides can make peace with. He needs to identify what we might call a Fourth Way.

First of all, it’s great that the White House pledges that Obama is going to be focused on issues like raising the minimum wage and extending unemployment insurance (and, of course, getting Americans health care). The median wage, as Center for American Progress CEO Neera Tanden pointed out, has fallen nearly 10 percent since 2000, from $56,000 to just under $51,500. The slow recovery and the prevalence of lower-wage jobs for people who have found work aren’t felt by the elites, but they’re felt all across the country by millions. Meanwhile, corporate profit hoarding is at record levels.

The left’s critics of the Bush presidency are no match to today’s paranoid right, as this week’s insane innuendo—from the Hawaii plane crash to The Handshake—perfectly illustrates.

Permit me to share with you my favorite set of headlines from Thursday.

USA Today: Official who OK’d Obama birth papers dies in crash.

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© Shannon Stapleton / Reuters

NPR: Hawaiian Official Who Released Obama’s Birth Certificate Dies in Plane Crash.

Rising Star

Paul Ryan Makes His ’16 Play

House budget vote: Tea Party stock way down, Paul Ryan stock way up.

The headlines this morning are about John Boehner, how he finally unloaded on the right wing. That's understandable because he's the speaker, and it's interesting, but there's more to look at here. Three angles interest me: what last night's vote revealed about the actual balance of power within the House GOP; what's next for the outside groups; and what this does for Paul Ryan.

Mark the vote last night among House Republicans--169 of them voted for the budget, and just 62 of them opposed it. That's nearly three to one voting to play ball. Not that it's a great budget. A number of Democrats opposed it too, mostly because of the limit on unemployment benefits. And the overall funding levels, while better than the sequester, are still awfully low.

But at least it is a budget. The difference between no dinner and a bad dinner is the presence of food on the plate. At least there's food.

They could have been behaving this way the whole time, you know. I mean, this is what they are first and foremost paid to do--to legislate, the first order of business of which is to pass a budget. They could and should have been behaving this way since 2009.

Enrollment Spike

Told You So: Obamacare’s Back

From an atrocious starting point, enrollment on HealthCare.gov is essentially quadrupling. As predicted, by next fall, the law is going to be a net plus for Obama and the Democrats.

If one looks just at the raw, bottom-line number the Department of Health and Human Services released Wednesday—365,000 citizens enrolled since October 1—one might be inclined to think it’s not so hot. And it isn’t. That’s 180,000 or so a month, and if you post that number against the stated goal of 7 million by next spring, the stated goal looks awfully chimerical, and the thing seems a disaster (180,000 times six months, the enrollment period, is just 1.08 million).

Dig a little deeper and things look considerably better. If we could graph it, the bar line of enrollment would make for a pretty impressive ski slope: After just 27,000 people signed up in the whole of October, The New York Times reported over the weekend, about 100,000 people signed up in November, and then, in the first week of December alone, 112,000 chose plans. The Los Angeles Times put out slightly different numbers Wednesday but agreed on the trend. From an obviously atrocious starting place, enrollment is essentially quadrupling. If that pace were to continue, the 7 million figure would be cleared in March.

I still wouldn’t quite bet on that. But I would definitely and unflinchingly bet on the central proposition I argued last week:  By next fall, HealthCare.gov is going to be a net plus for Obama and the Democrats.

Wishful thinking? You can call it that if you want to. But I warn you I’m not usually a wishful thinker. Like most partisans on either side, I tend to expect the worst. It’s usually a wise insurance policy; you’re rarely disappointed. I write such things only when I really think them, like the time in August 2012 when I wrote a column suggesting that Obama could very well win about 330 electoral votes. He won 332, which most anyone else would have said when I wrote that piece was crazy.

About the Author

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Michael Tomasky

The Daily Beast special correspondent Michael Tomasky is also editor of Democracy: A Journal of Ideas.

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