Browsing the blog archivesfor the day Friday, April 11th, 2014.


The Real Death Panels

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Health Care, Obama Administration

Health and Human Services Secretary Kathleen Sebelius resigned yesterday, which the Right heralds as a sign of victory. Some guy at the Federalist already is salivating over the grand fight they’re going to have nominating her replacement —

In any case, it appears that this resignation presents Republicans with a golden opportunity to reignite their crusade against Obamacare with Sylvia Burwell’s nomination as a proxy for all the problems with the law. Burwell is a political loyalist and a veteran of the shutdown fight with no record on health care, and will likely be coached to avoid answering questions about specific challenges with implementation at HHS. Senate Republicans actually have an advantage here in the wake of the Nuclear Option’s implementation: they can easily come up with a list of facts they claim the administration has hidden, details kicked aside, statutes ignored, and a host of other challenging questions on accountability over the implementation (and non-implementation) of the law. A list of every question Sebelius has dodged over the past several years would suffice. By demanding answers before the HHS nomination moves forward and refusing to rubber stamp the president’s pick, Republicans could force more vulnerable Democrats to take a vote that ties them both to the Nuclear Option and Obamacare six months before a critical election.

I understand Rachel Maddow was bothered that the resignation stepped on a week of good news about the ACA. But by November, it may not matter. I do not think most folks give a hoo-haw about the nuclear option, and who knows what public opinion of the ACA will be by November? If Republicans grandstand overmuch over the nomination hearings, they risk overplaying their hand, as they are prone to do.

Krugman writes,

When it comes to health reform, Republicans suffer from delusions of disaster. They know, just know, that the Affordable Care Act is doomed to utter failure, so failure is what they see, never mind the facts on the ground.

Thus, on Tuesday, Mitch McConnell, the Senate minority leader, dismissed the push for pay equity as an attempt to “change the subject from the nightmare of Obamacare”; on the same day, the nonpartisan RAND Corporation released a study estimating “a net gain of 9.3 million in the number of American adults with health insurance coverage from September 2013 to mid-March 2014.” Some nightmare. And the overall gain, including children and those who signed up during the late-March enrollment surge, must be considerably larger.

However, we still have the huge injustice of the refusal to expand Medicaid.

What’s amazing about this wave of rejection is that it appears to be motivated by pure spite. The federal government is prepared to pay for Medicaid expansion, so it would cost the states nothing, and would, in fact, provide an inflow of dollars. The health economist Jonathan Gruber, one of the principal architects of health reform — and normally a very mild-mannered guy — recently summed it up: The Medicaid-rejection states “are willing to sacrifice billions of dollars of injections into their economy in order to punish poor people. It really is just almost awesome in its evilness.” Indeed.

And while supposed Obamacare horror stories keep on turning out to be false, it’s already quite easy to find examples of people who died because their states refused to expand Medicaid. According to one recent study, the death toll from Medicaid rejection is likely to run between 7,000 and 17,000 Americans each year.

There’s your death panels, folks. They’re called “Republican governors.”

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