Category Archives: Congress

Harris Strikes Right Balance On Health Care Reform

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Democratic presidential candidates have been having a white hot debate about whether to support Medicare-for-All, which would move people onto Medicare and eliminate private health insurance plans, or a Medicare buy-in option, which would allow Americans to choose between government-run Medicare and corporate-run health plans.

Substantively, Medicare-For-All is Best

Substantively, Medicare-for-All makes more sense.  Going to a government-run single payer system would be the fastest and most effective way to cover all Americans, reduce administrative overhead, stop excessive profiteering, reduce medical costs, make the American economy more competitive, incentivize better health care best practices, and produce better outcomes. 

Compared to health systems used by other developed nations that are to varying degrees more like Medicare-for-all would be, the current U.S. system is worst.

Yes, a large tax increase would be needed to finance Medicare-for-All, and Democrats should be honest about that. At the same time, Americans would no longer be paying premiums, deductibles and copays.  Many Americans who have subsidized employer-based coverage should see higher pay as employers are freed of that enormous expense.  Because of these kinds of issues, 200 independent economists recently signed a letter stating that Americans would be paying less overall with a single government-run system than they pay under the current system, not more.

Politically, Medicare Buy-In Option Is Best

Politically, however, a Medicare buy-in option makes much more sense.  Because many Americans get extremely nervous about not having the option to stick with their familiar private health plan, about 75% of Americans support a Medicare buy-in option compared to about 56% who support Medicare-for-All.   Given how difficult it will be to defeat Trump in 2020 and pass something in the Senate in 2021 and beyond, political marketability and sustainability is no small consideration.

Harris’s Hybrid

After initially indicating support for Medicare-for-All, Senator Kamala Harris yesterday proposed a thoughtful hybrid approach.  While Harris still calls her proposal “Medicare-for-All,” it’s more accurate to call it “Medicare-for-All-Who-Want-It,” since it allows Americans to choose private plans that are required to have the same benefits as Medicare.  After a 10-year phase-in to limit transition-related bumps, all Americans would have the kind of coverage Medicare currently offers, with some coverage upgrades.

This approach would achieve much, but not all, of the substantive benefit of Medicare-for-All, and it has enormous political advantages over Medicare-for-All.  Importantly, when Trump and the corporate insurance interests attack “government-run health care that takes away your insurance coverage,” those critics can be disarmed with very simple and compelling rebuttals: “If you don’t like it, you don’t have to choose it.” “If it’s as bad as they claim, no one will choose it.” 

Those simple, powerful rebuttals, which can only be used with a buy-in option, de-fang the “they’re taking away your health insurance” bite.

Progressive critics like Sanders are criticizing the Harris plan as too “moderate.” It certainly is moderate compared to the Sanders Medicare-for-All plan.  But when compared to ACA repeal/Trumpcare, where 20 million lose their coverage and all Americans would lose popular and effective ACA protections, the Harris proposal represents huge progress.  Also, the Harris plan offers an important quantum leap forward from the current ACA-driven system. 

Importantly, the Harris proposal offers Americans a consumer-driven path to the future.  When given a choice, it’s very likely that most Americans will choose the cheaper and better Medicare option over corporate care. Corporate care won’t be competitive with Medicare, because of its higher overhead and the need to make profits. But giving all Americans the ability to comparison shop and vote with their feet is key, so that Medicare-for-All eventually comes to American by popular mandate, rather than government mandate. Taking that consumer-driven approach ultimately will make Medicare-for-All more politically durable.

Though I don’t know all the details yet, I like the general balance Senator Harris has struck.  Obama’s former chief Medicare/Medicaid administrator Andy Slavitt said it well:

“Sen. Harris’s plan balances idealism and pragmatism. It says in effect: We have a mandate to get everyone affordable health care and put people over profits — but we don’t need to tear down the things people have and they like in order to do it.”

That’s what Democrats need: Idealism to stay true to their progressive values and excite lightly voting Democratic constituencies such as young people and people of color and pragmatism to smooth over political and logistical challenges and win over critically important moderate swing voters. 

If You Like TrumpCare, You’ll Love JohnsonCare

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Minnesota gubernatorial candidate Jeff Johnson (R-Plymouth) is crying foul over an Alliance for Better Minnesota television ad that says Johnson’s health care proposals would take health care away from Minnesotans who need it.

But the Alliance’s ad is accurate. Without question, the health care “reform” approach candidate Johnson is promoting during his campaign would take health care away from Minnesotans who need it.

Let’s break down the proposed JohnsonCare plan, piece-by-piece.

Johnson Eliminating ACA Protections

Johnson wants to make the Affordable Care Act (ACA) a thing of the past in Minnesota, via a federal waiver granted by the Trump Administration. More specifically, Johnson wants to eliminate the ACA approach that has:

  • Protected Record Numbers of Minnesotans. Under the ACA framework, Minnesota achieved the highest rate of health care coverage in state history.
  • Made Previously Unaffordable Protections Affordable. For lower and middle-income Minnesotans who don’t get coverage through their employer, the ACA has provided hundreds of millions in financial assistance to reduce or eliminate premium costs.
  • Strengthened Minnesotans’ Protections. The ACA also banned the hated preexisting condition denials, insurance payment limits, and dangerous junk coverage.  Because fewer Americans are no longer living one illness or injury away from being crushed by a mountain of bankrupting medical bills, personal bankruptcies have decreased by 50 percent during the time the ACA has existed.

If Johnson eliminates the increasingly popular ACA protections in Minnesota, that all goes away.  So yes, in several different and dramatic ways, Johnson absolutely would take health care away from Minnesotans who need it. The ad is correct about that.

Johnson’s False Claims

Johnson’s criticism of his opponent’s health care proposal is also utterly ridiculous.  Johnson says claims opponent Tim Walz “wants to eliminate private health insurance and force all Minnesotans onto one government program.”

The reality is, Walz supports a MinnesotaCare buy-in option. Under that approach, Minnesotans would have the option of either buying private plans or buying into the MinnesotaCare program, which is a government program operated by private health insurance programs.

In other words, Johnson’s claims that Walz wants to “eliminate private health insurance” and “force all Minnesotans onto one government program” are flat wrong.

If Walz is proposing a government-run single payer plan in the short-term, I’m not aware of it. Even if that were true, Johnson’s inference that eliminating private insurance in favor of government run health care would hurt Minnesotans is also wrong.  After all, Medicare, a government-run health plan, is popular and effective.  Medicare is helping Minnesotans, not hurting them.

Moreover, government run health plans are used in many other developed nations. Compared to the United States, consumers in those nations have 1) universal comprehensive coverage, 2) lower overall health costs and 3)  better overall health outcomes.

JohnsonCare and TrumpCare

Instead of the ACA, Johnson wants to back a high risk pool program that was very expensive for both consumers and taxpayers when it was used pre-ACA. Minnesota Public Radio reported:

Craig Britton of Plymouth, Minn., once had a plan through the state’s high-risk pool. It cost him $18,000 a year in premiums.

Britton was forced to buy the expensive MCHA coverage because of a pancreatitis diagnosis. He calls the idea that high-risk pools are good for consumers “a lot of baloney.”

“That is catastrophic cost,” Britton says. “You have to have a good living just to pay for insurance.”

And that’s the problem with high-risk pools, says Stefan Gildemeister, an economist with Minnesota’s health department.

“It’s not cheap coverage to the individual, and it’s not cheap coverage to the system,” Gildemeister says.

MCHA’s monthly premiums cost policy holders 25 percent more than conventional coverage, Gildemeister points out, and that left many people uninsured in Minnesota.

Johnson also wants to promote “junk,” “short-term,” or “skinny” plans, which are cheap because they don’t cover basic protections.  Promoting junk plans to reduce health care costs is like promoting cheaper cars lacking seat belts, airbags, crumple zones, safety glass, and anti-lock brakes. They look good if you’re only considering the price tag, but they’re a disaster when you and your family are in dangerous situations and desperately need those life-saving protections.

On health care, as with so most other issues, Jeff Johnson is aping Trump. President Trump is obsessed with eliminating Americans’ ACA protections in favor of a skimpy TrumpCare replacement. Trump insists that TrumpCare will cover everyone and cut costs, while the nonpartisan Congressional Budget Office finds that 23 million Americans would lose their protections, and millions more would pay higher premiums.

So Minnesotans, if you like TrumpCare – and only 17% of Americans do – you’re going to love JohnsonCare.

MN GOPers Aren’t the Health Care Saviors They Claim To Be

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Exuberant Minnesota Republicans seem to think they have a winning health care issue for the 2018 election season–reinsurance. And they do deserve a great deal of credit for helping to enact a state reinsurance program that is reducing premiums for Minnesotans in the individual market. The individual market is for the 162,000 Minnesotans who can’t get insurance from their employer or the government.

While their claim that premium increases in 2016 and 2017 were due to DFL policies is ridiculous, it is true that the Minnesota reinsurance program they helped pass is helping those consumers. As the Star Tribune reported:

Jim McManus, a Blue Cross spokesman, said that were it not for the state’s reinsurance program, the carrier’s Blue Plus HMO would be seeking an average individual market premium increase of 4.8 percent as opposed to the 11.8 percent decrease cited Friday by Commerce

Impressive, and Republicans deserve credit for this.

The Rest of the Story

But as Ricky Ricardo would say, before Minnesota Republicans can credibly brand themselves health coverage saviors, they still have some splainin to do.

Why Not National Reinsurance? First, they need to explain why their party – in complete control of the U.S. Senate, U.S. House and the Presidency and entire U.S. Executive Branch of the federal government – doesn’t enact reinsurance to help all Americans. Because of economies of scale and the need for market consistency, a national reinsurance program makes much more sense than a hodgepodge of variable state programs.

Moreover, if stabilizing the market and helping consumers pay less is good for Minnesotans, wouldn’t it be even more awesome to do that for all Americans?  That’s likely why 75% of Americans support enacting reinsurance at the national level.

Why Sabotage the ACA?  So why aren’t Rep. Erik Paulsen, Rep. Jason Lewis, Rep. Tom Emmer, Jeff Johnson or former Governor Tim Pawlenty pressing for reinsurance at a national level? Because they and their White House puppet master would rather sabotage the remarkably effective Affordable Care Act (ACA) than improve the ACA to help American families.

The list of things Trump and his congressional Trumpbulicans are doing to irresponsibly sabotage American families benefiting from ACA protections is long and breathtakingly irresponsible.  This is hurting tens of millions of struggling Americans.  Republicans are ignoring the 71% of Americans who say the Administration should do all it can to make the the ACA work, compared to just 21% who support efforts to make the ACA fail and replace it later.

Why Oppose Adding A MinnesotaCare Buy-in Option?  The other thing Republicans boasting about the state reinsurance bill need to explain is this: Why aren’t they supporting giving the 162,000 Minnesotans in the individual market a MinnesotaCare buy-in option?

The MinnesotaCare buy-in option would achieve much of what Republicans profess to support — more plan and doctor choices for consumers in sparsely populated areas, guaranteed coverage for all Minnesotans in sparsely populated areas, and more competition to control prices.

The fact that Minnesota Republicans won’t support the common sensical MinnesotaCare buy-in option proposal, won’t push for a national reinsurance program, and continue to actively sabotage the ACA makes their gloating about being health care saviors ring very hollow.

Republicans Extremely Unlikely To Impeach Trump

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Cursor_and_trump_impeachment_-_Google_SearchThere’s a popular theory among the chattering classes that Trump will be impeached fairly soon.  It goes something like this: Republican members of Congress are getting very sick of Trump, because of his incompetence, conflicts-of-interest, Putin slavishness, and overall lunacy. Long-term, they worry that Trump will hurt their brand with the non-extreme swing voters they need to win elections.

So, the theory goes, congressional Republicans will eventually latch on to an impeachable offense, such as a blatant violation of a court order, which would spark a constitutional crisis. Congressional Republicans will then join with Democrats to impeach Trump, knowing all the while that doing so will empower one of their own, Vice President Mike Pence.

To congressional Republicans, Pence, a former member of Congress and Governor, is a comfortable old shoe.  He has extremely conservative positions on social issues that won’t sit well with American swing voters.  But he has at least been to charm school, and is competent, administratively speaking. So, the Ryans and McConnells of the world would be relieved to have Pence in the Oval Office instead of Trump.

Anyway, that’s the widely discussed theory.

Not Going To Happen

I find it very unlikely. Here’s why:

Yes, Trump is committing impeachable offenses.  Yes, most Republican congressional leaders worry about Trump, and much prefer Pence.  That part of the theory makes perfect sense.

But more than anything, congressional Republicans care about winning elections and holding onto their power. That is their lifeblood. To hold on to their seats and their majority, they need to a) survive Republican primary challenges in deep red gerrymandered congressional districts and b) have their hardcore Trump-loving base turn out to vote in general elections.

I believe it is highly likely that a significant slice of the Trump loyalists would stick with Trump, even after an impeachment, and maybe especially after an impeachment.  A significant proportion of the Trump voters will never stop being loyal to him.

After a historically bizarre and controversial campaign season, Trump is currently going through a disastrous transition and first couple of weeks in power.  He has criticism coming at him from all directions, including from prominent conservative leaders.   At the same time, Republicans no longer have the demonized Hillary Clinton to cast in their “lesser of two evils” narrative, which helped them win moderates in the Presidential election.

Despite all of that working against Trump, a Public Policy Polling (PPP) survey recently found that 95 percent of Trump voters still approve of the job Trump is doing, even though only a 47 percent minority of Americans approve, a historically low level for a President in his honeymoon period.  After all of that, 95 percent of Trump voters still approve of his performance.

Clearly, Trump voters are exceptionally loyal to him.  Still, as the Trump-generated outrages continue to pile up, and Trump fatigue sets in, some of that support will die off. Eventually, I could foresee as many as half of the Trump voters changing their mind about Trump.

But even if only half of Trump voters remain loyal to Trump after an impeachment proceeding, the remaining impeachment-inflamed Trump diehards – stoked by the unrepentant pro-Trump messaging machines like Breitbart, InfoWars, and many others — could wreak havoc on incumbent Republicans who supported impeachment. In general elections, a sizable number of post-impeachment Trump loyalists – enraged by the spurning of their hero — could stay home and cause otherwise safe congressional Republicans to lose in November 2018.

None of this is lost on congressional Republicans, who are hyper-sensitive to the Trump voters.  At the end of the day, most Republican Members of Congress seem to care much more about preserving their political power than they do about saving the republic from a crooked, unstable authoritarian. Because of that, and because Trump’s hard core loyalist voters will stick with him through just about anything, I just can’t see the current Republican majority ever agreeing to impeach Trump.

In other words, unless Trump steps down on his own, I think we’re almost certainly stuck with Trump for four years.

The Health Reform Middle Ground Between Bernie and Hillary

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Cursor_and_bernie_hillary_debate_msnbc_-_Google_SearchTo hear Senator Hillary Clinton’s campaign tell it, you would think that there is absolutely no way to transition from the Affordable Care Act (ACA) world of today to an eventual Medicare-for-All world that her opponent Senator Bernie Sanders promotes.

The Clinton campaign asserts that the ACA and Medicare-for-All are effectively mutually exclusive. That is, they claim that if you support Medicare-for-All, you must be against the ACA. For instance, former First Daughter Chelsea Clinton was put out on the stump to play Chicken Little:

“Senator Sanders wants to dismantle Obamacare, dismantle the CHIP program, dismantle Medicare, and dismantle private insurance. I worry if we give Republicans Democratic permission to do that, we’ll go back to an era — before we had the Affordable Care Act — that would strip millions and millions and millions of people off their health insurance.”

Chelsea’s mom, a bona fide health care policy expert, knows better. She knows that Senator Sanders proposes to consolidate public insurance programs to make coverage better and more efficient, not eliminate public coverage.

The Clinton campaign’s dire warnings aside, there is a potential middle ground between Senator Sanders’ Medicare-for-All Model and Secretary Clinton’s Stick With The ACA Model.  It’s a middle ground that is more politically viable than what Sanders proposes, and more progressive than what Clinton proposes.

The middle ground is this: Amend the Affordable Care Act to allow ACA exchange shoppers the option of voluntarily buying into Medicare.

This middle ground approach would effectively empower patients to decide the fate of Medicare-for-All.  Here’s how:  If over the years enough ACA exchange shoppers choose of their own free will to buy into Medicare, we will be making progress towards a public single payer system, which in numerous other western countries has proven to be a more effective and efficient model than America’s current model.

On the other hand, if private insurance options prove to be the most attractive, on a quality and/or price basis, the Medicare buy-in option will die off, because it will be exposed as being as inferior as Republicans claim it to be.

But with this Medicare buy-in option, patients would effectively decide Medicare-for-All’s ultimate fate, not politicians.  That’s why it’s a middle ground position.

Senator Clinton maintains that a public option lacks sufficient congressional support to pass, and that is certainly a distinct possibility. But if she proves to be correct and it gets defeated, the ACA will still be there. At that point, we would simply stay with the status quo ACA model.

But I’d like to see an aspirational President who was willing to lead a campaign to enact this middle ground approach.  Because this would be merely optional for patients, it is much more politically feasible than Sanders’ proposal to mandate Medicare-for-All.  Even if a Medicare buy-in option loses, promoting the issue now may pave the way for eventual passage in the future.   It moves the national debate forward.

I actually think a passionate, committed President would have an outside shot of passing this.  After all, there already is a great deal of support for this approach. GBA Strategies recently asked 1,500 likely 2016 voters whether they supporting giving “all Americans the choice of buying health insurance through Medicare or private insurances, which would provide competition for insurance companies and more options for consumers.”

An overwhelming 71% supported this Medicare buy-in option, including 63% of Republicans and 71% of Independents. Only 13% opposed. 

After the special interests start their multi-million distortion and lobbying campaigns, the Medicare buy-in option may well get defeated in a Congress that defeats just about everything. (In fact, any of Senator Clinton’s ideas for incrementally improving the ACA also face a steep uphill battle with a Republican-controlled House).   But this survey tells me that there is a solid foundation of support to build on. So why not lead the American people towards this place halfway between Bernie and Hillary, and at least try to make some progress.

Note:  This post was featured in MinnPost’s Blog Cabin.

Think Marco Rubio is “Moderate?” Think Again.

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The popularity of Donald Trump among Republicans poses huge long-term threats to the Republican Party. In a nation that is increasingly diverse, the nomination of Trump could further cement the party’s image as the party of bullying white bigots and misogynists. But if there is a silver lining associated with the dark Trump cloud, it is this: It sometimes creates the perception that Trump rivals like Senator Marco Rubio are “moderate” by comparison.  If Rubio gets the nomination, such a “moderate” label would serve him well.

That’s quite a gift to Senator Rubio, because he is far from a moderate. Rubio’s positions put him far, far to the right on the American political spectrum. For instance:

  • Marco_Rubio_Tea_PartyRubio ran for Senate in Florida as the candidate of the extremist Tea Party, not as the moderate alternative to the Tea Party.
  • He has a lifetime pro-choice record of 0% from NARAL Pro-choice America.
  • On safety net issues, the Alliance for Retired Americans gives him a lifetime voting record rating of just 5%.
  • On environmental issues, the League of Conservation Voters gives him a lifetime voting record score of only 9%.
  • On science issues, the Evolution Institute rates his voting record a rock bottom 0%.
  • On veterans issues, the Disabled Veterans of America gave the flag waving Rubio a 0% on its most recent rating.
  • Overall, the American Conservative Union (ACU) gives Rubio a lifetime voting record rating of 98%. In other words, Senator Rubio favored this ultra-conservative group’s positions 98% of the time. For context, conservative Senator Lindsey Graham (R-SC) got an 87% rating, conservative House Speaker John Boehner got an 83% rating, and Senator Susan Collins (R-ME), an actual “moderate,” got a 47% ACU rating.

Admittedly, the definition of a political “moderate” is not a precise one. But I think we all can agree that the definition of “moderate” is not “one who supports conservative or liberal positions 98% of the time.”

no_moderate_Rebulicans_chartBy any reasonable measure, Senator Rubio is a far-right extremist, as is Ohio Republican Governor John Kasich (88% lifetime ACU rating), who is also sometimes inaccurately labeled a moderate by simplistic pundits.  Political scientists have documented the fact that Republican members of Congress have moved sharply to the right in recent years, and that seismic shift away from the political center is reflected in this year’s field of Republican presidential contenders.

Senator Rubio is not even a moderate in comparison to Mr. Trump. Rubio is more considerably conservative than Trump on several issues, such as affirmative action, Planned Parenthood funding, a progressive income tax, gay rights, and an assault weapon ban.

It is true that Senator Rubio’s rhetorical tone is more mild than Trump’s, and that often drives shallow pundits’ characterization of him as a “moderate.” The Atlantic’s Peter Beinart explains Rubio’s smooth style well:

Rubio has mastered the same technique Barack Obama used so effectively when he was seeking the presidency. When faced with a controversial issue, he doffs his cap to the other side, pleads for civility and respect, insists that it’s a hard call—and then comes out exactly where you’d expect him to come out. On social issues, Rubio is as predictably conservative as Obama is predictably liberal. What they share is their moderate-sounding rhetorical style.

But in the end, moderation is not a function of decibels and diplomacy. Ultimately, it is a function of positions on the issues. If moderate voters are searching for a substantive moderate in this year’s Republican presidential field, the truth is they’re not going to find one.

Congress Needs To Vote On Obama’s Proposed War on ISIL

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I’m an Obama backer.  Though no President can ever be perfect, I admire what this President has done on the economy, health care reform, bringing home the troops from the Bush Middle East wars, and many other things.

Congress_war_declaration_authorityBut I disagreed with him last night when he said it would be “welcome” if Congress supported U.S. attacks on ISIL.  It would be more than welcome.  It would be necessary.

I’ll let others decide whether congressional authorization is constitutionally or statutorily required for a bombs and “advisers” action like this.   But strict legality aside, democratic principles dictate that a democracy’s representative body probe the executive branch’s plans and vote on authorization before we commit as a nation to the human and economic costs associated with a potentially protracted military engagement.

In 2008, I agreed with Obama when he said:

The President does not have power under the Constitution to unilaterally authorize a military attack in a situation that does not involve stopping an actual or imminent threat to the nation.

As Commander-in-Chief, the President does have a duty to protect and defend the United States. In instances of self-defense, the President would be within his constitutional authority to act before advising Congress or seeking its consent. History has shown us time and again, however, that military action is most successful when it is authorized and supported by the Legislative branch. It is always preferable to have the informed consent of Congress prior to any military action.

With only a 15-minute presidential speech presenting one side of the argument available, none of us yet has sufficient evidence to make an informed decision about whether or not we should support these proposed attacks on ISIL.  Congress needs to do it’s job and give the nation a free and open debate, and a democratic decision.  If Members of Congress really want to “support the troops,” an informed, transparent pre-strike debate about the pros and cons of this military action would support the troops in a much more meaningful way than yellow ribbons ever could.

– Loveland

Reporters Let McFadden Have It Both Ways On Health Reform

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You can’t simultaneously support deism and atheism, or capitalism and communism.  Embracing one makes it logically impossible to simultaneously embrace the other.  They are mutually exclusive.  If a candidate came out and claimed to be for both of those ideological constructs at the same time, in an attempt to win support from supporters of each idea, they would be the laughing stock of American politics.

If you doubt that, imagine if you saw these headlines in today’s news:

Dayton Tells Congregation “I Support Atheistic Christianity”

McFadden Tells Business Group He Embraces “Capitalistic Communism”

The candidates would be laughed out of the race for taking such absurd positions.

I submit that the same should be true of simultaneously advocating to 1) outlaw denial of health coverage due to a pre-existing health condition and 2) make health insurance coverage optional.  It’s defensible to embrace either of those two positions.  But it’s not defensible to embrace those two approaches simultaneously.

Here’s why:  If you outlaw the insurance companies’ enormously unpopular ability to deny coverage due to pre-existing conditions, but simultaneously make purchasing health insurance optional, millions of people would stay out of the insurance market until the moment they got sick or hurt.  After all, why would anyone choose to pay high premiums for years to protect themselves against the expenses associated with treating an illness or injury when they know that the insurance company will be forced to pay the treatment expenses after they suffer from the ailment? And if millions of people refused to pay premiums until the moment they need insurance benefits, the insurance industry would very quickly need to dramatically jack up premiums, or go bankrupt.

There is broad consensus about this.  The Georgetown University Center on Health Insurance, the Manhattan Institute, America’s Health Insurance Plans (AHIP), the Pacific Research Institute, the Manhattan Institute, The Concord Coalition, the Center on Budget and Policy Priorities, Families USA and many others have all said that a coverage mandate and preexisting condition reform have to be paired in order for the finances of health reform to work.

Mike_McFadden_scissors_obamacareYet when GOP politicians endorse those two mutually exclusive positions, almost no political reporters note the absurdity of it.  When reporters allow politicians to get away with simultaneously endorsing the part of Obamacare that outlaws pre-existing condition denials and opposing the part of Obamacare that mandates insurance coverage, they effectively allow those politicians to say something every bit as absurd as “I’m for capitalism, but I also support communism.”

For example Minnesota U.S. Senate candidate, and millionaire investment banker, Mike McFadden (R-Sunfish Lake) says:

Before we can make the kind of changes Americans deserve, we need to repeal the “Unaffordable Care Act” (which would repeal the coverage mandates)

…when we repeal and replace Obamacare, we need to make sure that those with pre-existing conditions actually have access to affordable insurance plans that cover their illnesses.

Any actuary will tell you that if McFadden and other GOP pols simultaneously enacted those two policies it would lead to a complete and utter meltdown of the nation’s health care finance system.  But almost no political reporters will.

– Loveland

Note:  This post was also featured on MinnPost’s Blog Cabin.

Al Franken: He’s Good Enough, He’s Smart Enough, and Doggone It People…Are A Little Bored With Him

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Al_Franken_pencilWhen Al Franken started running for the U.S. Senate in Minnesota, a lot of Minnesotans worried he would embarrass them by becoming the class clown of the Senate.  Franken had been silly-to-outrageous as a comedian, talk radio host, and author, so Minnesotans understandably worried he would be a goofball as a senator as well.

But Franken ran a serious-minded campaign, narrowly defeated then-Senator Norm Coleman, and, according to polls, has won over many voters since then.

How did Franken convert the skeptics?  As a Senator, Franken hasn’t been the class clown.  In fact, he has been the class nerd, serious as a heart attack, even by stoic Minnesotan standards.  Franken has bent over backwards to show that he takes his job seriously, and he has had some serious legislative victories on important but obscure policy issues, such medical loss ratios, diabetes prevention, and promotion of agricultural energy technologies.

To paraphrase  Franken’s Saturday Night Live character Stuart Smalley, Senator Franken has proven to Minnesotans that he’s “good enough” and “smart enough.”   But when it comes to likability, sometimes it’s difficult for Minnesotans to warm up to Franken, simply because they don’t see his less serious side very often.

Being perceived as too serious is perhaps a good problem to have for a recovering comedian.  But it could pose a bit of a political challenge as Franken prepares to connect with voters during a reelection fight in a difficult year for Democrats.  After all, this is the same state that elected  the cartoonish Jesse Ventura, in part because Ventura’s humorous debate appearances helped Minnesota voters relate to him on a personal level.

Having proven that he can be serious and effective, I think Minnesotans now would be okay if Franken showed a bit of his humorous side more often.  He shouldn’t return to SNL or Air America form, but he could occassionally lighten it up.  After all, many serious-minded congressional leaders have shown that serious legislating and humor can go together.

 “It’s a great country, where anyone can grow up to be President…except me.” – Senator Barry Goldwater (R-AZ)

“They appear to have become so attached to their outrage that they are even more outraged that they won’t be able to be outraged anymore.”  Representative Barney Frank (D-MA)

“We have the same percentage of lightweights in Congress as you have in your hometown.  After all, it’s representative government.  Senator Alan Simpson (R-WY)

“I’ve never really warmed up to television and, in fairness to television, it’s never warmed up to me.” Senator Walter Mondale (D-MN)

“The difference between a caucus and a cactus is that the cactus has the pricks on the outside.”  Representative Mo Udall (D-AZ)

Meanwhile comedian Al Franken is here to tell us:

“Antitrust enforcement has always been more effective at stopping horizontal integration…than it has at this kind of vertical integration.”

Rimshot.

A New York Times headline recently noted Franken’s earnest dive into the complex Comcast-Time Warner merger is “No Joke.”  Don’t we know it.   When the subject turns to the Sherman Antitrust Act of 1890, Franken’s eyes light up.  Most Minnesotans’ eyes glaze over.

I wholeheartedly applaud the studiousness and work ethic that Franken is bringing to his Senate duties.  In an age when self-serving circus ponies like Michele Bachmann can’t stop posing for the cameras long enough to accomplish anything for the people they serve, Congress needs more work horses like Franken to do the thoughtful legislating.

That focus on legislative plodding really does impact the lives of ordinary Americans.  For example, Franken’s “medical loss ratio” legislative victory may not make for scintillating water cooler discussions, but it is helping taxpayers save a remarkable $4 billion per year.   That’s billion with a “b.”  Unsung policy accomplishments like this are why I am thrilled to have Senator Serious representing me.

Still, debates aren’t only impacted by persistence and process mastery.  Congressional leaders like Bob Dole and Mo Udall proved that debates also can be informed and shaped by judicious use of humor.  Like Dole and Udall, Senator Franken has a special gift that all too few of his congressional colleagues possess.  After he is given a well-earned reelection victory, here’s hoping he feels more free to use it.

– Loveland

Note:  This post was featured as a “best of the best” by MinnPost’s Blog Cabin.

South Dakota’s Rick Weiland: A Different Kind of U.S. Senate Candidate

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Most U.S. Senate candidates spend all of their time traveling to Wall Street, K Street, LaSalle Street, Montgomery Street, and Federal Street to beg for money from millionaires and billionaires who demand obedience after they’re elected.

Most U.S. Senate candidates produce phony cookie cutter ads whose stock photography make them all look and sound the same.

So, it’s refreshing to see at least one U.S. Senate candidate, South Dakota’s Rick Weiland, running a very different kind of campaign, on Main Streets running to reform Wall Street.    Three hundred and eleven South Dakota Main Streets, to be precise.

This video, shot and editied by the candidate’s son Nick, and song, performed by the candidate with family members and friends, isn’t the slickest thing you’ll ever see.  It might even be a little corny for some of you hipsters.  But it’s also a rare breath of fresh air in an all too polluted political atmosphere.

Franken Opponent McFadden Refuses To Confirm Own Existence

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invisible_manSaint Paul, Minnesota — Minnesota U.S.  Senate candidate Mike McFadden held a news conference today to announce that he would be announcing nothing.

“Minnesota is great, and I’ll do lots of great stuff in the Senate to make it even greater,” said McFadden, to roaring applause from his supporters.  “Beyond that, I promise that I will not do wasteful ungreat things that keep Minnesota from becoming greater.”

Under questioning from reporters, the wealthy businessman running to replace U.S. Senator Al Franken refused to provide positions  on the national policy issues that are debated in the U.S. Senate.   For example, McFadden declined to state his position on the minimum wage, the Paycheck Fairness Act and a “personhood” anti-birth control measure.

MinnPost reporter Eric Black recently attempted to profile the stealth Senate candidate, but struggled to find anything to profile beyond the over $2 million the former businessman has raised from enthusiastic conservative donors.  Black characterized the McFadden record like this:

I’m not sure what the record is for seeking a seat in the U.S. Senate without disclosing issue positions, but McFadden, who declared his candidacy nine months ago, may be giving it a run.

There is no “issues” section on his campaign website. He skipped the first three opportunities to debate his Republican opponents for the nomination.  On Monday, he appeared at the fourth debate, but that one was closed to the press and public.

The McFadden campaign maintains that the candidate has taken many position stands, such as his desire to “name way more awesome things after Ronald Reagan” and “repeal and replace” the federal Affordable Care Act (ACA).

When pressed for details about what he would replace the ACA with, McFadden said that announcement would need to wait until he begins his six-year term in office.

“We will help, not hurt Americans,” McFadden  explained.

The campaign did release a 12-page single spaced list of things McFadden would rename after Ronald Reagan.

When asked to name political role models McFadden listed Ronald Reagan, several Reagan impersonators and Chauncey Gardiner.

“By standing for no one, and Mike is appealing to everyone,” said Saul Loes, a conservative political consultant advising the McFadden campaign. “He just might be the most brilliant politician of our generation, if he exists, which we are neither confirming nor denying.”

Note:  This post is satire.

MN Congressional Candidates Take Note: 6 of 10 Americans Want To Keep Obamacare

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The reporting on Obamacare public opinion research has been consistently shallow, as I’ve noted for years.  Despite the many simplistic “Public Opposes Obamacare” stories and punditifications, a deeper dive into the polls shows that an overwhelming majority of Americans want to either keep the Affordable Care Act (ACA) as is, or improve it.

The latest Kaiser Family Health Foundation Tracking Poll, which was fielded prior to this week’s positive publicity about ACA insurance exchanges targets being met, finds that this trend is continuing.  Even after a pre-deadline deluge of anti-Obamacare advertising, Americans still oppose repealing the Affordable Care Act, by a huge 29% to 59% margin.  Independent voters, who will be so important in the upcoming mid-term elections, also overwhelmingly oppose the GOP’s repeal calls, by a 32% to 52% margin.

Survey__59_pct_want_to_keep_acaSo, nervous DFL congressional candidates, improvements to the ACA — a better exhange website, a more robust exchange call center, more exchange “navigators,” stronger enrollment incentives for young adults,  and/or a public insurance option — would be welcomed by voters.  But let your Republican opponents blather on about “repeal and replace” all they want, because it simply is not selling.

– Loveland

Note:  This post was featured in Politics in Minnesota’s Best of the Blogs.

SD Senate Challenger Shows How Obama Should Have Led On Health Care Reform

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rick_weiland_head_shot-2President Obama and his supporters have struggled mightily to market the byzantine Affordable Care Act (ACA) reforms to the public.  But by uttering three simple words – “Medicare for all” –  U.S. Senate candidate Rick Weiland in neighboring South Dakota is showing President Obama how it should have been done way back in 2008.

The “Medicare For All” approach that Weiland proposed last week is much easier to sell than the ACA.  The Associated Press reports:

Weiland has proposed that citizens of any age be allowed to buy into Medicare, which now is generally open only to people 65 and older, as an alternative to private health insurance plans.

“People understand Medicare,” Weiland told The Argus Leader. “It works, it’s efficient, and all this other stuff that they’re having now to focus on is extremely complicated, and they don’t understand it.”

Clear.  Concise.  Compelling.  The same can’t be said about most ACA-related rhetoric.

Obama Framed Up The Wrong Comparison

In the book Predictably Irrational,  Dan Ariely, a psychology and behavioral economics professor, examines how we make choices.  One of the phenomena Ariely describes is research showing that humans tend to judge their environment in relation to things that are comparable.

For instance, let’s say you give newlyweds the choice of three honeymoon options – Paris with free breakfast included, Rome with free breakfast included, and Rome with no breakfast included.  Because the two Rome options are comparable, most will gravitate away from the single Paris option.  We are attracted to comparability.

The Comparability Obama Offered.  With that research in mind, consider what President Obama and congressional Democrats did on health reform in 2008.  He believed that Americans needed to have a system that was comparable with what they were familiar with, our American system of private insurers and private health care providers.  So, from 2008 to 2010, Obama framed the health care reform debate as the choice of two comparable things:

Private-centered status quo model.  The pre-2010 status quo system of private insurers and private health care providers.

vs.

Private-centered model, coupled with reforms..  The status quo system of private insurers and health care providers coupled with complicated reforms.

Affordable_Care_Act_infographic-2The ACA reforms were enormously complex, mostly because the underlying pre-2010 status quo health care system was so decentralized and entangled.  Obama’s reforms were narrowly enacted in 2010, primarily because the status quo was so overwhelmingly unpopular.

The Comparability Obama Should Have Offered.  But what if Obama had framed up  a different kind of comparable choice for the American people?  While it’s true that Americans are familiar with private health insurance, they are also familiar with Medicare.  So why didn’t Obama frame the debate up as a choice between these two comparable things:

Medicare for some.  A status quo system where Medicare is available only to seniors.

vs.

Medicare for all.  A new system where Medicare is available to everyone who wants it.

The Political Advantages of Medicare for All

Obama didn’t go with Medicare For All, presumably because he was afraid that Republicans would castigate it as “government run health care” and “socialism.”

As it turned out, the Republican spin machine was determined to characterize anything Obama proposed as “government run health care” and “socialism.” After all, it uses those terms to describe the ACA, which is  absurd, because the ACA relies on private insurers and private caregivers without permitting a single government-run option in the mix.

President Obama was never going to avoid this “government run health care” political attack , so there was no good reason to allow it to shape the proposal.

Moreover, Medicare happens to be “government run health care” that Americans really like.  About 56 percent of Medicare recipients give it a rating of 9 or 10 on a 0-10 scale, while only about 40 percent of Americans enrolled in private health insurance gave their plans such a high rating. An amazing 70% of Medicare recipients say they always get access to needed health care, while only 51% of people with private insurance say that.

A 2007 Associated Press/Yahoo survey showed that about two-thirds of Americans (65%) agreed that “the United States should adopt a universal health insurance program in which everyone is covered under a program like Medicare that is run by the government and financed by taxpayers.”

So demonizing the specific (“Medicare”) would have been much more politically difficult for Republicans than demonizing the abstract (“government run health care” or “socialism”).

Could Obama have passed a “Medicare For All” bill?  Expanding the nation’s most popular health plan was certainly possible.   After all, knowing that two-thirds of Americans support Medicare for All, what politician of either party would want to take to the stump arguing:

“For your parents, grandparents, neighbors, and friends, Medicare is terrific.   I’ll fight to the death to protect it for them.  But for the rest of you,  I am blocking you from accessing  Medicare.  Medicare for YOU would be radical socialism that would lead to horrific health problems.”

Huh?  That would be a head-spinning political argument to sell.

Still, because the insurance lobby is so strong, maybe Congress would have rejected Medicare for All, against the wishes of two-thirds of their constituents.  But if Obama had made  Medicare for All the starting point for the debate, the compromise at the end of the process may have been more progressive, such as a private-dominated marketplace with a Medicare-like public option impacting market competition.

Incumbents who voted for the ACA in 2010 need to defend that confusing law in the 2014 mid-term elections, and the ACA is certainly a vast improvement over the pre-ACA status quo that Republicans have effectively embraced by not offering alternatives for reducing the rate of uninsurance and outlawing preexisting condition bans.  The ACA, for all its warts, is the most significant health care reform since the creation of Medicare.

But even in a neon red state like South Dakota, challengers like Mr. Weiland are wise to adopt the clear, concise and compelling “Medicare for All” rallying call, just as Obama and congressional Democrats should have done back in  2008.

Loveland

Note:  This post was featured in MinnPost’s Blog Cabin.

Now Is The Winter of Our MNbamacare Discontent

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So much political analysis is focused on the short-term:  “Which side won yesterday’s news cycle.” But unless it’s the day before an election, such short-term analyses aren’t particularly meaningful.

Hand_of_cards-2The more useful question to ask is this: “On the next Election Day, would I rather be playing the proponents’ or opponents’ hand?”     Applying that question to the issue of MNsure and Obamacare, I’d  much rather be playing the supporters’ hand.

Public relations-wise, MNsure has definitely “lost” many a news cycle over the last several months.  Security breaches, website crashes, protracted customer service waits, and data transfer blunders.  And as we all know, when the going got tough, the tough got going, to a Costa Rican beach, a particularly damaging episode.

These things all hurt, and I don’t mean to diminish them.  MNsure and Obamacare supporters have been dealt bad cards in recent days.  If you’re only focused on the short-term history, it looks like reform supporters might have a very bad political hand to play in the 2014 elections.

But forget about December 2013 for a moment, and consider how things will look like on November 4, 2014.

What GOP Will Be Proposing To Eliminate In 2014

By Election Day 2014, eliminating the reforms will be a more difficult sell, because by that time the reforms will have touched millions of lives in pretty significant ways.  Republican candidates will need to make the case “I will eliminate something that has…”

PAID MILLIONS IN REBATES.  Produced millions of dollars in rebates paid by insurance companies to thousands of Minnesotans and millions of Americans, thanks to an Obamacare provision authored by Minnesota’s U.S. Senator Al Franken.  The provision limits the proportion of premium dollars insurers can use for non-health care expenses, and requires that the difference be paid back in customer rebates.

HELPED THE MOST VULNERABLE MINNESOTANS.  Got 95,000 of Minnesota’s most vulnerable citizens efficiently covered in Medicaid, including about 12,000 uninsured Minnesotans whose medical expenses were being shifted to insured Minnesotans.

COVERED UNINSURED YOUNG ADULTS.  Covered 35,000 Minnesota young adults, who otherwise would have been uninsured and now are able to stay on their parents health policy until age 26.

MADE PRIVATE COVERAGE MORE FEASIBLE.  Offered lower costs in the marketplace to 382,595 Minnesotans who are uninsured or otherwise eligible for subsidies.

HELPED CONTROL HEALTH EXPENDITURES.  Contributed, along with state and health plan-driven reforms, to the slowest growth of health care expenditures since the state began tracking expenses in the mid 1990s, which will immensely help Minnesota’s future fiscal and economic outlook.

ELIMINATED CO-PAYS FOR PREVENTATIVE HEALTH SERVICES.  More than 1.4 million Minnesotans no longer have to shell out co-pays for preventative health care, because of an Obamacare requirement.  This includes things like flu shots, colonoscopies, mammograms and well-child check-ups.

DELIVERED LOWEST PREMIUMS IN THE NATION.  Created a simple-to-understand — though still not simple to use — apples-to-apples insurance marketplace that has prompted competitors to offer Minnesota consumers the lowest insurance premiums in the nation.

ENDED PRE-EXISTING CONDITION BANS.  Made it illegal for private insurance companies to deny coverage due to pre-existing health conditions, something that impacts many of the 2.3 million Minnesotans who have some type of pre-existing condition.

Presentation1Again, I don’t intend to sugar coat the current situation.  It’s been a rough few months for Obamacare and MNsure supporters.  The exchange website, call center, and management problems need to be improved as soon as possible.  Now most definitely is the winter of MNbamacare supporters’ discontent.

But come next fall,  Republican candidates, who offer no viable health care reform plan of their own, will have a very difficult time making the case for elimination of reforms that have been producing strong benefits for millions of Minnesotans.  “Elect me, to increase our rate of uninsurance again!”  “Elect me, to eliminate what you want to work better.”  “Elect me, to bring back pre-existing condition bans for your family!”

MNsure and Obamacare’s 2013 frailties aside, trying to take away those widespread benefits will be a very difficult political hand for the GOP to play in the 2014 elections.

– Loveland

Note:  This post was also republished in MinnPost, and featured in Politics in Minnesota’s Best of the Blogs.

Paulsen and Kline Finally Support A Jobs Bill

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Erik_Paulsen_John_KlineIn the past, I’ve been critical of Minnesota Republican  Congressmen John Kline and Erik Paulsen for not doing enough to address America’s chronic unemployment problem.  But I have to hand it to them, because yesterday they passed legislation ending the government shutdown that will immediately put 800,000 Americans back to work, and stabilize the economic position of many others.  That’s fantastic news.

Unfortunately, Paulsen and Kline haven’t always been so strong supporting job creation for Americans.  They both refused to support President Obama’s 2009 American Recovery and Reinvestment Act that, according to the independent, non-partisan organization FactCheck.org, created a whole lot of jobs:

“…the nonpartisan Congressional Budget Office released a report in August that said the stimulus bill has “[l]owered the unemployment rate by between 0.7 percentage points and 1.8 percentage points” and “[i]ncreased the number of people employed by between 1.4 million and 3.3 million.”

Simply put, more people would be unemployed if not for the stimulus bill. The exact number of jobs created and saved is difficult to estimate, but nonpartisan economists say there’s no doubt that the number is positive.”

Paulsen and Kline have also refused to support pending legislation proposed by President Obama, the American Jobs Act, that, according to private sector experts, would stimulate millions of more jobs:

Moody’s Analytics Chief Economist Mark Zandi: “The fiscal boost from the jobs package next year would be larger than in the first year of the 2009 economic stimulus, said Mark Zandi, chief economist at Moody’s Analytics Inc. Zandi, who was briefed on the plan before the president’s speech, forecast passage of the entire jobs package would add 2 percentage points to economic growth next year and bring down the unemployment rate by 1 percentage point compared with current policy, under which a temporary payroll tax cut and an extended unemployment benefits both expire Dec. 31.”

This morning Economic Forecasting FirmMacroeconomic Advisers issued a report: “We estimate that the American Jobs Act (AJA), if enacted, would give a significant boost to GDP and employment over the near-term. The various tax cuts aimed at raising workers’ after-tax income and encouraging hiring and investing, combined with the spending increases aimed at maintaining state & local employment and funding infrastructure modernization, would: Boost the level of GDP by 1.3% by the end of 2012, and by 0.2% by the end of 2013. Raise nonfarm establishment employment by 1.3 million by the end of 2012 and 0.8 million by the end of 2013, relative to the baseline.”

…Citigroup Chairman Richard Parsons said, “The President’s proposed combination of personal and business tax relief, targeted spending to support infrastructure, and aid to states offers several direct and innovative ways of creating jobs and bolstering our economy. The President’s focus on assisting small business is spot on, since small business is the engine of job creation.”

Finally, Paulsen and Kline have refused to support legislation to end the “sequester” of billions of dollars federal funds.  CBO economists say lifting these spending cuts would immediately add millions more jobs for the American people.

The nonpartisan Congressional Budget Office on Thursday estimated that keeping the spending cuts from sequestration in place through fiscal 2014 would cost up to 1.6 million jobs.

Canceling the cuts, on the other hand, would yield between 300,000 to 1.6 million new jobs, with the most likely outcome being the addition of 900,000, the CBO said.

“Those changes would increase the level of real (inflation-adjusted) gross domestic product (GDP) by 0.7 percent and increase the level of employment by 0.9 million in the third quarter of calendar year 2014 (the end of fiscal year 2014) relative to the levels projected under current law,” the report states.

Again, these are the job creation bills that Kline and Paulsen have historically refused to support.

But I do want to give credit where credit is due.  The bipartisan legislation Paulsen and Kline supported yesterday will immediately put 800,000 more Americans back to work, and end a government shutdown that will have cost taxpayers, according to Standard and Poors, about $24 billion.  That’s $24 billion that isn’t circulating in the economy creating jobs.

Forget that Kline and Paulsen originally did nothing to speak out against their fellow House Republicans who were giddy in forcing these 800,000 Americans out of work.  At long last, Paulsen and Kline have supported a jobs bill.  Here’s hoping it’s the beginning of a trend.

– Loveland

Note:  This post also was featured in Minnpost’s Blog Cabin.

The Minnesota Legislator Salary Shutdown Act of 2014

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carrot_and_stick_vintage_photoSometimes good policy and good politics intersect.  Fixing the problem of ideological extremists shutting down governments with a steady stream of ransom demands is one of those instances.   Any legislator who could figure out a way to reduce the frequency of hugely unpopular shutdowns would further the cause of a more stable democracy, as well as harvest political benefits with three-fourths of voters.

I recently promoted the idea of challenging candidates to pledge to not shutdown government, to effectively increase the political price for shutdowns.  But another way to address the problem it is to increase the personal price for shutdowns.

I therefore propose the Minnesota Legislator Pay Shutdown Act of 2014:

Whereas, reaching consensus and keeping government services operating is the job of the Minnesota legislators;

Whereas, government shutdowns are a clear indication that Minnesota legislators are not doing their jobs;

Therefore, be it resolved that any Minnesota state legislator who supports legislation that results in a government shutdown shall be ineligible to draw their state government salary for a period of one year.

Nobody would ever accuse me of being a legislative draftsman, so this language is obviously illustrative only.  Legislative staffers would need to substitute murky legalese so that virtually no one ultimately could understand it.  But you get the general idea.

Is that fair or just demagogic blogger bluster?  Well, people from surgeons to salespeople have “pay-for-performance” pay models.   So why not legislators?

– Loveland

Note:  This post was also featured in Politics in Minnesota’s Best of the Blogs.

When Government Ceases To Be An Abstraction

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shutdown__sign“Oh wait, don’t shutdown the monuments for millions of visitors.  That’s mean-spirited political theater.  Oh wait, don’t shutdown veterans benefits.  That’s un-American.  Oh wait, don’t stop protecting us against infectious diseases, food-borne illnesses and environmental catastrophes.  That endangers public health.  Oh wait, don’t delay passport and visa applications, bankruptcy court cases, small business loans and mortgage applications.  That hurts our economy.  Oh wait, don’t furlough workers in my home state who buy stuff from my home state businesses.  That hurts Main Street.  We only shut down a nameless, faceless abstract stereotype called ‘big government,’ not that stuff.”

This is the noise coming from the congressional Republicans who were reportedly “giddy” when they first shutdown the government, and now are blaming President Obama when confronted with the effects of an overwhelmingly unpopular shutdown.

Anatomy of the GOP Miscalculation

How did Republicans make such a massive miscalculation?  In large part, they misread public opinion polls that consistently say the American people want “less government spending.”   This emboldened them.

But what they apparently didn’t read were the public opinion polls that broke government down to its component services.  That research makes it clear that a majority of Americans absolutely do not want to cut government services.

According to one Pew Resarch poll, only 32% of Americans want to cut unemployment benefits, 24% want to cut aid to the poor, 22% want to cut environmental protection, 20% want to cut government research, 17% want to cut roads and infrastructure, 14% want to cut combatting crime, and 10% want to cut education.   The truth is, the fans of cutting government are a fringe minority of Americans.

It’s not just veterans and memorials that Americans want to protect.  A majority of Americans oppose cuts in any of the 19 major areas Pew asked about, and they most certainly don’t want to shut down those services altogether.

Obamacare:  Abstract v. Specifics

The same is true of the Affordable Care Act, or “Obamacare.”  As an abstraction, Obamacare faces some opposition, though less than most believe.  Only one in five (20%) Americans want to repeal it in its entirety, while a majority of Americans either want to keep it or strengthen it.

While there are concerns about Obamacare as an abstraction, a Reuters poll shows that the component parts of it are overwhelmingly popular.

  • Allowing 6.6 million young adults to be covered on their parents’ policies until age 26?  61 percent of American support it.
  • Requiring companies with more than 50 workers to provide health insurance for employees?  72 percent of Americans support it.
  • Banning insurance companies from denying coverage to people with pre-existing health problems?  82 percent of Americans support it, including 78% of Republicans.

If you think a government shutdown is unpopular, just try to shutdown Obamacare in 2014 or 2015.  As soon as Americans understand that repealing Obamacare would re-empower insurance corporations to deny coverage to their sick family members, friends, neighbors and co-workers, you would have 82 percent of Americans, and 78% of Republicans, up in arms.

Government in the abstract is quite unpopular, while government in the specific is quite popular.  If any good could come of this fiasco, it would be the Republicans learning this fundamental lesson about  the American people they represent.

– Loveland

Note:  This post was also re-published in Minnpost.

Which MN Candidates Will Sign The Pull-The-Plug Pledge?

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Pull_the_plugAs a general matter, I despise campaign pledges.  Candidates are continually badgered by interest groups to pledge in writing that they will always do X, or never do Y.

The Problem With Pledges

The problem with most pledges is the “always” or “never” parts of them.  The world changes, and policy positions therefore sometimes need to change with them.

  • Pledging to not increase taxes today may make sense at one point in history, but a few years later the circumstances may have changed dramatically.
  • Pledging to support a policy or project now may make sense, but not after surprising new information surfaces.
  • Pledging to tax millionaires may make sense at a time when they’re not paying their fair share, but not a few years later when circumstances may have changed.

So sometimes making policy shifts isn’t  a sign of weakness or dishonesty, as pledge enforcers often claim.  Sometimes, shifting is a sign of courage, vision and integrity.

That’s why I don’t like most campaign pledges.

Pull-the-Plug Pledge

But I came across a pledge the other day that fits our times, and has an infinite shelf life.  South Dakota congressional candidate Rick Weiland challenged all congressional candidates to sign this simple pledge:

“I hereby pledge that, if elected to represent you, I will never vote to shut down your government, or to place your government in default, in order to force it to act, or to prevent it from acting, on unrelated issues.” 

As a voter, I want to know where every Minnesota congressional candidate stands on this Pull-The-Plug Pledge.

Flat_line-2If there are candidates out there who think it is acceptable from them to pull the plug on the American people’s government and economy, that is their right.  But it’s also the right of the overwhelming 72% percent of Americans who oppose the Republicans’ current plug-pulling scheme to be forewarned of a congressional candidate’s position on that  issue, so that they can vote with their eyes wide open.

Yes, Americans and their policymakers must always be able to make their government a different size and shape as future circumstances dictate.  This pledge doesn’t prevent them from having such flexibility. It simply says it’s not acceptable to completely pull the plug on the American economy and government.

So, Tim Walz, Mike Benson, John Kline, Mike Obermuller, Paula Overby, Betty McCollum, Keith Ellison, Erik Paulsen, Tom Emmer, Rhonda Sivarajah, Phil Krinkie, John Pederson, Judy Adams, Collin Pederson, Rick Nolan, Stewart Mills III, Monti Moreno, Chris Dahlberg, Mike McFadden, Julianne Ortman, Jim Abeler, and Al Franken, will you sign the Pull-The-Plug Pledge?

– Loveland

Note:  This post was also featured in Politics in Minnesota‘s Best of the Blogs.

Learning To Lose With MnSure

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Bunyan_woodpeckerIn case you haven’t heard, Republicans hate health insurance exchanges like MnSure. While the conservative Heritage Foundation developed the approach, conservative leaders like Bob Dole, Newt Gingrich and Orrin Hatch endorsed it, and conservative standard bearer Mitt Romney pioneered it, contemporary conservatives have come to despise it since it was adopted by President Obama.

Conservatives now prefer to allow insurance companies to compete across state lines governed by federal regulations, instead of the current system of state-by-state regulation of insurance products.  But there isn’t sufficient political support to enact the conservatives’ preferred interstate competition approach.

I feel my conservative friends’ pain, because my preferred approach also doesn’t have enough political support to become law, and I also don’t love insurance exchanges like MnSure.  I’d much rather have a single payer system — the system that delivers the best care and value in other industrialized nations — than this competitive private sector exchange model.  However, since there wasn’t sufficient political support for my first choice, my fallback preference was to authorize a “public option”—a Medicare-for-All — competing against private options to test which model is more efficient and effective.

But alas, after a long, fair and considered congressional debate, I lost on both my first and second choices.  Now I and all Americans have to accept the private competitive exchange model that prevailed in the democratic arena.

Memo to my Republican friends:  That’s how losing works in a democracy.  You have to accept the outcome of the democratic process, and move on like an adult.

While insurance exchanges like MnSure were far from my preferred option, there are things I like about them.  For the first time, they require products to be directly comparable, so that a lightly informed consumer like me can actually do apples-to-apples shopping, or silver plan-to-silver plan shopping.

That represents a significant improvement that will reshape the marketplace in a somewhat more consumer-friendly way. With private and non-profit insurers required to create directly comparable products, insurers now know that many consumers are going to buy the more affordable apple over the comparatively expensive apple.  That puts consumer demand pressure on insurers to offer the most affordable apple possible, just as airlines have constant demand pressure to offer the most affordable ticket to New York City via online marketplaces like Kayak, Orbitz and Travelocity.

Whether we’re talking about Kayak or MnSure, the widespread availability and use of the Internet makes this kind of comparison shopping possible.  Social media and advertising guru Simon Mainwaring is among those those who have written about how the Internet changes modern marketplaces:

“More than ever before, consumers have the ability to unify their voices and coalesce their buying power to influence corporate behaviors.”

So far, this type of “coalesced buying power” is showing promise.  In Minnesota’s competitive exchange, we are seeing among the lowest premium prices in the nation.  That’s a tribute to Minnesota’s non-profit health insurance companies, the state health care model that Republican Governor Arne Carlson significantly shaped and the exchange model that Republicans developed, supported and pioneered.

In life and in policy making, sometimes we don’t get our first choice, or even our second choice.   Liberals like me certainly didn’t get our first or second choice in the 2010 federal health reform debate.  But that doesn’t mean that some good can’t come from the third choice, if we’re adult enough to give it a chance, instead of working overtime to sabotage it.

So my conservative friends, on the launch day for MnSure, join me in belting out those healing Stephen Stills lyrics:  “If you can’t be with the one you love, honey, love the one you’re with.”

– Loveland

Note:  This post was also featured in Politics in Minnesota’s Best of the Blogs.

Time for Obamacare Supporters To Let Their Light Shine

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insurance_denialObamacare is easy to misunderstand.  It’s complex, confusing and heavily demagogued, and those things all plant seeds of doubt in a lightly informed citizenry.  Given the barrage of lies flying around, it astounds me that a majority either still want to keep it or make it stronger.

But as Senator Ted Cruz and many others can tell you, it is very easy to whip about a third of the population into a fervor over Obamacare.  Listening to Cruz, Boehner and the boys discuss Obamacare, you’d think the End Times are nigh.

One of their favorite tactics is the ritualistic burning of the Obamacare Card.   Though there is no such thing as an Obamacare Card, a conservative group called Freedomworks printed up a batch of faux cards so they could burn them in the public square.

The minority intent on repealing Obamacare has created a good visual with the card burnings.  Now, the majority of Americans who either want to maintain or strengthen Obamacare need to create a memorable counter visual.

I nominate burning insurance rejection documents.  For decades, insurance companies have been denying health coverage for seriously ill Americans, because seriously ill people are expensive and unprofitable to cover.   I’m not blaming insurance companies for doing this, because we have built a system that effectively requires them to deny coverage to those with expensive medical needs.  After all, any insurance company that started covering the most sick, expensive patients would be run out of business, because they wouldn’t be able to compete against competitors who reject the most sick, expensive patients.  Unless all insurance companies are mandated to cover these folks, none will.

Everyone agrees that these denials have tragic consequences for an enormous group of ailing Americans.    According to research by the Commonweath Fund:

An estimated 9 million were turned down or charged a higher price because of a health problem, or had a preexisting condition excluded from their coverage.

The tragedies that stem from such denials are widespread.  Non-treatment.  Under-treatment. Inefficient and ineffective treatment.  Bankruptcies driven by mountains of unpayable medical bills.  Cost-shifting to the rest of us.

No more.  Starting with the insurance policies going on sale  October 1, 2013, Obamacare makes it illegal for any insurance company to ever again deny coverage based on a preexisting condition.  As a result, 9 million of some of the sickest Americans finally will be eligible for coverage, and if you get sick or hurt in the future, so will you.

This Obamacare-mandated change is revolutionary for those who have been rejected in the past, and for any of us who could be denied in the future, which is all of us.  It is a vastly under-appreciated aspect of Obamacare.

bonfire_celebrationSo to celebrate this momentous occasion, let’s burn some insurance company rejection documents.  Since there are 9 million lives impacted, let’s burn 9 million denial documents. Just as fake Obamacare Cards needed to be produced for theatrical effect, symbolic rejection documents would have to be recreated.  (Most people don’t save their rejection letters to put into their baby books.)

Imagine what that blaze would represent.  Coverage denial for victims of all types of cancer, diabetes, hepatitis C, multiple sclerosis, schizophrenia, quadriplegia, Parkinson’s disease, AIDS/HIV and countless other ailments?  Up in smoke.  Coverage denial for patients in desperate need of doctor-recommended medications?  Burn, baby, burn.

Think about it.  Never again will any of your desperately ill family members, friends, co-workers and neighbors receive a coverage rejection letter again.  The banning of pre-existing condition denials is now a reality, thanks to Obamacare.  Let’s tell that story.  Let’s create that visual.  Let’s have that celebration.  Supporters of Obamacare should quit cowering in the shadows of the Obamacare Card burnings, and let that light shine brightly.

– Loveland

Note:  This post was featured as a “best of the best” in MinnPost’s Blog Cabin.