Category Archives: Patient Protection and Affordable Care Act

Will Bakk Building Put DFL Back Out of Power?

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While Minnesota DFLers controlled state government the past two years, they have done some very constructive things:

  • TRULY BALANCED BUDGET.  Unlike their GOP predecessors, DFLers balanced the budget without relying on irresponsible gimmicks and shifts, and they paid back public schools for the money the GOP shamefully “borrowed” from them.
  • TAX FAIRNESS.  The DFL also restored a bit of tax fairness to an unfair system, by increasing taxes on the wealthiest Minnesotans who were paying a lower percentage of their income in taxes than other citizens.
  • 5 G’s.  Importantly, DFLers didn’t get bogged down with issues associated with “the five G’s” — gays, guns, gambling, God and gynecology — which tend to dominate under GOP control.  DFLers enacted marriage equality swiftly and efficiently — a very historic and important achievement — then moved on to other important non-G business.
  • ALL-DAY K.  DFLers passed universal all-day kindergarten.  While that’s not the first education investment I’d prioritize, it is a constructive move, and a publicly popular move.
  • JOBS AND INFRASTRUCTURE.  The DFL authorized and funded a long list of needed capital improvement projects that are rebuilding Minnesota’s deteriorating infrastructure and putting long-suffering construction workers back to work.
  • NO DELAYS OR SHUTDOWNS.  Finally, the DFL got its work done on time, and didn’t shut down state government, as the previous GOP-controlled Legislature did. DFLers mostly governed like grown-ups.

That’s a very nice body of work for the DFL to showcase to voters.  They should be proud of it.

If DFLers lose control of all or some of state government, it likely will have had to do with environmental factors they can’t change , such as low DFL constituency turnout in a non-presidential election and an unpopular Democratic President.  Their policymaking performance will not be their biggest political problem.

Minnesota_Senate_office_buildingBut there is at least one policymaking unforced error that is making things a bit more difficult for the DFL — the DFLers authorization of a new Senate office building.

The new Senate office building project is nowhere near as wasteful as Republicans claim.  It also is nowhere near as necessary as Senate DFLers claim.  But one thing is indisputable:   The political optics of the project are bad for the DFL during the election season.

Attack_mailing_PDF__1_page_Most voters won’t do a comprehensive financial analysis of whether DFL leaders are doing a good job stewarding their tax dollars.   They will judge fiscal stewardship based on an isolated example or two.  Republicans are working overtime to make sure that the Senate Office Building is the example voters use to make their judgement.

The Senate office building works well for the GOP on a political level.  First, the building is built for legislators by legislators.  On its face, that seems self-serving and arrogant to many voters.  Minnesotans don’t take kindly to self-serving and arrogant.

Second, this is not a pole building, and therefore can be made to seem extravagant.  The building renderings strike me as modest, responsible and utilitarian, but demagogues are making the Senate office building seem like something akin to Emperor Nero’s Domus Aurea.

The issue is obviously being overblown by Republicans.  This project represents only a small fraction of the entire state budget, and the argument for the building is strong, if you actually take the time to study and consider it.  But at-a-glance, voters perceive the building to be self-serving and extravagant, and Republicans realize most will voters only consider the issue at-a-glance.

In what is likely to be a close non-presidential election with little room for error, the DFL legislators can’t afford many unforced errors.  Choosing this year to build the new Senate office building is one very big unforced political error.

– Loveland

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

News Flash: GOP Activist Reveals That Veteran GOP Consultant Is Supporting A GOPer for Governor

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Tom_HornerMinnPost reporter Cyndy Brucato is breaking the blockbuster news that 2010 Independence Party gubernatorial candidate Tom Horner is, gasp, crossing party boundaries to support Republican gubernatorial candidate Jeff Johnson!  The reporter breathlessly reports:

Another leader in the Minnesota Independence Party is gravitating toward support of a Republican statewide candidate.   Tom Horner, the Independence Party candidate for governor in 2010, is meeting this week with GOP candidate for governor Jeff Johnson to discuss joining his campaign.

Wow, if that happens, that does sound like huge news!

Unless you pay close attention to politics.

If you do pay close attention to politics, you know that Tom Horner is a long-time Republican staffer, supporter, consultant and pundit.  Before Horner spent one year as a right-leaning Independence Party candidate for Governor, he was the head staffer for Republican U.S. Senator Dave Durenberger, has advocated for Republican candidates like Norm Coleman his entire adult life, has long counseled Republicans, and served for many years as the Republican voice on Minnesota Public Radio (MPR) and other news outlets.

In short, for decades Horner has been one of the most visible Republicans in Minnesota. Reporter Brucato is aware of this because she was a lead staffer for Republican Governor Arne Carlson and Norm Coleman.  But she mentions none of Horner’s GOP bona fides in the article.

In other words, the real headline here is actually a wee bit less newsworthy.  It’s more like:

GOP Activist Reveals That Veteran GOP Consultant Is Supporting A GOPer for Governor

Zzzzzzzzzzzz.

I like and respect Tom Horner a great deal.  Though we disagree on many policy issues, Tom is intelligent, has integrity, and Mr. Johnson is lucky to have his policy and PR counsel.    But let’s get real.  This hardly qualifies as the blockbuster news the reporter makes it out to be.

I support MinnPost relying on a ex-staffers of politicians for opinion pieces. That’s an appropriate role for an ex-staffer.  But they shouldn’t rely on ex-staffers from either party for news reporting like this, because their advocacy background naturally calls their objectivity into question.

While  the lede was blown way out of proportion, I did find a few things intriguing about the article that left me hungry for deeper reporting.  On taxes, Horner says:

 “I wasn’t opposed to raising more revenue, but the way the governor went about it is not in the best long-term interest of Minnesota. Just adding fourth tier only reinforces a tax system that isn’t suited to a global market. Maybe we need more revenue but tilt the policy much more to tax consumption and more to reward investment.”

And on health care, Horner says:

“MnSure is where Republicans could play an effective role. It’s good that we’re expanding access and covering children and have a more robust marketplace.  Now how do we control the underlying drivers of health care?”

The fact that Tea Party-backed Republican gubernatorial candidate Jeff Johnson may be bringing in a pro-tax, pro-Obamacare consultant for policy advice raises additional questions that were not posed by the reporter:

  • Does Horner think tax increases were only needed in the past, or does he think that more may be needed in the future?  If so, which taxes would he favor increasing?
  • Which parts of health reform would Horner favor retaining?  Medicaid expansion?  Tax credits?  The insurance exchange system?  Pre-existing condition reform paired with the insurance mandates?  Other?  How would Horner propose Mr. Johnson could better control health care costs?
  • Does candidate Johnson share Horner’s opinions on taxes and health reform?
  • What do key Tea Party-friendly supporters of Johnson think of bringing in Horner to advocate for these positions?

The answers to those questions would have been informative, and would have qualified as actual news.

– 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.

Minnesota Senate Candidate McFadden Releases New Humorous Ad

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Mike_McFadden_groin_hilaritySaint Paul, Minn. — Minnesota U.S. Senate candidate Mike McFadden (R-Sunfish Lake) followed an earlier campaign television ad that ended with a child-inflicted injury to his groin with a new  television ad that uses thinly veiled flatulence-based humor to further make his case for election to the U.S. Senate.

“We’re just trying to have some good clean fun, while making a very serious point about Al Franken’s big government, job-killing stuff,” said McFadden.

The ad opens with a fog rolling over a grainy black-and-white photo of a frowning Senator Al Franken. Ominous music drones throughout the spot, and two 10-year old boys on a playground chime in in a sign-songy tone.

Male adult announcer: “Something is very, very rotten in Washington.”

Male child actor #1: “Al Franken says the Iraq War and Great Recesssion  are not his fault. But he who smelt it, dealt it.” (giggle)

Announcer: “Death panels.  IRSgate. Benghazi. Al Franken wants to keep it silent. But we all know, they’re silent but DEADLY.”

Male child actor #2: “Whoever rebuts it, cuts it.” (giggle)

Mike McFadden: (Giggling and holding his nose ) “I’m Mike McFadden, and I declare it, so Al can no longer blare it.”

(McFadden then sits on whoopee cushion. McFadden and kids giggle in unison.)

Mike McFadden:  “Oh no, not again, Al!”

The ad began running across Minnesota today. Like the groin ad, it was created by Washington-based Sophmoric Productions.

– Loveland

Note:  This post is satire and the featured ad doesn’t exist, for now.

Stewart Mills’ Ad On Truth Serum

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This is the script of a political ad that was recently released by conservative Republican Stewart Mills III, who is running against DFL Congressman Rick Nolan in Minnesota’s 8th Congressional District.  The ad shows young Stew the third sporting the orange shirt worn by front line employees at the Mills Fleet Farm chain of big box stores that his family operates.

I’m Stuart Mills.  My family operates Mills Fleet Farm.

As a teenager, I worked here stocking shelves.  (chuckle)  Then I got promoted to mopping floors.

Now I run the health care program for thousands of our employees and their families.

Everyday, I see how Obamacare hurts small businesses and the middle class.

As your congressman, I’ll replace it.

I’m Stewart Mills and I approve this message, because we need to grow the middle class and get Minnesota back to work.

Stewart_Mills_III_orange_shirt

If Stew the third were injected with truth serum, the ad might sound more like this:

I’m Stewart Mills the third.  My family operates Mills Fleet Farm.

As a teenager, I worked there stocking shelves.  (chuckle)  Then I said,  screw this, daddy, make me a top executive faster than everyone else.  And he did.

In other words, I was born on third base, but think I hit a triple.

Now I’m fighting to protect my millions of dollars in inherited wealth.

But every day in Minnesota I see how 350,000 minimum wage workers have gotten a raise, 95,000 have new Medicaid coverage, and 2.3 million with pre-existing conditions have gotten their coverage protected through Obamacare.

As your congressman, I would oppose those things, and  offer no alternatives.

I’m Stewart Mills III, and a bunch of other folks with inherited wealth approve of this message, because they want a fellow silver spooner growing the upper class and putting ordinary Minnesotans back in their place.

 

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

Billionaire Purchases Naming Rights To Uninsured South Dakotans

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Sioux Falls, South Dakota — South Dakota billionaire banker and philanthropist T. Denny Sanford announced today that he will fund free health coverage for 48,000 uninsured, low-income South Dakotans.  The announcement comes in the wake of Republican Governor Dennis Daugaard’s continued refusal to accept $224 million in federal funding to cover the same group of citizens.

In recent years, Sanford has been lauded for donating large amounts of money to South Dakota health facilities, sports complexes, and other popular projects.   The high interest banker often has his projects named after him, such as Sanford Health™, Sanford Children’s™, Sanford Heart™,  Sanford Medical School™, Sanford Pentagon™, Sanford Sports Complex™, and Denny Sanford Premier Center™.

Sanford’s latest donation comes in the midst of a bitter political debate that has been intensifying in South Dakota for several years.

As part of the federal Affordable Care Act (ACA), sometimes called Obamacare, about 48,000 low income South Dakotans are eligible for Medicaid coverage.  By the year 2020, South Dakota was to have received a massive influx of $224 million due to this expansion of coverage.

Medicaid_ExpansionHowever Governor Daugaard has refused the $224 million to cover uninsured poor people, citing his  personal opposition to Obamacare and the cost of the expansion that would be paid by South Dakota.  The federal government is paying 100 percent of the total costs through 2016, and 90 percent after that.

The neighboring states of Iowa, North Dakota, and Minnesota are all expanding Medicaid coverage to uninsured citizens, while Nebraska, Montana and Wyoming are not.  States that are opting out of the program will leave over 5 million of the poorest Americans without basic health benefits, or shifting their health care costs to other citizens.

Under pressure from South Dakota physicians and 63% of South Dakotans who support the Medicaid expansion, Daugaard recently asked the federal government to cover a little over half of the eligible citizens, but deny coverage to the rest of eligible citizens. The federal government rejected Daugaard’s proposal, leaving all 48,000 South Dakotans without coverage.  The Legislature  refused to allow the Medicaid expansion question to be posed to South Dakota voters at the ballot box.

But Sanford stepped into the fray today, announcing that he is creating a new Medicaid-like health plan, which he is calling SanfordCare™.  Any South Dakota citizen who would have been eligible for the Obamacare expansion would be eligible for the free SandfordCare™ coverage, provided they agree to legally change their surnames to Sanford™.  Any children born while under the health coverage would also have to adopt the first name Denny™ or Denita™.

Note:  This post is, to the best of our knowledge, satire.  There is no SanfordCare proposal, but there are 48,000 South Dakotans being denied health coverage.

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.