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Just seven percent of Americans think the Affordable Care Act is working well and should be kept in place as it is. Far more, 48 percent, think there are some good things in the law, but changes are needed to make it work better, and another 43 percent think the law needs to be repealed entirely.
(Emphasis supplied.) Mend it, don't end it.
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In terms of ObamaCare, my problems with the "market reforms" is a matter of record - I think the regulatory reform/exchanges/mandate is bad policy. I preferred the expansion of public insurance (such as Medicaid expansion, which is the piece of OCare that is unequivocally good and working. But we are where we are - ObamaCare is under fire and extremely unpopular. What do Dems do now?
ObamaCare is not changing any time soon imo. The President won't support any repeal and the GOP won't support any fixes. This means what to do next will necessarily be a 2016 issue.
Here's my modest proposal -- mend ACA as follows - replace the mandate with autoenrollment in Medicare for those persons who either do not qualify for Medicaid or do not have private insurance, using the existing tax credit/subsidy structure where applicable. Simple and effective imo. And politically feasible.
This would have the effect of providing insurance to as many as possible, improving the solvency of Medicare (improving the health of the Medicare pool will lower costs) and be politically popular.
My two cents.
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While the wonk created Rube Goldberg contraptions known as the exchanges goes through their problems, one aspect of ObamaCare has gone off without a hitch - Medicaid Expansion:
The underdog of government health care programs is emerging as a rare early success story of President Obama's technologically challenged health overhaul. Often dismissed, Medicaid has signed up 444,000 people in 10 states in the six weeks since open enrollment began, according to Avalere Health, a market analysis firm that compiled data from those states. Twenty-five states are expanding their Medicaid programs, but data for all of them was not available.
[...] The Obama administration plans to release October enrollment statistics this week, but publicly available figures already provide a contrast between a robust start for Medicaid expansion and lukewarm early signups for new, government-subsidized private plans offered separately under the law. "Medicaid is exceeding expectations in most places," said Dan Mendelson, Avalere's president. "It is definitely a bright picture in states that have chosen to expand."
The wonky proponents of the exchanges aren't particularly interested, but it does prove that the public insurance component of ACA is the superior part of the program.
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[T[his is a dumb way to give people health insurance. This is a program that, by design, is going to annoy literally millions of Americans immediately. It will improve most of those people’s lives, but it will do so in a way that feels as coercive as possible. It didn’t have to be that way! No one is ever annoyed that they qualify for Medicare or Medicaid. People may hate paying the taxes that fund those programs, but people always appreciate direct benefits.The way the ACA deals with people [...] illustrates nearly every problem with attempting to design conservative, “market-based” ways to do things best done by straightforward government programs. It exposes the flaws in both the technocratic wing of the Democratic Party — a too-clever solution to a very simple problem — and the centrist third-way wing — making legislation intentionally worse to shield Democrats from increasingly ineffective accusations of liberalism, or to pick up Republican support that, in this environment, is never coming. So we end up with a program that hides many of its best and most important features, and loudly advertises its most coercive element.
More . .
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I give him an A- so far in these negotiations. Doing quite well imo.
I thought President Obama was A+ in this presser today.
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President Obama is about to address the nation on Syria. Here's a thread to discuss.
Update: Shorter version is Obama is asking Congress to delay a vote.
Obama lays out the evidence Assad's regime used chemical weapons. He says if we don't act, Assad will not hesitate to do it again. Other dictators will try to obtain chemical weapons, as will terrorist groups. Turkey Jordan and Israel are at risk.
He determined in the national security interest of the U.S. to respond by a targeted military strike. He knows it won't be popular, after a decade of war in Iraq and Afghanistan. The purpose is deterring and degrading Assad's chemical capability.
Even though he has the authority to order the strike himself, he took the debate to Congress. [More...]
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Homeland Security Secretary Janet Napolitano is resigning. She has accepted a new position as President of the University of California system. The current U.C. president earns $591,000 a year.
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There are many predictable calls for Attorney General Eric Holder's resignation. Until the recent disclosure of mass and indiscriminate electronic surveillance of telecom records, most have been partisan attacks. There are signs that is changing.
Will Eric Holder resign? Matthew Cooper, writing in The Atlantic, has an interesting article today, What Happened to Eric Holder? It chronicles his career, past and current, and makes this observation:
Holder was never going to stay through both terms. (Reno is the only attorney general in the country's history to stay that long.) And they say he'll be gone when Susan Rice and Samantha Power get settled in with John Kerry and Chuck Hagel and after James Comey is confirmed as the new FBI Director.
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The Democrats have lost on sequestration
The Democrats have lost on sequestration. That’s the simple reality of Friday’s vote to ease the pain for the Federal Aviation Administration. By assenting to it, Democrats have agreed to sequestration for the foreseeable future.
This is a curious conclusion. After all, the deal is to restore $253 million to the FAA, relative chump change in terms of the federal budget. Is this really the moment Democrat "lost" on sequestration? Not really. Ezra writes:
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Today President Obama released his 2014 proposed budget for the Department of Justice. It's very disappointing. It includes:
- $8.6 billion, a 4.3 percent increase over the 2012 enacted level, for Federal prisons and detention facilities. These funds are provided to continue activation of newly completed or acquired prisons, and to provide additional
contract beds to address growth by alleviating
crowding in low security facilities and systemwide.
Translation: We're spending to build new prisons and give more money to private prisons, but when it comes to reducing prison time for non-violent offenders, that remains, according to the budget, "an option to be explored."
- $2.6 billion for drug enforcement and organized crime targeting programs. This funding includes an increase of $3 million for the International Organized Crime Center to help further implement strategies to combat major drug trafficking organizations and transnational organized crime syndicates.
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President Obama's new budget is likely to include cuts to Medicare and Social Security. About the only details being leaked are:
- a change in the way inflation is calculated which is likely to result in social security recipients receiving less
- cuts in payments to medical providers and drug companies (which will mean fewer doctors for the elderly, a group that is rapidly increasing in size)
- Medicare premiums will be higher for those in upper income brackets.
In exchange for the cuts, Obama is said to be demanding Republicans agree to the tax increases he proposed last year, including higher taxes for wealthier Americans.
Another Obama suggestion: More taxes on cigarettes to cover making pre-kindergarten free nationwide.
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One of the interesting aspects of the ongoing budget negotiations is that while Paul Ryan's proposal is an attack on the social safety net with a huge tax giveaway for the rich, the one thing it is not is a call to cut Social Security:
Here is Paul Ryan’s path to a balanced budget in three sentences: He cuts deep into spending on health care for the poor and some combination of education, infrastructure, research, public-safety, and low-income programs. The Affordable Care Act’s Medicare cuts remain, but the military is spared, as is Social Security. [Emphasis supplied.]Meanwhile, President Obama is standing firm on insisting on Social Security cuts:
Obama had discussed entitlement reform with a dozen Senate Republicans over a private dinner last week. “I urged him not to cut Social Security and benefits for disabled veterans,” said Sen. Bernie Sanders (Vt.), an independent who caucuses with Democrats. [...] “At this point I think he is more inclined to cut benefits, which I strongly disagree with,” Sanders said.[Emphasis supplied.]
At this point it is impossible to deny that the idea of cutting Social Security is on Obama's wish list, not the GOP's.
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Due to the sequester, doctors face a 2% cut in Medicare reimbursements:
The bottom line is that doctors who treat Medicare beneficiaries will only be reimbursed 98 cents on every dollar for a vast array of services. Reimbursement for low-income beneficiaries is exempt.
...The cuts could make it harder for patients to get care, [AMA President Jeremy] Lazarus added. "One in five Medicare patients already is facing difficulties in finding a doctor to take them. If you cut their pay, this access problem will only get worse."
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President Obama granted 17 pardons today. The list is here. Most are low level offenders who got probation.
There are only two drug offenders in the group:
Michael John Petri – Montrose, South Dakota.
Offense: Conspiracy to possess with intent to distribute and distribution of a controlled
substance (cocaine), 21 U.S.C. §§ 841(a), 846.
Sentence: Five years imprisonment, three years supervised release.
Lynn Marie Stanek – Tualatin, Oregon.
Offense: Unlawful use of a communication facility to distribute cocaine, 21 U.S.C. § 843(b).
Sentence: Six months in jail, five years probation conditioned on residence in a
community treatment center for a period not to exceed one year.
On this day of sequester, why not commute the sentences of non-violent offenders serving double-digit sentences, and those under deportation orders who will be deported from prison when their time is up? At least we'd save some money -- $25-30,000 per inmate per year. Or seriously medically ill elderly inmates who cost even more to warehouse in medical prisons? If there were fewer inmates, we wouldn't need to spend so many billions on new prisons and contracts with private prisons.
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Republicans today filibustered the nomination of Chuck Hagel as defense secretary. Will it matter?
Both sides still think the former GOP senator from Nebraska will be confirmed, but the filibuster brought stark condemnations from Obama and Senate Democrats, who decried it as an unprecedented partisan move against a nominee to lead the Pentagon.
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