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MERCATUS BS STUDY

Congress takes notice

Congress is also paying more attention to the Mercatus Center, which from 1999 to 2008 was mentioned by name 32 times in either the Congressional Record or congressional committee reports. Since 2009, it’s been mentioned 93 times, often in reference to Mercatus Center faculty who were testifying before Congress.

2015]

This year, Congress even cited Mercatus Center research in the text of budget bills. House Concurrent Resolution 27 and Senate Concurrent Resolution 11 note that a Mercatus Center study “estimates that Obamacare will reduce employment by up to 3 percent, or about 4 million full-time equivalent workers.”

Mercatus Center Vice President Carrie Conko, while declining to address critics’ “ad hominem attacks” of Charles Koch, stressed the institution’s work is the product of hard work and high standards — not the whims of some patron puppet master.

“As a university research center, our scholarship is independent and subjected to rigorous peer review,” Conko said. “Our researchers are interested in understanding what shapes societies and economies and that covers a spectrum of research from the history of economic thought to the application of economics to questions of public policy.”

Conko also noted that the Mercatus Center abides by a strong conflict of interest and research independence policy, which she described as “stronger than those of most found with typical academic centers or departments.”

Mercatus Center officials note that the center isn’t part of George Mason University the same way as, say, its chemistry or psychology departments. Instead, it’s organized as a stand-alone nonprofit, and as such, George Mason University isn’t directly responsible for it.

The Mercatus Center doesn’t receive direct funding from George Mason University, Conko said.

But George Mason University and its students do receive millions of dollars in annual financial benefit from the Mercatus Center, according to federal tax filings.

That alone is a major incentive for a public university in Virginia, where state funding of higher education is dwindling, to host a privately funded operation on its campus — today, a fairly common practice among public schools.

The Mercatus Center spent $3.64 million during that time to “support graduate students at George Mason University” by “training future scholars and decision-makers to advance and apply a research agenda for understanding institutions and change,” according to a tax filing.

The Mercatus Center helped fund $1.82 million worth of communication efforts that included promoting its research and ideas “to the media and opinion shapers.”

And it made a $10,000 grant to the Atlas Economic Research Foundation, which operates a “global network of more than 400 free market organizations.” They include several Koch-backed nonprofit groups such as Americans for Prosperity, the American Legislative Exchange Council and Americans for Tax Reform.

McAuliffe mum?

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MMA

Right-wing media distract from GOP sabotage of the Affordable Care Act

Trump's media apologists praise his lackluster replacement health care proposal

Written by Zachary Pleat

Published 02/03/26

After Republicans let enhanced premium tax credits for Affordable Care Act Marketplace plans lapse at the end of 2025, health insurance premium costs for many Americans have risen significantly — and are projected to more than double for those who received those subsidies — and the number of signups has plummeted.

Now that Trump has announced his “Great Healthcare Plan” — a vague set of health care policies — and a rural hospital fund established by Trump’s tax cuts announced its first round of funding, right-wing media have jumped on board, ignoring Republicans’ long history of sabotaging the ACA in favor of claiming that the program is unaffordable and praising Trump’s policy ideas, which fail to address the problems he and Republicans helped to create.

Analyses predict massive spikes in insurance premiums and millions losing their insurance from the expiration of enhanced premium tax credits

Trump’s proposal includes a mix of initiatives that are already underway, such as Trump’s push to cut U.S. drug prices by linking them with the lower cost of drugs sold abroad, and some of his stalled ambitions, such as his desire to redirect billions of dollars in federal funding away from health insurers and toward average Americans. Trump also called to restore funding for the ACA’s cost-sharing reduction program, an insurance subsidy program that he ended in his first term, and to institute “maximum price transparency” by requiring hospitals and insurers to make more information available to consumers.

The proposal does not include new ideas to expand health coverage or simplify America’s often-byzantine health care system.

Additionally, other existing Republican policies stemming from their latest tax cut for the rich are estimated to cause up to 15 million Americans, and possibly more, to lose their health insurance. Other experts said Trump’s plans are so vague that it is unknown what effects they may have but they put people with preexisting conditions at risk and don’t reestablish the expired subsidies:

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  1. ### Fox misleadingly claimed that a government shutdown would impede relief for winter storms, glossing over the real threat to disaster-stricken communities

02/03/26 1:38 PM EST

  1. ### Fox won’t tell viewers that the UAE bought off Trump

02/03/26 11:00 AM EST

  1. ### Border Czar Tom Homan in resurfaced Fox interview: “We need a judicial warrant for a search”

02/03/26

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324 an

rural hospitals close bc states rejected ACA medicare $

origin at heritage fdn

https://thebolditalic.com/the-painful-irony-of-the-gop-repeal-of-obamacare-503e6b8f7a25

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BOGUS ACA TOWN HALLS MOJO

Town Hall Protests: Astroturf 2.0? – Mother Jones

This summer, town hall meetings to discuss health care reform have turned into battlegrounds—with fist fights, belligerent protestors, and at least one lawmaker reporting a death threat. Some Democrats have blamed the chaos on astroturf operations: fake grassroots groups funded by special interests. But are the forces whipping up the anti-health care frenzy really astroturf—or a new form of corporate-funded campaigning?

Most astroturf operations are semi-covert activities, precisely targeted at vulnerable or undecided lawmakers. Tried-and-true practices include phone banks in which paid callers posing as concerned voters read from prepared scripts, or phony citizens groups with few members, if any, but plenty of industry money to bankroll television ads and mailers. Particularly unscrupulous operators might mobilize a narrow constituency—like conservative Christians—on behalf of their corporate clients. The idea is to create the impressionof grassroots activism, but rarely to seriously attempt to influence broader public opinion. Michael Scanlon, a colleague of disgraced uberlobbyist Jack Abramoff, once captured the logic succinctly: “Simply put we want to bring out the wackos to vote against something and make sure the rest of the public lets the whole thing slip past them.”

By that standard, some of the groups orchestrating town hall protests against Obama’s health care reform have adopted a new, hybrid model—one that blurs the lines between astroturf and grassroots activism. As far as it’s possible to tell, their financial base remains heavily dependent on corporate interests, and some of their tactics are familiar, too. But instead of furtively targeting selected lawmakers, they’re also mounting highly visible outreach efforts via public forums and Facebook, Twitter, and other social networking tools. In the process, they’re picking up at least some genuine support. It remains to be seen whether they can attract large numbers to their cause, but already they’ve helped to hijack the health care debate at a critical juncture. Here’s MoJo‘s guide to the major groups and their backers.

Americans for Prosperity

Americans for Prosperity is one of the most prominent groups opposing the Obama administration’s two key domestic policy goals: health care reform and cap and trade. The organization presents itself as a grassroots movement that espouses limited government. But a large portion of its money comes via staunch free-market conservative David Koch, part owner of Koch Industries, an oil and gas conglomerate that is perhaps the largest privately owned company in the US, with holdings in medical device and pharmaceutical companies.

Koch helped found AFP in 2003 and serves as chairman of its affiliated foundation. Its president is Tim Phillips, a master of the art of astroturf. Along with Ralph Reed, he cofounded Century Strategies, a PR and consulting firm known for effectively renting out Reed’s evangelical Christian allies to its clients—not to mention clients of Jack Abramoff. In 1999 and 2000, Century mobilized anti-gambling evangelicals to protest proposed casinos—but didn’t know Century was working for an Abramoff client, a casino-owning Indian tribe hoping to vanquish its competition. In a memo, an Abramoff colleague noted that Century’s Christian connections would ensure a “political effort that truly resembles a people’s movement” without the signs of a “paid political operation.”

This year, AFP is devoting its deep resources and strategic prowess to organize protests at Democratic health care town hall meetings, where activists hold signs like “Sorry Grandma, No Health Care for You.” But unlike most typical astroturf operations, AFP’s efforts seem intended to gather a broader base of supporters. To that end, the group makes use of social networking sites to reach out to potential followers. It posts information about local events and organizing strategies for its nearly 4,500 fans on Facebook, who share YouTube videos of protests. More than 1,000 people rallied at an August event in Scottsdale, Arizona, organized by AFP; the local fire department was called to handle overflow.

AFP sponsors two other groups advocating against the Obama administration’s proposed reforms, innocuously titled Patients United Now and Patients First. Both fund ads that make misleading claims. One Patients United Now television ad wrongly asserts that “Washington wants to bring Canadian-style health care to the US.” Patients First also launched a 13-state bus tour that wraps up at the end of August. At one stop a speaker compared proposed reforms to the Stalin and Hitler regimes because they would lead to “physician-assisted suicide”—a blatantly false claim. But these outlandish accusations have proved convincing to some: More than 206,000 people have signed Patients First’s petition opposing current health care reform proposals.

FreedomWorks

FreedomWorks is headed by former GOP House majority leader Dick Armey, who left government in 2003 and became a heavy-hitting lobbyist for DLA Piper, whose numerous corporate clients include pharmaceutical firms.

FreedomWorks grew from a group called Citizens for a Sound Economy, which was founded in 1984 and whose resume includes orchestrating “grassroots” opposition to cigarette taxes on behalf of Philip Morris. In 2006, the Washington Post reported that the group had once duped nearly 16,000 people into swelling its membership rolls: Brokers for a company called Medical Savings Insurance Co. pitched patients on discounted insurance, and those who signed up automatically became members of Citizens for a Sound Economy. (A small part of their monthly bill also went to the group, eventually netting it more than $600,000.) In 2003, a spokesman acknowledged that two-thirds of the organization’s money came from corporations, as well as corporate-funded conservative foundations. The next year, CSE morphed into FreedomWorks. Last year, the organization was identified as the creator of AngryRenter.com, an amateur-looking website presented as a spontaneous effort from ordinary Americans opposing government mortgage relief for homeowners.

The arrival of the Obama administration has ushered in a busy year for FreedomWorks, which played a pivotal role in engineering “tea party” protests against government spending. The group distributed organizational tips and talking points and helped to coordinate gatherings around the country that garnered breathless media coverage. FreedomWorks operatives have urged followers to mimic the tactics of the grandfather of community organizing—and inspiration to Barack Obama—Saul Alinsky.

This summer, FreedomWorks is using those tactics to defeat health care reform. It claims a membership of more than 770,000 people and an email list of 400,000 readers. Its website provides numerous resources, including an “August Recess Action Kit” to aid supporters in exposing “the real intentions and the economic ramifications of the Cap and Tax and health care reform legislation on the table.” FreedomWorks has plotted locations of town halls on Google Maps; one memo encouraged supporters to “rattle” lawmakers at these forums. FreedomWorks is also sponsoring a march on Washington on September 12.

In mid-August, Armey abruptly announced that he was leaving DLA Piper after a flurry of media reports raised questions about whether FreedomWorks activities were related to the goals of the firm’s big pharma clients.

Coalition to Protect Patients’ Rights

The Coalition to Protect Patients’ Rights describes itself as a “nonpartisan, grassroots coalition of patients, healthcare professionals, advocacy groups, and engaged citizens.” Its source of funding is unknown. However, according to Think Progress, PR for the organization is managed by the DCI Group, a political consulting firm with a long history of rustling up phony advocacy groups to serve the interests of its corporate clients.

DCI’s managing partners have deep experience in the political dark arts. Tom Synhorst, for instance, is a former associate of Ralph Reed (as well as a former aide to GOP Sen. Chuck Grassley of Iowa). Synhorst and fellow founding partners Doug Goodyear and Tim Hyde spent years working for or with the tobacco conglomerate RJR Nabisco, where they supported “smokers’ rights” groups.

In the 1990s, DCI generated fake “citizen” letters opposing the breakup of Microsoft, then under investigation for antitrust violations. At least two of the letters were from dead people. During the Bush years, DCI created fake “grassroots” groups to champion one of the administration’s pet causes, privatizing Social Security. And in 2005, Freddie Mac paid DCI $2 million to drum up opposition to a bill that would have reined in the mortgage giant and its sister, Fannie Mae—three years before they nearly collapsed under the weight of their subprime loans.

Its resume also includes several health care campaigns: In 2002, DCI was hired by the Health Benefits Coalition—an HMO trade association—to defeat a proposed “patients’ bill of rights” in Congress. In 2003 and 2004, DCI worked with Pharmaceutical Research and Manufacturers of America (PhRMA) to pass the GOP’s Medicare prescription drug bill, going so far as to pay health care consultants to find elderly people to speak positively about the proposal.

The face of the Coalition to Protect Patients Rights (CPPR) is Dr. Donald J. Palmisano, a former American Medical Association president whose idea of protecting patients’ rights consists of trying to limit their ability to sue doctors for malpractice. A longtime shill for the tort-reform movement, Palmisano sits on the board of the Doctors Company, a medical liability insurance company, and founded a claims review company that serves physicians and hospitals.

This year, CPPR’s efforts to kill health care reform are more visible and more ambitious than many previous initiatives linked with DCI. It is aggressively seeking supporters for the anti-reform cause via press events, op-eds, a Facebook page, and its Twitter feed, which so far has a modest 1,485 followers. (Sample tweet: “POTUS says you will be able to keep your insurance…but will your insurance survive competition with a public option?”) CPPR has also organized a group of doctors to tour the country warning of the perils of single-payer care. At one recent press conference that it sponsored, a physician said that in countries with government-run health care, the “sickest patients” are denied treatment.

60 Plus

60 Plus presents itself as a “grassroots senior citizen organization.” Although it claims to be nonpartisan, it was formed with help from stalwart conservative direct-mail king Richard Viguerie and refers to its honorary chairman Roger Zion as “one of Washington’s leading spokesmen for the conservative cause.” This year, it’s run a more traditional astroturf operation opposing the administration’s health care proposals.

During the Bush administration, 60 Plus was linked to several dubious political campaigns, and had ties to Jack Abramoff. The investigation of the lobbyist revealed that in 2001, Abramoff told one of his clients, the Coushatta Tribe of Louisiana to give $25,000 intended for Tom DeLay’s political action committee to 60 Plus, although the tribe’s primary interest was in gambling legislation. (A lawyer for the tribe said that Abramoff advised them that the donation would help the tribe win clout with the Republican leadership in Congress.)

But for several years Big Pharma was 60 Plus’ major benefactor. According to a 2006 investigation by the AARP Bulletin, the pharmaceutical industry accounted for “virtually all of [60 Plus’] largest contributions” in the early years of this decade. In return, the group lobbied hard against state laws that would have reduced prescription-drug prices. On one occasion, the industry hired Bonner & Associates (a Washington strategic operation currently being investigated by Congress for forging letters opposing cap and trade and sending them to lawmakers). Bonner paid callers to read from scripts that identified them as members of 60 Plus and urged citizens to tell their governor to veto the legislation. Pfizer later admitted to funding the calls. Ken Johnson Sr., a vice president of PhRMA, told Mother Jones that the organization has not given 60 Plus any money since 2004.

This year, 60 Plus has been tirelessly working to torpedo Obama’s health care reform with a series of misleading and alarmist ads. On August 10, 60 Plus released a television ad warning that “The government—not doctors—will decide if older patients are worth the cost.” A recent mailing from 60 Plus told recipients that proposed changes to Medicare would mean “longer wait times at hospitals and doctors’ offices, less money for new treatments, restrictions on care, prescriptions and what’s best for you—the patient!” And a flyer distributed in Nebraska by 60 Plus features a picture of ailing elderly people and quotes Obama out of context saying, “Maybe you’re better off not having the surgery, but taking the painkiller.”

Conservatives for Patients Rights

CPR was founded by discredited hospital executive Rick Scott, who has emerged as perhaps the most dogged opponent of a Medicare-style public option that would cover uninsured Americans. To sell its message, CPR has enlisted the services of the same PR firm that brought you the Swiftboating of John Kerry: CRC Public Relations. So it should come as no surprise that its million-dollar ads on television and talk radio feature highly questionable assertions to scare citizens into sticking with the status quo. In one ad, an announcer ominously intoned that reform “could put a bureaucrat in charge of your medical decisions, not you.” A CPR flyer referred to the public option as “Patient Enemy #1.”

Scott claims that he will spend as much as $20 million dollars to defeat health care reform—he has already kicked in $5 million of his own funds to jump-start CPR’s media blitz. As Mother Jones has previously reported, he owns an urgent care company called Solantis. That gives him a direct incentive to block the expansion of health insurance coverage. To that end, CPR has sought to whip up frenzies at town hall forums during the August congressional recess, issuing alerts for meetings around the country and posting video footage of heated exchanges on its website. Earlier this month, White House press secretary Robert Gibbs denounced CPR for “organizing and manufacturing that anger.”

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In Texas, Jonathan Mitchell — the far-right attorney who was behind Texas’ draconian anti-abortion law — has also declared war on a part of the Affordable Care Act of 2010, a.k.a. Obamacare, that he claims is discriminating against Christians. Mitchell has filed a lawsuit challenging the ACA’s requirement that a private company’s health care plan cover preventative services, including anti-HIV drugs, which some far-right Christian fundamentalists view as pro-gay. And on Wednesday, September 7, Judge Reed O’Connor, a hard-right appointee of President George W. Bush, agreed with Mitchell’s lawsuit and the claim that anti-HIV medication “facilitates and encourages homosexual behavior.”

The Washington Post’s Ruth Marcus is vehemently critical of Reed’s ruling and Mitchell’s lawsuit in her September 8 column, arguing that both of them are willing to endanger the health and wellbeing of Americans in order to pander to Christianity’s lunatic fringe. The company that Mitchell is representing in the lawsuit is Braidwood Management.

“Mitchell, pressing an array of arguments that conservatives have deployed to dismantle the modern administrative state, argued that the mandates for free contraception and other preventive services were unconstitutional because the entities imposing the rules weren’t subject to enough presidential control or congressional oversight,” Marcus explains. “He lost on the contraception claim, but the judge, Reed O’Connor, found that the panel that determines what other services should be covered is unconstitutional because its members aren’t appointed by the president or confirmed by the Senate — threatening guaranteed no-cost coverage for everything from cancer screening to vaccines.”

READ MORE:**How abortion rights and redistricting are firing up state supreme court races in 2022**

The Post columnist continues, “The decision might not stand. After all, this is the same judge who, in 2018, struck down the entire Affordable Care Act based on a cockamamie theory involving the supposed unconstitutionality of a single section — the individual mandate. Last year, the Supreme Court, ruling 7-2, slapped him down, finding that Texas and others challenging the ACA didn’t have standing because they hadn’t proved the provision injured them…. Yet, here we go again; pushed by conservative lawyers, a conservative judge — O’Connor was nominated by George W. Bush — bends over backward to accommodate strained claims of religious liberties.”

The 64-year-old Marcus, who is Jewish, stresses that she isn’t trying to be “dismissive of freedom of religion.”

“As a member of a minority faith,” Marcus writes, “I’m sympathetic to such arguments…. But, as this dispute demonstrates, things have gotten entirely out of whack and, in this era of conservative-dominated courts, now tilt too far in the direction of religious rights.”

Marcus continues, “Medicine has made enormous strides since the emergence of the AIDs epidemic. Antiviral PrEP medications — short for pre-exposure prophylaxis — reduce the risk of contracting HIV from sex by 99 percent. As a result, a government advisory committee recommended, in 2019, that the drugs be made part of the mandatory package of fully subsidized preventive care. This is a development that everyone should cheer, including people who call themselves Christians: It prevents needless death.”

READ MORE:**Even if Griswold stands, states are likely to ban contraception**

The columnist argues that it is twisted logic to claim that coverage of anti-HIV drugs is “subsidizing gay conduct.”

“If it’s subsidizing gay conduct to cover anti-HIV medication,” Marcus writes, “then isn’t it subsidizing gay conduct to pay gay employees? The court in Bostock (v. Clayton) said religious rights might ‘supersede’ anti-discrimination law ‘in appropriate cases’ and put off the issue for another day. The Mitchell-O’Connor approach would carve a gaping loophole in that protection, which might suit this conservative court just fine.”

READ MORE:**With Roe overturned, Clarence Thomas is now preparing for a full-frontal assault on contraception, gay rights**

new 10/18

Montana, a Tough Negotiator Proved Employers Don’t Have to Pay So Much for Health Care

by Marshall Allen

With its employee health plan in financial crisis, Montana hired a former insurance insider who pushed back against industry players with vested interests in keeping costs high. She proved, essentially, that bargaining down health care prices works....

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https://www.vox.com/policy-and-politics/2018/4/13/17226566/obamacare-penalty-2018-individual-mandate-still-in-effect

sez loss no big deal]

dylan scott

I hope you held your 1095 form close when you filed your taxes this year because it is not long for this world.

Obamacare’s individual mandate will soon be dead. Republicans have killed it.

When the Affordable Care Act passed in 2010, no provision was more reviled than the law’s requirement that every American who does not buy health insurance pay a penalty. It was the foundation of the conservative constitutional challenge to the law, a case they very nearly won at the Supreme Court.

This idea was never all that popular with the public either. So many individual pieces of Obamacare polled very well — federal subsidies for private coverage, the expansion of Medicaid, eliminating preexisting conditions — but the mandate was woefully underwater.

Maybe worst of all: It didn’t really work. The mandate was billed as an unfortunate necessity. If you were going to force insurers to cover everybody, then you needed the mandate. It would bring in healthy people to offset the costs of covering the sick. But whatever the reason — maybe the subsidies (the carrot) weren’t generous enough, maybe the penalty (the stick) wasn’t harsh enough — that didn’t really happen. Somewhere around 6 million people elected to pay the penalty rather than buy insurance, and both the Obama and the Trump administrations doled out plenty of exemptions.

The mandate was a failed policy experiment, and its failures in a way mirror how the ACA has fallen short of what it was hoped to be, even if the law has undeniably had its successes. Next year, while the rest of the law remains, the mandate will simply vanish.

What a fitting end.

The mandate was Obamacare’s original sin for Republicans

The individual mandate had actually emerged decades earlier in the right-leaning think tank world as a market-based means to achieve universal coverage.

But conservatives quickly turned against it after Democrats adopted it. It was an affront to personal freedom: big-government liberals forcing Americans to buy something they might not want or need. Nothing better symbolized the federal overreach in the Democrats’ health care plan.

“Obamacare is a job-killer, and our economy simply cannot afford this unprecedented, unconstitutional power grab by the federal government,” then-House Speaker John Boehner said in 2010, a few months after the law was signed by Obama, as he was supporting a legal challenge to overturn the mandate and, with it, the whole law.

The mandate was the core of the GOP’s lawsuits to invalidate Obamacare before it could ever really take effect. Conservative attorneys argued that the Constitution barred the federal government from requiring Americans to purchase any commercial product, as the mandate did.

They also said, using the law’s own logic against it, that if the mandate was unconstitutional then the entire law was illegal. They urged the Supreme Court to overturn the mandate and the entire Affordable Care Act alongside it in 2012. It was an existential issue for some of the conservatives pushing the lawsuits.

“There was more at stake than Obamacare. All future purchase mandates were at stake,” Randy Barnett, a Georgetown University law professor who helped craft the case, told me last year when I asked him to go back to the moment of the Court’s ruling.

But Chief Justice John Roberts disagreed — at least in part. While Roberts sided with conservatives in ruling that the government couldn’t require people to purchase something in isolation, he upheld the mandate because he said its penalty was an allowable use of the taxing power granted to Congress by the Constitution.

Maybe Congress couldn’t require you to buy something, but they could tax you if you didn’t, in other words. Whatever the legal minutiae, the mandate survived the Supreme Court by the narrowest and unlikeliest of margins. For a time, anyway.

But when Republicans took control of Congress and the White House last year, there was perhaps no safer bet than the GOP ending the hated mandate. They stumbled at first, when the Senate failed to pass a more sweeping Obamacare repeal bill. But they stuck the repeal of the mandate into their tax bill — it actually, for technical reasons, helped pay for the tax cuts for corporations and the wealthy — and Congress passed it in December. In 2019, the mandate would end for good.

“When the individual mandate is being repealed, that means Obamacare is being repealed,” Trump said at the time. “Obamacare has been repealed in this bill.”

Well, that’s not quite right. But you could forgive Trump for thinking so.

The mandate was supposed to be essential to Obamacare

Barack Obama opposed a requirement that all Americans purchase coverage while he was running for president. Democrats knew this wasn’t going to be a popular idea.

But Obama eventually came around, convinced the mandate was crucial to creating a properly functioning health insurance market.

Health care wonks compare the Affordable Care Act’s health insurance markets to a “three-legged stool.” Three key policies work in tandem to expand coverage at an affordable price.

The first leg of the stool is ending preexisting conditions and allowing all people, sick or healthy, to buy insurance at the same price.

But it also wasn’t thought to work as a standalone policy. Mandating that insurers accept all customers would likely mean only the sicker patients — people who expect to use lots of health care — would sign up. Healthier people would just skip the market, figuring they’d do better not paying premiums and just buying health care when they need it.

This was where the second leg of the stool came in: the individual mandate. The requirement to purchase insurance was meant to ensure that sick andhealthy people sign up for coverage. The mandate was supposed to help reduce premiums by nudging healthy people who are cheaper to cover into the market.

The third leg of the stool was the subsidies designed to make insurance affordable. If there is a requirement to buy insurance, Obamacare’s drafters reasoned, then it needs to be affordable for all Americans. This is how the health care law ended up with a sliding scale of subsidies, with more help given to the lowest-income enrollees.

The idea was to create a fine that wasn’t quiteas expensive as purchasing insurance but was high enough that it would make consumers think twice about skipping coverage. The fine started lower — $395 or 1 percent of income, whichever was higher — in 2014 increasing to $695 or 2.5 percent of income in 2016, where it was intended to stay.

But the ACA’s penalty wasn’t nearly as harsh as those imposed in other countries. As Princeton University’s Uwe Reinhardt told Vox’s Sarah Kliff in 2016:

When you do this as the Swiss or Germans do, you brutally enforce the mandate. You make young people sign up and pay. But we are too chicken to do that, so we allow people to stay out by doing two things: We give them a mandate penalty that is lower than the premium. And we tell them, If you’re really sick, we’ll take care of you anyhow.

When they run these exchanges, they accompany them with a very harsh mandate. If you don’t obey the mandate, the Swiss find out, and they go after you and garnish your wages. If you’re not insured, they’ll look at your wages and recoup the premiums you owe. They’re very tough. And we’ve never been tough.

But the mandate didn’t really work — and Obamacare will probably be fine

It worked out as you’d expect. In 2016, 6.5 million Americans paid an average fine of $70 for not being covered the year before. Along the way, the Obama administration expanded the exemptions people could claim to avoid the mandate.

The Trump administration is building on its predecessors’ work for the mandate’s final year, ruling that people who live in counties with only one Obamacare insurer or people who are opposed to abortion and only have plans that cover abortions available to them do not have to pay the penalty for 2018.

Ending the mandate is going to increase premiums: Dave Dillon, a fellow of the Society of Actuaries, estimates health plans will tack on another 2.5 to 7.5 percent increase to make up for the loss of the mandate in 2019.

But the truth is most health policy experts had already come to believe the mandate wasn’t really working as intended. It was probably a combination of two factors: The penalty itself wasn’t big enough to compel people to buy health insurance, and the subsidies that people received from the federal government to buy coverage weren’t generous enough to draw more of them in either.

“A stronger individual mandate and bigger and broader premium subsidies would have made the ACA more successful,” Larry Levitt, senior vice president at the Kaiser Family Foundation, told me in October. “Of course, there are always trade-offs. Bigger premium subsidies would have required bigger tax increases.”

Yet Obamacare, the imperfect product that it is, isn’t going to collapse without the mandate. The law has proved rather resilient under Trump: Nearly as many people signed up for coverage for 2018 as did for 2017. The subsidies deserve the credit: For people with lower incomes, they help make insurance genuinely affordable or even free.

That won’t change when the mandate goes away. Even if insurers raise their premiums, the subsidies will protect the people who receive them from those hikes.

So Obamacare is likely to keep its market of 10 million or so customers. The mandate will retreat to the annals of history, while federal tax credits, Medicaid expansion, and the end of preexisting conditions become even more embedded in the fabric of our safety net.

A failed experiment comes to an end.

==

https://www.alternet.org/news-amp-politics/republicans-are-coming-your-health-care-paul-krugman-exposes-gops-deceptive-plan

Though it has largely disappeared from news coverage, health care remains one of the central issues in American politics that voters care about — and the health care system as a whole continues to be riddled with cruelty, neglect, and abuses.

And as economist Paul Krugman explained in a new column for the New York Times, Republicans have plans to make the American health care system much worse if they retain control of Congress in the midterm elections. Despite the fact that they've completely abandoned the topic as a campaign issue, the Trump administration and the GOP hopes it can finally dismantle Obamacare for good in 2019.

"[If] Republicans hold Congress in November, they will indeed repeal Obamacare. That’s not a guess: It’s an explicit promise, made by Vice President Mike Pence last week," wrote Krugman.

But despite many a Republican politician's promise — most notably, President Donald Trump's promise — that they will improvethe American health care system with a replacement for Obamacare, there's absolutely no chance of that happening.

Krugman explained:

The G.O.P. can’t come up with an alternative to the Affordable Care Act because no such alternative exists. In particular, if you want to preserve protection for people with pre-existing conditions — the health issue that matters most to voters, including half of Republicans — Obamacare is the most conservative policy that can do that. The only other options are things like Medicare for all that would involve moving significantly to the left, not the right.

The GOP often says, of course, that it wants to protect people with pre-existing conditions. Republicans sometimes even convince credulous journalists to write articles about their commitments to these protections.

But it's a lie. Every time they've had the chance, Republicans have pushed for legislation that would undermine these protections.

And if they have the chance, they'll do it again.

"So if you’re an American who suffers from a pre-existing medical condition, or fear that you might develop such a condition in the future, you need to be clear about the reality: Republicans are coming for your health care," wrote Krugman. "If they hold the line in November, health insurance at an affordable price — maybe at any price — will be gone in a matter of months."

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slate on princeton oligarch study (note aca as equalizer):

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But in the more recent decades Gilens and Page examine, neither party has enacted policy that fulfilled the wishes of average Americans alone. It did not matter whether the majority party was Democrat or Republican—both tend to ignore the median public opinion. This does not necessarily mean the average voter always loses: Just as poor folk in Kansas sometimes favor policies that benefit the rich, affluent individuals and interest groups can favor policies that benefit the poor. Gilens points out in his 2012 essay that LBJ’s landmark Great Society bills enjoyed only slightly less popularity among elites than among low- and middle-income Americans, but were supported by both groups. Warren Buffett saying he ought to pay higher taxes may not be as unusual as it seems.But it is the support of the rich that matter. Policies favored by the average voter are likelier to pass based on the chance that the rich support them.

Over at the New York Times, Ruy Teixeira thinkspolitical inequality aggravates economic inequality; Jelani Cobb thinks we’re letting the oligarchs rule. Paul Krugman’s response from Monday was more hopeful than most others. He writes:

“Obama has in fact significantly raised taxes on very high incomes, largely through special surcharges included in the Affordable Care Act; and what the Act does with the extra revenue is expand Medicaid and provide subsidies on the exchanges, both means-testedprograms whose beneficiaries tend to be mainly lower-income adults.” [NB the dread income redisr, the road to commie serfdom]

Indeed, it is worth pointing out that the most recent data analyzed for the paper ends in 2002. While the relative political clout of the rich has probably only increased, it also means that the data predate the clear expansions of welfare since then. Rich whites are more likely to dislike the Affordable Care Act, and yet it is here to stay. So I don’t think we should be unduly dour. Studying the relative fairness of representation between rich and poor and individuals and political groups is only possible in a mature, self-aware democracy with an eye toward self-improvement. Gilens concluded as much two years ago, when he wrote:...

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prop 56 tobacco tax, use to expand medical? vs intent dr/hmo

wonk sez worse fed bill did not pass, ca will be ok; makes it sound like doubt on mandate buy?

https://kpfa.org/episode/talkies-july-18-2018/

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no lnx

The States Attacking Obamacare Pre-Existing Condition Protections Would Be Most Harmed by Their Repeal

These efforts will disproportionately hurt the people of the states that are now suing to strike down the law's protection

By Joan McCarter / Daily Kos July 18, 2018, 6:15 AM GMT

https://www.alternet.org/news-amp-politics/states-attacking-obamacare-pre-existing-condition-protections-would-be-most-harmed

Gov. Mike Parsons of Missouri. The state's pre-existing condition rate is over 35 percent.

At some point you would think that the leadership in Republican states would just get over their hatred of President Barack Obama and realize that the Affordable Care Act has helped them. Or failing that, the people Obamacare has been helping would realize they have shitheads for leadership, and vote them out. Because here we go again—the efforts of Republican leadership in conservatives states will disproportionately hurt the people of the states that are now suing to strike down the law's protections, reports Kaiser Health News.

"These states have been opposed to the ACA from the beginning," said Gerald Kominski, a senior fellow at the UCLA Center for Health Policy Research. "They’re hurting their most vulnerable citizens."

Looking at data from insurance companies and the U.S. Centers for Disease Control and Prevention, KHN determined which states have the highest rates of adults with pre-existing conditions, and 9 out of the 11 have signed on to the lawsuit to strike down the ACA. West Virginia has the highest rate, with 36 percent of adults under age 65 living with preexisting conditions. Probably 1 in 3 of those would have a hard time buying insurance on the individual market of their state if Attorney General Patrick Morrisey, who joined the legal challenge against the ACA, were to prevail. There's one more argument for Sen. Joe Manchin (D-WV) to oppose the nomination of Brett Kavanaugh, who's proven hostile to the ACA, to the Supreme Court.

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A reminder of who's at risk here: "Common conditions that led insurance companies to deny coverage included high blood pressure, cancer, obesity, diabetes and depression, among many others. Some people were denied for having acne, asthma or for being pregnant." That encompasses at least a quarter of all adults who are under age 65—more than 50 million Americans.

That's just one reason so many people—three-quarters of Americans—say keeping these protections is "very important," including majorities of Democratic, Republican and independent voters.

If Sens. Susan Collins and Lisa Murkowski want their refusal to go along with Obamacare repeal and their repeated claims that they want to see these protections maintained to mean anything at all, to have any lasting effect, they've got to oppose this nomination.

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ref

https://khn.org/news/states-attacking-aca-would-hurt-most-if-shield-on-preexisting-conditions-were-axed/

If the Affordable Care Act’s protections for people with preexisting medical conditions are struck down in court, residents of the Republican-led states that are challenging the law have the most to lose.

“These states have been opposed to the ACA from the beginning,” said Gerald Kominski, a senior fellow at the UCLA Center for Health Policy Research. “They’re hurting their most vulnerable citizens.”

Twenty Republican state attorneys generaland governors challenged the constitutionality of the ACA in federal court in February. Last month, U.S. Attorney General Jeff Sessions and the Department of Justice made the unusual decision not to defend key portions of the law against this legal challenge.

The states’ lawsuit argues that because Congress eliminated the Obamacare tax penalty for not having insurance coverage, effective next year, the entire law is unconstitutional. By extension, the suit calls on federal courts to find the health law’s protections for people with preexisting conditions unconstitutional — and Sessions agrees.

Nine of the 11 states with the highest rates of preexisting conditions among adults under 65 have signed onto the lawsuit to strike down the ACA, according to data from insurance companies and the U.S. Centers for Disease Control and Prevention. The 2015 data, the most recent available, were analyzed by the Kaiser Family Foundation in 2016. (Kaiser Health News, which produces California Healthline, is an editorially independent program of the foundation.)

Those who support the lawsuit contend that there are other means of protecting people with preexisting conditions.

“If a court strikes down the constitutionality of the ACA, there are ways to repeal and replace without Arizonans with preexisting conditions losing their coverage,” said Katie Conner, a spokeswoman for Arizona Attorney General Mark Brnovich.

Conner said her boss, who is party to the lawsuit, believes preexisting conditions should “always be covered.” In Arizona, more than 1 in 4 adult adults under 65 have a preexisting condition, according to the data.

The state with the highest rate of adults with preexisting conditions is West Virginia — 36 percent of those under age 65. That means that about 1 in 3 of them could have a hard time buying insurance through the individual marketplace without the ACA protections.

The office of West Virginia Attorney General Patrick Morrisey, who joined the legal challenge against the ACA, declined to comment. But a spokesman for Morrisey’s re-election campaign told PolitiFact last month that “help should be provided to those who need it most, including those with preexisting conditions.”

Plaintiffs in the lawsuit “are paying lip service to these critical protections for people, but they are in fact engaged in a strategy that would get rid of those protections,” said Justin Giovannelli, an associate research professor at Georgetown University’s Center on Health Insurance Reforms. “Frankly, it’s hard to square what they’re saying on the one hand and what they’re arguing in the courts on the other.”

According to a poll released in June, also by the Kaiser Family Foundation, three-quarters of Americans say that maintaining protections for people with preexisting conditions is “very important.” This includes majorities of Democratic, Republican and independent voters.

Before the health law was adopted, insurance companies routinely denied coverage to millions of people with preexisting conditions who purchased insurance through the individual marketplace. If they didn’t deny coverage outright, some health plans charged consumers exorbitant premiums, or offered policies that excluded coverage for pricey conditions. (Although many people got insurance through their employers or public plans that covered preexisting conditions, they could have been left vulnerable if their employment status or other circumstances changed.)

The ACA ended those practices.

Common conditions that led insurance companies to deny coverage included high blood pressure, cancer, obesity, diabetes and depression, among many others. Some people were denied for having acne, asthma or for being pregnant.

The KFF analysis estimated that at least 27 percent of adults under 65 — more than 50 million Americans — had at least one preexisting condition that would have jeopardized their coverage pre-ACA.The foundation said its estimates were an undercount because some diseases that insurers cited when declining coverage are not in the survey data. Also, each insurance company set its own rules and conditions for denials, making accurate counts of those who could be affected hard to nail down.

Less precise estimates by other researchers and the Department of Health and Human Services show that up to half of all adults under age 65 have at least one preexisting condition.

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kill aca

While Trump preens in the afterglow of his questionable achievements at the negotiating table with North Korea, let’s take a look elsewhere — at the Trump administration decision to abandon Obamacare requirements that health insurance cover pre-existing conditions.

Late last week, the government said in filings in a federal court case that the requirement to cover those who need healthcare the most will become “unconstitutional” next year as well as protections forbidding insurers to deny coverage to those with pre-existing medical conditions.

Indeed, the Justice Department declined to defend the federal lawin a suit brought by states against the provisions of the Affordable Care Act. Just how that fits with an administration that seems fixated on “law and order” is a little hard to explain, but if it comes down to defending a law with which the administration disagrees, I guess that is within bounds.

Several senators, mostly Democrats, attacked the decision.

As The Washington Post noted, “The administration’s legal stance injects profound uncertainty into the political debate and the health-care landscape at a critical moment, just as insurance companies are developing rates for the coming year and as candidates head into a summer campaign season that both parties will try to use to solidify a foothold for their agendas.”

We can expect that this issue will top every local Democratic agenda in the mid-term elections in November.

Across the board, Republicans, Democrats and health professionals all say they have plans for providing healthcare, but none of these ideas ever seems to make it into legislation. So, instead, we have a guerrilla war underway with each state firing individual bullets at different targets. The government and individual states have taken various aspects of the overall Obamacare law to court.

The federal court suit over the Affordable Care Act became a potent threat to pre-existing conditions when the Justice Department filed a briefarguing that as of Jan. 1, 2019, those protections should be invalidated. The Justice Department argued that the judge should strike down the section of the law that protects people buying insurance from being charged higher premiums because of their health histories.Clearly lost in the discussion is anything resembling ways to assure that Americans are guaranteed access to actual healthcare.

According to a 2016 analysis by the Kaiser Family Foundation, approximately 52 million Americans under the age of 65could find their access to health insurance at risk because of a wide range of pre-existing conditions, from diabetes to cancer to pregnancy. Health insurers have for years been raising premiums, complaining about uncertainty and withdrawing from the business of selling individual insurance plans; more changes could further destabilize the market.

Still, many Republicans this weekend insisted they continued to support coverage for people with pre-existing conditions, such as high blood pressure, diabetes and cancer. The policy, unlike some elements of the Affordable Care Act, has widespread support. Several Republicans expressed bewilderment at the notion that this protection could be declared unconstitutional or overturned. “I certainly do not believe the provision on pre-existing conditions is unconstitutional. I don’t even understand what the legal argument would be,” Rep. Leonard Lance, R-N.J., told the Post.

Democrats leaped on the filing to re-issue healthcare as a party mainstay issue. More liberal Democrats are publicly favoring a Medicare-for-all approach to healthcare, something that Republicans clearly oppose.

...

https://www.alternet.org/while-no-ones-looking-republicans-are-waging-guerrilla-war-your-healthcare

https://www.alternet.org/news-amp-politics/idaho-brazenly-disregards-affordable-care-act-defying-rule-law

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house "mean" but senate not much better

http://www.alternet.org/news-amp-politics/how-corporate-media-enabled-gops-audacious-plan-steal-health-care-coverage-23

https://www.democracynow.org/2017/3/14/alec_for_profit_health_industry_embrace

As the Congressional Budget Office projects 24 million people will lose health insurance coverage by 2026 under the Republican plan to replace the Affordable Care Act, we look at who stands to benefit from the law. Lee Fang, investigative journalist at The Intercept, talks about how the American Legislative Exchange Council (ALEC) and the for-profit medical industry is backing the plan despite opposition from health providers. Plus, we look at how the bill is just the first of a three-part plan to repeal Obamacare.

TRANSCRIPT

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: As we continue to talk about healthcare, I also want to bring in investigative reporter Lee Fang of The Intercept. He recently wrote a piece headlined "Next Phase of Obamacare Repeal Will Target Mandate Requiring Prenatal Coverage, GOP Leader Tells Allies." The article begins, "When Republican Congressman John Shimkus expressed outrage during a House committee hearing Wednesday 'about men having to purchase prenatal care' in their health insurance—the video clip of which caught fire on social media as an example of misogyny and cluelessness—he wasn’t going rogue. He was just getting ahead of party leaders, who haven’t publicly announced their next steps quite yet." This is Shimkus making the comment after being questioned by Democratic Congressman Michael Doyle.

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Samuel Rodriguez

Samuel Rodriguez, who heads the National Christian Hispanic Leadership Conference and is a regular speaker at Religious Right gatherings, has fostered [26] a media image as a nonpartisan moderate [27] while simultaneously urging Hispanic voters to support right-wing candidates and Religious Right causes, and even filming a video promoting the Republican Party’s faith outreach project. In May, for example, he said it would be “morally reprehensible” for Christians to vote for a candidate who supports Planned Parenthood, saying they would need to repent.

Rodriguez, who served on Marco Rubio’s faith advisory board [28], was initially critical [29] of Trump’s anti-immigrant rhetoric. In July 2015 he joined the Southern Baptist Convention’s Russell Moore in a Wall Street Journal op-ed denouncing Trump and declaring, “Those who see immigrants as easy targets for scaremongering will find that they will lose more than the Hispanic vote; they also will lose those who sing, maybe in different languages, from the same hymnbook.” In May 2016, after Trump provided an NHCLC conference a perfunctory video that included no apology [30] for his anti-immigrant demagoguery, Rodriguez said he had “no plans on endorsing Donald Trump whatsoever.” But Rodriguez threw immigrant families under the wheels of the Trump bus after the candidate’s big meeting with evangelical leaders in June, praising Trump’s comments about abortion, religious liberty and the Supreme Court.

Rodriguez had previously given Trump political cover by saying he is not a racist and telling Christians that getting conservative justices on the Supreme Court is more important than immigration reform.

Rodriguez pushes the Religious Right line that the religious freedom [31] of Christians is under threat in America.[ID victim politics mirror ?] In 2012, after President Obama spoke in favor of marriage equality, Rodriguez said [32] the promotion of marriage equality is “an attempt to silence the church of Jesus Christ.” He believes there is a spiritual battle under way to “annihilate” the family and warns that Christians cannot sit out elections because “today’s complacency is tomorrow’s captivity.” [33]

In September, as part of the Religious Right operation My Faith Votes, Rodriguez warned a discouraged voter that “staying home may very well jeopardize my ability as a pastor to reach the people with the loving gospel of Jesus Christ.” He also said voters who don’t like either candidate should vote for “the party platform that best will protect your right to be a Christian and reach others with the loving, grace-filled message of Jesus Christ.”

Rodriguez also promotes right-wing positions on economics and government regulation. During the congressional battle to passhealth care reform,Rodriguez took part in a Religious Right “prayercast” that asked God to defeat the legislation. He has signed onto declarations that oppose progressive taxation [34] and embraced right-wing rhetoric [35] about people being “enslaved” by government and “uber-entitlements.”He has promoted the Koch brothers’ LIBRE Initiative,which is meant to proselytize an anti-government gospel of economic libertarianism to Latinos, saying in a LIBRE video that it is anti-Christian and anti-American to “punish success”—right-wing speak for progressive taxation.

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In his LIBRE video, Rodriguez embraced a prosperity gospel view of wealth [36]. “It’s anti-Christian to think that people that have been blessed…that they are wrong….Blessed people are a manifestation of scripture….In scripture there is an incredible amount of support for the idea that, yes, provision and abundance comes from God…”

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Rodriguez made the stridently anti-LGBT Liberty Counsel the official policy arm of the NHCLC, which went international in 2014 when it merged with an evangelical coalition in Latin America. Last year Rodriguez hailed controversial preacher Cindy Jacobs as “a legitimate prophet of God” and “one of the most anointed voices, prophetic voices in the Kingdom of God.”

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