John McCain Is No Savior

In the wake of the Republicans' failure to repeal and replace Obamacare, the media has found its one true hero - their decades-long man crush, John McCain. And while it is true that McCain was one of three Republican Senators who voted with the entire Democratic caucus to tank the so-called "skinny repeal" that represented the last ditch effort to pass something, ANYTHING Republicans could point to as dismantling  the Affordable Care Act, the media’s reflexive fellating of McCain was as predictable as it was misguided.

Of course, as a former flyboy, McCain knew how to milk the drama for all it was worth - ambling onto the Senate floor, gesturing to be recognized, and uttering a single syllable, "no,” as his mic drop moment.

Reporters could not get enough of this - the return of the maverick, blah blah blah, but while McCain did show some political courage, can we not lose sight of several underreported truths?

1. McCain himself helped create this imbroglio by (more drama!) flying back to DC from Arizona to cast a vote that opened debate in the first place. Had he not done this (or voted not to open debate) the rest of the episode never would have happened.

2. The relentless pressure by activists had far more to do with all of the Senate efforts being struck down than anything McCain did after not only voting to open debate but then voting in favor of certain options that other Republicans helped vote down. 

3. Why is the media bending over backwards to laud three Republican Senators, representing less than 10% of their caucus, for voting to NOT strip 16 million people of health insurance? This is a profile in courage? Perhaps some rethinking of how public policy is reported is also in order.

4. Another Senator is battling cancer. Her name is Maisie Hirono, and, unlike McCain, never wavered in her desire to protect access to health insurance for her fellow Americans. 

5. Read McCain's statement released after "skinny repeal" went down. Here’s part of what he had to say:

“I’ve stated time and time again that one of the major failures of Obamacare was that it was rammed through Congress by Democrats on a strict-party line basis (ed. note: that’s a lie) without a single Republican vote. We should not make the mistakes of the past that has led to Obamacare’s collapse, (ed. note: also a lie) including in my home state of Arizona where premiums are skyrocketing (ed. note: one more lie) and health care providers are fleeing the marketplace.”

He also said his goal is to “repeal and replace” Obamacare. This is the hero? Three lies in two sentences from a guy who was given the chance to work with Democrats in 2009 and 2010 but refused to do so? Who has had the better part of seven years to float his own ideas but has remained silent? Seriously?

This is all on top of the fact that McCain, whose health insurance is as gold-plated as it gets and who has been in Congress for more than 30 years, was even opening the door to the possibility that a law would be enacted taking health insurance away from people who are not like him (i.e., a multi-millionaire member of Congress with access to the best health care money can buy), will now be lost to the memory hole of history. It should not. What modicum of political courage he exercised very early Friday morning should not excuse what he did to help instigate the drama or take away from the people who worked far harder than he did to block this dangerous action from going forward.

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Obamacare Is Working ... Pass It On

Ever since Barack Obama made universal health insurance a defining feature of his first term in office, the Republican Party has engaged in a relentless campaign to destroy what we now refer to as “Obamacare.” During the bill’s movement through Congress, they threw up every legislative obstacle, ginned up protests and rowdy town halls, and attempted to sow fear with ominous warnings of death panels and government bureaucrats coming to pull the plug on granny. Once the law passed, immediate legal challenges cropped up attempting to stop implementation of the law, questioning its constitutionality, and otherwise gumming up the arteries of the legal system in a Hail Mary attempt to stop millions of people from gaining health insurance. Just this week, Congress held its 62^nd vote to repeal Obamacare, finally getting its symbolic victory so that the President can stamp “VETO” when it lands in his inbox. 

It was an odd and discomfiting experience, what with the fact that the law was modeled on an idea originally proposed by the Heritage Foundation and promised to hand health insurers millions of new customers all while maintaining our inefficient, privately-run system for health care delivery in the country. Regardless, weeks and weeks of coverage were provided on everything from a glitchy website to supposed insurance death sprials to claims that the new law would destroy jobs. All reported breathlessly by a media more than happy to ape Republican talking points without ever digging into their veracity. Of course, none of these things occurred, not that you would have noticed because the media had already moved on without bothering to issue corrections. Chuck Todd demanded an apology from President Obama when healthcare.gov was not working, but never proferred a mea culpa of his own once the program was up and running smoothly, helping millions find health insurance.

Comes now an editorial in the Washington Post that examines the three-legged stool of measuring Obamacare’s success: enrollment, cost control, and employment. On all three scores, the Affordable Care Act has delivered – big time. 

Enrollment: Before the Affordable Care Act passed, an estimated 18.5 percent of the adult population in America under the age of 65 was without health insurance. In 2015, that number dropped to 10.5 percent, a reduction of about 45 percent. As the editorial notes, that percentage would be even lower if all 50 states, instead of just 30, had expanded Medicaid coverage under the ACA. It is worth noting that if all 50 states had expanded Medicaid, the roughly 9 percent of American adults under 65 without health insurance is in line with pre-ACA estimates provided by the Congressional Budget Office. 

Cost Control: Here we have two points to consider. The first is whether the ACA did anything to rein in insurance rates that used to go up considerably year-to-year; the second is what impact the Medicare cost control measures included in the ACA did to reduce costs in that program. On both counts, the ACA has succeeded. Prior to Obamacare’s passage, it was estimated that health care expenditure rates would increase by 5.5 percent in 2013 and 7 percent in 2018. In reality, expenditures only increased 3.6 percent in 2013 and are now only estimated to go up by 5.3 percent in 2018 – huge cost savings. Similarly, the rise in premium rates and medical costs since the passage of the ACA have been well below what they were in the decade prior to its passage and the actual costs are lower than what were estimated by the CBO when the law passed. 

On the Medicare front, the cost savings should make any green eyeshade deficit hawk swoon. In 2009, the CBO expected the government to spend $723 billion on Medicare in 2015. The actual amount? $634 billion - $90 billion less than predicted. Extrapolate those savings out over a decade and you have “saved” almost $1 trillion. Not too shabby. 

So, the Affordable Care Act has cut the number of uninsured by nearly half, cost less than predicted, and saved Medicare tens of billions of dollars. But what about jobs? Republicans kept telling us that Obamacare would be a jobs killer. Not so. The past two years have been gang busters for employment. The jobless rate is now at just 5% and the economy has created millions of new, mostly full-time jobs in the process. 

That the good news is largely unreported is unsurprising. Humdrum stories of government functioning as intended (and even a little better) are not nearly as interesting as whatever insult Donald Trump has lobbed at an opponent today, but to the people who have benefitted from the Affordable Care Act, I suspect this is, as Vice President Biden said, a big fucking deal.

Follow me on Twitter - @scarylawyerguy