Today the Affordable Care Act (ACA) turns nine.
It is still a BFD.
Today the Affordable Care Act (ACA) turns nine.
It is still a BFD.
Looks like we could use a new election return open thread. A lot of votes to still be counted in a lot of places, so everyone just stay calm. No reason to borrow trouble from the future.
I’ve noticed a lot of commenters are concerned that the polling for specific races was off in those places, for instance Florida. I’ve written in a number of comments over the past several months that I think the polling models are off for this election. Specifically, I thought they weren’t polling the demographics that are signaling a lot of the things that wouldn’t be captured in a poll anyway. Specifically the number of women, women of color, people of color, and religious minorities running for office on the Democratic side. As well as the effects of non-elite and notable donations, organization, enthusiasm, etc. And, in many cases, candidate quality. You want to know why Beto O’Rourke is right now causing Ted Cruz’s human suit to break out in hives? It’s candidate quality. The same reason that Gillum is within about a 1% point in Florida. Mike Espy is currently leading in the Mississippi Senate race, and Stacy Abrams is likely to force a runoff with Brian Kemp. That’s all candidate quality and there are a lot more examples I could provide.
What we should take away from this regardless of tonight’s outcome, is that we’re seeing the leading edge of a major socio-political shift. Specifically, the changes in the demographics in the US are finally beginning to make themselves shown in American elections. From people deciding to run to the outcomes. What we should not expect is that even if the Democrats have a great night, that this shift was going to fully materialize and be realized tonight. Rather it is something that needs to be nurtured, built on, and expanded starting first thing tomorrow morning!
Also, congratulations to Sharice Davids in Kansas 3!
Update at 10:00 PM EST
MSNBC has just called the Kansas governor’s race for Democrat Laura Kelly.
Just 2 more shopping hours on the east coast until the 2020 presidential elections!
Nate McMurray is running against Chris Collins in NY-27, a Buffalo-area R+11 district that is carefully gerrymandered to avoid any urban areas. You probably remember Collins, who was Trump’s campaign chair, because he was indicted in August for insider trading and it’s a slam-dunk that he’s going to jail. It looked like he was going to drop out, but there was no way to replace him on the ballot, so the Republicans lived up to their reputation and he stayed on the ticket.
McMurray is just a great candidate. He’s made the journey from community college, to a Fulbright scholarship, to a career in international law that took him to China, all the way back to the small town of Grand Island, where he’s currently the town supervisor. Nate’s campaign began long before Collins was indicted, when the race was basically a write-off. He’s been making good use of the torrent of cash that’s come his way since the news about Collins broke, but long before that he was doing things like driving in a demolition derby, pounding the pavement to meet voters, and running on a solid set of Democratic issues:
—Medicare for all
—Free, reduced tuition
—Agriculture as a nat security issue
—Broadband for all
—No more wasteful wars
—Human rights, safe immigration
—Fair tax laws
— Nate McMurray for Congress (@Nate_McMurray) July 14, 2018
The polls are all over the place but it’s definitely a tight race. This will be one to watch Tuesday night. (The headline is McMurray’s tagline on Twitter.)
I consume baseball in the most Americana way imaginable. I listen to it on the radio in the summer Midwestern night surrounded by cornfields. In the orange streetlight, moth fluttering nights that refuse to drop below 80. I own a cleaning company and while you are at home winding down your day I am vacuuming and dusting and taking out trash and cleaning toilets and listening to the Chicago White Sox not make the playoffs since 2008. It’s easy to picture me. If I was a character in a Stephen King novel I would surely be the first to get knocked off by a vampire or a clown.
For this reason, most of the visuals of the game are lost to me except when I can tune in on weekends. This is one visual I will certainly not miss.
The New York Times is reporting that the Cleveland Indians, in cooperation with Major League Baseball, are abandoning the Chief Wahoo logo after the 2018 season.
I live fifty miles northwest of Champaign-Urbana and its resident University of Illinois, so I had a mezzanine seat to the Retire the Chief / Save the Chief hullabaloo, which is still going on to this day. The Chief is a sort of local MAGA hat that we’ve had for decades. If I walk into a business or an office that’s festooned Chief stuff, I know the kind of person I’m dealing with upfront. A friend who witnessed the mascot’s formal retirement in 2007–he worked for the local paper and the university–once let me look through his personal letters-to-the-editor Chief file. They ranged from sedate and prosecutorial to spittle-flecked. I liked this:
Unfortunately, all that pageantry was built around a product of the rather odd obsession white people had with their view of Native American culture nearly 100 years ago. Too bad we are still saddled with the decisions of an assistant band director who was just trying to put on a good halftime show. If he had simply chosen some other kind of symbol to be the focus of all that audience participation stuff, we wouldn’t be dealing with this mess today. Can you imagine!
But forsaking the revolting Chief Wahoo logo is more complicated than it appears on the surface. Let’s Go Tribe goes on to say:
It’s interesting, but not surprising, that the Chief Wahoo merchandise will still be sold in local markets. According to Jordan Bastian, this is in part because the Indians still maintain a trademark for the logo and are required to keep it in retail spaces to do so.
“The Indians will maintain control of the Chief Wahoo trademark. In order to do so, it will still have a limited retail presence. No retail presence would open door for another party to seize control of the mark and profit from it.”
Not only will they keep the trademark, but the flood of people who support a logo over their favorite baseball team will likely flock to buy up whatever they can. Make no mistake about it, the Indians are going to keep profiting off the logo for a long, long time.
So either the team profits on its heritage of racism or some third-party does. Short of the team donating those profits to a reservation, there are no good choices here.
This is worth at least an quasi-ironic chuckle. The implementation of the Affordable Care Act in 2018 is closer to some elements of the early 2007 campaign version of Obama’s health care vision than the ACA implementation from 2010-2017 was.
Now let’s go look at the tape, from Polifact 2007:
Obama shot back: “Well, let’s talk about health care right now because the fact of the matter is that I do provide universal health care. The only difference between Sen. Clinton’s health care plan and mine is that she thinks the problem for people without health care is that nobody has mandated — forced — them to get health care.”….
One of the few differences is that Clinton and Edwards include a universal mandate….
Obama’s decision not to include a mandate is a more cautious approach, one Obama says is designed not to penalize people with modest incomes. If premiums don’t drop enough after all the reforms are implemented, people will still be unable to afford insurance.
Obama contended during the 2008 primary that the subsidies would be rich enough that no mandate would be needed. And then the desire to hit a particular CBO score came into play as well as a need to not lose a single Democratic senator dictated that subsidies were going to be a lot weaker than the House wanted.
However with Cost Sharing Reduction (CSR) sabotage leading to Silverloading and Gold gapping, subsidies for individuals who make between 100% Federal Poverty Line (FPL) and 400% FPL ($12,020-$48,080) will have become effectively much richer for people who buy plans that cost less than the benchmark.
This is just an irony if seen from a skewed point of view.
In comments to the post on pragmatic evolution of US health policy on Monday, The Question raised a point that I want to respond to:
on health care why do we always have to pre-negotiate with ourselves and have ourselves primed to accept half a loaf? I am so tired of being sensible when there is no gorram reward. If loudly shouting the most extreme thing we want gets us even half what the republicans have gotten out of it why the hell not??
I want to raise an empirical point and then a broader political/policy point that explains my thought process.
First, empirically, what has “shouting the most extreme thing” gotten Republicans?
It has gotten them power.
What have they done with it so far? In 2009, Democrats at this point had a smaller functional majority in the Senate and a slightly larger majority in the House than the Republicans have today. Democrats had passed and signed into law the stimulus, CHIP re-authorization, Lily Ledbetter, and the
Dodd-Frank CARD ACT by now. They were grinding their way through what would become the ACA.
What have the Republicans accomplished as of today?
They got a Supreme Court justice at the cost of allowing liberals to nominate liberals in the future. And they named a bunch of post offices. What else have they gotten at the legislative level? And they also got a President who is at 34% who is leading to massive swings against the GOP. Those swings are large enough to endanger the gerrymandered House GOP majority even if they do nothing.
That is my pragmatic point. Being howler monkeys may be a successful strategy to gain power but it has not been a successful strategy to exercise power.
Now onto the broader point of pragmatism or pre-compromising depending on your point of view, I want to bring back a post from December 2015 regarding a statement made by the current FDA Commissioner Scott Gottlieb on the ACA Exchanges. First I will highlight a post from earlier that week explaining the bullshit:
leading lights of the conservative “health wonk” community is peddling bullshit that is technically true if you parse it correctly but designed to mislead anyone but a hyper technical reader.
Last year open enrollment started on November 15th. The 6th week of open enrollment would have been the first week of January.
This year, open enrollment started on November 1st. The 6th week of open enrollment just wrapped up.
Yes, at the six week mark of open enrollment, 2014 enrollment is running higher than 2015 enrollment. However there is one massive fact that will show 2015 open enrollment 7th week selections running ahead of 2014 7th week selections. Sometime at the end of this week, Healthcare.gov and most of the state based exchanges will conduct a massive automatic renewal of plans.
Trump is a partial consequence of over-promising
And next year, when Obamacare does not collapse in on itself like a neutron star of fail, the same opinion leaders and expert validaters will trot out the same story.
The Republican base has been promised a lot and their party can’t deliver on those goals. The elites don’t have legitimacy because their bullshit has been marked to market so new entries with new, creatively destructive forms of bullshit have a niches that they can fill and a willing mass audience that wants to believe that this time the new guy can deliver on their promises while ignoring the elites who have no credibility.
I want to avoid that cycle. I would rather under-promise and over deliver than over promise and under deliver.
I also believe that the details matter and an accurate assessment of the current state and a reasonable approximation of future states is critical in doing anything well. I can be accused of having that bias for professional and financial reasons as I am a health policy wonk and figuring out complex systems pays the mortgage. I don’t think that is what drives me, but I will acknowledge that possibility.
I want a political and policy program that has two realistic chances. The first is that it needs a realistic chance of passing Congress and being signed into law. The second is that once it is law, it needs to have a realistic chance of actually working and doing what it intends to do without surprising consequences in type or scale.
From these preferences, that means identifying things that imperil those two chances. Great politics don’t always means great policy as we see with the risk pool damage that the Under-26 provision of the ACA creates by pulling out healthy young people from the market. Needed policy is not always great politics as we see with the individual mandate. Sometimes a bad is needed to be accepted on one side of the equation to allow the other side to work but those bads should be minimized to the essentials for passage or functionality. And that means being disciplined in our thinking.
The valuation of “bad” will vary. It is a combination of projection and a value judgement as to what trade-offs are acceptable. Having that discussion now and hopefully coming to some type of consensus or at least a clear understanding of different valuations is a good thing as there is time to tweak and rejigger plans.
What a fucking idiot. The first rule of opposing a livable wage is you don’t call it a livable wage.
During Tuesday night’s debate for an open U.S. House seat in Georgia, Republican candidate Karen Handel said that she does not support a “livable wage.”
I’m not raising money for Ossoff because I think the 30 million spent on the race already is enough but let’s keep raising money for the eventual Democratic nominee in all 238 districts Republicans currently hold. Let’s make the next Democratic majority a 435 seat one.
It’s instructive in a “compare and contrast” sense to read today’s NYT columns from David Brooks and Paul Krugman. Brooks is contemplating the Trumpocalypse and what it all means for professional plutocracy apologists like himself. He warns us to gird ourselves for more Applebees salad bar stories, as Doug points out downstairs, dog help us.
Brooks attributes Trump’s rise — and Sanders’ too — to a broad sense of American decline:
This election — not only the Trump phenomenon but the rise of Bernie Sanders, also — has reminded us how much pain there is in this country. According to a Pew Research poll, 75 percent of Trump voters say that life has gotten worse for people like them over the last half century.
In the morning thread, sharp-eyed commenter Jeffro noticed Brooks’ rhetorical switcheroo there, speaking of Sanders and Trump voters and then citing a poll result exclusive to the Trumpenproletariat, as if Sanders voters share the exact same concerns. And it is a sly form of both-sides-do-it-ism.
Krugman has a different take on why the Trumpites are angry as well as an explanation for why the GOP establishment candidates went down to humiliating defeat while Clinton is prevailing on the Dem side:
Both parties make promises to their bases. But while the Democratic establishment more or less tries to make good on those promises, the Republican establishment has essentially been playing bait-and-switch for decades. And voters finally rebelled against the con.
Krugman is right. But Brooks isn’t 100% wrong when he says there is pain on both sides of the political divide, even if he is dishonest in how he frames it. There is real pain out there, and it’s not all attributable to aggrieved white men who are finally getting a taste of the economic insecurity the rest of the world has been swallowing for decades.
Ostensibly middle-class families are one outpatient surgery deductible away from financial catastrophe. Students are graduating with crushing debt. Parents have no idea how they’ll ever retire. The unemployment rate is at a 40-year low, but try finding a decent job if you’re a 50-something woman or a 17-year-old black kid.
These things are real. And what Hillary Clinton is going to have to do is thread that needle – highlighting, protecting and expanding what President Obama and his Democratic predecessors have accomplished on the one hand while at the same time communicating that she understands how much further we have to go. It won’t be an easy task.
Yesterday, Bernie Sanders gave a speech in which he allegedly dialed back the criticism of Hillary Clinton a bit but lambasted the Democratic Party instead:
“The Democratic Party has to reach a fundamental conclusion: Are we on the side of working people or big-money interests? Do we stand with the elderly, the children, the sick and the poor? Or do we stand with Wall Street speculators and the drug companies and the insurance companies?”
When I heard that, my first thought was, gosh, that’s not particularly helpful. How about at least acknowledging that there’s exactly one party that recently expanded healthcare coverage to 20 million people, passed Medicare, Social Security and CHIP and imposed any regulation at all on Wall Street and Big Pharma? And over the screaming intransigence of the only other party that is relevant in US elections?
But aren’t Sanders’ remarks a perfect segue for Clinton to deliver the message she must communicate? I still think Sanders will come around to endorsing Clinton and urging his supporters to support her and elect the Democratic Congressional majority she’ll need to get shit done. But in the meantime, maybe starting this conversation will do. If Hillary is going to sew it up, it’s time to thread that needle.
ETA: A piping hot new version of Cleek’s pie filter has just come out of the oven. Lay claim to your slice here.
— MB (@baxterdc) March 25, 2016
So under budget and on projection for the target uninsured rate even with Chief Justice Roberts enabling sociopaths and assholes to stop Medicaid Expansion in 20 states.
Not bad at all….
UPDATE 1: The next time there is a massive social program passing Congress with uncertain costs, we need to put in mechanisms to take advantage of success instead of safeguards against massive cost overruns. The ACA has triggers where if the total federal cost of the advanced premium tax credit and the cost sharing reduction subsidies were more than .504% of GDP, future year individual shares would increase and the thresholds for federal subsidies would decline.
There were no mechanisms in place to say if subsidies were significant below budget that either subsidies for currently qualified individuals would get richer so their out of pocket premium expense would decline OR more people would become eligible for subsidies.
This is just a note to self to find again in 20 years.
Just some more good news:
— Margot Sanger-Katz (@sangerkatz) March 3, 2016
and the good news will probably continue for the first quarter of 2016:
— Richard Mayhew (@bjdickmayhew) March 3, 2016
So in 3 years, all of the data sources suggest that we’ve cut the uninsured rate in half and slowed the cost curve. There are another couple percentage points of easy gains once the rest of the Confederacy and the everyone between the Mississippi’s left bank and the Columbia’s south bank expand Medicaid.
Then we’ll actually need to take another whack to get the last 5% of the population covered AND get better coverage for 25% to 30% of the currently covered population.
Just a few quick notes on the current campaign through the eyes of a white liberal who has never felt the Bern.
The Sanders campaign announced Tuesday it raised $42.7 million in February, and the Clinton campaign announced Wednesday morning it raised $30 million during the month.
There are three times as many nonblack voters as black voters in the Democratic primary electorate. To cancel her strength, Mr. Sanders would need to win nonblack voters by about 20 percentage points, since Mrs. Clinton leads by more than 60 points among black voters.
And now backing things out a bit.
The Dean campaign in 2004 was overwhelmingly white liberals who were looking for a cause. The Dean campaign was the first time I showed up on an FEC report.
The Obama coalition in the 2008 primary was a combination of white liberals and the African American community plus not getting crushed among the other major groups within the Democratic primary electorate. The Sanders coalition is primarily white liberals and rural Democrats. The Clinton 2008 coalition was moderate and conservative Democrats, Latinos and a bit more female then the party as a whole. Her coalition in 2016 is her 2008 coalition plus the African American bloc.
What we are seeing is the limit of white liberal power within the Democratic coalition.
It is more than sufficient to fund campaigns but it is insufficient to create a durable national majority. White liberals by themselves are a much larger, and far less crazy analogue to the Paulbots of the Republican Party — more then sufficient to generate a lot of money and advance ideological arguments. It is well connected to to privileged positions within the media and discussion ecosystem and due to its demographics plus committment of its members, it can fundraise efficiently on the internet at small to medium donor levels. Internet fundraising allows for a fairly low burn rate on the part of ideological and aspirational campaigns to tap this set of small donors. These are two very strong political assets.
However white liberals alone or with minor coalition partners, are not able to form a majority within the Democratic Party. . White liberals get a whole lot closer to forming a majority than libertarian dude bros but they cap out significantly short of a majority.
One of the dumbest arguments of the 2008 Democratic primary season was the extrapolation of primary results to general election results.
“Obama rolls up big margins on the Plains, he can win there in November…”
“Clinton winning the Democratic primaries in Ohio and Pennsylvania means she and only she can win the industrial Midwest”
Both sides of that argument are stupid.
And we’re seeing the same stupid on Iowa:
It seems like Clinton’s weakness among youth should be a big warning for the general that it’ll be hard to replicate Obama’s coalition.
— Joseph Weisenthal (@TheStalwart) February 2, 2016
Repeat after me, primary electorates and caucus selectorates are not random samples of the general electorate.
It is perfectly plausible in 2016 for a 23 year old Democratic activist in Iowa to have the following preference order: Sanders>Clinton>Chlamydia>Republican Nominee.
In last night’s contest the only part of the preference order that was under examination was how Sanders and Clinton related.
In November, the relevant preference order is either Sanders and Republican nominee, or far more likely Clinton and Republican nominee.
The same logic applied in 2008. In Pennsylvania, the primary preference order was usually Clinton-Obama, but the general election preference order was Obama over McCain.
The people who take part in caucuses are highly unlikely to flip parties in the general election. They are self-identified intense partisans. Trying to generalize caucus results into general election results is obtuse.
Paul Krugman kinda sounds like many commenters on this here blog on the topic of transformational rhetoric vs realpolitik in today’s NYT column. Like all Krugman columns, it’s worth reading in full, but here’s excerpt:
[O]n the left there is always a contingent of idealistic voters eager to believe that a sufficiently high-minded leader can conjure up the better angels of America’s nature and persuade the broad public to support a radical overhaul of our institutions. In 2008 that contingent rallied behind Mr. Obama; now they’re backing Mr. Sanders…
But as Mr. Obama himself found out as soon as he took office, transformational rhetoric isn’t how change happens. That’s not to say that he’s a failure. On the contrary, he’s been an extremely consequential president, doing more to advance the progressive agenda than anyone since L.B.J….
Yet his achievements have depended at every stage on accepting half loaves as being better than none: health reform that leaves the system largely private, financial reform that seriously restricts Wall Street’s abuses without fully breaking its power, higher taxes on the rich but no full-scale assault on inequality.
There’s a sort of mini-dispute among Democrats over who can claim to be Mr. Obama’s true heir — Mr. Sanders or Mrs. Clinton? But the answer is obvious: Mr. Sanders is the heir to candidate Obama, but Mrs. Clinton is the heir to President Obama. (In fact, the health reform we got was basically her proposal, not his.)
Krugman closes by reminding readers not to “let idealism veer into destructive self-indulgence,” which is sound advice. But I’m not sure his assessment is fair to former candidate Obama or current candidate Sanders, both senators and intelligent men who surely have/had some inkling of what they would face when trying to implement their agendas as president.
Maybe it’s more about what’s appropriate for the times. A couple of days ago in the “Town Hall” thread, valued commenter MomSense posited a theory of why a transformational campaign might be wrong for this particular election:
Part of the problem for Sanders this election is that this year isn’t a change election on the Dems side. The polls say 80-87% of Dems depending on demographics approve of the job the president is doing and think we are going in the right direction… It’s the flip side of the problem Clinton had in 2008… Her 2008 election was far too status quo than the mood of the Democratic base. 2016 is a guard the change and expand on reform election for the Democratic base. I just don’t think there is an appetite among the Democratic base to risk what we’ve gained on unrealistic promises of revolution.
The part about “change” vs. “guard-the-change” elections sounds about right to me. It’s not that Sanders is wrong to be aspirational about addressing wealth inequality, etc., now — even with the knowledge that Republicans will obstruct him at every turn — any more than it was wrong for then-candidate Obama to run on breaking down partisan divides and then paring down his goals and adjusting his strategy to accommodate GOP recalcitrance when he became president. But it may be that there’s too little demand for a revolution right now, at least among Democrats. We’ll see.
ETA: There’s a site maintenance thread downstairs to report bugs and comments about the design update.
The Cook Political Report Partisan Voter Index is an attempt to categorize how much more red or blue a state is compared to a national average. It works by taking the average national two party vote share of the past two elections and calling that the zero index value. States with vote shares for the Democrats that are above that index value are considered to have a D+x PVI. States that vote more Republican than the index value are considered to have an R+x PVI. It is very closely related to the hypothetical uniform swing.
It is a decent indicator of partisan lean of a state although it lags on fast changes (The eastern mountain states probably have an actual PVI above the reported PVI).
I want to point out some of the states whose Senators voted for PPACA and what their 2010 PVI was as a public service announcement:
North Dakota R+10 *
North Dakota R+10
South Dakota R+9,
West Virginia R+8
West Virginia R+8 *
Only two of those seats are still held by Democrats. None of those seats are on the top tier of the Democratic target list for 2016.
These ten seats were a minimal majority blocking coalition. Another 8 Democrats were sitting in Republican leaning seats and plus the asshat Lieberman as a massive opportunity cost in Connecticut. That is 19 Democrats in the Senate including any plausible majority combination where fulfilling major liberal policy goals was either personally distasteful (at least 1) or politically challenging giving their home turf. The actual policy space was severely constrained.