(Early) Monday Smackdown: The Washington Post and Chris Cillizza

Duncan Black: Eschaton: America's Worst Humans: "Chris Cillizza. I'm sure Cillizza got his career opportunities through nothing other than the pure meritocracy...

...that exists in our free market Nirvana. Certainly he got none of the breaks that blah people do. Still if he wasn't doing this, I don't see how he wouldn't be under a bridge somewhere.

Scott Lemieux: Love Is Always Scarpering, Or Cowering, Or Fawning: "This month’s Cillizza Award for Outstanding Achievement in the Field Of Hackdom goes to… Chris Cillizza:

@TheFix: You should watch this Paul Ryan town hall on CNN. The guy is extremely impressive.

@OnceUponA: It is very difficult to have a working understanding of health policy and simultaneously be impressed by his answers on ACA. https://t.co/NTdpL9gTIw

You can watch Ryan’s comments about health care yourself, but they’re evasive gibberish when they’re not outright dishonest. The idea that state high-risk pools — especially at the levels the GOP would plausibly fund them — could effectively cover people with pre-existing conditions is a joke. (More here.) The claim that insurance markets are in a “death spiral” is a flat-out lie. His assertions that the proposed Republican reforms would provide better and cheaper policy options was supported by no detail whatsoever. Ryan, as always, is the anthithesis of impressive, and yet his media reputation as a Real Wonky Man of Seriousity never fades.

To be Scrupulously Fair, Ryan’s primary goal to offer worse or no health insurance to more than 20 million people to pay for upper-class tax cuts does has not, to the best of my knowledge, deviated from best practices in email management.

Memories of Past Policy Disasters, and the Likelihood of ACA Repeal

Clowns (ICP)

Ah. Memories of 1981...

Back in 1981 the Reagan administration promised big tax cuts for the rich; higher defense spending; no spending cuts in programs that were really useful but only in rent-seeking waste, fraud, and abuse; and a balanced budget. They didn't add up. They went forward anyway.

The consequence was the huge full-employment Reagan budget deficit, and gave America a Hobson's choice between:

  1. a decade of slow growth if a weak-dollar policy aimed at balanced trade and the financing requirements of the federal government starved private investment.

  2. a decade of the destruction of American midwestern manufacturing as the capital inflow to finance investment was in its turn financed by the eagerness generated by a strong-dollar policy to purchase from abroad.

The Reagan administration chose (2)--which was bad, although better than (1) for the country as a whole. The Reagan Democrats of McComb County got what they deserved. And a lot of other Americans got what they did not deserve.

My late friend Susan Rasky--who was covering the budget for the New York Times that year--blamed the press corps of which she was a part for allowing itself to report the fake news that the situation was confused, and that the Reagan administration did have a plan to juggle the situation--big tax cuts for the rich; higher defense spending; no spending cuts in programs that were really useful but only in rent-seeking waste, fraud, and abuse; and a balanced budget--because Reagan budget director David Stockman was a wizard. And she always put a large part of the blame for the press corps' institutional failure on then-Washington Post editor William Greider.

In her estimation, Greider guided his reporters away from the real story in order to preserve his own forthcoming scoop of reporting it in the Atlantic profile of David Stockman he was going to publish after the budget fight was over. And she found herself unable to get her own editors to back her as fully as she wanted them to--for they asked: "If you are right about this, why is the Washington Post reporting things differently?"

The Republican senate majority leader back in 1981, Howard Baker, characterized the Reagan administration's plans as "a riverboat gamble". That was not a compliment. He was waiting to see whether outside pressure from the public sphere might force the Reagan administration to reconsider, but without that pressure he was not brave enough to do anything other than shut up and soldier.

Similarly, back in 2001 neither Paul O'Neill nor Alan Greenspan was brave enough to say that the Bush tax cuts should be conditional on the continued existence of a budget surplus to pay for them.

Today's Republicans are unlikely to do any better than their predecessors--Greenspan, O'Neill, Baker. And is today's press corps?

Josh Marshall: Chauncey Trump: "The AMA, which has been rather comically pro-Trump to date, came out today and told Republicans that they shouldn't repeal Obamacare without a clear replacement...

...Notably, even two of the most conservative health care economists at AEI, came out yesterday and said that 'repeal and delay' would be a disaster. The truth is that "repeal and delay" is the policy equivalent of taking off from JFK to Heathrow with 2,000 miles worth of gas and saying you're going to figure it out en route.... This morning President-Elect Trump is out with an ambiguous and possibly meaningless (it's sort of like Being There) series of tweets warning Republicans to "be careful" and make sure that Democrats "own" the "ObamaCare disaster." But... only about a quarter of Americans want Obamacare repealed. A quarter!

The gist of what Republicans are saying this morning - both Trump and the GOP - is that they need to remind Americans how awful the ACA is so they'll have some way to explain, to justify why they're taking health care coverage from 20 to 25 million Americans, to have some explanation for the s%$&storm they're about the fly the country's health care system into.... They simply have no idea what to do and now they're being taunted by Trump not to blow it and he doesn't have any idea either. It would be funny if millions of people's lives and well being weren't on the line.

Weekend Reading: Mitt Romney: Full Transcript of the 47% Secret Video

Mitt Romney (2012): Secret 47% Video:

Romney: ...And I guess everybody here is a dignitary, and I appreciate your help. And by the way, I am serious about the food. Bring that... clear the place, but Hilary has to eat her beets... [Audience laughs.]

MotherJones: Full Transcript of the Mitt Romney Secret 47% Video:

Below is a complete transcript, produced by Mother Jones, of the entire unedited Romney videos that we published on September 18. (See our exclusive coverage of Romney writing off half of America's voters and trashing the Mideast peace process at his recent fundraiser in Florida.)

...I'm gonna—because the table is small enough and the room is intimate enough, I'd like to spend our time responding to questions you have, listening to advice you might have. Occasionally, as I did just a moment ago, I get envelopes like that, which is, and I'll open this and there'll be campaign ideas—"Why don't you talk about the following issues…"—so I'm happy to take advice and then we can all vote on it, whether it's a good piece of advice or bad advice. And so we'll get a chance to do that, but I'm looking to get your perspectives.

Just to tell you a couple of things you may not know about me. You probably know that I'm father of five and grandfather now of 18—my oldest son just had twins just last week, and so our grandchild nest is getting larger, and they're a source of great joy. When I was probably halfway through my career at Bain Consulting, I met with a lawyer to draft a will, and she said, "How do you want to divide what estate you might eventually have?" And I said—I didn't have anything at that point—I said, "I want to divide it equally among my five sons." And she said, "Well, how much will you want to give to the grandchildren that they will ultimately have," and I said, "Well, I don't want to give anything to the grandchildren—I'll give it to the sons, and they in turn will give it to their children as needed." And she said, "You'll change your mind." And I said, "No, I don't think so." So I saw her not long ago, and I said, "I don't want to give anything to my sons, I want to give it [to all to my grandchildren.] [Audience laughs.]

Romney: This, uh, it's not as…

Audience Member: This is my daughter. [More laughter.]

Romney: It's not just because I love my grandchildren, as I do, and I love my sons and [unintelligible], it's that I'm very concerned about what the nation is gonna be like over the coming decade or two. And I really do.

As I said in my remarks earlier, I see these two very different scenarios.

One is as America really powering the world economy, with an extraordinary economy here, with China working with us, wanting to see stability in the world, and a very vibrant America, with freedom and prosperity for the great bulk of the American people.

On the other hand, I really do see something like Europe. And I think that's the path we're on right now. So that's why I wanna make sure what little I'll have left after the campaigns goes to you know, goes to my grandchildren.

That's one piece about me that you may not know.

The other is just about my heritage—my dad, you probably know, was the governor of Michigan and was the head of a car company, but he was born in Mexico. And had he been born of Mexican parents I'd have a better shot at winning this, but he was [audience laughs] unfortunately born of Americans living in Mexico. They'd lived there for a number of years, and, uh, I mean I say that jokingly, but it'd be helpful if they'd been Latino…

Audience Member: Pull an Elizabeth Warren!

Romney: Pardon?

Audience Member: Pull an Elizabeth Warren.

Romney: That's right. Those that don't know Elizabeth Warren—she's the woman who's running for US Senate in Massachusetts, who said that she's Cherokee, has put in her application over the years that she's Cherokee, and Harvard put down that she's one of their minority faculty members.

It turns out that at most she's 1/32 Cherokee, and even that can't be proven.

So, in any event, yeah, I can put down my dad was born in Mexico and leave it at that. But his dad was in construction, very successful in Mexico, but in America went broke more than once. So my dad never had the money or time to get a college degree. Without a college degree, became head of a big car company and ultimately a governor. And believed in America, believed in the opportunity in this country, never doubted for a moment that he could achieve his dreams.

And Ann's dad, my wife's dad, was born in Wales. His dad was a coal miner. This coal miner got injured in a coal mining accident; realizing that there was no future there for him or his four children, he came to Detroit and worked in the auto factories until he could save enough money to bring his kids over, which he did. And then they got together as a family and said, you know, to be successful in America, you've got to get an education. And they couldn't afford an education. And the kids and the parents said you know, if we all work, and we all save, we could afford to send one of us to college. And they, they sent my wife's dad.

Can you imagine working every day, taking a couple of jobs, saving your money so that your brother could go to—I mean, I would never do that for my brother—that he could go to co… so he went to college, and got a degree at the General Motors Institute of Technology, which is one of these programs where you work a semester, and then you go to school a semester and… and then after it was over he started a little company, he became more successful, and he was able to hire his brothers and his brother-in-law, and provide for them in an extraordinary way.

By the way, both my dad and Ann's dad did quite well in their life, but when they came to the end of their lives, and, and passed along inheritances to Ann and to me, we both decided to give it all away. So, I had inherited nothing. Everything that Ann and I have we earned the old-fashioned way, and that's by hard work and… [applause] I see that—

Audience Member: You've just lost Samantha's vote for a second time. [Audience laughs.]

Audience member (female): These jokes are [unintelligible]. [More laughter.]

Romney: I say that because there's the percent that's, "Oh, you were born with a silver spoon," you know, "You never had to earn anything," and so forth.

And, and frankly, I was born with a silver spoon, which is the greatest gift you could have, which is to get born in America. I'll tell ya, there is—95 percent of life is set up for you if you're born in this country. And I remember going to—sorry just to bore you with stories—but I was, when I was back in my private equity days, we went to China to buy a factory there, employed about 20,000 people, and they were almost all young women between the ages of about 18 and 22 or 23. They were saving for potentially becoming married, and they worked in these huge factories, they made various small appliances, and as we were walking through this facility, seeing them work, the number of hours they worked per day, the pittance they earned, living in dormitories with little bathrooms at the end with maybe ten rooms. And the rooms, they had 12 girls per room, three bunk beds on top of each other. You've seen them.

Audience Member: Oh, yeah.

Romney: And around this factory was a fence, a huge fence with barbed wire, and guard towers. And we said, "Gosh, I can't believe that you, you know, you keep these girls in." They said, "No, no, no—this is to keep other people from coming in. Because people want so badly to come work in this factory that we have to keep them out, or they'll just come in here and start working and try and get compensated. So, we—this is to keep people out."

And they said, "Actually, Chinese New Year, is the girls go home, sometimes they decide they've saved enough money and they don't come back to the factory." And he said, "And so on the weekend after Chinese New Year, there'll be a line of people hundreds long outside the factory, hoping that some girls haven't come back and they can come to the factory. And so, as we were experiencing this for the first time, for me to see a factory like this in China some years ago, the Bain partner I was with turned to me and said, "You know, 95 percent of life is settled if you're born in America."

This is an amazing land. And what we have is unique, and fortunately it is so special we're sharing it with the world. I'm concerned about the future, but also optimistic as I said, and I look forward to getting America back on track, and having people plan on bringing their ideas and their dreams to this country.

We get big dreamers, by the way.

Oh, I just, we didn't talk about immigration today. Gosh, I'd love to bring in more legal immigrants that have skill and [unintelligible]. I'd like to staple a green card to every Ph.D. in the world and say, "Come to America, we want you here." Instead, we make it hard for people who get educated here or elsewhere to make this their home. Unless, of course, you have no skill or experience, in which case you're welcome to cross the border and stay here for the rest of your life. [Audience laughs.]

It's very strange. It's run by people who don't understand the words "global competition of ideas," and our idea has to win, but only if America reigns strong. But with that introduction, I'm going to turn to you for counsel, advice, or questions. Policy questions. Wanna talk about tax policy? Or political questions? How I win? Please.

Audience Member: One comment, Governor.

Romney: Yes.

Audience Member: The debates are gonna be coming, and I hope at the right moment you can turn to President Obama, look at the American people, and say, "If you vote to reelect President Obama, you're voting to bankrupt the United States." I hope you keep that in your quiver because that's what gonna happen. And I think it's going to be very effective. Just wanted to give you that.

Romney: Yeah, it's interesting… the former head of Goldman Sachs, John Whitehead, was also the former head of the New York Federal Reserve. And I met with him, and he said as soon as the Fed stops buying all the debt that we're issuing—which they've been doing, the Fed's buying like three-quarters of the debt that America issues. He said, once that's over, he said we're going to have a failed Treasury auction, interest rates are going to have to go up.

We're living in this borrowed fantasy world, where the government keeps on borrowing money. You know, we borrow this extra trillion a year, we wonder who's loaning us the trillion? The Chinese aren't loaning us anymore. The Russians aren't loaning it to us anymore. So who's giving us the trillion? And the answer is we're just making it up. The Federal Reserve is just taking it and saying, "Here, we're giving it.' It's just made up money, and this does not augur well for our economic future.

You know, some of these things are complex enough it's not easy for people to understand, but your point of saying, "bankruptcy", usually concentrates the mind.

Yeah, George.

Audience member, "George": Governor, to your point on complexity. How is—you've traveled around America and talked to people in larger groups and perhaps people with different backgrounds, and people in this room: To what extent do people really understand that we're hurtling toward a cliff, and to what extent do people understand the severity of the fiscal situation we're in. Do people get it?

Romney: They don't. By and large people don't get it. People in our party, and part of—it's our fault because we've been talking about deficits and debt for about 25 or 30 years as a party, and so they've heard us say it and say it and say it. The fact that Greece is going what it's going through, and they read about France and Italy and Spain, has finally made this issue topical for the American people.

And so when you do polls, and you ask people what is the biggest issue in the 2012 election, No. 1 is the economy and jobs by a wide margin. But No. 2 is the deficit. But debt, that doesn't calculate for folks, but the deficit does. They recognize you can't go on forever like this. Although the people who recognize that tend to be Republicans, and the people who don't recognize that tend to be Democrats. And what we have to get is that 5 or 10 percent in the middle who sometimes vote Republican, sometimes vote Democrat, and have them understand how important this is.

It's a challenge.

I did the calculation for folks today, and USA Today publishes this every year. It's a front-page story: the headline once a year, it somehow escapes people's attention, and that is, if you take the total national debt and the unfunded liabilities of Medicare, Social Security, and Medicaid, the amount of debt plus unfunded liabilities per household in America is $520,000. Per household.

Audience Member: It's like 12 times their income, right?

Romney: At least. 10, 12 times their income. Even though we're not going to be writing the check for that amount per household, they're going to be paying the interest on that. You'll be paying the interest on that. [Audience laughs.] Because we—my generation will be long gone, and you'll be paying the interest. And so you'll be paying taxes, not only for the things you want in your generation, but for all the things we spent money on, which is just—it's extraordinary to think the tax rates, someone calculated what would happen.

If we don't change Medicare or Social Security, the tax rate—you know what the payroll tax is now, it's 15.3 percent—if we don't change those programs, that tax rate will have to ultimately rise to 44 percent. The payroll tax.

Then there's the income tax on top, which the president wants to take to 40 percent. Then there's state tax in most states. And sales tax. So you end up having to take 100 percent of people's income.

And yet the president, three and a half years in, won't talk about reforming Social Security or Medicare. And when the Republicans do, it's "Oh, you're throwing granny off the cliff." It's like you're killing the kids. The biggest surprise that I have is that young people will vote for Democrats. They look at this and say, "Holy cow! The only guys who are worried about the future of our country and our future are Republicans." But the Democrats, they talk about social issues, draw in the young people, and they vote on that issue. It's like, I mean, there won't be any houses like this if we stay on the road we're on.

Please. Yeah—I heard a voice, please.

Audience Member: Gov. Romney, we are former Bostonians, and we'll talk about how we know you.

Romney: Uh, oh. [Audience laughter, cross talk.]

Audience Member: It's good!…and we totally agree with what you said economically. But I would like to know, and I would like to get into much more discussion on what I consider the real issues: the real issues of Iran, and how your point of view differs from President Obama's.

Romney: Thank you—and by the way, start eating, those of you who have food in front of you that's warm, start eating. I'm standing up so I can see you, but I'm not standing up so you that you have to stop and look at me. It's important to look at your food as you're eating it. [Audience laughs.] Noticed you putting a fork in your finger here, all right…[cross talk, laughter].

You are right, which is a nuclear Iran is an unthinkable outcome, not just for our friends in Israel and our friends in Europe, but also for us. Because Iran is the state sponsor of terror in the world, has Hezbollah now throughout Latin America, Hezbollah with fissile material. If I were Iran, and a crazed fanatic, I'd say let's get a little fissile material to Hezbollah, have them carry it to Chicago or some other place, and then if anything goes wrong or if America starts acting up, we'll just say, "Guess what, unless you stand down, why we're gonna let off a dirty bomb."

This is where we head, where American can be held up and blackmailed by Iran, by the mullahs, by crazy people. So we really don't have any option but to keep Iran from having a nuclear weapon.

I'll give the specifics about Iran, and then maybe talk more broadly about foreign policy. The specific on Iran is that we should have put in place crippling sanctions at the beginning of the president's term. We did not. He will say, "Yes, but Russian wouldn't go along with us." Well, he gave Russia their No. 1 foreign objective: For a decade, all they've cared about is getting the missile defense sites out of Poland, and he gave them that and got nothing in return.

He could have—I presume—gotten them to agree to crippling sanctions on Iran. He did not, which is in my opinion, one of the greatest foreign policy errors of the modern time. And by the way, if he could not have gotten that from Russia, he should have kept the missile defense sites in Poland, just to keep a bargaining chip on table. I mean, put nothing in if he wants—I would have kept them, I wouldn't have traded them away, but that's where he was.

No. 2, we should have been aggressively supporting the voices of dissent in Iran, and when there was an effort towards revolution there we should been aggressively supporting. And finally we should have made it clear, at least by now, that we have military plans to potentially remove their nuclear capabilities. That doesn't mean we actually pull the trigger, but it means we communicate to them that we're ready to do so. And that it is unacceptable to America to have a nuclear Iran.

Instead what this administration has done is communicate to the Iranians that we're more worried about Israel attacking them than we are about them becoming nuclear. It's extraordinary. So those are some thoughts directly at Iran.

I'll step back on foreign policy: The president's foreign policy, in my opinion, is formed in part by a perception that he has that his magnetism and his charm and his persuasiveness is so compelling that he can sit down with people like Putin, Chávez, and Ahmadinejad. And that they'll find we're such wonderful people that they'll go on with us. And they'll stop doing bad things.

And it's an extraordinarily naive perception, and it has led to huge errors in North Korea, in Iraq, obviously in Iran, in Egypt, around the world.

My own view is that that the centerpiece of American foreign policy has to be strength. Everything I do will be calculated to increasing America's strength. When you stand by your allies, you increase your strength. When you attack your allies, you become weaker. When you stand by your principles, you get stronger. When you have a big military—that's bigger than anyone else's—you're stronger. [Unintelligible.]

When you have a strong economy, you build America's strength. For me, everything is about strength and communicating to people what is and is not acceptable. It's speaking softly but carrying a very, very, very big stick. And this president instead speaks loudly and carries a tiny stick. And that is, you know, that's not the right course for a foreign policy. I saw Dr. Kissinger in New York—you're not eating! [Audience laughs.]

Audience Member: I'm mesmerized! [unintelligible]

Romney: He's bored to tears. [Audience laughs.] I saw Dr. Kissinger; I said to him, "How are we perceived around the world?" And he said, "One word: VEAK!" [Audience laughs.]

We are weak, and that's how this president is perceived, by our friends and, unfortunately, by our foes. And it's no wonder that people like Kim Jong Un, the new leader of North Korea, announces a long-range missile test only a week after he said he wouldn't. Because, it's like, what's this president going to do about it? If you can't act, why, don't threaten.

[To another audience member with a question] Please.

Audience Member: [Asks about Iraq. (Garbled.)]

Romney: I'm just gonna taste this by the way. I just wanna show you how it's done: You take this in your fork…[Audience laughs.]…you put it in…That's good, that's good. [To audience member]: Please, go ahead.

Audience Member: If you get the call as president, and you had hostages… Ronald Reagan was able to make a statement, even before he became, was actually sworn in—

Romney: Yeah—

Audience Member: the hostages were released—

Romney: on the day of his inauguration, yeah.

Audience Member: So my question is, really, how can you sort of duplicate that scenario?

Romney: Ohhhh. [A few chuckles in audience.] I'm gonna ask you, how do I duplicate that scenario.

Audience Member: I think that had to do with the fact that the Iranians perceived Reagan would do something to really get them out. In other words [unintelligible]… and that's why I'm suggesting that something that you say over the next few months gets the Iranians to understand that their pursuit of the bomb is something that you would predict and I think that's something that could possibly resonate very well with American Republican voters.

Romney: I appreciate the idea. I can't—one of the other things that's frustrating to me is that at a typical day like this, when I do three or four events like this, the number of foreign policy questions that I get are between zero and one. And the American people are not concentrated at all on China, on Russia, Iran, Iraq.

This president's failure to put in place a status forces agreement allowing 10-20,000 troops to stay in Iraq? Unthinkable! And yet, in that election, in the Jimmy Carter election, the fact that we have hostages in Iran, I mean, that was all we talked about. And we had the two helicopters crash in the desert, I mean that's—that was—that was the focus, and so him solving that made all the difference in the world.

I'm afraid today if you said, "We got Iran to agree to stand down a nuclear weapon," they'd go hold on. It's really a, but… by the way, if something of that nature presents itself, I will work to find a way to take advantage of the opportunity.

Romney [to another audience member]: Please—yes?

Audience Member: It's your lucky night: more foreign policy! [Audience laughs/crosstalk.]… actually the first time you were in Jerusalem. And we appreciate you being there. How do you think that the Palestinian problem can be solved, and what are you going to do about it?

Romney: I'm torn by two perspectives in this regard.

One is the one which I've had for some time, which is that the Palestinians have no interest whatsoever in establishing peace. And that the pathway to peace is almost unthinkable to accomplish. Now, why do I say that? Some might say well just let the Palestinians have the West Bank and have security and set up a separate nation for the Palestinians.

And then come a couple of thorny questions. And I don't have a map here to look at the geography. But the border between Israel and the West Bank is obviously right there, right next to Tel Aviv, which is the financial capital, the industrial capital of Israel. The center of Israel. It's, uh—what? The border would be maybe seven miles from Tel Aviv to what would be the West Bank?

Audience Member: Nine.

Romney: Nine miles. Okay, I'd be close. Nine miles. The challenge is the other side of the West Bank… the other side of the West Bank, the other side of what would be this new Palestinian state would either be Syria at one point or Jordan.

And, of course, the Iranians would want to do through the West Bank exactly what they did through Lebanon and what they did in Gaza. Which is the Iranians would want to bring missiles and armament into the West Bank and potentially threaten Israel. So Israel, of course, would have to say that can't happen. We've got to keep the Iranians from bringing weaponry into the West Bank. Well, that means that—who?—the Israelis are going to control the border between Jordan, Syria, and this new Palestinian nation?

Well, the Palestinians would say, "Ah, no way! We're an independent country. You can't guard our border with other Arab nations."

And then how about the airport? How about flying into this Palestinian nation? Are we going to allow military aircraft to come in? And weaponry to come in? And if not, who's going to keep it from coming in? Well, the Israelis. Well, the Palestinians are going to say, "We're not an independent nation if Israel is able to come in and tell us what can land at our airport." These are problems, and they're very hard to solve, alright?

And I look at the Palestinians not wanting to see peace anyway, for political purposes, committed to the destruction and elimination of Israel, and these thorny issues, and I say there's just no way. And so what you do is you say you move things along the best way you can. You hope for some degree of stability, but you recognize that it's going to remain an unsolved problem.

I mean, we look at that in China and Taiwan. All right, we have a potentially volatile situation, but we sort of live with it. And we kick the ball down the field and hope that ultimately, somehow, something will happen and resolve. We don't go to war to try and resolve it.

On the other hand, I got a call from a former secretary of state—and I won't mention which one it was—but this individual said to me, "You know, I think there's a prospect for a settlement between the Palestinians and the Israelis after the Palestinian elections." I said, "Really?" And his answer was, "Yes, I think there's some prospect." And I didn't delve into it but you know, I always keep open the idea of, I have to tell ya, the idea of pushing on the Israelis?—to give something up, to get the Palestinians to act, is the worst idea in the world. We have done that time and time and time again. It does not work.

So, the only answer is show your strength.

Again, American strength, American resolve, as the Palestinians someday reach the point where they want peace more than we're trying to push peace on them—and then it's worth having the discussion. Until then, it's just wishful thinking.

[Audience crosstalk.]

Audience Member: Individuals in this room obviously are your supporters. I am very concerned that the average American, who doesn't know you, there's a terrible misconception. And I spend numerous hours trying to [unintelligible]. Years and years ago, I called George Bush Sr., and he had helped me in my campaign in Massachusetts when I ran for Senate. I told him that there's a guy named Clinton who's running for the following reasons. And he laughed. Right now, I'm very concerned… Women would not want to be involved for you. Hispanics, majority of them do not want to vote for you. College students don't. After talking to them, and explaining and rationalizing on a one-on-one basis, we are able to change their opinions. But on a mass level, what do you want us to do, this group here, as your emissaries, going out to convert these individuals to someone who's obviously going to be such an incredible asset to this country. We want you.

Romney: Well…

Audience Member: But what do we do? Just tell us what we can help…

Romney: I have—I have some good news for you. It's not impossible. Now, the reason I say that is for instance, the New York Times had a poll last week, the New York Times and NBC, and I was leading by two points among women. All right. Now, the president came out and said this is an outrageous poll, they don't know what they were doing—by the way, the polls at this stage make no difference at all—but the point is, women are open to supporting me. They like the president [unintelligible], but they're disappointed. They're disappointed with the jobs they're seeing for their kids, they're disappointed with their own economic standing right now.

So we can capture women's votes, we're having a much harder time with Hispanic voters. And if the Hispanic voting bloc becomes as committed to the Democrats as the African-American voting bloc has in the past, why we're in trouble as a party and, I think, as a nation.

Audience Member: Rubio!

(Different) Audience Member: Exactly.

Audience Member: Pick him up!

Romney: And so…[Audience laughs.] We have some great—we have some great Hispanic leaders in our party who will help communicate what our party stands for, and what I think, frankly, what I need you to do is to raise millions of dollars, because the president's going to have about $800 to $900 million. And that's—that's by far the most important thing you could do.

Audience Member: [Unintelligible.]

Romney: Because, well, because you don't have the capacity to speak to hundreds of thousands of people. I will be in those debates. It will be, I don't know, 150 million Americans watching. If I do well, it'll help. If I don't, it won't help…

Audience Member: You will do so well. Your debates are incredible. [Audience laughs, claps.]

Romney: Thank you, thanks, thank you. But advertising makes a difference, and the president will engage in a personal character assassination campaign. And so we'll have to fire back one, in defense, and No. 2, in offense. And that's [unintelligible]…Florida will be one of those states that is the key state. And so all the money will get spent in 10 states, and this is one of them. So, I—the best thing I could ask you to do—I mean, yeah, sure, talk to people and tell them how you know me and word of mouth makes a big difference. But you know, I'm not terribly well known by the general American public, because…

Audience Member: You're known as a rich boy. I mean, they say, "He's a rich man."

Romney: They don't. But don't worry—given all those negative things, given all those negative things, the fact that I'm either tied or close to the president, and the fact that, you know, he's out there talking about the one-year anniversary of Osama bin Laden being captured, unemployment coming down, unleashing his campaign, new campaign, and we're still sort of tied? That's very interesting. And it's, it's encouraging. Please.

Audience Member: I would disagree with that. I think a lot of young children coming out of college feel they're let down by the president. And they feel there's not a job out there for them, and [unintelligible] making $60,000 and now they're making $30,000. Very similar to the U6.

Romney: Yeah, yeah.

Audience Member: My question to you is, Why don't you stick up for yourself? To me, you should be so proud of your wealth. That's what we all aspire to be—we kill ourselves, we don't work a nine to five. We're away from our families five days a week. I'm away from my four girls five days a week and my wife. Why not stick up for yourself and say, "Why is it bad to be, to aspire to be wealthy and successful? You know, why is it bad to kill yourself? And why is it bad to cut 30 jobs that protect 300?" And, when people talk about you cutting jobs, you save companies that were failing...[unintelligible]. So my question is, when does that stand up…[unintelligible].

(Different) Audience Member: …neighborhood…and worked his way up from nothing to be an incredibly successful entrepreneur, so, it, it…

Romney: You heard in my speech tonight, I talked it [crosstalk]...again, but if it…oh, you weren't here.

Audience Member: He came here, so he missed the…

Romney: In every stump speech I give, I speak about the fact that people who dream and achieve enormous success do not make us poorer—they make us better off. And the Republican audience that I typically speak to applauds. I said that tonight, and the media's there, and they write about it, they say that Romney defends success in America and dreamers and so forth. So they write about it. But in terms of what gets through to the American consciousness, that's—I have very little influence on that in this stage, as to what they write about.

And that will happen—and we'll have three debates, we'll have a chance to talk about that in the debates. There will be ads which attack me; I will fire back in a way that describes in the best way we can the fact that if, the theme in my speech is that—I wind up in, you know, the ambassadors [unintelligible] me today, several times—I wind up talking about how the thing which I find most disappointing in this president is his attack of one American against another American, the division of America based on going after those who have been successful.

And then I quote Marco Rubio, I tell in my speeches, I say, Marco Rubio—I think what I said would be [unintelligible]…

I also think I said that at a fundraising event earlier today, but I did when I was in Empire…[unintelligible] [Audience laughs.]…

I just said Sen. Rubio says that when he grew up here, poor, that they looked at people that had a lot of wealth, and his parents never once said, "We need some of what they have, they should give us some." Instead they said that you work hard and go to school, someday we might be able to have enough. That's…[Applause.]

I will continue to do that, how much of that gets picked up, there are so many things that don't get picked up in a campaign because people aren't watching them. By the way, most people don't watch during the summer. I said we're going to go into a season here starting with the beginning of June with almost no attention paid, then after Labor Day, in September and October, that's when it'll get fun.

Audience Member: For the last three years, all everybody's been told is, "Don't worry, we'll take care of you." How are you going to do it, in two months before the elections, to convince everybody you've got to take care of yourself?

Romney: There are 47 percent of the people who will vote for the president no matter what. All right, there are 47 percent who are with him, who are dependent upon government, who believe that they are victims, who believe that government has a responsibility to care for them, who believe that they are entitled to health care, to food, to housing, to you name it. That that's an entitlement. And the government should give it to them. And they will vote for this president no matter what.

And I mean, the president starts off with 48, 49, 48—he starts off with a huge number. These are people who pay no income tax. Forty-seven percent of Americans pay no income tax. So our message of low taxes doesn't connect. And he'll be out there talking about tax cuts for the rich. I mean that's what they sell every four years.

And so my job is not to worry about those people—I'll never convince them that they should take personal responsibility and care for their lives.

What I have to do is convince the 5 to 10 percent in the center that are independents that are thoughtful, that look at voting one way or the other depending upon in some cases emotion, whether they like the guy or not, what it looks like. I mean, when you ask those people… we do all these polls—I find it amazing—we poll all these people, see where you stand on the polls, but 45 percent of the people will go with a Republican, and 48 or 4…

[Recording interrupted...]

Romney: …and about twice as much as China, not 10 times as much like it's reported. And we have responsibility for the whole world. They're only focused on one little area of the world, the South China Sea, the East China Sea, that's it. And they're building a military at a rapid rate. So this idea that somehow we've already spent so much money in the military—it's like, guys, don't overthink how strong we are. We—you probably know it, this was a couple of years ago, but we had one of our aircraft carriers sailing by Japan, and the Chinese pulled up behind it in a diesel sub, in a super-quiet diesel sub, pulled up behind it. It could have been torpedoed. And, I mean, we're in that kind of—our Navy's smaller in number of ships than anytime since 1917, and this president wants to shrink it. The list goes on. Our Air Force is older and smaller than anytime since '47 when the Air Force was formed, and he wants to shrink it. If we go the way of Europe, which is spending 1 to 2 percent of their economy on the military, we will not be able to have freedom in the world.

Audience Member: When the [unintelligible] in September, the markets are going to be looking—marginal tax rates going up, overheads going, fine, but sequestration under the debt ceiling deal—what do they call it?

Romney: Taxageddon?

Audience Member: Yeah, they call it that. The Obamacare, taxes on dividends and capital gains—I mean, the markets are going to be speaking very wildly in October on all of those issues.

Romney: They'll probably be looking at what the polls are saying. If it looks like I'm going to win, the markets will be happy. If it looks like the president's going to win, the markets should not be terribly happy. It depends, of course, which markets you're talking about, which types of commodities and so forth, but my own view is, if we win on November 6th there will be a great deal of optimism about the future of this country. We'll see capital come back, and we'll see—without actually doing anything—we'll actually get a boost in the economy.

If the president gets reelected, I don't know what will happen. I can never predict what the markets will do. Sometimes it does the exact opposite of what I would have expected. But my own view is that if we get the—the "Taxageddon," as they call it, January 1st, with this president, and with a Congress that can't work together, it really is frightening, really frightening in my view.

Audience Member: Fifty-four percent of American voters think China's economy is bigger than the US. When I first met you four or five years ago, you did a diagram where you went very granular and you said, "Look, guys"—this was a small group—and you said, "this is it, this is what it is, tell it like it is." How are you going to win if 54 percent of the voters think China's economy is bigger than ours? Or if it costs 4 cents to make a penny and we keep making pennies?

Canada got it right a month ago. Why isn't someone saying, "Stop making pennies, round it to the nearest nickel?" You know, that's an easy thing, compared to Iran. I want to see you take the gloves off and talk to people that actually read the paper and read the book and care about knowing the facts and acknowledges power. As opposed to people who are swayed by, you know, what sounds good at the moment. If you turned it into like, "Eat what you kill," it'd be a landslide. In my humble opinion.

Romney: [Laughs.] Well, I wrote a book that lays out my view for what has to happen in the country. And people who are fascinated by policy will read the book. We have a website that lays out white papers on a whole series of issues that I care about. I have to tell you, I don't think this will have a significant impact on my electability. Um, I wish it did. I think our ads will have a much bigger impact. I think the debates will have a big impact. You know, I—

Audience Member: No one even knows who Pete Peterson is and he's [unintelligible] trouble 20 years ago.

Romney: But that's my point. Which is—my dad used to say, "Being right early is not good in politics." And in a setting like this—a highly intellectual subject, a discussion of a whole series of important topics—typically doesn't win elections. And there are, for instance, this president won because of hope and change. All right? He won because of hope and change.

Audience Member: Keep the change. [Audience laughs.]

Romney: Yeah, well. So it's—I can tell you I have a very good team of extraordinarily experienced, highly successful consultants. A couple of people in particular who've done races around the world. I didn't realize these guys in the US, the Karl Rove equivalents, they do races all over the world. In Armenia. In Africa. In Israel. I mean, they work for Bibi Netanyahu in his races. So they do his races and see which ads work and which processes work best and, uh, we have ideas about what we do over the course of the campaign. I'd tell them to you, but I'd have to, you know, shoot ya. [Audience laughs.] Hopefully it will be a successful place.

Audience Member: I think one of the aspects about hope and change that worked well for Obama four years ago was he promised to bring us more honest, transparent governance in Washington. I've been around politics—the first campaign I worked for was Barry Goldwater in 1964. I've gotta be the oldest Republican in [unintelligible]. But from what I've seen, particularly in the last seven months because of my own personal involvement in an issue, is the government in Washington right now is just permeated by cronyism, outright corruption. Our regulatory agencies that are supposed to protect the public are protecting the people that they're supposed to be regulating. And I think people are fed up with that.

Doesn't matter if you're in the tea party of Occupy Wall Street, people see that the government is working for the powerful interests and the people who well-connected politically and not the common person. Which threatens that whole idea that we have this great opportunity—which we should have and have had, historically—in the US for anybody, from whatever background, to become successful. One way that that becomes compromised is when the government is no longer seen as being an honest agent. And where our tax dollars are not really being put to work for us but for the people who are plugged-in politically.

You know, you had cases like Solyndra and [unintelligible] that I've talked about and gotten involved in. You have Eric Holder who is probably the most corrupt attorney general that we had ever in American history. And I think it's something that if spun the right way in simple terms can actually resonate with the American people. Obama did not keep his promises. Nancy Pelosi was supposed to give us an honest Congress and has given us just the opposite as speaker. And I think that's a campaign issue that can work well. I'm optimistic that you'll be elected president. And my recommendation would be clean house, immediately. The SEC, the CFEC are disaster areas.

Romney: I wish they weren't unionized, so we could go a lot deeper than you're actually allowed to go. Yeah. I can say this, which I'm sure you'll agree with this as well. We speak with voters across the country about their perceptions. Those people I told you, the 5 to 6 or 7 percent that we have to bring onto our side, they all voted for Barack Obama four years ago. So, and by the way, when you say to them, "Do you think Barack Obama is a failure?" they overwhelmingly say no. They like him.

But when you say, "Are you disappointed in his policies that haven't worked?" they say yes. And because they voted for him, they don't want to be told that they were wrong, that he's a bad guy, that he did bad things, that he's corrupt. Those people that we that have to get, they want to think they did the right thing but he just wasn't up to the task. They love the phrase, "He's in over his head."

But we, you see, you and I, we spend our day with Republicans. We spend our days with people who agree with us, and these people are people who voted for him and don't agree with us. And so the things that animate us are not the things that animate them.

And the best success I have speaking with those people is, you know, the president's been a disappointment. He told you he'd keep unemployment below 8 percent, hasn't been below 8 percent since. Fifty percent of kids coming out of school can't get a job. Fifty percent. Fifty percent of the kids in high school in our 50 largest cities won't graduate from high school. What are they gonna do? They usually pass on saying…and I could say to that audience that they nod their heads and say, "Yeah, I think you're right."

What's he going to do by the way is try and vilify me as someone who's been successful. Or who's closed business or laid people off—an evil, bad guy. And that may work. I actually think that right now people are saying, "I want somebody who can make things better, that's gonna motivate me, who can get jobs for my kids and get rising incomes." And I hope to be able to be the one who wins that battle.

Audience Member: I've seen Obama a lot of times on talk shows, interviews, but I've never seen you on any of them. I think a lot of people, especially you know, [unintelligible] I think people would see you in a different light. I think a lot of women especially do not watch debates. They don't come to these functions. You maybe have to show your face more on TV and talk just like regular [unintelligible] typical American last name.

Romney: Smith.

(Different) Audience Member: In Sweden, you say Johansson. [Audience laughs.]

Audience Member: So I think maybe you could reach a lot of people.

Romney: Well, thank you. I have been on The View twice now. [Audience laughs.] I've been on The View twice. It went very well. [Audience cross talk.]

Romney: Regis is gone. I've done the night, the evening shows. I've been on Letterman a couple of times. I've been on Leno more than a couple times, and now Letterman hates me because I've been on Leno more than him. They're very jealous of one another as you know. And there's, I was asked to go on Saturday Night Live. I did not do that, in part because you want to show that you're fun and you're a good person, but you also want to be presidential. And Saturday Night Live has the potential of looking slapstick and not presidential.

But The View is fine. Although The View is high risk because of the five women on it, only one is conservative. Four are sharp-tongued and not conservative, Whoopi Goldberg in particular. Although last time I was on the show, she said to me, "You know what? I think I could vote for you." And I said, "I must have done something really wrong." [Audience laughs.]

I had to sit down and—oop, Darlene, you get the last word.

Audience Member: I was just gonna say, I think a media strategy would be sending Ann on the road. Because she, I think, is your best friend, your best advocate. She connects so well. People talk so much about this connect—and somebody said over there, people think he's a rich, rich guy. Most of us know that you know that's—

Romney: You know that I'm as poor as a church mouse. [Audience laughter]

Audience Member: We know that you value [unintelligible] and hard work. And Ann really connects with people, and she can tell a story about the hard work and she can tell about the person who [unintelligible] and go on Good Morning America and go on The View and hold her own against these people. And really get you the women connecting to you more. Seeing her and think she's a great—

Romney: I think you're right. Absolutely right. We use Ann sparingly right now, so that people don't tired of her, or start attacking.

Audience Member: Who gets tired of Ann?

Romney: [Audience laughs.] I'll tell ya—. But you will see more of her in the September, October timeframe. And you know we had, what's her name, Hilary Rosen, who, you know, attacked her, and that made Ann much more visible to the American people, which I think is very helpful. It gave her a platform she wouldn't have had otherwise. And I agree with you. I think she will be extraordinarily helpful.

Audience Member: Just a quick—. Can you be a friend of her on Facebook or whatever happened after Hilary Rosen [unintelligible]…That shows you the value of social networking and just how important the media can be in this election cycle, and I just think that she is amazing. And I know she wants, she wants [unintelligible]…

Romney: She's out there. She's, she's in Texas tonight. She was in Louisiana last night. She's raising money in those places. She was at Ben Crenshaw's house for dinner today, tonight. [Unintelligible.]

So there are some benefits. One of the benefits I get is eating the world's best dessert, which I will. [Audience laughs.]

Thank you. [Applause.]

Transcription by Sydney Brownstone, Maya Dusenbery, Ryan Jacobs, Deanna Pan, and Sarah Zhang.

Beating America’s Health-Care Monopolists: Fresh at Project Syndicate

J Bradford DeLong Project Syndicate

J. Bradford DeLong and Michael M. DeLong: Beating America’s Health-Care Monopolists: BERKELEY – The United States’ Affordable Care Act (ACA), President Barack Obama’s signature 2010 health-care reform, has significantly increased the need for effective antitrust enforcement in health-insurance markets. Despite recent good news on this front, the odds remain stacked against consumers.

As Berkeley economics professor Aaron Edlin has pointed out, consumer abstention is the ultimate competitor. Companies cannot purchase or contrive a solution to consumers who say, “I’m just not going to buy this.” But the ACA requires individuals to purchase health insurance, thus creating a vertical demand curve for potential monopolists. Under these conditions, profits – and consumer abuse – can be maximized through collusion. Read MOAR at Project Syndicate

bradford-delong.com: Grasping Reality with the Invisible Hand… 2016-08-27 21:30:16

Must-Read: Richard Mayhew: A Thousand and One Posts:

Wow, that last post was my 1,000th post here at Balloon Juice. I was not expecting that when I first got started here...

I saw a lot of good questions about the ACA and how it would effect our community. I... asked if I could write a couple of posts to answer a couple of questions.... I figured that I would twenty to thirty thousand words in forty or fifty posts and then I would be done. Over the past three years, I have eight hundred or more health insurance posts with about half a million words written. That was a slight miscalculation....

My education has deepened as the community here and a second community of wonks, advocates and researchers. If I need to know about anti-trust law, I have a couple of world class experts who share their time with me. If I need to know more about Medicare, I can talk to people who are on it, I can talk with CMS techno-wonks, and national level advocates. If I need to learn more accounting, there are plenty of people who will share their knowledge and expertise with me. I never thought I would have written here for more than a couple of months. But between all of you, the community and John’s amazing ability to let things flow, I am more energized than I ever thought I would be a thousand posts ago.

bradford-delong.com: Grasping Reality with the Invisible Hand… 2016-08-22 15:02:12

Live from Trumpland: Who is attracted to voting for Trump? And why am I not--even as more than half of my income class is going to pull the lever for Trump this fall? Is it my urbanity? My education level? My unwillingness to fall for one of the most obvious grifts on the planet? The fact that I took too many American Studies courses as a child and so identify not as "white" but as "Yankee"--a descendant predominantly of East Anglian and Severn Valley Puritans, the position of whose culture and values in America today is not a result of relative numbers?

Josh Marshall wrestles with this hard problem, and comes up with a Polanyiesque interpretation: the disappointment by the market economic system of what had been thought as reasonable expectations leads to a politics of revenge--but not just of revenge against the Masters of the Universe, revenge against those who are somehow getting above themselves and getting free stuff:

Josh Marshall: Trumpism is a Politics of Loss and Revenge:

Trump support is highly correlated with areas experiencing rising mortality rates for whites--a massively important societal development, in addition to a tragedy....

The people responding most to anti-immigration politics and xenophobia are ones living in fairly racially homogenous and white communities.... I continue to believe that it is best understood as a reaction to the erosion of white privilege, supremacy and centrality in American life.... Trumpism is about loss. And that loss is real. It's not just about being haters or uneducated or stupid. The fact that what's being lost is in most respects something that wasn't legitimate to have in the first place--status, centrality and racial privilege--should not blind us to the fact that the loss is real and that it will have political consequences....

If you look at the language of Trumpism we see repeated references to getting stuff back, reclamation, anger.... The appeal of an extreme dominance politics is particularly to those who feel they've lost power and who feel increasingly marginal to the direction of the country as a whole.... I like being part of a genuinely multi-racial political party. The increasing diversity of American political life feels like an unalloyed good which I feel threatened by not in the least. But of course, if I'm stopped by a police officer alone at night, I'm 100% white. If I apply for a bank loan, I'm totally white. The privilege comes with me no matter what ideas I have in my head....

If your political identity is strongly tied up with your whiteness, you don't have to hate non-white people to find it profoundly unsettling to realize that at some point around the middle of this century most of the people in the country won't be white. You don't need to hate non-whites to be attached to the dominant position whites have historically had in American life.... Losing that dominance, if you don't feel able or ready or willing to relinquish it almost inevitably generates hatred and a desire for revenge...

bradford-delong.com: Grasping Reality with the Invisible Hand… 2016-08-12 05:22:42

Must-Read: S. Dorn and M. Buettgens: The Cost to States of Not Expanding Medicaid:

If the nineteen nonexpansion states expanded Medicaid, they would see economic savings...

States that have expanded Medicaid report net budget savings, furthering the claim that nonexpansion states are losing out on potential economic savings. From 2017 through 2026:

  • For every $1 a state spends on Medicaid expansion, it draws in $7 to $8 from the federal government.
  • By expanding Medicaid, the 19 states that have yet to expand Medicaid would see an estimated $27 billion drop in uncompensated care spending.
  • If the 19 holdout states expanded Medicaid, the federal government would spend $43 billion less on uncompensated care and $129 billion less on marketplace subsides.

Conclusion: For most states with relevant analyses, net budget gains are expected for the foreseeable future, even after states begin paying 10 percent of expansion costs.

bradford-delong.com: Grasping Reality with the Invisible Hand… 2016-08-09 17:12:35

Must-Read: Aaron Carroll: Helpless to Prevent Cancer? Actually, Quite a Bit Is in Your Control:

Of the nearly 90,000 women and more than 46,000 men, 16,531 women and 11,731 men fell into the low-risk group....

Over all... Minyang Song and Edward Giovannucci found 25 percent of cancer in women and 33 percent in men was potentially preventable. Close to half of all cancer deaths might be prevented as well. No study is perfect, and this is no exception. These cohorts are overwhelmingly white and consist of health professionals.... This also isn’t a randomized controlled trial, and we can certainly argue that it doesn’t prove causation.... “Low risk” status required all four healthy lifestyles... never having smoked or having quit at least five years ago... no more than one drink a day on average for women, and no more than two for men... a B.M.I. of at least 18.5 and no more than 27.5... 150 minutes a week of moderate-intensity activity or 75 minutes of vigorous-intensity activity.... I was surprised to realize that I’m already “low risk.” I bet many people reading this are “low risk,” too.

bradford-delong.com: Grasping Reality with the Invisible Hand… 2016-08-08 02:48:18

Must-Read: The extremely sharp Jonathan Chait sends me to one of today's must-reads...

Back when John Roberts as Chief Justice of the Supreme Court did not nullify RomneyCare--excuse me, ObamaCare--from the bench but did lawlessly and without precedent give states the option to nullify the Medicaid expansion part of ObamaCare, I thought that this was a meaningless sop thrown to the right.

My smarter wife Ann Marie Marciarille disagreed. I thought that every governor and state legislator who could add would do the math and note the expanding Medicaid would allow them to do lots of things at the state level--open hospitals and clinics, engage in initiatives, take money that would otherwise have been used to provide uncompensated care and use it for other programs and to fund tax cuts. It was certainly true that I could not find a Republican governor or state legislature who would, in private, say that they welcomed Roberts's nullification-option decision: they all would rather have been forced to expand Medicaid so that they could have spent the money and inveighed against unconstitutional big government tyranny. And so I expected that they would find some way to get it done: find some way to minimize the ideological hit and still get Medicaid expanded so that they could spend the money to expand programs to make their citizens healthier and lower taxes.

I was wrong.

Rather than being a symbolic victory for the right but a substantive nothingburger, John Roberts's lawless creation of the Medicaid expansion-nullification option, when interacted with the poisonous identity politics of Republicans, looks from any kind of technocratic policy perspective that values lower mortality and morbidity like a truly damnable deed--as we see now, as the icejam of cruel policy begins to break:

Noam N. Levey: In Louisiana, Rush to Sign Up for ObamaCare Highlights a 'Long Overdue' Demand for Health Insurance:

Patients burst into tears at this city’s glistening new charity hospital when they learned they could get Medicaid health insurance...

Must-Read: The extremely sharp Jonathan Chait sends me to one of today's must-reads...

Back when John Roberts as Chief Justice of the Supreme Court did not nullify RomneyCare--excuse me, ObamaCare--from the bench but did lawlessly and without precedent give states the option to nullify the Medicaid expansion part of ObamaCare, I thought that this was a meaningless sop thrown to the right.

My smarter wife Ann Marie Marciarille disagreed. I thought that every governor and state legislator who could add would do the math and note the expanding Medicaid would allow them to do lots of things at the state level--open hospitals and clinics, engage in initiatives, take money that would otherwise have been used to provide uncompensated care and use it for other programs and to fund tax cuts. It was certainly true that I could not find a Republican governor or state legislature who would, in private, say that they welcomed Roberts's nullification-option decision: they all would rather have been forced to expand Medicaid so that they could have spent the money and inveighed against unconstitutional big government tyranny. And so I expected that they would find some way to get it done: find some way to minimize the ideological hit and still get Medicaid expanded so that they could spend the money to expand programs to make their citizens healthier and lower taxes.

I was wrong.

Rather than being a symbolic victory for the right but a substantive nothingburger, John Roberts's lawless creation of the Medicaid expansion-nullification option, when interacted with the poisonous identity politics of Republicans, looks from any kind of technocratic policy perspective that values lower mortality and morbidity like a truly damnable deed--as we see now, as the icejam of cruel policy begins to break:

Noam N. Levey: In Louisiana, Rush to Sign Up for ObamaCare Highlights a 'Long Overdue' Demand for Health Insurance:

Patients burst into tears at this city’s glistening new charity hospital when they learned they could get Medicaid health insurance...

In Baton Rouge, state officials had to bring in extra workers to process the flood of applications for coverage. And at the call center for one of Louisiana’s private Medicaid plans, operators recorded their busiest day on record. The outpouring began in June, when Louisiana became the 31st state to offer expanded Medicaid coverage through the Affordable Care Act, effectively guaranteeing health insurance to its residents for the first time. Now, as Republican presidential nominee Donald Trump promises to repeal the healthcare law, Louisiana is emerging as a powerful illustration of the huge pent-up demand for health insurance, particularly in red states where elected officials have fought the 2010 law. “People have needed coverage here for a long, long time,” said David Hood, who served as state health secretary under a Republican governor from 1998 to 2004. “This is long overdue.”

As of the beginning of August, 265,723 low-income Louisianians have newly signed up for Medicaid, according to state officials. Other states that have expanded Medicaid through Obamacare are seeing a similar flood.... Medicaid sign-ups in Montana are already double what the state expected, just seven months after expansion began there. In Michigan, enrollment last year surpassed what state officials projected it would be in 2020. More than 15 million people across the country have enrolled in Medicaid and the related Children’s Health Insurance Program since the health law’s coverage expansion began in 2014, federal data show.... In Pennsylvania, for example, nearly 10% of the more than 650,000 people who have enrolled in Medicaid since the state expanded last year have gone into treatment for drug and alcohol abuse, with three-quarters getting services in the first two months they were enrolled. “When people get that treatment, they can keep working, stay out of the hospital, remain a part of their families’ lives,” said Pennsylvania Human Services Secretary Ted Dallas, who has overseen the Medicaid expansion. “Folks have to weigh the costs for everyone if these people didn’t have coverage.”...

Nineteen states have rejected federal aid made available under Obamacare to expand their Medicaid programs, a key pillar of the law’s program for guaranteeing health coverage. Medicaid allows adults making less than 138% of the federal poverty line, or about $16,000 a year, to get insurance. Rejection of the expansion has left nearly 3 million low-income Americans without health insurance in those states....

Louisiana... has the nation’s fourth-lowest life expectancy, live nearly six years less... than residents of the healthiest states, according to federal data. And Louisiana had among the highest uninsured rates.... Republican Bobby Jindal, was a fierce foe of expanding Medicaid eligibility, however, calling universal health coverage a “liberal shibboleth” and warning that expansion would “jeopardize the care of the most vulnerable in our society.” But Jindal’s mismanagement of the state’s budget helped Democrat John Bel Edwards sweep into office in November on the promise to reverse Jindal’s policies....

The outpouring since sign-ups began in June has surprised even the program’s biggest advocates. Though Louisiana set up a system to automatically enroll thousands, many more low-income Louisianians came forward on their own, seeking help that many had put off for years because they couldn’t afford it. At CrescentCare, a New Orleans clinic serving low-income patients, people have been calling to ask how they can get dental care and help with mental health, officials there said. Dr. Sarah Candler, who worked as a primary care physician at another safety-net clinic in the city, said she cried with one of her patients who recently learned she would get the new Medicaid coverage. “It was like I got to tell her I cured cancer,” said Candler, who said the woman had routinely postponed recommended screenings and put off filling her prescriptions because she couldn’t afford them. “It was so powerful to be able to say that I could fix at least one of the things that was making her sick.” For Cherry Jackson, a 55-year-old New Orleans native who had been living in a homeless shelter, the Medicaid coverage has helped her get medicines she needs to control her high blood pressure and diabetes. "I thank God for this program." — Cherry Jackson“Every time my doctor would give me a prescription, I couldn’t pay for it,” Jackson said. “I thank God for this program.”

There is growing evidence nationally that Medicaid coverage is affecting patients.... After Kentucky and Arkansas expanded... in 2014... researchers found poor patients there skipped fewer medications and were more likely to get regular care.... By contrast, the researchers found little improvement in Texas, which continues to oppose the Medicaid expansion....

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