Live-Blogging the 2014 State of the Union Address

I know people who insist on the irrelevance of State of the Union Addresses.  As far as I’m concerned, which measures of the Address lead to legislation, and which do not, tell us as much about the state of play in American politics as anything.  Non-action on an issue, or specific themes which the opposition party raises during their rebuttal speech, also raises the pertinent questions.  I for one want to know what the President hopes to achieve during the calendar year.  Even if, as was the case with President Obama’s 2013 State of the Union Address, he hopes in part that his agenda will contribute to the alienation of the opposition party, the issues he raises and the frame he uses tells you a lot about what he believes about the disposition of the opposition party, and of the sentiments and perceptions of the country.

For what it’s worth, I sincerely thought Congresswoman McMorris Rodgers would have more to say, whether attacking President Obama’s proposals (some of which she had plenty of time to anticipate) or offering an alternative agenda, which is what a Republican Governor would have had no trouble doing.  This was a shallow, disappointing Republican Response.  The punditry is largely harping on the same point: To a surprising extent, McMorris Rodgers simply failed to propose real policy goals.

10:38 pm: McMorris Rodgers gives us an anecdote about a Washington constituent whose health insurance premiums rose $700–an extreme case.  Interestingly, she doesn’t mention whether less-expensive health insurance was available to the woman she invoked through the Washington State health insurance exchange!  Republicans continue to be intellectually paralyzed by health care issues since passage of the Medicare Prescription Drug Benefit in 2003.

10:35 pm: McMorris Rodgers mentions her son who was diagnosed in the womb with down syndrome.  She says that she and her husband saw potential, that they appreciate the value of each and every human life.  That’s some interesting dog-whistle politics for invoking the “pro-life” movement during a response to a State of the Union Address that was entirely focused on bread-and-butter issues.

10:34 pm: Congresswoman McMorris Rodgers says the Republican goal is “A Washington that plays by the same rules that you do!”  So, that’s why the Republicans are trying to starve the Federal Government of cash and telling everyone to be afraid of the future.

10:31 pm: Cathy McMorris Rodgers (R-WA), a Conservative footsoldier in the House of Representatives, delivers the Republican Response to the State of the Union Address:
“SOMETHING ABOUT AMERICA.”

10:20 pm: The President refrains on our well-trodden differences, but notes that these differences haven’t stopped us from fighting tyranny abroad and ending injustices at home.  The speech closes, coming in at 55 minutes.  I wonder if insisting that our differences haven’t gotten the better of our moral sense is the right way to close.  It would raise some grim thoughts in future readings if there is no action on these policy priorities again.

10:18 pm: Congressman Paul Ryan (R-WI) gives the wounded veteran a thumbs-up during his extended applause.  Just a small reminder that he might in fact want to run for President.

10:14 pm: It’s an interesting tradition of State of the Union Address that the President picks out ordinary citizens who have done something extraordinary in order to compose a narrative of where America stands.  Presidential candidates will point to people who need help, or who are indignant; a President will find examples of strength, people who the national audience will want to see succeed and whose account sometimes challenges one’s perspective.  Tonight he mentioned a Midwestern small businessman who raised his workers’ pay to $10 an hour on his own motion, and a severely-wounded recent war veteran whose rehabilitation progresses steadily.

10:09 pm: A plea to Congress to allow talks with Iran to end its independent uranium-enrichment program.  Critics of President Obama’s position that talks should be allowed to proceed seem to forget that President W. Bush’s paralysis over Iran in his 2nd term–an outgrowth of his realization that he was unwilling to bear the heavy cost of going to war with Iran–was pathetic to behold.  Talks with Iran were the only policy to proceed with under these circumstances, and they were unprecedented in over 30 years of icy tension with the World’s first Islamist revolutionary state.

10:06 pm: President Obama insists on his faith in the international community’s capacity to achieve a lasting peace, both for the people of war-torn Syria and in the Israel-Palestine dispute.  Those are the right conflicts to mention and decry in such a speech, but the Palestinian Territories have been under IDF occupation for about 47 years now; the best that can be said for our non-involvement in Syria’s civil war and all the harm it has enabled is that it has left the door open for international action to dispose of Syria’s large chemical weapons stockpile, and to provide emergency food and medical assistance to some of the Syrian populations that have been dispossessed and wounded by their near-3-year-old civil war.

10:03 pm: We’re into the part of the speech where the President defends his policies on drone attacks on terrorists and NSA surveillance methods.

As an addendum to the last point, the President defended the Affordable Care Act on very general terms just now.  He had no reason not to, and I’m convinced that he’s speaking from the heart in defending his best-known law.  (That would be “Obamacare,” for those who have never heard it called any other name.)  I’m convinced that continuing opposition to the Affordable Care Act, now that new health insurance policies conforming to the law are in place, and now that most health insurance exchanges are working well, and with the Act’s expansion of Medicaid being hugely popular, will be politically harmful to the Republicans.

9:55 pm: “We all owe it to the American people to say what we’re for, not just what we’re against.”  The President notes the attendance of Kentucky Governor Steve Beshear, a popular Democratic Governor of a very Red State.  “I did not get my highest vote totals in Kentucky,” the President says in a massive euphemism.  Governor Beshear very eagerly embraced both a Commonwealth-based health insurance exchange and the Medicaid expansion offered through the Affordable Care Act.

9:51 pm: “Let’s give America a raise.”  Raising the minimum wage is very popular with the public.  We may have called the President’s efforts to create an “everyone versus House Republicans” frame in national politics unsuccessful prematurely.  The issues he’s emphasizing this year are a little less recognizably partisan and more-popular with the public than last year.

9:50 pm: President Obama notes that, adjusted for inflation, the value of the Federal minimum wage is more than 20% yes than it was when Ronald Reagan was President.

9:49 pm: The President notes he asked Congress to raise the minimum wage a year ago, and that 5 States have raised their own minimum wage.  He also tells us that he will pass an Executive order to raise the minimum wage for Federal Government contractors to $10 an hour.  He is harping on the need to go around Congress, or at least House Republicans.

9:47 pm: “It is time to do away with workplace policies that belong in a Mad Men episode.”  Income inequality between the sexes, embarrassingly, continues at a wider than 5:4 ratio for the same work.  Republicans applaud, perfunctorily.

9:44 pm: The President notes that Federal Government collaboration with Apple, Microsoft, Sprint and Verizon will bring broadband Internet access to 20 million more American students.  A friend watching the debate with me noted that it is currently easier to get corporations to move on infrastructure development (which they are notoriously reticent to invest in) than the Federal Government.

9:40 pm: The President calls on Congress (that is, Congressional Republicans) to do more to give the long-term unemployed “a fair chance.”  Our high rate of long-term unemployment, of course, is the reason the maintenance of what is technically a temporary extension of Federally-funded long-term unemployment insurance is a salient issue.  Extended unemployment insurance was a component of the Stimulus–and like many individual parts of both the Stimulus and the Affordable Care Act, it is very popular with the public.  Much like their apparently about-face on immigration reform, the apparent Republican collapse on resisting the extension of unemployment insurance suggests that Republicans perceive how vulnerable they are in continuing to resist the President.

9:35 pm: “Let’s get immigration reform done this year.  Let’s get it done; it’s time.”  No more needs to be said in this speech.  That’s in part because former President George W. Bush eagerly talked-up similar immigration policy liberalization during the 2004 Presidential Election, and made an honest push to achieve it in his 2nd term that ultimately went nowhere.  President Obama’s sponsorship of the DREAM Act during the 111th Congress was 1 of just 2 policy failures from his first 2 years.  The Senate passed its own immigration reform bill by about 2-to-1 last year, but the House refused to work on it.  Now the far more-Conservative House is working on its own immigration reform proposal, and it is much closer to the Senate bill than anyone had expected; President Obama probably doesn’t want to jinx this positive development by involving himself in a discussion of the particular measures too deeply.

9:33 pm: In a discussion of industrial pollution and global warming, President Obama notes that the United States has done more in recent years than any other country to control its carbon emissions.  This in part is probably an effect of the many investments in energy efficiency and cleaner power sources made by the woefully under-appreciated 2009 Stimulus.

9:31 pm: The President promises to use Federal funds to protect more wilderness lands.  I was a little surprised to hear that one; President Clinton had made big strides in preserving Federal lands, and while George W. Bush did not, he didn’t fight those National Forest, Park or Monument dedications.  In a time of prolonged economic stagnation, land preservation by the Federal Government has taken a back seat, including to other environmental priorities.

9:29 pm: “Remember, China and Europe aren’t standing on the sidelines; neither should we.”  This smart transition links the President’s discussions of trade integration and Federal funding for science and technological research.  He notes that Google and smart phones were made possible because of generous Federal research funding.  These Federal research grants have been squeezed by the Budget Control Act of 2011 and subsequent sequestration budget cuts.

9:26 pm: President Obama proposes closing tax loopholes for corporations that outsource jobs, and to create tax incentives for businesses that create jobs inside the United States.  Again, he raised this issue back during the 2004 Democratic National Convention: Depressing.  Congressional Republicans have thus far resisted the elimination of any corporate tax deductions.

9:24 pm: President Obama talks-up college access for those of limited means.  It may encourage more if he talks about the efforts of his administration to publicize rankings of the job prospects of the graduates of various colleges and universities, and to gear university programs towards professional skills.

9:21 pm: “Too many Americans are working harder just to get by, not just to get ahead.”  If you consider that then-Senator Obama’s Keynote Speech at the 2004 Democratic National Convention contained similar themes, you might feel depressed.

9:18 pm: The President notes that many investment analysts no longer rank China as the best country to invest in.  That’s partly because debt-financed capital spending in China has gone on too long; not only are current municipal deficits in China not sustainable over the long-term, but capital spending has become more and more-infamously dominated by make-work projects not always rationally scaled to growth.  It is also true that US competitiveness is improving, but there is a warning sign in the minor keys now being struck in China’s development jingle.

9:16 pm: “Today in America, a teacher spent more time with a student who needed it…An entrepreneur flicked the lights on at her tech startup…An autoworker fine-tuned some of the best-made cars in the world…A rural doctor gave a child the first prescription for asthma that his mother could afford…”  That’s right, in case you haven’t heard: The theme of President Obama’s speech is going to be income inequality.

9:10 pm: Wow, not in much of a hurry tonight, are they?

Conservative Groups and Money–Both Mind and Body–Undermine the Republican Party

It took just a few months for us to be able to call the Republican Party’s latest effort at re-branding a failure.  If anyone thinks that’s a bit much, why are the House Republican leadership unable to pass the bills they have previously called crucial to this effort?  To date the 113th Congress has actually been far less-productive than the 112th to this point in 2011.  This includes Republican filibustering of background checks for unlicensed gun sales, House Republicans’ refusal to support a catastrophic-risk insurance pool favored by House Majority Leader Eric Cantor as a partial alternative to the Affordable Care Act, failure to reach agreement in the Senate to prevent a doubling of student loan interest rates, House Republicans’ oddly-timid refusal to negotiate a budget with Senate Democrats (after demanding Senate Democrats pass a budget plan for years) and the failure of a farm bill that was supported by a majority of House Republicans but opposed by a majority of the House.

Because of its chronic inability to follow-through on any broadly-accepted agenda outside of obsessive opposition to President Obama’s policies, the Republican Party is actually much weaker than its current electoral strength should suggest.  Two sources of this weakness were until recently believed to be strengths of the New Right–its intelligentsia which insist on ideological purity, and the free flow of money to and from special-interest groups that can organize votes more-easily than local constituencies of interest.  Some people have called these groups a cancer in American democracy, but strictly-speaking they are actually a cancer in the Republican Party.  National Journal has had some excellent reporting of House Republicans’ undeniable and unprofitable dysfunction of late, and these remarkable words of protest from the House Agriculture Committee Chairman in a recent article on the next step for the farm bill bring to mind the closing words from Lord of War: “Never go to war–especially with yourself”:

“Last week the relentlessness of the conservative campaign became apparent when House Agriculture Committee Chairman Frank Lucas, R-Okla., was back in his district. On July 1, the Tulsa World reported that conservative activists, some of whom do not live in Lucas’s 3rd District, had shown up that day at a town-hall meeting in Skiatook, Okla. ‘If you want the conservative Republican vote, you need to come forward with a conservative Republican bill,’ said Ronda Vuillemont-Smith, a conservative activist from Broken Arrow, which is in the 1st District, where tea-party groups in 2012 ousted Republican Rep. John Sullivan in favor of now-Rep. Jim Bridenstine, who voted against the farm bill.

“Lucas, who has also been the target of Heritage Action radio ads threatening to recruit a ‘real conservative’ to run against him, fought back. ‘I’m under attack by those people,’ Lucas said. ‘They’re coming after me. They are all special interest groups that exist to sell subscriptions, to collect seminar fees, and to perpetuate their goals.’

“Lucas continued, ‘You’ve got to understand: They don’t necessarily want a Republican president or a Republican Congress,’ he continued. ‘…They made more money when [Democrat] Nancy [Pelosi] was speaker.… It’s a business.’

“Vuillemont-Smith replied: ‘That’s a perverted way to look at it.’

“‘I’m sorry. I have to deal in the real world,’ Lucas said, adding that by opposing the bill, conservatives were turning their back on the bill’s $40 billion in savings over 10 years, including a $20 billion cut in food stamps.”

Syria: This Time, Fools Fear to Tread Where Angels Rush In

A good, blunt article just appeared in Slate pegging President Obama as seeing all war as politics by other means–even where that heuristic may be naive in practice.  For all his Liberalism in the divisive domestic policy questions of today, in matters of foreign policy President Obama is no humanitarian but a Realist. I prefer for foreign policy to be conducted through the prism of power rather than principle, but I make an exception in major cases of preventable violence. I consider establishing criteria and protocols for humanitarian intervention to prevent or halt genocide and (where possible) civil war violence to be among the most-important foreign policy business we can address. For that reason I applauded President Obama’s decision to support a coalition that toppled Colonel Gaddafi in Libya in 2011, and I support his decision–very late–to support the uprising against the Assad Family Regime in Syria.

But there are risks associated with this intervention, and I don’t mean Russian arms, the Hizballah militant faction, the prospect of a wider sectarian conflict in the region or even Syria’s large arsenal of chemical agents, forbidden by widely-accepted treaty. That risk is the prism through which President Obama probably views this intervention in the 1st place: Rather than see this civil war as both the Assad Family Regime and the Russians do–that is, as a zero-sum game over a strategic unit of Middle Eastern real estate–President Obama seems to view his decision to intervene in a transactional sense, as a gesture to demonstrate that President-for-life Bashar al-Assad and his Russian benefactors will have to accept a settlement with the Rebels in order to end the war.

I think that ship has sailed. Unlike when Sunni-sponsored terrorism begat Shi’a-led mass killing during the Iraq War (which Syria’s civil war may soon surpass in bloodiness in 1/5 the time), no external power is prepared to police the streets of Syria. It may be time to subdivide the lot.

After the Assad Family Regime’s brutal treatment of initially peaceful protests, the rump state seems literally at war with 1/2 of the country. In order to maintain the rump state, the Regime has decided to define the uprising in sectarian terms, creating a self-fulfilling prophecy in which Syria’s religious minorities have no future other than under Regime protection. Trying to arrange a military stalemate to force all parties to come to the table to talk-out their differences could actually prolong the war, or even escalate it. If provisions of arms and other material assistance could bring moderates among the Rebels to the fore, and grant them victory, that would be best. If that is not possible and the uprising is now essentially sectarian and ethnic, then we could still do some good in intervening, as we did in Bosnia and Kosovo. But *partition* was the end result of those conflicts, and while it was far from an ideal situation, it *did* sustain the halt to slaughter, both times. Atrocities on a truly nationwide scale were replaced with more-localized injustices. We already assumed that this was not in Slobodan Milosevic’s interest in any way–nor in Russia’s. We didn’t negotiate to terms with either of them; we essentially destroyed Milosevic’s regime through repeated uses of military force and undermined Russian interests in the Balkan region. This incurred their outrage, but they could not regain what they had lost because it was built on the support of an autocracy that was overthrown in a state that was now fragmented.

We have to be prepared to truly take sides again. Equivocating between factions in a civil war could make things worse. This is a good case in politics (which is always about power wielded in the shadow of expectations) where motivations actually count.

Affordable Care Act Implementation Among the States, Part 2: Medicaid Expansion

The Supreme Court upheld the Patient Protection and Affordable Care Act on June 28 of last year, but it also sent the Obama Administration a serious curve ball: In a 7-2 decision, the Court held that Medicaid expansion would have to occur by agreement between the Federal Government and each of the States.  Medicaid was created in 1965 by President Lyndon Johnson and a Democratic Congress as Title XIX of the Social Security Act.  Essentially, it was created to assist States in providing health care to poor families and individuals who could not obtain health insurance.  Along with Medicare, the Federally-managed health care program for senior citizens also created in 1965, Medicaid was the Johnson Administration’s consolation prize for its failure to implement single-payer health insurance in the face of determined opposition from the American Medical Association and health insurance companies.  Because Medicaid was created as an entitlement for those unable to afford to buy private health insurance in a series of State health insurance markets, its exact spending and benefit levels are set by agreement between the Federal Government and each of the States.

1 State’s Medicaid program (New York’s, for instance) may be fairly progressive; another State’s Medicaid program (take Missouri’s) may be risible, leaving hundreds of thousands of the poor without any health care at all.  Not only does the list of those entitled to Medicaid depend on the State, but the percentage of Medicaid costs covered by the Federal Government (as opposed to the State) varies from State to State.  Only the character of benefits provided through what is still effectively a Federal entitlement program is the same from State to State, as a condition for the Federal Government to provide matching funds to each State’s Medicaid program.

The Patient Protection and Affordable Care Act mandated that Medicaid eligibility be expanded to all State resident citizens earning up to 138% of the State’s poverty level, starting in 2014.  The Federal Government would pay 100% of the cost of the expansion of Medicaid from 2014 to 2016, then its contribution would slowly reduce to 90% of the cost of the expansion from 2017 to 2019, remaining at a mandatory 90% thereafter.  Originally, under the Affordable Care Act States had to accept this expansion of Medicaid or they would lose their existing Federal matching funds for the program; in its 7-2 decision on that provision of the law, the Supreme Court ruled that it violated Federalism and States’ rightful prerogative to force them to accept the Medicaid expansion.  The expansion became a standing invitation rather than an imposition.  This was consistent with the Court’s more-controversial decision on the Affordable Care Act, that the individual mandate requiring citizens to buy health insurance could not be justified under the Commerce Clause’s provision for the Federal Government to regulate interstate commerce, but could be justified in its financial penalty to those who fail to buy health insurance, through the Federal Government’s power to tax.  It also meant that State governments had the power to extend or deny health care to a combined millions of poor and working-class Americans.

Some Republican Governors, particularly in the South, said they would refuse to expand Medicaid almost immediately.  In particular, Nikki Haley of South Carolina, Rick Scott of Florida, Phil Bryant of Mississippi, Bobby Jindal of Louisiana, and Rick Perry of Texas came out against the Medicaid expansion within 2 weeks of the National Federation of Independent Business v. Sebelius decision.  This list of those formally declared for or against the Medicaid expansion changed little in the 4 months leading up to the 2012 Presidential Election; Medicaid would be expanded through State budgets, and since the expansion would start in 2014 it wouldn’t be necessary for State governments to declare for or against the expansion until the following spring, as they discussed and passed their new budgets.  This meant that only Governors studiously shoring-up their Conservative bona fides and failing to perceive other political pressures would have an incentive to “stand firm” against the Federal Government’s program to help the poor with their medical expenses.  President Obama’s re-election meant that, not only would the law stand, but it would not be repealed.  Free Federal money was sitting on the table.  (“The money isn’t free,” Conservatives rejoined.  “We’re paying for the Medicaid expansion and the rest of the Affordable Care Act through taxes.”  Actually, the rich payed for much of the expansion through higher capital gains taxes and fees on luxury medical procedures, but the point is a valid one.  Still, this arguably makes the argument for States expanding Medicaid stronger; a State that declined to expand its Medicaid program would effectively see its Federal tax dollars going to States that did decide to expand the program.)

And wouldn’t you know it?  After what doubtless was some serious intellectual rigors and soul-searching among them–most Republican Governors declined to expand their Medicaid programs in the end.  In the past several months, 8 out of 30 Republican Governors did decide to embrace the expansion of Medicaid; all were significant.  Brian Sandoval of Nevada (announcement made December 11), Susanna Martinez of New Mexico (January 9), Jack Dalrymple of North Dakota (January 12), Jan Brewer of Arizona (January 14), John Kasich of Ohio (February 4), Rick Snyder of Michigan (February 6), Rick Scott of Florida (February 20), and Chris Christie of New Jersey (February 26) all embraced available Federal funding to provide health care for the poor in their respective States.  Governors Sandoval, Martinez and Christie all work with Democratic State legislatures which were happy to embrace the Medicaid expansion.  North Dakota, with a small and homogeneous population and flush with cash from a growing oil and natural gas industry, saw legislative passage of the Medicaid expansion by a wide margin.  Arizona continues to debate implementation of the Medicaid expansion; the biggest sticking point there, apparently, is whether expanded Medicaid services would result in Federal funding for abortions.  (It couldn’t be used for that; an Executive Order by President Obama in March 2010 specifically prohibited the use of Federal funds under the Affordable Care Act to cover abortions.)  Still, most advocates of the Medicaid expansion in the Arizona legislature expect it to ultimately pass, if perhaps the vote will be close.  Finally, there are 3 States–Ohio, Michigan, and Florida–where a Republican Governor elected with Tea Party support made a lot of news by accepting the Medicaid expansion, only to see the proposal rejected by both chambers of a Republican State legislature.  Very few Republican State legislatures have been coaxed into accepting the expansion of Medicaid, though many organizations have endorsed it and many rallies have been held to support the expansion in State capitals.  Arizona, Montana, North Dakota, Missouri, Arkansas, Michigan, Ohio, and Florida all have Governors who declared they would support the Medicaid expansion and fully-Republican State legislatures; all but Arizona’s, North Dakota’s and Arkansas’ have blocked the expansion–though in Montana’s and Florida’s case there remains some hope that the State legislature will support a very limited expansion.  Kentucky and New Hampshire both have Governors who support the Medicaid expansion and split partisan majorities in their State legislatures; both States have Conservative-Republican Senates that seem opposed to the Medicaid expansion, though there is some possibility of at least 1 Republican State Senator in New Hampshire crossing party lines and allowing the Medicaid expansion to move forward.

With the exception of North Dakota and Arkansas, and at least prospectively of Arizona, New Hampshire, Tennessee and Kentucky, this map of the progress of State expansion of the Medicaid program under the Affordable Care Act is a pretty good indicator of Democratic control of both chambers of a State legislature.  The Republican Governors of Wisconsin, Iowa, and Indiana, however, have proposed serious non-Medicaid alternatives for establishing universal health care using other components of the Affordable Care Act.  They are currently in different stages of obtaining Federal approval for these alternatives.  Map credit: Sarah Kliff, The Washington Post.

With the exception of North Dakota and Arkansas, and at least prospectively of Arizona, New Hampshire, Tennessee and Kentucky, this map of the progress of State expansion of the Medicaid program under the Affordable Care Act is a pretty good indicator of Democratic control of both chambers of a State legislature. The Republican Governors of Wisconsin, Iowa, and Indiana, however, have proposed serious non-Medicaid alternatives for establishing universal health care using other components of the Affordable Care Act. They are currently in different stages of obtaining Federal approval for these alternatives. Map credit: Sarah Kliff, The Washington Post.

That makes just 3 1/2 Republican State legislatures working with supportive Governors to expand Medicaid thus far.  Several States are working on plans to provide full or partial health care coverage without a conventional Medicaid expansion, however.  Some of these proposals (notably Wisconsin’s) have good prospects of passing; some, like 1 coming out of the Missouri legislature, have little chance of winning either the Democratic Governor’s or the Obama Administration’s support, and may even be a gimmick.  Arkansas’s passage of Medicaid expansion was a major breakthrough–not just because its was only the 2nd Republican State legislature to vote for expansion, but because budget authorization required 3/4 of both legislative chambers to vote in favor.  Governor Mike Beebe, a very popular Democrat in his 2nd term, made passage of the Medicaid expansion a central policy priority.  (For some reason, however, Jay Nixon, the popular Governor of neighboring Missouri, was not able to cajole or pressure his State’s Republican legislature into supporting Medicaid expansion.)

NPR recently reported that States that do not expand Medicaid will create unintended and politically-awkward situations in which some groups of people are arbitrarily insured while others are not.  According to the report, businesses with 50 or more employees will have to pay a fine if even 1 of their employees obtains health insurance through a Federally-subsidized exchange rather than through their employer; if the employees make no more than 138% of the State poverty level, thus qualifying them for Medicaid, however, the employer doesn’t have to pay a fine for leaving them to Medicaid.  Thus, declining the Medicaid expansion, 100% of which is initially Federally-funded and 90% of which is permanently Federally-funded, exposes many businesses to new fines if any employees make between 100% and 138% of a poverty-level income and do not receive health insurance from their employer.  Then there is the health care coverage for immigrants, which isn’t affected by States declining the Medicaid expansion: Since non-naturalized immigrants don’t qualify for Medicaid in the 1st place, the Affordable Care Act covered them through Federal subsidies to purchase private health insurance only.  Since the Supreme Court ruled the Medicaid expansion an option for the States because it requires them to spend money, this means States can choose to leave low-income citizens without health care while legal non-naturalized immigrants will be taken care of.  Finally, Federal subsidies to buy private health insurance through your local health insurance exchange can extend down to those making just above a poverty-level income; below that income it is assumed any citizens without insurance would be covered through Medicaid.  So, if your State leaders choose not to expand Medicaid and you make, say, 102% of a poverty-level income, your health insurance will be purchased for you by the Federal Government; if you make 98% of a poverty-level income, you get no health care.  The Affordable Care Act goes into full implementation in 2014.  In that year, the elected leaders of a lot of Republican-led State governments will have to explain these rather obvious inequities in health care coverage while Democrats will be able to tell those people the incumbent simply chose not to insure them; later that year, most Governors and State legislatures will face an election.

Affordable Care Act Implementation Among the States, Part 1: Health Insurance Exchanges

When the Patient Protection and Affordable Care Act was enacted by Congress, it contained basic provisions that would impact the situation of public health in certain States differently.  Primarily, it would be left up to the determination of each State to decide whether to establish its own health insurance exchange, to run its health insurance exchange in a complimentary partnership with the Federal Government, or to leave the task of instituting such an exchange up to the Feds completely.  The health insurance exchange is a regulated marketplace, accessible online, which provides item-by-item comparisons of various private insurance plans.  Federal guidelines indicate what information has to be provided by insurers to the general public, just as new regulations instituted through the Affordable Care Act mandates certain minimum responsibilities for health insurers.  (For example, health insurance companies had to insure children of their policyholders through age 26, could not deny their policyholders’ claims on the grounds of possessing “preexisting conditions,” and could not cancel their insurance policies in advance of claims for treatment after making them pay premiums.  These sorts of measures–as well as declining to provide apples-to-apples comparisons between one’s own health insurance policies and another insurer’s–were all legal before the Affordable Care Act was passed, just so you understand the measures Congressional and State Republicans have so doggedly fought.) By my count (based on a critical reading of information provided by the Kaiser Family Foundation), 18 States (including the District of Columbia among them) have instituted State-based insurance exchanges, 7 States are planning partnership exchanges in conjunction with the Federal Government, and 26 States have declined to institute their own exchanges, instead opting to let the Federal Government establish and run the exchanges for them. Every State with both a Democratic Governor and a unitary Democratic State legislature–there are 16, counting nominally–has opted to create either a full State-based or partnership exchange.  Of the 25 States with both a Republican Governor and a majority-Republican State legislature–counting Virginia with its nuclear partisan control and excluding Nebraska with its non-partisan State Senate–only 3 have instituted State or partnership exchanges, 1 of which (Utah’s) was pre-existing.  Ohio has a State-Federal partnership exchange in all but name, based on an existing State regulatory agency which reserves the right to oversee health insurance companies listed on its Federally-operated health insurance exchange.  Of the 10 States (counting Nebraska) that have split-control governments, 6 have State or partnership health insurance exchanges.  3 in this latter category were proposed by Democratic Governors (though 1 Governor, Kentucky’s Steve Beshear, had to implement it through executive order to bypass the Conservative-Republican State Senate) and 2 by Republican Governors who work with Democratic legislatures; 1 (Iowa’s) was already in place shortly before passage of the Affordable Care Act and was fashioned into the State component of a partnership exchange.  Rick Snyder, the moderate Republican Governor of Michigan, failed to persuade his Republican State legislature to institute either his desired partnership health insurance exchange or the expansion of Medicaid.State Health Insurance Exchanges as of April 1, 2013

So, we can group States on implementation by several types.

States that already had State-based or partnership exchanges: Massachusetts, Utah, Ohio, Iowa

States that produced health insurance exchanges in response to ACA enabling legislation and grants: Hawaii, Washington, Oregon, Idaho, California, Nevada, Colorado, New Mexico, Minnesota, Illinois, Arkansas, West Virginia, Maryland, Washington DC, Delaware, New Jersey, New York, Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire

States in which health insurance exchanges were proposed by a Governor but rejected by a legislature or by referendum: Montana, Michigan, Missouri, North Carolina

State in which a State Insurance Commissioner proposed a State health insurance exchange which was not sustained by either the Governor or the Department of Health and Human Services: Mississippi

States which rejected creation of a State or partnership exchange without controversy: Alaska, Wyoming, Arizona, North Dakota, South Dakota, Nebraska, Kansas, Oklahoma, Texas, Louisiana, Wisconsin, Indiana, Tennessee, Alabama, Georgia, Florida, South Carolina, Virginia, Pennsylvania, New Jersey, Maine

A few political realities can be inferred from this outcome:

1.) Democratic Governors and State legislatures were eager to embrace the Affordable Care Act, period:  Every Democratic Governor except the relatively-Conservative John Lynch of New Hampshire at least attempted to institute a health insurance exchange.  2 of these Governors were thwarted by Republicans–the now-retired Brian Schweitzer in the Legislature in Montana and Jay Nixon by a failed referendum in Missouri.  Governor Beshear in Kentucky was able to act on his own through executive order; on that note…

2.) Where institutional agency resides matters.

3.) The health insurance exchanges were the earlier State-based component of the Affordable Care Act to be implemented, and it brought fewer obvious benefits from the Federal Government than the Medicaid expansion; consequently, few Republican Governors felt compelled to join even if they were relatively pragmatic: Only 6 out of 30 States with Republican Governors–20%–have either State-run (Utah, Idaho, Nevada, New Mexico) or State-Federal partnership (Iowa, Ohio) exchanges.  Utah, Iowa and Ohio instituted exchanges or health insurance plan management agencies through pre-existing State offices, while the other 3 States created new exchanges.  It’s worth noting that in 2010 Idaho Governor C. L. Otter faced charges from his Democratic opponent that he was too ideological, while Brian Sandoval of Nevada and Susanna Martinez of New Mexico are both Hispanic Governors of States with large minority (particularly large Hispanic) populations and majority-Democratic State legislatures.  So, Republican gubernatorial buy-in to the health insurance exchanges was largely a function of a path of least resistance or greater political pressure to compromise.

4.) On health insurance exchange implementation, Governors were about as willing to play politics as State legislatures.  As I mentioned before, every Democratic Governor save 1 at least attempted to establish a State-based or partnership insurance exchange; in the case of Governor Maggie Hassan, elected in 2012 to replace New Hampshire’s retiring Governor Lynch, she used her election and her party’s massive victory in the State House elections that year to reverse her Conservative-Democratic predecessor’s decision to forego both a heallth insurance exchange and the Medicaid expansion under the Affordable Care Act.  The rump Republican majority in the State Senate, coming off an election that was even more disastrous for its party locally than it was nationally, has assured Governor Hassan of its cooperation.

5.) Barring implementation trouble with the new health insurance exchanges, which could just as plausibly be used as talking points against the Affordable Care Act, the picture of State and Federal health insurance exchanges depicted above is unlikely to change.  Unlike States which reject the expansion of Medicaid, which will clearly deny health care in aggregate to millions of the poor, a State’s failure to create its own health insurance exchange won’t necessarily have repercussions for its residents.  While a State-run health insurance exchange is likely to be more-convenient to use and will probably be governed differently, the handling of its functions by the Federal Government won’t necessarily lead to perceptibly-different service or the failure of the exchange itself.  (To an extent, this reality may depend on House Republicans’ efforts to deny funding to health insurance exchange implementation, but it may prove difficult either procedurally or politically to deny funding to implementation.)  As such the picture you see above of mapped variation in the creation of health insurance exchanges above is likely to stay with us.

Social Conservatives in the Republican Party: Their Disenfranchisement is Real, the Threat They Face Less-Than-Existential

Jonathan Martin recently wrote an interesting conceptual scoop for Politico, wherein social Conservatives offer a surprisingly-subtle recriminatory argument: They can’t be the source of systemic weakness in the Republican Party because President Obama’s banner Presidential Election wins in 2008 and 2012 came in the face of socially-moderate Republican Presidential candidates.  Sure, President Obama may have won election and re-election on the basis of energizing a majority coalition for Liberalism, but that doesn’t mean (goes the argument) there isn’t such a natural constituency for Conservatism.  They assert that the Republican Party was weak in the past 2 Presidential Elections because the party’s leaders were running from their base, rather than because it alienated key demographics.

It’s an interesting, counterintuitive argument.  It’s also rubbish.  Christian Conservatives actually surged around the moderate-ish John McCain in 2008–and he performed about as poorly as any Republican Presidential candidate since Barry Goldwater in 1964.  Furthermore, it’s curious how easily the Christian Conservatives interviewed here either forgot or skirted around the shameful cases of Todd Akin and Richard Mourdock, 2 Republican Senate candidates who were considered near-guarantees to win Red State Senate seats until they each argued that raped women shouldn’t be allowed to obtain abortions.  Oops.

Towards the end of the article, the author notes that abortion is not gay marriage; he is right.  The much-noted sea change in attitudes towards gay marriage is real and irreversible; the general spread of opinion on abortion, strangely, has hardly shifted at all since Roe v. Wade was decided in 1973.  So, I expect the Republican Party’s positions on social issues to be determined not so much by some aggregated interest group within the party winning some abstract argument but by actual party leaders and candidates following incentives.

Gay marriage is gaining acceptance and legal recognition so quickly now because it is about people who differ from us only in sexual orientation asking for the same rights the rest of us have; once people feel safe to admit they are gay (which the bigotry of Judaism, Christianity and Islam made almost impossible for millennia), it soon becomes difficult to appraise bans on gay marriage as anything other than institutional discrimination for a difference of orientation that is both beyond one’s control and completely harmless. The very fact that one doesn’t need to live in fear means that society will be confronted with any attendant forms of exclusion or domination of their difference, and when this is seen it will be found to be bereft of justification.

Abortion is not an issue in the same class; it has never stopped being divisive.  In fact, as the article notes, the Republican Party is now more consistently pro-life (and the Democratic Party more consistently pro-choice) than ever before.  With the domination of several State governments–as with the much-maligned new Virginia requirement that women seeking an abortion first submit to a transvaginal ultrasound and most recently as a Republican legislative supermajority in North Dakota legally establishing personhood at the point of quickening (roughly 6 weeks)–the pro-life side has flexed its muscle and expanded its denial of women’s right to choose.

Before you opine that its pro-life stance is killing the Republican Party with women, remember that the Republican Party was, if anything, more emphatically pro-life in 2004 and that didn’t stop President George W. Bush from taking a slim majority of the popular vote in that Election.  Plenty of women are pro-life; they were going to vote for Todd Akin and Richard Mourdock, too–until they realized how callous they were towards rape victims.  The Roe v. Wade decision remains the law of the land and the Supreme Court doesn’t seem to be interested in re-litigating it; many of the qualifications to abortion rights which Conservatives have pushed for in Congress or in the States are actually broadly popular, if perhaps their real-world impact on women isn’t well-understood by many.  My point is that, disappointing as it may be to many fellow-Liberals, there is no reason to believe that Republicans will feel motivated to jettison their hostility to abortion rights, or that they will pay an electoral price for their disinclination to do so.  (Much as some social Conservatives say, Republicans would pay an electoral price for giving up the pro-life cause, no less if it was explicitly done as a groping attempt at re-branding.)

So, forget about the Republican Party becoming the Libertarian Party or the culture wars simply disappearing; there is no evidence of a link between broader demographic shifts and Republican concessions on certain social issues and Republican concessions on other issues.  Regarding low levels of support among women, Republicans probably just balanced their social Conservatism with support from Conservative women poorly in 2012–specifically, on account of recent extremist gestures.

Gay marriage has taken up more of this discussion–as it did in this article–but immigration reform is another example of an issue where the Republican Party is coming around, in this case to former President W. Bush’s Liberal-leaning position.  A legal guest worker program for nominally illegal immigrants, which offers an opportunity for them to work their way to citizenship, has a serious chance of passing through a split-control Congress, which it couldn’t do in 2007 with a Democratic Congress due to massive opposition from Senate Conservatives from both parties.  Again, here the Republican Party is simply following incentives: The party’s leaders and leading lights are anxious about their party’s growing reputation for callousness and simply need to assuage Hispanics’ fears of their intentions if it is going to remain viable in the Southwest–and eventually, in the biggest States of the South.

Add a possible cultural shift against the “gun show loophole” in favor of universal comprehensive background checks for gun purchasers (and hopefully, reasonable restrictions on the high-capacity bullet clips that allow any private citizen to mount their own assault), and we’ve probably just about seen the extent of the concessions Congressional Republicans will feel they have to make to Liberals in the Culture Wars.

Note that these distinctions represent different factors–an abrupt and broad cultural shift following open acceptance of homosexuality; Republicans mounting offensives against abortion rights and facing electoral punishment from alienated women and secular men in specific cases where the optics suggested callousness towards women; a simple need to calm the fears of and do something for America’s largest minority group; and growing public awareness of the dangerous gaps which NRA interference has left in our nation’s ability to research who is trying to buy a gun in the wake of a growing number of mass shootings.  These general factors have put pressure on Republicans because they fear appearing cruel or too insular on these issues (which have identifiable constituencies).  It doesn’t mean the Republican Party will become openly affirming of gay marriage in every State (at least not for a generation, perhaps), or that it will stop being pro-life (it won’t), or that we are going to see another 1986-style amnesty as President Reagan instituted (we have nearly 4 times as many illegal immigrants now as then and this has become an emotional issue) or that Republicans will stop being active supporters of the gun culture (actually, if President Obama’s gun control legislation passes Congress this year it will likely create significant headwinds for Congressional Democrats in 2014).  Republican retreat on these issues is real and tangible; but in the fashion of good military metaphor, not to make strategic retreats on these issues would bring far greater injury to Republicans on the electoral front lines than the ideological space under contestation warrants.  But this is by no means a wholesale exchange of a Conservative ideology for a Libertarian one, or even a Republican Party that is going to have any chance of appealing to metropolitan Liberals as merely a “fiscally conservative” party.  The Republican Party still has its power base in rural areas and culturally-homogenized suburbs; there is no reason to believe it will try to profoundly alienate those people, and I really don’t think its electoral situation is that desperate.

Now, in contrast to what social Conservatives such as Gary Bauer said, limited-government Conservatism probably *is* needed to bind the party’s disparate wings together, so if the Republican Party feels more-Libertarian than it did when George W. Bush was President, well, by that general standard you are right.  Whatever gays, women, Hispanics, Asians, the Millennial generation, the college-educated and metropolitan-dwellers may think it, the Republican Party has remade itself with impressive speed as a more-committed small-government party, and it has to maintain this promise to its core supporters.  Hence the focus on cosmetic changes which encourages jokes: The Republican base doesn’t want “armies of compassion,” it wants to be left alone…unless someone wants an abortion, of course.

“They Just Jumped the Sharquester”

That memorable phrase Is the contribution of John Hart, a spokesman for Conservative Senator Tom Coburn (R-OK), and was made in response to the White House’s report that it will discontinue spring tours due to the forced spending cuts of sequestration.  This phrase is perhaps the pithiest manifestation of Congressional Republicans’ talking points over the spending cuts, the most-common form of which is “crying wolf.”  So far, the public essentially agrees.

So, the forced spending cuts of the sequester have officially begun, and the sting hasn’t been felt yet.  That was always a possibility–exact budget authority is a bit of an abstraction, since it’s the money that various Federal Departments and Agencies are allowed to spend, rather than how much money is actually spent and what it is spent on.  In coming weeks we will probably get a clearer grasp of where the money won’t be going and who will be most-affected by it, and then perhaps our preliminary picture will change.  For the time being, though, President Obama’s grim portents of the budget cuts of the sequester look like bluster.

This was the concern that I raised in my last entry, at which point I’d concluded that President Obama was gambling too much on setting-up Republicans to take the blame for allowing the forced spending cuts to happen.  Since the State of the Union Address I’ve suspected the President was priming the public for the sequester to happen; in recent weeks Congressional Republicans deftly parried this attack by offering the President the power to modify spending levels within affected Departments or agencies so that spending on priorities could be left intact.  When the President and Senate Democrats refused to entertain the offer, the focus shifted to why.  It didn’t help that the Senate Democrats’ proposal to replace the cuts to domestic spending in the sequester was obviously designed to be unacceptable to Republicans.  The bill would have instituted a 30% minimum tax on millionaires, elimination of all farm subsidies, and left the deep cuts to Defense spending in place, in exchange for restoring all other cuts to domestic discretionary spending.  It failed on a filibuster, 51-49–irrelevant, since it wouldn’t have had a prayer in the House.

Congressional Republicans, surprisingly, comported themselves with perspective and discipline throughout all of this.  Indicating early on that the forced budget cuts of the sequester were likely to go into effect, several Congressional Republican leaders said that “President Obama already got his revenues,” and that the sequester could only be modified in the context of a farther-reaching deal to reduce future Federal spending.  Congressional Republican leaders then allowed a successful vote to raise the debt limit for 3 months, though many Republicans voted–without fanfare–against it.  As I already mentioned, when President Obama said these spending cuts were unacceptably blunt-edged, they offered to give him the power to shift budget authority from 1 part of an affected office to another to shore-up priority spending at the expense of less-essential programs.  Now the House of Representatives, mostly through the House Republican Conference, has voted for a continuing resolution to maintain Federal discretionary spending at the level permitted by the sequester through September 30th–the balance of this fiscal year.  So far, Congressional Republicans are keeping to the strategy I had thought leadership media statements in January had suggested: Avoid direct confrontations with President Obama (who is now a 2-termer and personally popular), bend on his other legislative priorities, and focus relentlessly on their supposedly-urgent message of cutting Federal spending.

To the President’s credit, he seems to have recognized that his effort to force Republicans to choose between capitulation and public embarrassment over the sequester has failed, at least for now.  On Tuesday he pivoted to outreach, calling several Republican Senators to discuss Federal fiscal policy and inviting 8 of them to a White House dinner that night to discuss the outline of a “grand bargain” to replace some of the cuts to domestic discretionary spending with a combination of tax loophole closures and long-term benefits reductions to Social Security and Medicare.  Several Republican Senators who were party to these discussions are cautiously optimistic.

So the House of Representatives passed a continuing resolution maintaining Federal discretionary spending levels at roughly the cap set by the sequester through September 30th, the end of this fiscal year.  The measure passed the House 267-151, with 214 Republicans and 53 Democrats voting for it.  It’s unsurprising that most House Democrats voted against the lower spending levels of the continuing resolution (as they had also proposed to raise certain taxes in order to restore some spending); it’s also noteworthy, however, that even with a slightly-reduced attendance the House Republican Conference almost needed Democratic votes in order to pass it due to 14 Republican holdouts from the right and 4 non-attendees.

But while support from Conservative and centrist Democrats in the House may be a coveted goal if the House Republican leadership want to pass viable bills in their chamber, the fact remains that President Obama and Senate Democrats correspondingly have little choice but to support reduced Federal spending for now.  They could win some modifications in spending levels for particular domestic program priorities as long as overall spending levels remain within the limits mandated by the sequester, but that’s no more than what Republicans offered them before the sequester took effect.  Now, Senate Democrats are preparing their own continuing resolution.

In other words, Congressional Republicans won the staring match over the sequester.  True, the full effects of Federal program cuts may not be felt for a few weeks or a few months, and at that point public sentiment may shift more-emphatically against further spending cuts.  But in the meantime President Obama and the Democrats will have had the opportunity to shore-up some of their own budgetary priorities at the expense of programs they consider less-essential.  So, some hurtful cuts may never really go into effect, and other programs may be eliminated outright.  After many losses in years of fights over government with President Obama, the Republicans won this one.

This win is significant, because President Obama has been playing to take the House in 2014, and the public seems to be skeptical of his claim that House Republicans are on the warpath.  If they can otherwise keep their focus on Federal spending, their unassuming passivity may work for them.