2017-03-09

David Catron chastises conservatives who would prefer some ideal free-market health plan that is never going to be enacted instead of being happy with what can be done.

What the voters really wants is cheap, accessible care — any way they can get it.

Free market purists, including yours truly, believe the best way to achieve that goal is through unfettered competition and open markets. But if one follows that line of reasoning to its logical conclusion, it means that that the government — both state and federal — must stay completely out of health care. Medicare, Medicaid, and every other government health care program would have to be repealed. The public wouldn’t stand for it. The voters don’t object to Obamacare because it’s a gateway drug to single-payer. If that were true they would abjure Medicare. They hate it because it fines them for failing to buy health insurance coverage that costs them too much.

And, not coincidentally, those very issues are what the American Health Care Act addresses. First, and most important, the plan repeals the unconstitutional individual mandate — effective after December 31, 2015....Likewise, the job-killing employer mandate will be retroactively repealed. Employers will no longer have to hold off hiring new workers in order to avoid outrageous fines for not providing health insurance coverage that neither they nor their employees can afford.

The bill also kills the vast majority of stealth taxes Obamacare imposes on you. For example, it eliminates the tax on over-the-counter medications. Oh, you didn’t realize you were paying that? Prior to Obamacare, you were permitted to pay for over-the counter-medication on a pre-tax basis by using a Flexible Spending Account (FSA). The “Affordable Care Act” killed that. The bill repeals Obamacare’s cap on contributions to FSAs, which were unlimited before the advent of President Obama’s “signature domestic achievement.” This cap was particularly hard on parents of special needs children, many of whom used FSAs to pay for special needs education.

The much-maligned GOP plan also eliminates the high medical bill tax. Didn’t know about that one either?...The much-maligned Republican plan also reduces Obamacare’s HSA tax. Haven’t heard about that one? Obamacare increased the tax on early withdrawals from an HSA from 10 to 20 percent. The American Health Care Act takes that back down to 10 percent. The plan also eliminates the moronic medical device tax, a natural born job killer....

And, while conservatives complain about the bill, they should consider that it does two things for which they have long been clamoring: It defunds Planned Parenthood and it reforms Medicaid.
Yes, it's far from perfect. But, as Catron writes, "perfect isn't one of our choices."

If conservatives hold out for full repeal and cling to the fantasy of a free market replacement plan, there is a real danger that Obamacare will never be repealed.
That would be so stupid that only the Republicans could manage doing that.

The Wall Street Journal explains how the GOP opponents of the House healthcare bill don't really have any other option.
The House Freedom Caucus and some Senators prefer to revert to the repeal bill that Republicans passed in 2015 to test the limits of reconciliation. That measure would eliminate funding for ObamaCare’s Medicaid expansion and the exchange subsidies roughly two years after enactment. After this so-called clean repeal, they say, Republicans can debate replacement options and form a consensus later in this Congress—maybe.

But stand-alone repeal is unlikely to pass the Senate, not least because Republicans ran on repeal and replace, not repeal alone. Senators and most of the House also recognize that repeal—without the cushion of the replacement provisions for a smoother transition—will capsize insurance markets and accelerate ObamaCare’s collapse. The market won’t revert automatically to 2009 because that market no longer exists.

Instead, insurers and state Medicaid programs will have to recalibrate everything on the fly, with little time to prepare and adjust amid maximum market disruption. Governors in the 31 states that expanded Medicaid won’t be allies if the feds blow a hole in their budgets. The flight of insurers from the exchanges will increase as executives flee a dying business, and any insurers of last resort that remain will surge premiums to compensate.

Nearly a third of U.S. counties are now served by merely a single insurer. It could fall to zero. Republicans would own every horror story about cancer patients losing coverage and the poor thrown off the Medicaid rolls. Democrats suffered politically when ObamaCare caused a wave of insurance cancellations in 2013.

But let’s give the critics the benefit of the doubt and say repeal-only could get 50 Senate votes. Then what?

The GOP would have to move a replace bill with less political capital and a threshold of 60 Senate votes absent reconciliation. Good luck getting Chuck Schumer and the Democrats to agree under regular order to the reforms in the current House bill, which include block grants for Medicaid, expanded health-savings accounts and funding for high-risk pools. Republicans would go into 2018 having repealed ObamaCare without a replacement.
And the conservatives' complaints don't really make sense.
Especially odd is the conservative opposition to tax credits for people who buy individual insurance. These were previewed in the “Better Way” and are a regular feature of all major GOP plans over the years, from Coburn-Burr-Hatch (2014), Ryan-Kline-Upton (2015) and Tom Price’s Empowering Patients First Act, which has existed in some form since 2009. We prefer tax deductions to credits, but that ship sailed a decade ago.

Mr. Price, now Health and Human Services Secretary, eventually found 84 GOP cosponsors in the last Congress. They include North Carolina’s Mark Meadows, the chairman of the Freedom Caucus and a leading if born-again tax credit critic. Did he read Mr. Price’s bill?

The policy dilemma for conservatives is how to move to a richer market for individual insurance that doesn’t receive the tax subsidy that employer-sponsored insurance does. You can begin to equalize that treatment either by adding a subsidy for individuals or reducing the one for companies. In an ideal word we wouldn’t have a subsidy for either. But that isn’t today’s health market.

The House bill’s tax credits and health-savings accounts are an attempt to equalize the tax treatment over time for individuals, and it’s a shame Republicans took out the cap on the tax exclusion for business. Conservatives should fight to restore it. But at least the House bill is progress toward the kind of market-based, patient-centered coverage conservatives say they want.

Some on the right now say that doing nothing is better than the House bill, claiming they can let ObamaCare deteriorate further and blame Democrats for creating it. But voters aren’t stupid. They know they elected a unified Republican government that promised repeal and replace. Voters will conclude the GOP is either feckless or pulled a bait and switch.

***
Entitlements by their nature are difficult to roll back once they’ve gained a constituency, which is one reason we opposed ObamaCare. But the GOP has to try. By all means Members should attempt to fix the House bill’s flaws, including the three-year delay in Medicaid reform and the too-generous inflation formula for funding the states, among other things.

But conservatives should keep in mind that failure will have a cost, and the irony could be that they block repeal because the replacement has flaws. Are those flaws really worse than the ObamaCare status quo?

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Kelsey Harkness writes about what International Women's Day should have been about.
Internationally, an estimated 200 million women and girls have undergone female genital mutilation. Female genital mutilation is a cultural procedure that removes part or all of a woman’s genitalia. Not only does it carry long-term health consequences, but it takes away pleasure from intimate relationships. Actually, it makes sex hurt. A lot.

Despite the progress we’d like to imagine the world is making on this front, rates of female genital mutilation are on the rise. In Egypt, for example, 87 percent of women aged 15 to 49 have been cut. If any p-ssies need help “grabbing back,” it’s theirs. Not yours.

Then there’s this statistic. In developing countries, approximately 830 women die every day from preventable causes related to pregnancy and childbirth. Yet, aside from the occasional op-ed by Nicholas Kristof, this issue hardly gets lip service among the Left. They’d rather talk about the cost of their abortions and birth control.

Then there’s the issue of honor killings. Despite how hard we pretend otherwise, these murders still occur every 90 minutes. Last year in Pakistan, three women a day were killed in the name of “honor.”

Just last month, The New York Times reported on a young Afghan couple arrested by police. While being held, an “armed mob” of 250 to 300 men—some of whom were actually related to the imprisoned young girl—stormed the police station and brutally murdered the couple. Their crime? Illegally eloping.

No one’s been arrested in their case, because in rural Afghanistan this is normal. It’s so normal, in fact, that in the United States and beyond, no one marched for this young couple. No one cared. On International Women’s Day, how about we talk about keeping women alive?
Instead of the silly "Day Without a Woman" grandstanding, it would have been nice if we could have seen the country organized to focus on true deprivations that women around the world suffer.

Ramesh Ponnuru notes that the Trump administration isn't even acting as if they are taking Trump's accusations against Obama about wiretapping at all seriously.

Nothing Trump's own administration has said or done so far indicates that it takes his accusations seriously. And that starts at the top with the president himself. Trump explicitly accused his predecessor of misconduct on the level of “Watergate,” and then moved on to tweeting about his feud with Arnold Schwarzenegger.

Trump press aide Sarah Huckabee Sanders went on ABC to say that her boss may have been onto something -- which means she can’t vouch for the accuracy of his assertion.

Sean Spicer, his press secretary, has taken a similar tack: Trump’s claim has become a troubling report, on his telling. He then said that since oversight is continuing, the White House would have no further comment on the matter, a stance that was hard to square with Trump’s decision to give it maximum publicity. Spicer didn’t let an hour pass without commenting on it again.

If any other administration, this would be bizarre behavior. For this one, it’s par for the course.

Again: The possibility that Trump has some legitimate grievance about the behavior of the Obama administration can’t be ruled out. But there’s no reason to take that possibility more seriously than Trump himself seems to be taking it.

Jonah Goldberg is exactly right about Trump's tweets this past weekend accusing, without any apparent evidence, Obama with wiretapping him. Trump had the best moment of his presidency with his speech to Congress. And he ruined it all with his wild tweets. If you're going to accuse a former president of a felony on Twitter, at least have some evidence to support your accusations.
Trump is destroying his presidency one tweet at a time. On Friday morning, Trump reportedly chewed out his senior staff for letting allegations of his campaign’s collusion with Russia distract from his post-speech agenda. By dawn the next morning, his tweets had made the Russia allegations a much bigger story and led to Spicer asking Congress to investigate whether his boss was onto something.

The pivot stuff was always false prophecy. Being president has a funny way of making people more presidential. And by day, Trump’s White House staff can contain his worst instincts. But all bets are off when he’s alone at Mar-a-Lago and the moon calls forth the beast.
Goldberg responds to criticisms of his post who argue that Trump's mastery of Twitter helped him bypass the MSM and win the presidency. There are those who think that Trump is playing three-dimensional chess while everyone else is playing checkers. And others don't care if he's right or wrong about Obama. They are quite prepared that Obama is guilty and they don't need any stinkin' proof.
Now, I think all of these arguments are bad. Yes, social media helped Trump win the presidency. But campaigning for president and being president are very different things. (To support my claim, I suggest you read, well, pretty much any book ever written about a U.S. president or American politics).

As for controlling the news cycle, no he’s not. He’s feeding a very negative storyline, making the Russia story bigger, not smaller — which is apparently the opposite of what he wants. He has an agenda — a mostly good agenda — that he wants to talk about. The White House loved the positive response to his address to Congress and they wanted to keep it going. But as I note in my column, his tweets blunted that momentum.

And then there the last two complaints, which boil down to either Trump may be right and Trump is right. I will concede that Trump might be right in some downgraded sort of way and I think that possibility should be investigated. But let’s be clear. Trump said one thing and the “proof” to back him up will almost surely be something less sensational. He said he “found out” that Obama wiretapped his phones. If there is a there there to this story, it will be something more along the lines of “The FISA court issued a warrant for the limited purpose of X or Y.” It would still be a big story (or could be). But it won’t be the “Watergate” claim that Obama personally ordered a political foe be bugged. It’s a bit like some of the other wild claims Trump has made. He claimed to see thousands of Muslims in New Jersey celebrating 9/11. No proof was forthcoming. Then there’s some much more modest anecdote that surfaces, and his supporters claim total vindication.

But if Trump is right — or even thinks he’s right — why is the White House running away from this story as quickly as possible? Why does it refuse to defend the charge made by Trump on the merits or provide evidence? Why hasn’t he asked the head of the FBI about it? Why did Trump ask his aides for evidence to back up something he already claimed to know had happened? Why does Trump believe the “fake” media only when it serves his purposes? Or as Ramesh puts it, “What if Trump took his wiretap story seriously?“

Trump asserted as fact something he clearly didn’t know to be true. I don’t think he lied. I think he just had a knee-jerk response to something he read and vented on Twitter about it (before he got to the important stuff, like Arnold Schwarzenegger’s bad ratings).

But here’s the important point. Even if Trump is absolutely positively 100 percent right about this; even if Barack Obama sent an elite squad of high tech ninjas into Trump tower to bug everything they could: His tweets would still be a very bad way to go. If this allegation were true, it would rock the country, according to virtually every conservative supporter of the president. True enough. So, all the more reason to call in your attorney general and the congressional leadership and figure out the most mature and reasonable way to proceed.

That’s not what he did. He did the very opposite of that.

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John Hinderaker reminds us of how closely Eric Holder came to committing perjury back in 2013 before the House Judiciary Committee. He told the committee that he's never "been involved in, heard of, or would think would be wise policy" to prosecute reporters under the 1917 Espionage Act. At that same time he had already signed off on a request for the courts to authorize a wiretap on James Rosen of Fox News. Holder signed off on characterizing Rosen as a potential criminal defendant because he had reported on a story that the administration wanted to prosecute the guy who leaked to him. As Paul Mirengoff wrote at the time,

So the issue is rather squarely posed: Holder testified that he had never “been involved in” or even “heard of” any “potential prosecution of the press for the disclosure of material.” And yet, he participated in “extensive deliberations,” “discussed” and approved of the filing of an application for a search warrant that specifically represented to the court that a reporter has “potential criminal liability in this matter.” It is hard to imagine a more direct contradiction.
Hinderaker comments,

Either Eric Holder was suffering from acute memory loss at a young age, or he committed perjury. But, because the press was slavishly devoted to Barack Obama and his minions, no matter how corrupt or dishonest they may be, hardly anyone knows about this shameful episode.
Compare that episode to anything Jeff Sessions said to Al Franken.

David Wasserman writes up an analysis at 538 about how our country has fewer and fewer purple districts.

President Trump’s victory over Hillary Clinton was among the narrowest in history, and the country is deeply split on his job performance so far. But if you feel like you hardly know anyone who disagrees with you about Trump, you’re not alone: Chances are the election was a landslide in your backyard.

More than 61 percent of voters cast ballots in counties that gave either Clinton or Trump at least 60 percent of the major-party vote last November. That’s up from 50 percent of voters who lived in such counties in 2012 and 39 percent in 1992 — an accelerating trend that confirms that America’s political fabric, geographically, is tearing apart.

Of the nation’s 3,113 counties (or county equivalents), just 303 were decided by single-digit margins — less than 10 percent. In contrast, 1,096 counties fit that description in 1992, even though that election featured a wider national spread.1 During the same period, the number of extreme landslide counties — those decided by margins exceeding 50 percentage points — exploded from 93 to 1,196, or over a third of the nation’s counties.

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Eli Lehrer explains why government spending on infrastructure is not the magic bullet politicians want to pretend it is.

With no obvious priority crying out for investment now—but lots of areas making cases that they need a new road, rail line, or bridge—Trump and Congress easily could agree on a package similar to President Barack Obama's misbegotten 2009 stimulus. That plan threw a bit over $100 billion at a variety of infrastructure purposes, ranging from highways and bridges ($27.5 billion) to upgrading federally owned power networks ($6.5 billion) to broadband Internet access ($7.2 billion). Unsurprisingly, this scattershot approach made few noticeable improvements in most Americans' lives. At best, the stimulus was simply a way to reduce unemployment and prime the economic pump, and some economists don't think it even did that. And if such pump-priming made sense when the unemployment rate approached 10 percent, it's far more difficult to justify when unemployment rate is flirting with 10-year lows.

Kevin Williamson wonders who would be trusted enough to investigate Trump's connections with Russia.

The Trump administration’s ties to Moscow probably should be investigated, if only for the sake of putting aside the wilder fears and more inflamed passions of less responsible partisans. The trouble is, the Obama administration and its Democratic allies in Congress have left us with no credible institution to undertake such an investigation. Whom would you trust? The Justice Department? The State Department? The FBI? The intelligence community? A special investigator? A bipartisan special committee that would be subject to the high ethical standards of Nancy Pelosi and Chuck Schumer?
As Williamson points out, the Obama administration didn't provide a model of trustworthiness.

The Obama administration left us with a poison bouquet, a federal government whose investigatory agencies are thoroughly corrupted, politicized, and untrustworthy. We know for a fact that the Internal Revenue Service, acting after demands from Democratic elected officials, targeted conservative-leaning activist groups for investigation and harassment, and that this harassment was outrageous, including demands that religiously oriented organizations disclose the very contents of their prayers. We know that that Internal Revenue Service illegally and maliciously leaked information about the donors of the National Organization for Marriage, in order to facilitate political and financial retaliation against them. We know that evidence, including e-mails, was destroyed to subvert investigation into this criminal conspiracy, and that congressional Democrats went to extraordinary lengths to protect IRS officials from being punished for their wrongdoing. We know that one of the key figures in that case, Lois Lerner, is enjoying a large federal pension rather than a small federal prison cell.

We know that the Department of Justice was wildly politicized during the Obama years, doing Democrats’ bidding on everything from voter-intimidation cases to the Clinton e-mail case. We know that the National Labor Relations Board was used as a political weapon to try to punish Boeing for setting up new production in Republican-leaning South Carolina rather than Democratic-leaning Washington State. We know that the ATF was used to audit a business whose owners were not involved in A, T, or F, but who were involved in election-reform projects, and that the same firm was targeted by OSHA and the IRS. We know that a politicized EPA was involved in such extraordinary shenanigans that its director felt the need to set up a pseudonymous e-mail account in order to hide her activities from ordinary oversight. Even our Democratic friends have concluded that the FBI under the Obama administration was politicized, though they cannot quite seem to make up their minds about the direction or intent of it. (Links in original)
So we have few left in public life who has earned the trust from both sides of the aisle. So Williamson has a good point. Whom can we trust to conduct such a politically fraught question as Trump and Russia?

What we might find out about Trump and the Russians — might — could damage trust in our institutions. What we already know about Obama and the IRS, EPA, NLRB, OSHA, ATF, etc., already has. That damage is not irreparable, but it is not being repaired.

And the IRS still is holding info on conservative groups.

The IRS has told a federal court that they've recently identified almost 7,000 more documents that could contain information on how the agency targeted the tax-exempt applications of Tea Party organizations or other conservative political groups starting back in 2010, according to a court document.

But IRS in the document would not commit to a timeline for releasing the documents.

The revelation of thousands of unreleased documents was made in response to a Freedom of Information Act lawsuit from Judicial Watch, a conservative watchdog group that specializes in filing, and in many instances litigating, FOIA requests.
Amazing.

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