Tuesday, December 22, 2009
Saturday, December 19, 2009
- Insurers in the large group market will be required to spend at least 85% of all premiums on medical care (that leaves 15% for administration, marketing, profit), in the small group market the standard will be 80%.
- Individuals and families under 400% of the federal poverty line who receive employer-sponsored coverage and spend 8-9.8% of their income on premiums, could “convert their tax-free employer health subsidies into vouchers that they can use to choose a health insurance plan in the new health insurance exchanges. This would allow folks more choices in selecting coverage and force insurers to compete with the exchange.
- Medicaid eligibility would be extended to everyone earning less than 133% of the federal poverty level and as a protection for states the federal government will pay for 100% of the cost until 2017 - typically a state pays nearly half the cost of Medicaid.
- Lieberman - Had it not been for Lieberman's efforts to strip away the public option the bill never would have received 60 votes. Lieberman has provided political cover for vulnerable Democrats like Mary Landrieu (D-LA) and Blanche Lincoln (D-AR) as well as dozens of House Democrats from conservative districts.
- Nelson - The abortion concessions won by Nelson will also provide coverage for House Blue Dogs, but Nelson's greatest contribution was his insistence that the full cost of the Medicaid expansion in Nebraska be covered by the federal government forever - while the expansion in all other states is covered for only 5 years. Seem unfair? Sen. Tom Harkin (D-IA) summed it up well "In 2017... when we have to start phasing back from 100 percent, ... they are going to say, 'Wait, there is one state that stays at 100?' And every governor in the country is going to say, 'Why doesn’t our state stay there?'" In other words, Nelson win for Nebraska is likely a win for every state.
If Harry Reid truly has the 60 votes necessary for cloture then the stage would be set for a vote by December 24th. After that it goes to conference committee where Nancy Pelosi will need to win major concessions from House liberals in order to avoid having this deal fall apart early in the new year. Of course, early word is that House Democrat conservatives may not be willing to accept the abortion compromise...
Thursday, December 17, 2009
Many believed that the one-two punch of the 2006 mid-terms and the 2008 presidential election was heralding a realignment in America with voters moving to the Democratic party. Indeed, the party reclaimed Congress and the White House and enjoyed a clear advantage in voter expressed party preference for the first time in 20 years. It appears that such realignment predictions were made in haste. Democrats no longer enjoy an advantage in voter preference and according to the latest NBC News/WSJ Poll only 38 percent of voters said their representative should be re-elected, while nearly half (49 percent) believe it’s time to give a new person a chance. According to Politico “That’s the lowest net re-elect number for Congress since November 2005 – and even worse than the polls taken right before the landslide election of 2006 that swept Democrats in control of Congress (39 re-elect/45 new person), and worse than those taken before the Republican revolution of 1994 (39/49).”
Translation? 2010 is shaping up to be another wave election – a term that non-political scientists and media commentators often use to describe a critical mid-term election. This presents a problem – critical elections were thought to usher in generational shifts in loyalty. But we have now had two wave elections in 12 years – 1994 and 2006 and may have a third on the way - only 4 short years after the last wave. All of this suggests that we have in fact dealigned in America. Voters are no longer loyal to any party, as such they willingly and easily switch allegiances from one election to the next. Writing for Politico back in August, Eamon Javers referred to this new generation of voters as “Fickle Kids” who change voting preference as often as they do cell phones. If this is true, if we have dealigned, if voters no longer have a true connection to either party, America is likely to enter a very unstable era in which party control of government will be very unpredictable and likely short-lived. It remains to be seen how the parties will react to this change.
Wednesday, December 16, 2009
For these analysts, Turkey’s recent ambitious domestic and international overtures are bound to doom for one overarching reason: Turkey is ruled by an “Islamist” party—Justice and Development Party (known as AKP)—and, because of its ideological identity, whatever initiative the government would advance will only help further Islamize the Turkish nation, undermine the secular political structure, and distance Turkey from the West. I believe that this outlook is not only reckless in assessing
One recent and—one of the most representative—example of this view was illustrated by David Schenker (The Wall Street Journal, November 5, 2009). The title of his essay says a lot: “A NATO Without Turkey?” According to Schenker, the Turkish government “is increasingly pursuing illiberal policies at home…while aligning itself with militant, anti-western
Both these views are part of a misguided approach based on the erroneous—or imprudent—reading of
Some assessments of the recent assertiveness of the Turkish foreign policy also suffer from similar one-sided and misguided reading of the events. Seeing AKP as an Islamist party with an arguably hidden Islamic agenda can provide emotional satisfaction for some. But this view is seriously missing the point.
To conclude, reading
Tuesday, December 15, 2009
Last month I took to this page to argue that health reform would fail to pass. In my original post and one subsequent follow-up I theorized that disagreements within the Democratic Party and between the House and Senate over funding, mandates, taxes, and abortion would ultimately sink health reform - and they almost did. But it is now increasingly likely that health reform will pass and all credit goes to two Senators - Max Baucus (D-MT) and Joe Lieberman (I-CT). Lieberman has become public enemy number one among the Left this week since stating that he would filibuster any bill with a Public Option AND any bill that allowed for a Medicare buy-in. Baucus enjoyed a similar bit of infamy back in September when his Senate Finance Committee drafted health reform legislation that did not include a public option and had watered done the individual and employer mandates. Baucus argued that his goal was to write a bill that could receive 60 votes.
Senate Majority Leader Harry Reid (D-NV) took Baucus' bill and added a public option and has spent the better part of a month trying to reach 60 votes. It seems that Reid has now surrendered. Word out of Washington is that the Senate will strip away the public option, will strip away the recently proposed Medicare expansion and will essentially consider the legislation originally reported by Baucus' committee back in October. Liberal Senate Democrats such as Tom Harkin (D-IA) have stated that they will accept scaled back legislation and the White House has urged Reid to make what ever concessions are necessary to get the bill passed.
Perhaps most significant is the increased likelihood that the scaled back Baucus inspired bill may receive 2 Republican votes – Olympia Snowe and Susan Collins, both from Maine. Snowe supported the Baucus bill in committee and Collins recently praised Lieberman’s efforts to strip away objectionable elements in the bill. So there you have it – the bill that Baucus originally produced has now become the savior of the Democrats' health reform effort and because of the efforts of Joe Lieberman it is likely to pass complete with a Republican vote or two.
If you are wondering why Harry Reid opted to not introduce the Baucus bill in the beginning it is because of the politics of the House of Representatives and the powerful progressive caucus there. Reid needed to prove that a public option could not survive in the Senate, he needed to prove that the Baucus bill was the only acceptable legislation. The last month has made that clear. Given that the House has passed a health care bill the normal process would be for a House/Senate Conference Committee to reconcile differences between the chambers and return a compromise bill for final votes in each. I do not expect that to happen – rather I suspect that whatever passes in the Senate will be introduced in the House and approved unamended, thereby negating the need for a conference. Any other approach would introduce more delay and uncertainty. The White House and Democratic Leaders will exert tremendous pressure on progressive House members to grit their teeth and simply vote for the Senate bill, or risk getting no reform at all.
I would add that abortion remains a hurdle – but I suspect that it is one that will be overcome.
Monday, December 14, 2009
Asking if 2010 will be like 1994 is not the same as asking if the the same dynamics that shaped 1994 will shape 2010. In all but two midterm election cycles in the past since FDR the party in the White House has lost seats in the midterm - what made 1994 unique was the size of the loss in the House and the Senate. In the past 50 years there have been 12 midterm elections, in 10 of those races the party in the White House lost seats. In 5 of the 12 the losses in the Houses amounted to 15 or fewer seats, in 2 of the 12 the losses ranged from 26 to 30 seats (1982 and 2006), in only 3 of the 12 did the losses top 40 seats -1966 (47 seats), 1974 (49 seats), and 1994 (52 seats). In 1998 and 2002 the party in power gained seats. So the real question for 2010 is whether the Democrats will suffer losses in line with historical norms - about 15 seats - or will the party suffer the more extraordinary losses registered in 1966, 1974, and 1994?
Current political conditions suggest that 2010 will not follow the historical norm model of 15 or so seats. The latest edition of the Cook Politcal Report finds that of the 258 House seats held by Democrats 218 are considered to be safe - that is the exact number needed to maintain their majority status. Cook rates 39 Democratic seats as competitive and only 11 Republican seats. The generic Congressional ballot from multiple pollsters favors the Republicans and 4 Democratic House members have announced plans to retire. Add to all of this a president with an approval rating below 50% and you have the makings for an election year that will not be good for the Democrats. At the moment the most likely scenario is a midterm that follows the 1982 and 2006 model of 25 to 30 losses. In the Senate, the Democrats face challenges in AR, CO, CT, DE, NV, NY, OH, and PA while Republicans are fighting to keep KY, MO, and NH - a net Republican gain of 4 or 5 seems likely at this point.
So will 2010 be like 1994? The dynamics of the race will be different - but such is true of all races. With regard to shifting control of Congress 2010 also is unlikely to be like 1994. But make no mistake, if Republicans gain 30 seats in the House and 5 seats in the Senate the 2010 election will be like 1994 in that it will fundamentally alter the political dynamic in Washington. The midterm vote will be viewed as a harsh assessment of the president and the Democratic majority and will result in an altered agenda leading into 2012. It will also give the GOP tremendous influence over that agenda as they reclaim the ability to filibuster in the Senate.
Friday, December 11, 2009
President Obama’s Nobel Peace Prize acceptance speech yesterday drew praise from both the left and right. The praise from the left is hardly surprising, but accolades from both the Wall Street Journal editorial board and Sarah Palin are noteworthy. The strong response from conservatives tended to focus on the section of the speech were Obama meditates on the notion of “just war” and the meaning of a President fighting two wars receiving the Peace Prize.
“But as a head of state sworn to protect and defend my nation ... I face the world as it is, and cannot stand idle in the face of threats to the American people. For make no mistake: Evil does exist in the world. A non-violent movement could not have halted Hitler's armies. Negotiations cannot convince al Qaeda's leaders to lay down their arms. To say that force may sometimes be necessary is not a call to cynicism -- it is a recognition of history; the imperfections of man and the limits of reason.”
This portion of the speech, arguing both that war may be justified and using the word “evil”, led other commentators to argue that Obama was simply using his flowery rhetoric to say the same things put more bluntly by his predecessor. Historian Walter Russell Mead from the Council on Foreign Relations argues that Obama is simply better than Bush at selling the same policies. He argues,
“Barack Obama's acceptance speech for the Nobel Peace Prize was a carefully reasoned defense of a foreign policy that differs very little from George Bush's... If Bush had said these things the world would be filled with violent denunciations. When Obama says them, people purr.”
Similar sentiments have been echoed elsewhere on the right. The only problem is that President Bush would have never given a speech like this. Let’s call it the “Only Obama Could Go To Oslo” phenomenon. Obama accepts the prize for peace and makes the case for the necessity of war. However, the greatest differences between Bush and Obama were not in what Obama said, but in those things left unsaid. There was no discussion of Iraq, other than the oblique reference to a war that “is winding down.” No discussion of the need to use U.S. power to spread American ideals. And while Obama did mention evil in the world, there is no talk of good versus evil.
In fact, while Obama front-loads the discussion of just war, the speech ranged over a number of topics that draw upon a broad array of international relations theories. The clear-eyed discussion of war reflects political realism, while the call for the United States to adhere to global standards reflects idealism. The significance of international institutions in maintaining the post-war order mixes in neoliberal institutionalism, while arguing that, “America alone cannot secure the peace,” draws in traditional foreign policy liberals. For good measure, Obama includes a discussion on democratic peace (“America has never fought a war against a democracy”), just war (“philosophers and clerics and statesmen seek to regulate the destructive power of war”), classical realism (“War, in one form or another, appeared with the first man.”), and clash of civilizations-type arguments (“the cultural leveling of modernity… people fear the loss of what they cherish in their particular identities”).
If anything, the Oslo speech seems to undergird Obama’s emphasis on addressing the complexity of the problems confronting the United States and the administration’s emphasis on “smart power.” While the meaning of “smart power” remains broad enough to be frustratingly elusive, the general emphasis of Obama’s speech seemed to be that it is critical to find the proper diplomatic tool to fit the job. Thus, to Nobel speech can draw praise from across the American political spectrum, because it acknowledges a simple point: the Obama’s foreign policy will draw on a broad array of international relations theories. While this may frustrate those who seek clear and simple guiding principles in U.S. foreign policy, it offers hope to those that believe context is critical.
Wednesday, December 9, 2009
As negotiations on health reform continue a new Quinnipiac poll shows the public opposes reform by a 52% to 38% margin. The polls also found a nearly equal level of disapproval of Obama's handling of health reform and the 20 point advantage that he enjoyed over Republicans on the issue back in July has now shrunk to 7 points. As for the 2010 midterms - the list of Democratic incumbents who plan to retire has now grown to 3 and Charlie Cook counts 39 potentially vulnerable Democratic House seats and only 11 Republican seats (and the number of vulnerable Democrats grows each week). In the ever important swing state of Ohio (crucial to any Republican White House quest) the Democratic incumbent Ted Strickland now trails challenger John Kasich by 9 points. It's hard to find any cause for optimism among Democrats other than the news that the national unemployment rate dropped from 10.2% to 10% last month. So far the political trajectory of 2009 is looking a lot like 1993 - Democrats desperately need a course correction to keep 2010 from ending up like 1994.
Update: Late word indicates that GOP moderate Olympia Snowe is not a fan of the new compromise that would expand Medicare and Medicaid, this could make it very hard for Democrats to reach 60 votes. Especially if they lose Ben Nelson over the issue of abortion coverage.
News today suggests that significant progress is being made in the Senate on compromise health care reform as Democratic Party leaders seek a path to 60 votes. It is increasingly clear that the Public Option that Majority Leader Harry Reid had included in the bill will be dropped - but progressive members of the Democratic caucus have not simply surrendered, rather they are using the elimination of the Public Option to bargain for new and potentially far reaching concessions. Multiple sources are reporting that the Public Option would be replaced with a new nationwide nonprofit health plan to be administered by the federal Office of Personnel Management (the same agency that administered the federal employee health benefit system). The new national plan would be offered by a private insurance company. Party leaders hope that progressives will find this to be an acceptable alternative to a Public Option run by the government. In exchange for dropping their demands for the Public Option, progressives have pursued amendments to the current legislation in the form a significant expansion of the Medicare program – the nation’s health insurance system for those over the age of 65. Under the proposal currently being discussed, the Medicare program would be opened to Americans over the age of 55. This is a population that can face great difficulty obtaining affordable coverage – especially if they suffer a job loss. Also being pursued is a proposal to open the new national health insurance exchange to more Americans. As originally proposed, the exchange would have been limited to a select few small employers and uninsured Americans, perhaps as few as 15-30 million. Adoption of these compromises would have a far more significant impact on health reform and coverage expansion than would the limited Public Option and progressives would be wise to pursue them.
Interestingly, or perhaps distressingly for Democrats, just as progress is being made on reform public opposition is on the rise and public support is collapsing. According to the latest tallies from Pollster.Com a majority of the country now opposes reform and less than 40% is in support. As heated debates remain over touchy issues such as abortion and funding – to say nothing of a needed reconciliation with the House – Democrats in tough re-election fights need the cover of public support - at the moment they do not have it. Only time will tell if that changes as details of these new negotiations emerge.