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Morning Plum: Why normal debate about Obamacare is impossible

Foes of Obamacare are excitedly citing a rash of new stories claiming untold Americans are “losing” their insurance, as CBS News’ Norah O’Donnell puts it. One of them is this NBC News story, which reports that “millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.”

Critics of the law are right to ask whether it is having an adverse impact on these millions of Americans. And the White House could have been clearer in laying the groundwork for this political argument: It wasn’t sufficient to say people who like their plans will be able to keep it, which is narrowly untrue.

But the GOP outrage about Americans supposedly “losing” coverage is largely just more of the same old misdirection. It’s a subset of a larger Republican refusal to have an actual debate about the law’s tradeoffs — one in which the law’s benefits for millions of Americans are also reckoned with in a serious way.

On the substance of this argument, Igor Volsky has a good response, noting that these Americans aren’t “losing” coverage at all:

Individuals receiving cancellation notices will have a choice of enrolling in subsidized insurance in the exchanges and will probably end up paying less for more coverage. Those who don’t qualify for the tax credits will be paying more for comprehensive insurance that will be there for them when they become sick (and could actually end up spending less for health care since more services will now be covered). They will also no longer be part of a system in which the young and healthy are offered cheap insurance premiums because their sick neighbors are priced out or denied coverage. That, after all, is the whole point of reform.

But many foes of Obamacare refuse to grapple seriously with the basic tradeoff at the core of the law. For a fair look at whether this tradeoff is “worth it,” see Jonathan Cohn.

While it is too soon to assess the true dimensions of this tradeoff, the debate over it is entirely legitimate. It is the policy debate we should be having. But some Obamacare foes don’t even acknowledge that the law involves a tradeoff at all. Only the law’s downsides, and not the millions who stand to gain — many old, poor or sick — must be acknowledged.

As the Post’s Glenn Kessler argued in debunking some of Ted Cruz’s rhetoric about “millions” losing from Obamacare: “The full impact of the health-care law will not be known for years, and there are bound to be winners and losers in any major change in social policy…he does not allow at all for the possibility that millions of people are benefiting from the law — and that quite likely the number of winners from the law is larger than the losers.”

All of this flows from a basic difference between the two parties. Most Dems believe the Federal government has a legitimate role in expanding health coverage to tens of millions of uninsured Americans — through more government oversight over the health system, and, yes, government spending that is to some degree (though the extent is not yet clear) redistributive. Most Republicans don’t believe this. Conservatives such as Charles Cooke forthrightly defend that position. But Congressional Republicans are trying to obscure the true nature of this difference, by pushing GOP reform ideas that are advertised as a federal solution for the “vulnerable,” even though they almost certainly would cover a very small fraction of those who will benefit from Obamacare. The core difference here can’t be papered over, and indeed it’s revealed anew in the refusal of many to acknowledge the law’s benefits for millions.

Meanwhile, because the only acceptable position on the law for Republicans is to demand full repeal, they spend too little time prioritizing which parts of the law they’d want to change and won’t engage in bipartisan fixes to it that GOP-aligned constituencies want.

It’s puzzling. If public opinion is on the side of Republicans on Obamacare, why can’t we have a normal debate about the actual tradeoffs at the core of the law and about fundamental questions as to the proper federal role in solving health care problems afflicting tens of millions of Americans?


* WHAT TO WATCH ON OBAMACARE TODAY: Marilyn Tavenner, who oversaw the creation of the problem-plagued Obamacare website rollout, is set to face a grilling from House Republicans, who will press her on what the administration knew about the problems and when. You can be certain they will demand to know how many people have enrolled on the federally-run exchanges.

There is still time, however, for enough people to sign on if the website gets fixed by the end of November.  As for today’s hearings, there is no question that real Congressional oversight would be welcome in this situation, but the question remains whether House Republicans are capable of supplying it.

* OBAMACARE’S WORST CASE SCENARIO: Jonathan Cohn games it out, concluding that even if the website isn’t fixed by the end of November, the law will likely survive. I think Cohn is right to note that one of the main threats here is that bad press “will make the law’s defenders too skittish.”

* THE NSA IS OUT OF CONTROL: Eugene Robinson nails it:

The National Security Agency snooped on the cellphone conversations of German Chancellor Angela Merkel? Perhaps for as long as a decade? And President Obama didn’t know a thing about it?
Either somebody’s lying or Obama needs to acknowledge that the NSA, in its quest for omniscience beyond anything Orwell could have imagined, is simply out of control.

Of course, it’s possible both are true, but either way, the latter point seems inarguable.


A group of Senate Democrats is slated Tuesday to introduce a plan allowing the president to raise the debt ceiling without the approval of Congress — a tactic dubbed the “McConnell Rule.”

This would disable debt limit extortion permanently, and if Republicans oppose it, Dems will cite it as evidence that Republicans want to reserve the ability for more of this extortion later.

* JOHN KASICH DECRIES “WAR ON THE POOR”: This is interesting: Ohio GOP Governor John Kasich is implicitly criticizing his own party with a robust defense of the social safety net:

“I’m concerned about the fact there seems to be a war on the poor,” he said, sitting at the head of a burnished table as members of his cabinet lingered after a meeting. “That if you’re poor, somehow you’re shiftless and lazy.”       
“You know what?” he said. “The very people who complain ought to ask their grandparents if they worked at the W.P.A.”

Kasich recently pushed through a version of a Medicaid expansion that extended coverage to 275,000 Ohioans, angering conservatives, a sign that over time, GOP governors will probably end up bucking the Tea Party demand that they do everything possible to prevent Obamacare’s benefits from helping their own constituents.

* WHY BUSINESS LEADERS SHOULD DECRY THE SEQUESTER: The Wall Street Journal’s Gerald Seib makes a smart point: Business leaders in particularly should be troubled by the sequester, because it is slashing funding for the kind of basic government-funded research that has historically given the U.S. a competitive edge.

In theory, this would be another area — like the debt ceiling — where a wedge has opened up between Tea Party Republicans and the pragmatic GOP-aligned business community. It would be interesting if business leaders (who tend to support GOP fiscal priorities) to  got involved in the push for a sequester replacement.

* AND DEMS HEAD FOR VICTORY IN VIRGINIA: A new Post poll finds that Dem Terry McAuliffe has opened up a double digit lead over Ken Cuccinelli, 51-39. McAuliffe leads among women by 24 points in a race that’s been partly about the Republican’s stand on women’s health issues.

Only 32 percent of likely Virginia voters view the national GOP favorably, while 65 percent view it unfavorably. Among independents: 25-69. Among moderates: 23-74. Those are striking numbers in a purple state that is pivotal in presidential elections. Also: McAuliffe is winning with a liberal agenda on social issues, a sign of shifting demographics that are expanding core Dem constituencies.

What else?