Unlike many of his competitors for the GOP presidential nomination, Louisiana Gov. Bobby Jindal has laid out a detailed plan for replacing President Obama's health-care reform, widely known as Obamacare.
The plan would give the states full control over Medicaid and would pool people at a high risk of illness, offering them subsidies with the goal of making sure that even the sickest Americans can afford insurance. Jindal would also get rid of the tax break that businesses get for offering employees health insurance to put workers at big firms on a level with the self-employed.
Jindal's proposal has been criticized by both the right and the left. At Talking Points Memo, Sahil Kapur argued that Jindal's plan for dealing with high-risk consumers would be too expensive. Ramesh Ponnuru, writing for National Review, wondered if his plan for employer-based insurance would be too disruptive to the existing system.
But at least Jindal has put something out there for discussion, and at least he's been honest about the goals, Greg Sargent wrote in The Washington Post earlier this year. Jindal has acknowledged that Obamacare will probably extend insurance to more people than conservative proposals to replace it.
"It’s objectively true that they don’t maintain the coverage levels that the ACA has. They would achieve more limited coverage objectives, and some Republicans have been pretty open about that," Drew Altman, the president of the Kaiser Family Foundation, told Wonkbook in an interview Wednesday. "Their objectives are different from the objectives of Democrats and liberals."
As a result, Altman said, the two parties often talk past each other. Republicans are more interested in maintaining choice, freedom and competition in the insurance market, while Democrats are focused on attaining universal coverage or something close to it.
What's in Wonkbook: 1) Jindal 2016 2) Opinions, including Suderman, Ponnuru and Sargent on Obamacare 3) Boehner plays enforcer, and more
Number of the day: 48. That's how many Americans have been killed by right-wing domestic terrorists since September 11, 2001. Since the attacks that day, only 26 more people have been killed by jihadists, according to a count by New America. Scott Shane in The New York Times.
1. Top story: Jindal declares presidential run
Jindal used to be a star. "He was elected governor on his second try, in 2007, at age 36. Back then, he seemed to offer an attractive new vision of what a conservative could be: an Ivy League-educated son of immigrants, who had a relentless focus on making the government run faster, smarter and cleaner. It wasn’t whether he’d be president, one prominent strategist said at the time, it was when. ... To address doubts among national conservatives, he repeatedly embraced harder-line conservative positions — both in terms of Louisiana’s budget and in terms of social issues. But each time, he moved further away from the wonky, pragmatic persona that had made him famous in the first place." David A. Fahrenthold in The Washington Post.
He's a long shot. "Jindal is polling in the low single digits in early Republican primary polls. He faces backlash at home over an agenda that his critics contend was catered more toward a White House bid then toward his constituents, including Jindal's reversal on his support for Common Core and his refusal to raise taxes—a fatal flaw to many in the GOP base—despite his state's persistent deficits. ... But those who dismiss Jindal entirely ignore the potential that once put him at the top of his party's list: He's a candidate who can hold his intellectual ground with anyone, and he has dominated Louisiana politics for the better part of a decade." Karyn Bruggeman in National Journal.
And he's made a mess of his state's budget. "Louisiana’s leaders have had to scramble to fill a $1.6 billion shortfall. Lower oil prices haven’t helped the energy-producing state keep its accounts in order. But a major underlying driver has been Mr. Jindal’s deep tax cuts and unwillingness to raise enough revenue to pay for state spending needs. He has raided various parts of the budget — hospitals, universities, rainy-day funds — to shore things up, but that’s neither sustainable nor prudent. Unsurprisingly, his home-state approval ratings are lousy. Mr. Jindal seems to have done this to market himself to tax-averse GOP presidential primary voters. ... Mr. Jindal would be in much better shape if he had made good on his original promise — to serve as the savvy Republican policy wonk he was known to be years ago," writes the editorial board of The Washington Post.
GREENBLATT: Jindal has dumbed himself down. "In 2013 Louisiana governor Bobby Jindal called on the GOP to 'stop being the stupid party.' A former Rhodes scholar with serious policy chops, he appeared perfectly positioned to elevate the discussion of ideas. Instead, Jindal has chosen to run in 2016 as the stupid party’s standard-bearer. ... A governor who reshaped his state by overhauling the education and Medicaid systems now hardly talks substance at all. In fairness, he has released detailed plans on taxes and education, but he routinely spends his time on the stump throwing red meat to the most conservative parts of his party. ... His pander approach hasn’t worked for him." Politico.
2. Top opinions
SUDERMAN: Republicans have never had any idea what to do about health care. "Regardless of how the Supreme Court decides this month on King v. Burwell, which challenges the legality of the administration’s decision to allow private insurance subsidies in federally run exchanges, what the episode reveals, yet again, is the Republican party’s historic failure to truly engage with the difficult realities and trade-offs of health policy... Obamacare is an exceedingly complex, poorly drafted law built atop the shaky superstructure of the existing, deeply fragmented American health system, with its separate tracks for individual, employer and government-run coverage. A better plan could sweep away much of the old mess and begin to unify the system: It would expand coverage and access to care by making it truly cheaper for everyone instead of increasing the cost and adding subsidies, and it would free American medicine from its current tangle of price controls, provider rules and patient regulations while reducing the government’s long-term fiscal problems in ways that don’t rely on uncertain savings from dubious technocratic payment systems. But Republicans can’t make the case for that plan because they’ve never figured out what it would look like." Politico.
PONNURU: Republicans will save Obamacare. "Just when Republicans are close to achieving one of their top goals, however, the party is in disarray. ... Republicans should have been prepared to respond. Ideally, they'd be ready to advance a bill that would ensure that Obamacare's regulations -- such as its required package of essential benefits -- no longer apply in the affected states while offering tax credits to people who could lose their insurance and who lack access to employer coverage. Then Congress would pass the bill and Obama would sign it. ... My guess is that if the court strikes down the subsidies, Congress will extend them pretty much as is. ... Too many Congress members want to protect people from losing their insurance, or at least don't want to be blamed if they do. ... Passing legislation to this effect will require Democratic votes, and Democrats will be able to extract concessions as a result." Bloomberg View.
SARGENT: Even if Obama loses in the Supreme Court and in Congress, things won't be that bad. "The absolute worst-case scenario you can envision unfolding from an adverse ruling is a considerably less awful outcome. Put simply, it’s very plausible the health care system would continue progressing towards universal health care in around 16 to 18 mostly blue states, while in many red states, something approaching chaos would set in, at least in the short term. ... Many millions of people could end up losing insurance, and the damage could radiate out beyond imploding insurance markets, possibly causing economic disruptions. There would no longer be a coverage guarantee in many states, a major setback to the goal of universal health care. Still, what continues to get lost in the coverage is that even if you assume that neither Congress nor state lawmakers do anything, much of Obamacare would remain in place, and significantly more people would retain its benefits than would lose them." The Washington Post.
BLOW: Taking down the rebel flag isn't enough. "When do we move from our consensus over taking down symbols to the much harder and more important work of taking down structures? I worry much less about individual expressions of racism than I do about institutional expressions of racism. And we live in an age where people are earnestly trying to convince us that institutional racism doesn’t exist. ... Institutional racism is often like a pathogen in the blood: You can’t see it; you have to test for it. But you can see its destructive effects as it sickens the host. Furthermore, institutional racism doesn’t require the enlisting of individual racists. The machine does the discriminating. It provides a remove, a space, between the unpleasantness of racial discrimination — and indeed hatred — and the ultimate, undeniable and, for some, desirable outcome of structural oppression." The New York Times.
LEVIN: Liberals only see what they want to see in the pope's encyclical. "Conquest, mastery, and possession—the expansion of human power—has been the goal of modern science... But for the modern Left, which wants to think of itself as the party of science, this goal is actually quite problematic. Over the past century or so, the Left in the developed world has come to take a rather complicated view of power. It has become highly suspicious of certain kinds of power in particular: the power of nations, of corporations, of the rich over the poor, and also of man over nature... Francis sees something of an opening in this peculiar (and often nonsensical) attitude—that he sees in it an admission of uncertainty by elite and mostly secular liberals... I don’t think the fundamental purpose of the encyclical is to tell Catholics they should care about environmentalism, even if the Pope would surely like them to do so. I think its purpose is to tell environmentalists they should care about their souls." National Review.
3. In case you missed it
Boehner is putting people in line. "Speaker John Boehner (R-Ohio) and his allies are charging ahead with their effort to punish conservatives who have been a thorn in leadership’s side — a purge that is roiling the GOP conference. The latest victim is Colorado Rep. Ken Buck, who could be stripped of his title as GOP freshman class president on Thursday morning. Boehner allies have been retaliating against rank-and-file members who voted against a procedural motion earlier this month, nearly derailing a major trade package favored by Republican leaders that is set to clear the House on Thursday. While the Speaker has lashed out at conservative rebels before, the latest intraparty purge has been particularly aggressive." Scott Wong and Cristina Marcos in The Hill.
His caucus isn't likely to support an Obamacare fix if the government loses its case. "Ahead of an imminent Supreme Court ruling that could erase health insurance subsidies for an estimated 6 million Americans, some House Republicans are pouring cold water on plans by party leaders to temporarily extend the tax breaks under Obamacare. The objections are an ominous sign for the insurers, hospitals and lower-income Americans that stand to lose if the justices deal a blow to President Barack Obama's signature domestic achievement. ... Republican leaders in the House and Senate—who want the court to deal what could be a death blow to the president's health care law—have floated a contingency plan in the event of victory. One reason Republicans are interested in doing so: Red states would be hit hardest if the justices rule against the White House. Many in Texas and the Deep South would see their subsidies evaporate, while New York and California—which set up states exchanges—would emerge unscathed." Sahil Kapur for Bloomberg.
Obama won on trade, but at a cost. "The open warfare within his own party was searing and may be slow to heal. Democratic lawmakers said an already fraught relationship with the president had soured further, and some vowed to keep fighting the trade pact, called the Trans-Pacific Partnership, foreshadowing another bruising battle. ... The legislation sent to Mr. Obama allows him to submit trade deals to Congress for up-or-down votes without amendments. But that means his Democratic critics will have another shot at defeating the Trans-Pacific Partnership if it is completed and sent to Congress for approval." Peter Baker in The New York Times.