I’m looking at two Talking Points Memo posts and breathing a sigh of relief at a Republican/reactionary strategic error:
One was narrowly political: win the 2010 and 2012 elections and repeal the law. The other was less visible but no less important: sabotage the law at the state level to engineer failure and force repeal or a combo of policy and political catastrophe for the Democrats. The first failed in November 2012. Now we know they whiffed on the second one too.
It’s simply too late to undo what happened in March 2010…
all the efforts at sabotage – trying to convince young people not to sign up, trying to scare people that they’d have their identities stolen, trying to prevent so-called ‘navigators’ from helping people enroll, refusing to set up state-based exchanges, opting out of Medicaid expansion and generally trying to scare the crap out of people with death panels and everything else so they wouldn’t sign up. All had one aim: undermine enrollment to force what health care economists call a risk pool death spiral.
I am a healthcare attorney for an insurance company and I wanted to share our experience with the implementation of the ACA. I know the idea is that state legislators have been working to subvert the ACA, but it actually goes deeper.
We are in a few states. One is Kentucky, a state based exchange, and the other states have conservative governors who opted to be part of the federal exchange. Even though states opt to be part of the federal exchange, the states are still responsible, in some cases, for day to day insurance activities (approval of forms, rates, etc). In the process of undergoing all of these changes and trying to make sense of all the new requirements between the federal and state exchanges, Kentucky has been excellent. The Kentucky Department of Insurance has helpful staff that answers the phone and gets back to us if we have questions or issues. The other departments of insurance in states with conservative governors have basically ignored our calls.
Most of the states that ran their own exchanges had significant local backing for healthcare expansion. There were exceptions such as Idaho and Nevada where the attitude was more along the lines that this program was coming so might as well make it work well enough for local needs and local elites. Some of the states screwed the pooch on their website launches. Oregon’s system suffered from massive scope overrreach and barely works, and Maryland may trash their exchange and go federal next year. However, there was often a political and technical will to make things work as well as possible. And on the whole, the states that were invested in success are seeing success.
The strategic error that I think the reactionaries made was keeping their hands completely clean from Obamacare implementation. I understand the political pressure from the teabaggers as any conservative who came within ninety three feet of Obamacare could expect a primary challenge in 2011 or 2012 from a True Believer ™. But the decision to hand the Exchanges and outreach to the Federal government where there was political will to get things to work was a minimally forced error. Sabotage from the outside can occur, and there was plenty of it, but effective sabotage from the outside is tough to pull off. Texas and Mississippi can’t really fuck with the Federal exchange on healthcare.gov. They can nibble navigators to death, they can make approving plans a pain in the ass, and refuse to quickly answer questions but they can’t cripple the system as they don’t get to see the guts of the system.
Imagine how sabotage would have been effective if Texas built their own Exchange by outsourcing the contract to the low bid firm of the illegitimate son of a minor political hack who had built SQL databases as a hobby? Imagine how effective sabotage would be if the Texas Exchange went live on Oct. 1 with the same cluster fuck set of complications as healthcare.gov but without any urgency to get the software working until 2019?
They would have been able to sabotage better from the inside but they would have also been blamed for the resulting mess.
And even that might have not had the desired effect since the state would actually own it.
They’re still suffering from the illusion that if they wish for something hard enough and appeal to their ideology as to why it must fail, then it will fail. Unskew the polls, etc.
Interesting idea, but I bet that this kind of inside sabotage never occurred to the GOP reactionaries, who seem tp be generally scientifically and technically challenged. Witness the 2012 election, where they showed that they did not understand statistics and Bayesian analysis (see Unskewed) and they had no idea how to build a dynamic Internet information system (ORCA).
Well, as Mitt Romney’s failtastic trainwreck of a campaign showed, tech skills and the people who have them do not seem to be the GOP’s strong point. I suppose it’s because like myself, my fellow tech workers have very little patience for fucking morons and do not have to work for them if we don’t wanna.
So, it may be they didn’t really have that option. The GOP’s antiscience bent has damaged them horrifically over the last few years. For the organization as a whole to be able to have technical agility, they’d have to have one or two “thought leaders” who weren’t totally intellectually lazy hacks, and actually could parse what is going on.
I do not believe there are any highly-placed GOPers who even begin to recognize the qualitative difference between having “tech” and having something that works. And given how imitative and unoriginal the GOP are when it comes to strategy, they’ve seen the proliferation of left-leaning communication tech sites and networks, and they’ve feebly put up a few cardboard-cutout Potempkin systems themselves, which have always been laugh-tastic.
One of the biggest drivers of the political conversation towards the left, other than the web of communications we enjoy amongst ourselves, has been the smart humor of our not-really-news news networks like Colbert and Stewart. The right’s lame response: The “Half Hour News Hour” that showed one episode and weakly died (or was it two)?
So, it’s not just that they chose the wrong path — they don’t have the path to intelligently, cleverly fuck things up anymore. All the smart people have left the GOP, or are being driven away now. They’ve self-reduced their demographic to old, out-of-touch, reactionary, hateful, and stupid people.
I’ve been harping on this theme for awhile . . . each successive shockwave of GOP self-destruction proves it to me again.
This, and even worse, even a crappy attempt would have granted legitimacy to the exchanges (“If even Texas is implementing one, how much of a Threat To Liberty(tm) could it be?”).
Is RM being snarky? I can imagine how sabotage from the inside, like that described at the end of the post, would backfire on the reactionaries, when the websites worked fine in supposedly hopelessly doofus naive liberal states like NY, WA and CA, and things were a never ending disaster in Texas. Wouldn’t have Uncle Sugar as an all-purpose scapegoat for total mess in the state insurance and provider markets.
Edit: I think the best sabotage from the inside would be a properly subtle and coordinated Congressional effort to make the ACE even more incremental and status quo friendly. And I imagine that is what the ‘moderate’ GOP and some Democrats wanted to do. But when you have the crazy and dumb as rocks teabaggers as allies, you really can’t do anything in situations like that except obstruct and delay.
Thank FSM I live in NY. The website was glitchy at first, but I waited a month and for the first time since the Great Recession ate my corporate job in 2008 I have health insurance; a decent plan for not a lot of money, too.
Sabotage from within would have meant sharing responsibility, as some have already pointed out. But conservatives were shooting for big game: seeking to delegitimacize the Obama administration and make him the new Jimmy Carter. It was important from that point of view that nothing ever pass. Also, if you see Obama’s election as an abberation, then it was important to their self-image to keep anything effective from happening. So they threw craps and lost.
Not sure about that at all. The way things have been going, it wouldn’t surprise me if they fucked it up and successfully shifted the blame to the bad ol’ federal gubmint.
Don’t now where your information comes from, but Nevada’s website is horrible and so far has not coughed up a policy for me. I’ve been applying repeatedly since October…I’ve hung on long “Hold” messages to talk to agents who lie and promise my policy is approved and is in the mail. It never is.
Now, the famous losing candidate Sharron Angle is petitioning for a constitutional amendment to ban the state from launching its exchange.
Coals to Newscastle, I call it…the state website is fumbling enough on its own. Luckily I am not currently sick.
I was thinking of calling my Congressman but…he’s a Republican so basically it’s Game Over.
I’m convinced what’s going on right now in North Carolina’s Department of Health and Human Services is deliberate sabotage. They’ve got backlogs of three months on foodstamp applications–27,000 families waiting for assistance. The new Medicaid payment system is a nightmare. They mailed 49,000 children’s Medicaid cards to the wrong addresses. . And what does the DHHS Secretary (a former Republican fundraiser) say is to blame? “The implementation of the Affordable Care Act.”
I think generally that the supposed business skills that these CEO types like Mitt Romney and our first “CEO President” C+Augustus have are highly overrated. I also think that the idea that big businesses are somehow more effective and/or efficient than government is highly exaggerated to flat out wrong. I prefer dealing with MSPRC to Bank of America any day of the week. I don’t have words to describe how maddening it can be to deal with Bank of America.
I think we have just been told repeatedly for decades that businesses are more competent and better at making decisions than government and consequently many people just accept it as truth.
O/T but, since we had a huge thread about him…
Brian Schweitzer showing his backside suddenly starts to make a lot of sense:
He worked for the USDA Farm Service Agency committee under Bill Clinton, and was appointed by Bubba to the national drought task force.
Carrying water for the Clintons’ Obama grudge it seems.
Out of curiosity, are you a naturalized citizen by any chance? That seems to be the situation causing the worst and most permanent blocks on the website.
Also, it sounds as though you should be able to call the Nevada Department of Insurance to complain, though holy moley their website is slow right now. Not sure if that’s my computer or if it really sucks that much.
JMM shoulda stuck to writing Penthouse Letters. They’re equally tittilating as fantasy, and more plausible.
The owner of a local TV radio station KSTP is something of a wingnut I believe (they ued to carry Mush Lamebrain & other wingnut radio until sports started paying better) hired a “security expert” to evaluate the security of the MNsure website. There was a large expose that the users were vulnerable to a man-in-the-middle attack (which they mistakenly identified as a pineapple attack because they are not very bright – long story). But the attack would work against almost all commercial site on an insecure wireless network. Don’t go to Starbucks & buy stuff online with your credit card people!
The head of MNsure was sacrificed & the damage was done, even the Nice Polite Republican radio station now refers to it as “the troubled MNsure web site”. fuckers.
West of the Cascades
Because things went so well the last time South Carolina “held the fort” and other states followed it. These ignorant ratbags will get their comeuppance someday, too.
Richard, is there good information yet on what is happening with these “navigators” nation-wide?
Support provided to them? Actions taken to hinder them? Resulting effectiveness?
Don’t think it would have worked, for Texas or any other state. For instance, Texas likes to compare itself to California. What would proud Texans think when they experienced a shitty website ongoing while California kicked their ass website wise? No, I think purposely building a shitty, barely functioning website would rebound negatively on those responsible.
I’ve been wondering if there will be a flight of people from bad ACA states to good ones.
@Jewish Steel: Honestly, I hope so.
My sister called to gleefully tell me about getting a subsidy for her healthcare through Covered California that reduced her payments to about $150 per month and covers tons more than what she was getting with Blue Cross. She told me she thinks she is on Medi-Cal but I think she can’t possibly be.
She had to check with the insurance company and talked to one of the agents who lives in Missouri,and my sister proceeded to tell me the “horror stories” about how terrible it is for those poor insurance agents, and about how some people can’t afford the coverage. I pointed out that Missouri had refused to participate in either setting up an exchange or expanding Medicare and that yes, people in those crummy places are screwed but not because of the ACA. I had to call it Obamacare for her.
Dad died 15 months ago so she doesn’t have a RW man to tell her what to think, so there is hope that she might start seeing through the Republicans. I hope.
@Suffern ACE: Good healthcare + not going broke from it is no trivial consideration. If I was young, mobile and stuck in one of those above mentioned Hobbesian shitholes, you damn right I’d get out.
” Texas likes to compare itself to California. ”
HA! They do, do they? And I would invite their comparisons, except in some ways CA is a little too much like Texas.
But seriously, I don’t understand snide regional and state stereotypes, and vague BS comparisons. I have problems with the way the current Texas government does things, but I would not engage in stereotypical jeering.
Now, if you got stats to back it up. They do tend to shoot more people and there is more divorce in the Deep South. And Texas has one of the highest poverty rates in the country (but CA not far enough better than TX for me to feel comfortable making snotty comments about it Edit: and I think same goes for proportion of residents with no health insurance too. But I don’t have time to look it up, and then too, that will change soon).
John C Calhoun’s ghost is alive and well in South Carolina I see. Nullification now, nullification forever!
OT from the twitters: What idiot called it the Popemobile instead of the Miracle Whip?
You know who ELSE lives in a pineapple….
Anyone spending considerable time in Redding or Bakersfield would certainly be granted the comparison. I didn’t see Rih trolling those particular folks to snag bidnez for Texas, however.
@Cervantes: I don’t know about nationwide, but Governor Voldemort and Death Row Barbie down here in FL banned them from county health departments and scare-mongered about privacy concerns:
@Betty Cracker: The navigators can fold space-time because of the spice. Of course they know personal information.
O/T Zimmerman lookalike somehow comes across as even more vile. (H/T Wonkette)
@Trollhattan: I don’t know your experience in Central Valley, but from my experience there, I would be much more concerned about problems with racial prejudice in Texas than pretty much anyplace in Central Valley.
I would not worry about going pretty much anyplace in Central Valley as part of a mixed couple, or in a mixed racial group. I would have some concerns about it in South, and parts of Texas. As I would in some backward parts of far Northern CA, Sierra hillbilly land, and parts of SoCal.
Edit: and to bring back to topic, healthwise, and cost of health care wise, Central Valley is in dire dire need of ACA. I am glad CA has its act together on the ACA. Lives will be saved and suffering relieved in Central Valley due to it. I know several folks, family friends or who work with family, who are in a health mess that the ACA will help.
C’mon people. Even if Republican had built their own death trap exchanges guaranteed to fail, they would still be blaming Obama.
That is the only trick in their bag.
@kindness: Sadly, in the hypothetical scenarios you suggest “Obama us made go out and shoot sick people” would work very well as an excuse.
Except, unless the recalcitrant reactionary GOP states decide to cooperate with the ACA, their governments will be complicit in killing people, but it won’t be so obvious.
Well Obama is the most divisive and polarizing President in modern American history.
Mike in NC
@J.D. Rhoades: We just got our ID cards for Blue Cross Blue Shield, but apparently they are way behind in meeting the target dates, to judge from the recorded message I heard.
In addition, we got two letters saying they would cancel our policy if we didn’t send a check for the monthly premium, which we paid for by credit card the day we signed up. Every time I call to tell them this, the customer service rep says they are basically overloaded with applications to process and are struggling to get caught up, so disregard the letters.
Same goes for me & mine. The NV site seems completely flummoxed by the fact that we want to cover our son (at college in Reno), though we live in Vegas. We go through the application & it just leaves him off at the end. We’ve spent what seems like DAYS on hold or talking to people from the site & they basically say “huh, it shouldn’t do that”. Then suggest that we start again with a new password & so on. (which we did, twice, to no avail).
We’re now making an appointment with the AARP (we’re 50), because we can’t find another navigator. It is really infuriating.
Edit to add: I realize that I’m not more worked up because we’ve been without insurance for so long. (since 2004) That’s how long it has been since myself or my spouse has had a checkup of any kind. You just get used to it, or in despair about it. Which is a sad commentary about our “health care” system. Best in the world, my ass.
Bill E Pilgrim
Absolutely priceless and classic McArdle Versus Reality ™ moment delivered in this case by Jonathan Chait:
The clip (scroll down at the link to watch it) doesn’t show what happens next but I’m assuming something about her explaining that her memory has gastritis or her calculator translated “true” to “not true” by mistake.
Mike in NC
Funny how all the teabaggers who want to undo the ACA are seniors on Medicare.
@Bill E Pilgrim: LMAO! That’s perfect.
ETA: I’d front page that right now (with attribution, of course), but I don’t want to stomp on AL’s post. That’s John’s job. ;-)
Bill E Pilgrim
@Betty Cracker: Yeah and the transcript doesn’t quite capture how good it is in the video as you saw, it might be the uproarious laughter of the audience.
@Betty Cracker: One thing I know about this site is that I have terrible timing. Posting something interesting seconds before a new open thread comes out is more the rule than exception.
Not only that but I have a list of people who should have to stuff a pineapple next to Hitler in Hell every day.
And they would have looked bad in comparison to any state that implemented the exchanges effectively. I won’t be surprised if the Democrats in Kentucky get a significant halo effect from the successful exchange rollout there, especially when compared to neighboring states where things are not going so well.
@jl: Where in the Valley did you live?
@Cacti: Oh for. If that were true he’d stay out of it and not say anything negative about Obama–Obama isn’t running again and there’s no way that Hillary Clinton, who has to run on having been in the guy’s cabinet, is planning on running a generic “Democrats are incompetent at governing” campaign. The most that anyone would say, friend or enemy of the clintons, is “lets look to the future.” Slanging off on Obama would be the stupidest thing for the Clintons to do, let alone a Clinton hanger on.
They would think what their media overlords told them to think, which would have been that Obama was treating red state exchanges the same way he told the IRS to treat Tea Party groups.
Why anyone believes, this late in the game, that there would be some logical, reasonable connection between cause and effect in the minds of the RWNJs is beyond me.
@Mike in NC:
Not at all; it’s of one piece with their zero sum worldview. They’re afraid that improving healthcare for other people will inevitably make healthcare worse for them.
@West of the Cascades:
Saw what you did. Nicely played, WotC.
@Betty Cracker: LOL
@Bill E Pilgrim:
You too? Happens to me All.The.Fucking.Time.
All of it.
@Anton Sirius: Absolutely. “No relation between cause and effect” is a great way to describe this. The entire Republican strategy has been to say “who are you going to believe, me or your lying eyes?”
@Bill E Pilgrim: Or she fainted in shock.
Mike in NC
@Roger Moore: Yup. I’ve even seen them parroting the FOX News lie that Obamacare means $500B cut from Medicare. Selfish assholes, many of our oldsters.
@Bill E Pilgrim:
You ain’t a drummer, then?
FWIW have lived in the valley more than half my life at this point. Texas, not at all. I find the place relentessly schizophrenic and outside the big cities, very redneckian. Hipster rednecks, who knew?
Not to mention Rush Limbaugh being our gift to the media world.
Not sure what you mean by Hipster rednecks? You mean in the Central Valley? I just meant, at least from my experience growing up and living there, that in Central Valley it’s rare to meet the overt in your face racial and ethnic prejudice that I have seen in my visits to other parts of the U.S., including other parts of CA. if there is sizable portion of the population who harbors it, they do not feel comfortable displaying it in public.
But that alone does not make for hipsters. And there is sure lots of residential and income/class segregation in the Central Valley, like anywhere else in the country.
Was ‘avin’ a bit of a laugh, but did you look at the pic? An illustration of what I consider the schizophrenic nature of the place. Election results are instructive too. (Look at McCain voting, then Prop 8).
We’re not Alabama, either.
@Mike in NC:
I don’t see that one as a lie so much as a misrepresentation of the truth. Fox could have told its viewers that Obamacare trims wasteful spending and improves the viability of the Medicare program. Fox chose not to do this.
@Trollhattan: You touched my defensive spot on Central Valley, many parts of which I admit have turned into real messes, almost like some place of the Inland Empire I used to make fun of.
The pic was interesting.
We are not Alabama, but some parts are too close to Oklahoma for my taste, and not the old fashioned Dust Bowl people either, who for the most part were good FDR and Truman Democrats (as many called themselves).
pseudonymous in nc
It’s pretty hard to differentiate deliberate fuck-up from sheer incompetence at Lady Wos’s fiefdom these days. Perhaps that was always the plan. There was certainly a concerted effort to do some Art Pope-style social engineering on DHHS from the top down.
@Bill E Pilgrim: It shall be posted later. It’s too good not to share.
@Bill E Pilgrim: Thanks for posting that clip, by the way. I’ve always hated McCardle in print but I had no idea how awful she was in person. She has such a smug, smarmy, pseudo sophisticated air about her and what she said was as deceptive and absurd as what she writes. But now I see how carefully crafted her persona is because its obvious that she can’t actually believe what she says and that it has been structured to appear fair ‘n balanced, market oriented but progressive, to people who don’t really understand the issues. The flaws would be obvious to anyone who did know the issues, though.
Thanks. How much of a hindrance is that, I wonder. One person quoted in the article was optimistic despite the state’s action.
@Cervantes: The real problem is that the wingnut state legislature rejected the Medicaid expansion. About a million Floridians earn too much to qualify for regular Medicaid and too little to qualify for tax credits, so they fall into a gap. They are screwed, and I hope every one of them realizes who’s screwing them.
@Betty Cracker: Yes, thanks. That’s a primary problem (the legislature rejecting Medicaid expansion).
I was curious about the “navigators,” specifically.
@Gene108: I was reminded also of the opposition to school desegregation.
That’s a perfect description. I was trying to figure out what it was I didn’t like about her in the clip and you summed it up very nicely.
Here in Kansas I was delighted when they decided not to set up their own website, because I was sure that they’d deliberately screw it up. Fortunately, the left it to the feds, and it worked fine for us. It’s awful that they wouldn’t expand Medicaid, though. 1/4 of Kansas children now live in poverty since Gov. Brownback gave all our money to the Koch brothers.