What’s causing the dam to break, especially in Texas? North Carolina, Republicans are preemptively removing a potent political weapon for Democrats. Georgia, I figure, might be the same.
I figure Texas is about money, since it’s always about money in Texas. Does Texas have a chance at running a decent state marketplace in a state dedicated to never taxing and never spending money?
I want to speculate.
The ACA was the center of American political disputes from 2009-2018. It ate up a lot of attention. It ate up a lot of news cycles. It ate up a lot of effort and time. By the end of 2017, it had survived two substantial Supreme Court challenges and a Republican trifecta that got to within one vote of massive Medicaid cuts and a systemic reconstruction of the individual market. It survived the 26 Governor strategy last ditch attempt of Graham-Cassidy-Heller. It survived and it was doing a good enough job; not a great job, but good enough job.
And then the ACA and Silverloading in 2018 distributed massive benefits to rural areas that directly addressed a substantial concern about benefits not being good enough for too much premium for some of the upper part of the subsidized distribution and reinsurance waivers took the edge off the pain for non-subsidized buyers. Concurrently, deeply conservative/Republican tilting states started to consistently vote for Medicaid expansions that local elites did not want. The Republican governor of Kentucky, Bivens who was a fierce opponent of the ACA, lost a nail-biter race for re-election in the fall of 2019.
There is just less energy on the right on the matter of the ACA and healthcare at the local and state level. It is not a motivating driver right now as it is becoming part of the background noise and the world has not ended because more people can afford to go to the doctor’s office and pick up a prescription.
The shiny object moved on.
OzarkHillbilly
Beware the Woke! The CRT! The Cancel Culture! The Trans! The Gay! The Libtards who want our guns!!!!!
Jay C
But unfortunately, it can always get called back.
Even more unfortunately, healthcare in this country is always going to have serious issues as long it it is mainly organized and carried on in the classic American manner: i.e. a capitalistic industry, run on for-profit lines.
IOW, forever.
RaflW
@Jay C: Yes. Former Trump ambassador Nikki Haley was certainly teeing off of Medicaid this week. The report that there are now 91M people receiving some form of coverage from Medicaid/CHIP during the year seems to have set her off.
Yes it’s a big number! Add that in with 59M Medicare enrollees, and we’re getting dangerously close to half the country having socialized* medicine. The horror.
*28M are on a Medicare Advantage program, so corporate insurers have their finger well into that ‘socialized’ pie. And don’t even get me started on how many seniors are getting Medicaid nursing home access. We have to look again at the estate clawback bulls**t there, too.
Fake Irishman
I would add a friendly amendment by making explicit what you’ve mentioned in passing in noting the passage of Medicaid expansion over the wishes local GOP elites:
Running against the ACA is an electoral loser and has been since 2017, and arguably since 2014. That’s why they’ve tried to find a new shiny object.
OverTwistWillie
I got fom reading local Texas ACA coverage, that the House Speaker has a tradition of appointing some opposition party chairs, which drives agenda moderation.
The state medicaid bills do highlight different member demographics (senate vs. house), and which body has less faith in the state gerrymander.
Fake Irishman
@OverTwistWillie:
A few opposition committee chairs has also been the tradition in the Senate as well, even the hyper partisan Dan Patrick version. (See John Whitmire for example)
Fraud Guy
The conservative choice in shiny objects has always baffled me.
Betsy
More losing choices by the GOP on electoral issues. They oppose what Americans want, and they have to stay in office by suppressing voters, gerrymandering, and of course using the baked-in advantage of dumbass states to control the national government via the Electoral College and Senate representation.
They hate what Americans want. It’s almost like their interests are not the same as what works for Americans.
p.a.
If opposition is an electoral loser I expect they will continue forever to attempt judicial nullification, whether whole-hog or piecemeal. There will always be some billionaire willing to burn $$$ on court cases. Scorpion/frog.
OverTwistWillie
@Fraud Guy:
It has to be a billionaire donor that has post-Obama stress disorder.
gene108
Republicans attempt at “improving” the ACA gave Democrats a cudgel to beat Republicans with in 2018. My current Rep. flipped this House seat by being very focused on healthcare in 2018.
I fully expect Republicans to go after the ACA after they get through outlawing abortion, trans people, etc. They’re still talking about privatizing Social Security.
WereBear
They want to cause suffering. It makes them feel good, in that possible-serial-killer kind of way. Only it’s stochastic, so they get away with it.
I think delusions that TFG won and 2/3rds of the country are in on the conspiracy? Now we’re in “thinking you’re Santa” territory.
Uncle Cosmo
Yeah, I realize you’re snarking furiously here, but just to point out: Their constituency isn’t “Americans,” it’s the greedy and/or ideologically-driven bazillionaires who provide the $$$$ for their campaigns to (1) use in bamboozling the electorate into voting them into office, and (2) bankroll cushy Wingnut Welfare “jobs” for them after they’re out. Bastards.
Ruckus
@RaflW:
I am a senior and I’d be on Medicare and/or Medicaid but I’m in another Federal government program, the VA. I also live in a Federal program seniors rent controlled/subsidized apartment complex. Most of the people that live here are on one or another federal program, such as SS, and most of which are less than fully adequate but are far better than nothing. The amounts of money that we use – much of which we never actually see, only the effects of, are minimal at best. And CA is a good state for the concept of at least attempting to take care of people who provided income tax to the federal government for, in my case 60 yrs of working. Which rethuglicans want all of for themselves because of course normal Americans deserve jack and shit, while they should get everything, except for those people who actually vote for rethuglicans and live in rethuglican states. Those people deserve nothing either. I believe the concept is, It only has value if someone else earns it for you.
New Deal democrat
“There is just less energy on the right on the matter of the ACA and healthcare at the local and state level. It is not a motivating driver right now as it is becoming part of the background noise . . . . The shiny object moved on.”
I am not so confident that ACA is safe as “part of the background noise.” Now that Barrett has replaced Ginsburg, there are probably 5 votes on the Supreme Court to reverse the ACA ruling and hold that it is Unconstitutional on the grounds that Democrats are trying to govern. All it takes is one nut job (e.g., Paxton going to the Amarillo District Court in TX) for the issue to resurface.
Kelly
Entrenchment? Partisans? I thought you were moving in on Adam’s Russo-Ukraine war beat.
Ken
@OzarkHillbilly: I’m trying to remember the movie, or maybe TV show, where character A says to character B, “We’ll just have to lt the chips fall where they may”; and character B responds, “But I’m the chips!”
Lobo
Good Enough. This should not be a “dirty” word to progressives. Often, what is needed is something “good enough” rather than perfect. A lot of mileage can come from getting 80%(80/20 rule). This is probably true in the choice space too.
BQuimby
Not sure how to reach you 1:1…I do not have Twitter, Facebook, etc.
Curious (and worried) about this for other entities/states.
Watch for other cities to make similar deals with the Medicare Advantage devil.
https://youtu.be/b8XjnHtdpTU
This is a BFD, and not in a good way. Most of you already know the problems with Medicare Advantage, so when New York City’s public union bosses sign off on making the privatized version of Medicare the only health insurance option available for the city’s retired workforce, well, it’s a disaster waiting to happen. Via the New York Daily News:
The stamp of approval from the Municipal Labor Committee, which is made up of reps for all local public sector unions, clears the way for Mayor Adams’ administration to eliminate SeniorCare, the city-funded supplement to traditional Medicare, as a choice for the city’s roughly 250,000 retired workers.
Mayor Eric Adams, who as we know, is both a political blowhard and a jackass, said he believes Aetna’s coverage is better than traditional Medicare, referencing the Advantage plan’s caps on deductibles and out-of-pocket expenses as well as new benefits for transportation, fitness and wellness.
Where do those benefits come from, Mayor Adams? From cutting actual medical coverage, of course!
Oren Barzilay, president of the FDNY union representing uniformed EMTs, paramedics and fire inspectors, said retired members of his union have been told by Aetna that its Advantage plan doesn’t cover certain medicines to the same degree traditional Medicare does.
Of course. City retirees are going to learn an unpleasant lesson.