Brooks and Krugman

Bobo has just made an important discovery:  “Republicans Can’t Pass Bills.”  From his fainting couch, clutching his pearls, he tells us that the G.O.P. used to be willing to govern. Not now.  No shit, Sherlock.  “Gemli” from Boston will have a response.  Prof. Krugman, in “Health Care in a Time of Sabotage,” says Republicans are working hard to make Obamacare fail.  Here’s Bobo:

There are many different flavors of freedom. For example, there is freedom as capacity and freedom as detachment.

Freedom as capacity means supporting people so they have the ability to take advantage of life’s opportunities. You encourage your friend to stick with piano practice so he will have the freedom to really play. You support your child during high school so she will have the liberty to pick her favorite college.

Freedom as detachment is giving people space to do their own thing. It’s based on the belief that people flourish best when they are unimpeded as much as possible. Freedom as detachment is marked by absence — the absence of coercion, interference and obstacles.

Back when the Republican Party functioned as a governing party it embraced both styles of freedom, but gave legislative priority to freedom of capacity. Look at the Republicans’ major legislative accomplishments of the past 30 years. They used government to give people more capacities.

In 1990, George H.W. Bush signed the Americans With Disabilities Act, which gave disabled people more freedom to move about society. In 1996, Republicans passed and Bill Clinton signed a welfare reform law that tied benefits to work requirements so that recipients would develop the skills they need to succeed in the labor force. In 2003, Republicans passed a law giving Americans a new prescription drug benefit, which used market mechanisms to give them more control over how to use it.

These legislative accomplishments were about using government in positive ways to widen people’s options. They aimed at many of the same goals as Democrats — broader health coverage, lower poverty rates — but relied on less top-down mechanisms to get there.

Over the past few decades Republicans cast off the freedom-as-capacity tendency. They became, exclusively, the party of freedom as detachment. They became the Get Government Off My Back Party, the Leave Us Alone Coalition, the Drain the Swamp Party, the Don’t Tread on Me Party.

Philosophically you can embrace or detest this shift, but one thing is indisputable: It has been a legislative disaster. The Republican Party has not been able to pass a single important piece of domestic legislation under this philosophic rubric. Despite all the screaming and campaigns, all the government shutdown fiascos, the G.O.P. hasn’t been able to eliminate a single important program or reform a single important entitlement or agency.

Today, the G.O.P. is flirting with its most humiliating failure, the failure to pass a health reform bill, even though the party controls all the levers of power. Worse, Republicans have managed to destroy any semblance of a normal legislative process along the way.

There are many reasons Republicans have been failing as a governing party, but the primary one is intellectual. The freedom-as-detachment philosophy is a negative philosophy. It is about cutting back, not building.

A party operating under this philosophy is not going to spawn creative thinkers who come up with positive new ideas for how to help people. It’s not going to nurture policy entrepreneurs. It’s not going to respect ideas, period. This is not a party that’s going to produce a lot of modern-day versions of Jack Kemp.

Second, Republican voters may respond to the freedom-as-detachment rhetoric during campaigns. It feels satisfying to say that everything would be fine if only those stuck-up elites in Washington got out of the way. But operationally, most Republicans support freedom-as-capacity legislation.

If you’re a regular American, the main threat to your freedom is illness, family breakdown, social decay, technological disruption and globalization. If you’re being buffeted by massive forces beyond your control, you don’t want legislation that says: Guess what? You’re on your own!

The Republicans could have come up with a health bill that helps people cope with illness and nurtures their capacities, a bill that offers catastrophic care to the millions of American left out of Obamacare, or health savings accounts to encourage preventive care. Republicans could have been honest with the American people and said, “We’re proposing a bill that preserves Obamacare and tries to make it sustainable.” They could have touted some of the small reforms that are in fact buried in the Senate bill.

But this is the Drain the Swamp Party. The Republican centerpiece is: “We’re going to cut your Medicaid.”

So now we have a health care bill that everybody hates. It has a 17 percent approval rating. It has no sponsors, no hearings, no champions and no advocates. As usual, Republican legislators have got themselves into a position where they have to vote for a bill they all despise. And if you think G.O.P. dysfunction is bad now, wait until we get to the debt ceiling wrangle, the budget fight and the tax reform crackup.

Sure, Donald Trump is a boob, but that doesn’t explain why Republicans can’t govern from Capitol Hill. The answer is that we’re living at a time when the prospects for the middle class are in sharp decline. And Republicans offer nothing but negativity, detachment, absence and an ax.

And here’s what “gemli” has to say about that:

“It’s hard for Republicans to govern when their slogan is “Give us all of your money, because we would like to have it.” They don’t even say thank you. They’re having trouble passing health care reform because “You’ll be fine as long as you don’t get sick” is hard to package. It ranks right up there with “Vote for us, because you’re stupid.”

This last one plays remarkably well, given that it stuffed Congress full of Republicans and put a complete doofus in the White House.

When they’re not grubbing for money, they’re making national laws against things they find personally disgusting. “Gay people are icky” has been the driving force behind much of their legislation, second only to “Women’s plumbing confuses us.”

America’s infrastructure is due for an update. Not much has happened since FDR and the WPA, when the motto was something like “Building a stronger America.” I don’t want to say that Republicans have been neglectful in this regard, but now it’s “Walk gently across that bridge.”

They’re big fans of the Second Amendment, but somewhere along the way a directive to ensure a well-regulated militia became “Hold still, we want to shoot you.”

Some decry the fact that since the last election nothing seems to be getting done. Under the circumstances, I’d say that’s a very good thing. It’s why the Democrat’s new motto is, “Never again.””

Now here’s Prof. Krugman:

Is Trumpcare finally dead? Even now, it’s hard to be sure, especially given Republican moderates’ long track record of caving in to extremists at crucial moments. But it does look as if the frontal assault on the Affordable Care Act has failed.

And let’s be clear: The reason this assault failed wasn’t that Donald Trump did a poor selling job, or that Mitch McConnell mishandled the legislative strategy. Obamacare survived because it has worked — because it brought about a dramatic reduction in the number of Americans without health insurance, and voters didn’t and don’t want to lose those gains.

Unfortunately, some of those gains will probably be lost all the same: The number of uninsured Americans is likely to tick up over the next few years. So it’s important to say clearly, in advance, why this is about to happen. It won’t be because the Affordable Care Act is failing; it will be the result of Trump administration sabotage.

Some background here: Even the A.C.A.’s supporters have always acknowledged that it’s a bit of a Rube Goldberg device. The simplest way to ensure that people have access to essential health care is for the government to pay their bills directly, the way Medicare does for older Americans. But in 2010, when the A.C.A. was enacted, Medicare for all was politically out of reach.

What we got instead was a system with a number of moving parts. It’s not as complex as all that — once you understand the basic concept of the “three-legged stool” of regulations, mandates and subsidies, you’ve got most of it. But it has more failure points than, say, Medicare or Social Security.

Notably, people aren’t automatically signed up for coverage, so it matters a lot whether the officials running the system try to make it work, reaching out to potential beneficiaries to ensure that they know what’s available, while reminding currently healthy Americans that they are still legally required to sign up for coverage.

You can see this dependence on good intentions by looking at how health reform has played out at the state level. States that embraced the law fully, like California and Kentucky, made great progress in reducing the number of the uninsured; states that dragged their feet, like Tennessee, benefited far less. Or consider the problem of counties served by only one insurer; as a recent study noted, this problem is almost entirely limited to states with Republican governors.

But now the federal government itself is run by people who couldn’t repeal Obamacare, but would clearly still like to see it fail — if only to justify the repeated, dishonest claims, especially by the tweeter in chief himself, that it was already failing. Or to put it a bit differently, when Trump threatens to “let Obamacare fail,” what he’s really threatening is to make it fail.

On Wednesday The Times reported on three ways the Trump administration is, in effect, sabotaging the A.C.A. (my term, not The Times’s). First, the administration is weakening enforcement of the requirement that healthy people buy coverage. Second, it’s letting states impose onerous rules like work requirements on people seeking Medicaid. Third, it has backed off on advertising and outreach designed to let people know about options for coverage.

Actually, it has done more than back off. As reported by The Daily Beast, the Department of Health and Human Services has diverted funds appropriated by law for “consumer information and outreach” and used them instead to finance a social media propaganda campaign against the law that H.H.S. is supposed to be administering — a move, by the way, of dubious legality. Meanwhile, the department’s website, which used to offer helpful links for people seeking insurance, now sends viewers to denunciations of the A.C.A.

And there may be worse to come: Insurance companies, which are required by law to limit out-of-pocket expenses of low-income customers, are already raising premiums sharply because they’re worried about a possible cutoff of the crucial federal “cost-sharing reduction” subsidies that help them meet that requirement.

The truly amazing thing about these sabotage efforts is that they don’t serve any obvious purpose. They won’t save money — in fact, cutting off those subsidies, in particular, would probably end up costing taxpayers more money than keeping them. They’re unlikely to revive Trumpcare’s political prospects.

So this isn’t about policy, or even politics in the normal sense. It’s basically about spite: Trump and his allies may have suffered a humiliating political defeat, but at least they can make millions of other people suffer.

Can anything be done to protect Americans from this temper tantrum? In some cases, I believe, state governments can insulate their citizens from malfeasance at H.H.S. But the most important thing, surely, is to place the blame where it belongs. No, Mr. Trump, Obamacare isn’t failing; you are.

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One Response to “Brooks and Krugman”

  1. Elena Rozbicka Says:

    Thank you for including Gemli’s lovely comment (and of course, in general, for your blog.

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