The Republican strategy for the 2014 midterm elections is not a secret: tie the Affordable Care Act to vulnerable Democrats and hope it will drag them down to defeat. The road to GOP control of the Senate runs through Arkansas, where Rep. Tom Cotton (R) is challenging incumbent Sen. Mark Pryor (D), and Republicans are not shy about their plans to make the Arkansas race entirely about Pryor's vote for the ACA.
This narrative, and its presumption of the ACA's overwhelming political toxicity, finds expression in a December 3 Wall Street Journal article which frames the Arkansas Senate race as a referendum on Pryor's 2009 vote for the health care reform law. "Mr. Pryor's GOP opponent, Mr. Cotton, is making opposition to Mr. Obama and the health-care law the centerpiece of his campaign," the Journal observes. What's missing from the article, for all its assumptions of political fallout from Pryor's support of the ACA, is any recognition of the fact that Arkansas actually represents an unlikely Obamacare success story.
According to the Journal:
Republicans believe Democrats running in 2014 will be hard pressed to distance themselves from criticism of the health-law rollout, as well as the political burden imposed by Mr. Obama's sinking approval ratings.
Mr. Pryor still backs the law but echoes other swing-state Democrats who say it needs fixing. Mr. Pryor supports legislation that would allow people to recover health policies that were canceled because they didn't meet the law's new standards.
The health law was a big part of the political fall of Sen. Blanche Lincoln (D., Ark.), who lost her re-election to Republican Rep. John Boozman in 2010. Democrats hope it will be a far smaller political problem by the midterm elections, assuming the government website continues to improve and the law's benefits come to be felt more broadly.
No one is going to argue that President Obama is popular in Arkansas -- he lost the state handily to Mitt Romney in 2012 -- and it stands to reason that his signature piece of legislation would also be viewed uncharitably. But Arkansas, for all its political hostility to the ACA, is one of the states making health care reform work.
From the December 3 edition of Fox News' Fox & Friends:
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From the December 2 edition of Fox News' The Kelly File:
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From the December 2 edition of Fox News' The Real Story with Gretchen Carlson:
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Fox News host Martha MacCallum hid the radical implications of a Supreme Court case which could allow for-profit corporations to use religion to discriminate against women and deny employees basic health care coverage, claiming the corporations were merely asking "for some tolerance of their religious belief."
On November 26, the Supreme Court agreed to hear oral arguments in two cases in which business owners -- Hobby Lobby and Conestoga Wood Specialties -- argue they should be exempt from an Affordable Care Act (ACA) requirement which mandates that large, for-profit corporations must offer employees health plans that cover contraceptives at no additional cost.
On December 2, America's Newsroom co-host Martha MacCallum supported the corporations' arguments, claiming that allowing employers to pick and choose what to cover under their health plans based on their religious beliefs was simply an issue of "tolerance" and that the health care law was asking employers to "violate their conscience" by offering contraceptive care:
It seems to me, I mean all they're asking is for an exemption, and for some tolerance of their religious belief, so if a company is owned by someone who doesn't believe that that is ethical, that they should be able to offer a plan that is accepted under Obamacare but that is exempted, that exempts contraception.
I don't understand what the issue would be, with offering a separate version that that employer feels doesn't violate their conscience? How can you ask someone to violate their conscience in the plan that they choose to offer to their employees?
What MacCallum ignores is that religious organizations and certain religiously affiliated nonprofits are already provided exemptions from the contraception mandate. The question posed by these cases to the Supreme Court is whether or not these exemptions should be extended to for-profit, secular companies. If the court rules in favor of the corporations, it would be an unprecedented extension of religious freedom rights and could have radical legal implications, going against the basic tenets of corporate law.
It could also set a dangerous precedent, allowing employers to use their religious beliefs to discriminate against women, and potentially deny all Americans benefits for a wide range of basic medical needs.
Requiring businesses to provide health care plans that cover contraception at no additional cost "was put into place in order to eliminate gender inequality in healthcare," Gretchen Borchelt, senior counsel at the National Women's Law Center, explained. As Micah Schwartzman and Nelson Tebbe noted in Slate, exempting for-profit corporations would reinstate that inequality, undermining a purpose of health care reform:
[E]xempting large, for-profit corporations from the contraception mandate would significantly burden female employees, along with all the wives and daughters covered by the policies of male employees. Thousands of women would lose all insurance coverage for contraception. That loss would be very real, and it would frustrate a central objective of Obamacare: namely to ensure that women have equal access to critical preventative care.
If the Supreme Court rules in favor of the corporations, it will not just put women's basic health care in jeopardy. As MSNBC's Irin Carmon and Slate's Dahlia Lithwick have pointed out, corporations could potentially be allowed to opt out of covering anything that is religiously contested, including things like vaccinations, psychiatric care, and AIDS medications. What if your employer is an Orthodox Jew who wants to refuse coverage for any medication that comes in a gelatin capsule? What if she is a Christian Scientist who doesn't believe in visiting doctors?
Requiring for-profit companies to offer health plans which cover birth control is not an attack on religious liberties. It ensures that everyone, regardless of their personal religious belief, has access to basic health coverage which they can then choose to use or ignore.
Former Obama adviser David Plouffe went on ABC News' This Week to discuss the Affordable Care Act, and he noted that the program "is going quite well" in states where health care exchanges and Medicaid expansion have been implemented, and other states may follow suit after President Obama leaves office, at which point "it'll work really well." Plouffe's point was that the law is working where it has been fully implemented, and will work even better if Republican-led state-level opposition to expanding Medicaid disappears after the 2016 elections. Several conservative media outlets, however, have mischaracterized Plouffe's remark to claim that he said the ACA will not work until 2017.
From the December 1 edition of Fox Broadcasting Co.'s Fox News Sunday:
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Fox News repeatedly conflated the emergency contraceptive Plan B (also known as the morning-after pill) with abortion while covering two Supreme Court cases brought by companies that object to the Affordable Care Act's (ACA) birth control coverage benefits. However, experts agree that the morning-after pill is not abortion -- it prevents pregnancy but cannot stop pregnancy after fertilization takes place.
After weeks of highlighting negative aspects of the Affordable Care Act (ACA), media outlets have largely underreported the law's success in helping slow the growth of health care costs.
From the November 26 edition of Fox News Channel's The Five:
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Fox News used the Senate's recent filibuster reforms to revive the long-debunked myth that the Affordable Care Act's (ACA) Independent Payment Advisory Board (IPAB) is a "death panel" that will now be staffed by Obama appointees who won't have to endure Republican obstruction efforts.
Senate Democrats changed rules on November 21 so that "judicial and executive branch nominees no longer need to clear a 60-vote threshold to reach the Senate floor and get an up-or-down vote," a changed referred to by critics as the "nuclear option."
On the November 26 edition of Fox's Happening Now, co-host Jenna Lee introduced a segment claiming "new fallout from the nuclear option" could allow Obama the power to nominate candidates to "so-called death panels" without GOP input. Chief Congressional correspondent Mike Emanuel explained correctly that the IPAB "is a 15 member panel and its role is to slow the growth in Medicare spending." But Fox's on-screen text referred to the IPAB as "Obama death panels," referencing a right-wing myth that IPAB will have the power to ration health care in America and decide who lives and dies:
The ACA does not allow IPAB to recommend rationing health care. The text of ACA explicitly states that IPAB cannot make "any recommendation to ration health care... or otherwise restrict benefits or modify eligibility criteria." A Politifact analysis reported that IPAB is "forbidden from submitting 'any recommendation to ration health care.'" Washington Post's Glenn Kessler pointed out that the ACA "explicitly says that the recommendations cannot lead to rationing of health care":
The Las Vegas Review-Journal claimed the Affordable Care Act (ACA) is hurting employment by forcing businesses to shift workers to part-time to avoid offering health insurance. However, substantial evidence proves that the ACA is not having any widespread impact on employment patterns.
In a November 25 article, the Review-Journal claimed the large service industry of Nevada would be hit hard by the health care law's mandate to count employees working more than 30 hours a week as full time -- the threshold for which employers must begin offering health insurance benefits to employees -- because it will give employers an incentive to cut worker hours to avoid offering health insurance:
So local businesses and unions alike want to know: What's another tweak or two?
They've set their sights on proposed federal laws that would change an Obamacare provision on who gets health insurance through work. The rule says employees who work more than 30 hours a week qualify as full-time, and employers have to offer them insurance or risk fines of $2,000 to $3,000 per worker. The rule applies to any company with more than 50 full-time-equivalent workers.
The threshold is causing unintended consequences as employers cut hours to drop workers below the 30-hour threshold.
That could be a huge issue in Las Vegas, with its high share of hourly service jobs in hospitality and restaurants, said Shaun O'Brien, assistant policy director for health and retirement for big labor group AFL-CIO. And with average weekly hours worked coming in at 33.7 in August, according to local research firm Applied Analysis, plenty of locals hover close enough to the threshold to cross it.
The article quoted Randi Thompson, the Nevada state director of the National Federation of Independent Business (NFIB), to bolster the claim that the ACA will force employers to cut hours. However, as the Georgetown Center on Health Insurance Reforms (CHIR) reported, Thompson's own organization conducted a survey that concluded the opposite. According to the survey by NFIB, only 13 percent of small businesses surveyed would cut employees or employee hours as a result of the law. Furthermore, the survey found that these decisions to "reduce employee hours seem strongly tied to profitability rather than ACA."
In support reduction in hours argument, the article referenced a survey sponsored by the Chamber of Commerce that found that franchised businesses have "already cut hours more than a year before the employer mandate." However this survey was conducted by Pulse Opinion Strategies, a known Republican polling firm and, according to an NFIB researcher, still doesn't prove the ACA is creating a part-time workforce:
The numbers contrast with a survey released two weeks ago by the National Federation of Independent Business finding that only 13 percent of 921 small companies plan to cut hours. The NFIB, like the [International Franchise Association] and the Chamber [of Commerce], thinks people working less than 40 hours shouldn't count as "full-time." But the group admitted that its numbers don't show Obamacare creating a part-time workforce. Many of those planning to cut hours were too small to be subject to the mandate, anyway. "If they cut or were cutting, it's almost assuredly due to the profitability rather than the ACA for those people," NFIB researcher William Dennis said.
These findings have been backed up by economists as well. In his analysis of the ACA's effect on weekly hours, economist Dean Baker explains that while some employers may reduce hours to avoid providing coverage to employees, "the number is too small to show up in the data." Furthermore, few work near the 30-hour full-time cutoff:
An analysis of data from the Current Population Survey shows that only a small number (0.6 percent of the workforce) of workers report working just below the 30 hour cutoff in the range of 26-29 hours per week. Furthermore, the number of workers who fall in this category was actually lower in 2013 than in 2012, the year before the sanctions would have applied. This suggests that employers do not appear to be changing hours in large numbers in response to the sanctions in the ACA.
The Center on Budget and Policy Priorities further explains that the number of involuntary part-time workers has decreased since the implementation of the ACA, instead of expanding as the perpetrators of the myth would lead one to believe:
A more rigorous test examines the recent trend in the share of involuntary part-timers -- workers who'd rather have full-time jobs but can't find them. If health reform's employer mandate were distorting hiring practices in the way critics claim, we'd expect the share of involuntary part-timers to be growing. Instead, as shown in Figure 1, it is down about one percentage point from its peak.
Nor do the employment data provide any evidence that employers have cut workers' hours below 30 hours a week to avoid the requirement to provide health insurance. During the first half of this year, the share of workers putting in 30 or more hours a week actually rose to 80.7 percent from 80.2 percent in the comparable part of 2012. Although the increase is small, it refutes the claim that shortening of the workweek is widespread.
Right-wing media are dismissing President Obama's and Congressional Democrats' work on filibuster reform, a diplomatic agreement with Iran, and immigration reform as merely attempts to distract from the Affordable Care Act.
From the November 26 edition of Fox News' Fox & Friends:
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The Richmond Times-Dispatch said Republican "political arguments" should not be blamed for the initial failures of the Affordable Care Act (ACA), despite the GOP's goal of obstructing of the law, hindering its rollout.
In a November 25 editorial discussing the ACA's rollout, the editorial board claimed that "political arguments" and "Republican boilerplate against the ACA" did not contribute to the failures of the rollout. From the Times-Dispatch:
Although President Barack Obama has accepted responsibility (sort of) for Obamacare's disastrous start, he continues to point fingers at others.
The Washington Post's Dana Milbank notes that Obama has whined about Republicans and the press. He has implied that GOP demands to repeal the Affordable Care Act have undermined the program's efficiency. Oh? Political arguments have no bearing on the mechanics of running Obamacare. Republican boilerplate against the ACA did not contribute to the fiasco. Conservatives may be reveling in the aftermath, but they did not cause the systemic failures.
The editorial fails to note the multiple instances of Republican obstructionism that have led to some of the problems with the law's implementation. As a November 1 Politico article noted, one of the causes of the flawed rollout was "calculated sabotage by Republicans at every step." The piece continued:
From the moment the bill was introduced, Republican leaders in both houses of Congress announced their intention to kill it. Republican troops pressed this cause all the way to the Supreme Court -- which upheld the law, but weakened a key part of it by giving states the option to reject an expansion of Medicaid. The GOP faithful then kept up their crusade past the president's reelection, in a pattern of "massive resistance" not seen since the Southern states' defiance of the Supreme Court's Brown v. Board of Education decision in 1954.
The opposition was strategic from the start: Derail President Barack Obama's biggest ambition, and derail Obama himself. Party leaders enforced discipline, withholding any support for the new law -- which passed with only Democratic votes, thus undermining its acceptance. Partisan divisions also meant that Democrats could not pass legislation smoothing out some rough language in the draft bill that passed the Senate. That left the administration forced to fill far more gaps through regulation than it otherwise would have had to do, because attempts -- usually routine -- to re-open the bill for small changes could have led to wholesale debate in the Senate all over again.