The original intent of President Obama’s Affordable Care Act (ACA) was to establish 50 state exchanges run by the 50 states themselves — the federal exchange was always meant to be a temporary fallback. Instead, 36 states currently rely upon the federal Healthcare.gov — and only two states, Maryland and Oregon, are fighting to get out.
Observers have noted, correctly, that this shift to a bigger and ostensibly more permanent federally-run system is underway — without debate, study or even funding. There are now more questions than answers about the long term future of the Washington-controlled system.
As pointed out by Politico, the primary reason this situation has occurred is due to “intransigent Republicans shunning state exchanges, and ambitious Democrats bungling them.” It is indeed ironic that Martin O’Malley in Maryland and John Kitzhaber in Oregon — two proud, overtly progressive governors — have botched their state exchanges as badly as they have.
All of this, of course, is yet another demonstration of how dysfunctional governance permeates the landscape both federally and at the state level.
The announcement from Oregon Governor John Kitzhaber that he will ask the state Attorney General to sue Oracle, the contractor behind the state’s failed Obamacare exchange, is great news for GOP Senate candidate Monica Wehby as it assures the fiasco will remain in the news. This, of course, is bad news for incumbent Senator Jeff Merkley, who is hoping to prevent the campaign dialogue from focusing on his unwavering Obamacare support.
This announcement concerning the Oracle lawsuit comes as the Democratic Senatorial Campaign Committee (DSCC) released a new survey showing Merkley leading Wehby 50-36. This is a defensive maneuver from the DSCC and shows that Wehby is still a threat, despite the incumbent’s lead in this and other surveys. In actuality, Merkely is likely to be hovering around 47-48% in the ballot — within striking distance for Wehby.
The Wall Street Journal editorial “Tea Party Agonistes” lays everything out perfectly: “The media’s latest political line is that the Republican establishment has finally crushed the tea party. The truth, as usual, is more interesting. The tea party has already changed the GOP on policy, and mostly for the better, but it is suffering this year because the candidates and operatives acting in its name have been more motivated by personal than policy agendas.”
While it’s a fact that the Club for Growth and other “anti-establishment” organizations spent $2.4 million to help elect Nebraska GOP Senate primary victor Ben Sasse, characterizing Sasse’s victory as a ‘defeat’ for the ‘establishment’ wing of the GOP is more hyperbole than reality. To be sure, Ted Cruz, Sarah Palin and a variety of Tea Party-oriented entities were Sasse-backers — but so were mainstream conservative politicians like Paul Ryan and others.
The “Tea Party versus Establishment” narrative came into play earlier in the contest when Mitch McConnell took offense at a Sasse comment urging the Senate Minority Leader to make a “real” effort to defeat Obamacare. With that, the race became a simplistic one side versus the other in terms of media coverage.
As always, it’s not that simple and clear-cut. The T-Party can legitimately claim victory, but so can a variety of GOP politicians and groups who supported Sasse from the beginning.
It’s well known that its harder than ever to complete a live phone call survey, and takes an increasing amount of time and money to query a requisite number of cell phone users in the ultimate sample. And with the preponderance of IVR robo-polls and ‘internet polls’ littering the political reporting landscape in state races, the validity of media-sponsored polling is at an all time low. In close races, the only dependable surveys are those generated by the campaigns themselves.
Here’s a perfect example of a dubious survey: a new “Super Poll” conducted by Georgia-based automated pollster InsiderAdvantage for Fox affiliates and regional newspapers throughout the state. The so-called “SuperPoll” is a mixed-mode survey that combines InsiderAdvantage’s use of IVR technology and registration-based sampling with Internet interviews conducted by the firm OpinionSavvy.
The automated-phone-plus-Internet methodology — in addition to the moniker “SuperPoll” — was dissed among pollsters and other commentators on social media, according to POLITICO reporting. The methodology statement included by InsiderAdvantage and Opinionsavvy confusing.
InsiderAdvantage CEO Matt Towery told POLITICO that his firm, which has for years conducted automated-phone polls, was moving to incorporate Web surveys to reach younger voters who don’t have landline phones. A phone message with Opinion Savvy was not returned, and an employee who answered at its Twitter account and provided an email address did not write back to a question seeking clarification regarding the sampling method.
As for the name “SuperPoll,” Towery told POLITICO: “It’s just a little bit of marketing razzmatazz.”
That says all you need to know how bad the polling industrial complex has become.
Incumbent Senator Mark Warner (D-VA) is currently characterized by Beltway observers as a relatively safe bet to win his race against his GOP opponent, Ed Gillespie — but the question isn’t whether this race will get close, the question is when Warner and his team will wake up to the possibility he can lose. With Warner topping out at about 46%-47% max in the ballot against Gillespie — and he and his campaign giving off a sluggish vibe — this is my bet for Senate race upset of the cycle.
As Warner has yet to be very active on the campaign trail, as of late he finds himself sucked into the state Obamacare debate in Richmond, where Governor McAuliffe has made Medicaid expansion his top legislative priority.
So not only is Warner saddled with supporting Obamacare at the federal level, he’s now involved in the state Medicaid expansion imbroglio — which will serve only to hinder his ability to advance the ostensible Warner brand attributes of moderation and bipartisanship.
Warner and apparatus are showing signs of rust, and while not yet noticeable in the manner and scope worthy of being reported upon, it soon will.
The Centers for Medicare and Medicaid Services (CMS) will today make available billions of dollars in Medicare payments to physicians — an unprecedented disclosure representing a new milestone in price transparency. Generally, the disclosure is being welcomed by researchers, consumer advocates, businesses and nonprofits seeking to increase access to the details needed to improve the U.S. health care system.
It’s “one step toward more transparency of truly meaningful data,” said Mark McClellan, a former administrator of CMS under President George W. Bush and now a fellow at the Brookings Institution. (Source: Politico)
Last May, CMS released a trove of Medicare data on what hospitals charge for certain procedures. It sparked a wave of local and national media coverage that revealed sometimes enormous variation among providers in a community. But for hospitals as well as doctors, the amounts billed to insurers have little to do with what most consumers pay out of pocket.
The more provider payment info of this nature released for media and consumer scrutiny the better. Those against further disclosure are not putting the public interest first.
Among the many ominous developments surrounding the ongoing saga known as “Obamacare” is the fact millions of Americans still have no clue about how to get enrolled, the deadlines involved, and the ramifications for not signing up. A Kaiser Family Foundation survey last month found an astounding 6 in 10 Americans didn’t know that deadline for enrollment was 3/31/14.
The broader implication, as pointed out by Politico Pro reporting (paywall), is that many who will become sick — and then try to sign up — will blame the President when they find out they missed the deadline.
So after all the White House and congressional Democrats’ popping of champagne corks about the 7 million enrollment figure (objectively, a laudable achievement), the political risks surrounding the inevitable ongoing confusion, and the associated blame, are palpable.
Last year’s storyline on Marco Rubio? After a failed attempt on immigration reform, he’s washed up as a 2016 presidential contender. The new 2014 storyline? Rubio is resurrecting his presidential prospects with smart public relations activities on the foreign policy and economic front. Cyclical up and down news coverage is what it is: largely illusory to determining reality. But there’s no denying Rubio’s 2014 activities have been crisp, strategic and competently executed.
Last week, Rubio delivered an address at Google’s DC offices entitled “Sparking Dynamic Growth in 21st Century America” and staked out a sorely lacking aspect of GOP congressional messaging: growing the economy, not just more austerity. The 24/7/365 austerity and budget cutting message is depressing, and Rubio appears to be moving out of that uninspiring construct. Smart move for the long term.
And besides investing heavily in his foreign policy messaging — conveniently coincidental to Putin’s Crimean muscle flexing — Rubio has addressed higher education reforms and the need to consolidate anti-poverty programs amid the discussion of income inequality.
The bottom line is that Rubio is doing what you’re supposed to do when you hit a political brick wall: change the subject, talk policy, make news, get people talking, and get back in the game. Immigration will be back for sure, but the lessons learned from his first unfortunate foray will help him better address the matter in the long term.
An impressive 2014 thus far for Marco Rubio.
Pat Roberts of Kansas is an excellent U.S. Senator — but instead of his positive record and opposition to Obamacare driving press coverage, his staff has fumbled its way into a dangerous situation: first they said they would release information detailing his in-state schedule, and then abruptly changed their mind. The time a Senator spends in-state on behalf of those who elected him should be 100% transparent — and am just calling it like I see it.
Roberts spokesperson Sarah Little said earlier this week: “We’re not going to release numbers [about in-state visits] because we’re not sure that any number would be acceptable to some of these outside groups. … We’re worried about what the yardstick is. Who defines how much is enough days in the state?”
Who defines how much is enough? Voters do. Duh.
Pat Roberts deserves much better counsel and advice. If he doesn’t release what should be routine information about how and where he conducts his job in-state, this pr faux pas will continue to overshadow the exemplary record of a very personable incumbent.