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New York Times Does the Single Payer Pivot


While most Obamacare news is still about the predictable glitches in the online systems, the other day the NYT led with a story on the the millions of low-income America’s who won’t be insured under the ACA. The reason for this coverage gap is the refusal of many red states to expand Medicaid:

Because they live in states largely controlled by Republicans that have declined to participate in a vast expansion of Medicaid, the medical insurance program for the poor, they are among the eight million Americans who are impoverished, uninsured and ineligible for help. The federal government will pay for the expansion through 2016 and no less than 90 percent of costs in later years.

Those excluded will be stranded without insurance, stuck between people with slightly higher incomes who will qualify for federal subsidies on the new health exchanges that went live this week, and those who are poor enough to qualify for Medicaid in its current form, which has income ceilings as low as $11 a day in some states.

This article is an example of the “single payer pivot” pieces we’ve started to see pop up here and there. A Medicaid expansion and a single payer system aren’t, of course, remotely the same thing, but they are both part of the same philosophy of health care reform, and the first would be a step in the direction of the second. At this stage, any effort by the NYT or other outlets to point out the flaws of Obamacare-in-practice will serve one purpose: arguing that the law we ended up with doesn’t go far enough, and we have to do more.

It’s possible the ACA could become so unpopular that the GOP could eventually replace it wholesale with an alternative, but it seems more likely at this point that we’ll end up with a tweaked version of Obamacare: either tweaked slightly by the left or more dramatically by the right. If that happens and a modified Obamacare becomes settled law, we’ll see this kind of single payer pivot piece more and more often.

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  • wigwag

    “It’s possible the ACA could become so unpopular that the GOP could eventually replace it wholesale…” (Walter Russell Mead)

    Yes I suppose anything is possible; after all,as Gregor Samsa awoke one morning from uneasy dreams he found himself transformed in his bed into a gigantic bug.

    Rather than focus on what’s possible, Professor Mead should focus on what’s plausible. To enact any version of health reform that it supports, the GOP needs to first reconcile the widely divergent views within the Party.

    Then they need to control both the House and the Senate and in the Senate they need to command 60 votes to overcome an almost inevitable Democratic filibuster. But even that’s not enough.

    The GOP would also need a Republican in the White House to assure that whatever legislation they passed in Congress wouldn’t be vetoed. Alternatively, they could control both congressional chambers by the two thirds necessary to override a veto from a Democratic President.

    Given the political realities that the GOP is facing, the chances of any of this happening are vanishingly small.

    It’s far more likely that John Boehner wakes up tomorrow morning only to discover that he has morphed into a giant insect. If it happens, at least he will be to get some advise from Ted Cruz who has already gone through the metamorphosis.

    • Anthony

      WigWag, related and amplifying: “…The largest effect is likely to be continued dysfunction in Washington, which if it continues over a decade or so, will threaten economic growth and America’s standing in the world, undermine social programs like the Affordable Care Act, and probably encourage more radical movements on the right and the left….”

      • GardenGnomeLF

        Actually this will end one of two ways, a total collapse of government or Republicans forcing spending cuts.
        We don’t have to pass anything, we just need to stop funding the monster.

        • Anthony

          I don’t do Hedgehog thinking (absolutely certain about human dynamics – neither accurate nor precise) but I am looking forward to WigWag’s take. Thanks.

  • LegalGunTotingPatriot

    Obviously the entitlement “free stuff” groupies should move to Democrat-controlled places like New York City and California! 🙂

    • John Morris

      We should be encouraging this migration with anti-blue laws. Pass laws designed to annoy blue people, even if we find it to be a bit annoying as well. Prevent another CO situation. Make sure blue people who are smart enough to see CA is dead don’t flee to our states and blues already there decide to move out.

      Purge any blue bastions in our states, (urban areas) by getting in there and breaking up the machines, convict the corrupt faster than they can rise through the ranks. Purge the drugged out losers into deciding living in section 8 housing in CA is better, they don’t drug test and harrass your ‘disability’ claims.

      Take back our schools and teach proper civics and thinking so blue people won’t want to live here where our ideas will ‘infect’ their precious snowflakes.

      Concentrate the fail in a couple of blue states that are already past the point of no return anyway. Then let em feel the power of stupid people in large numbers.

  • Boritz

    ***This article is an example of the “single payer pivot” pieces we’ve started to see pop up***

    To be followed, or perhaps even preceded, by the death panels pivot.

  • Burn_the_Witch

    This shouldn’t be surprising since it’s by design.

    “We’ll let them keep their employment-based insurance if their employer continues to provide it.”

    A lot hinges on that one little word “if”. Already losing mine. Thanks.

  • ColoComment

    The states that have declined to expand Medicaid are perhaps more aware of the longer-term economic costs of doing so. Recall Bill Clinton’s program to put 100k more police officers on the street, which was federally funded for only the first few years, after which it defaulted to the local jurisdiction to fund.
    The Medicaid expansion is federally funded for only the first, IIRC, 2 years, after which it will fall on each state to pick up an uncertain amount of the cost. And in general, those costs are approximately 25% of state budgets, and are increasing faster than state revenues.

    Any state should look twice at expanding its Medicaid obligations, especially when it’s virtually impossible to decrease funding or reduce the covered population for any welfare program once it’s implemented.

  • lehnne

    Why anybody expects the ACA, single payer, nationalized healthcare, etc. to work is beyond me. Perhaps it is a form of American Exceptionalism in which the authors and administrator believe it will work, contrary to decades of evidence in Europe and elsewhere, because they are Americans

    • GardenGnomeLF

      It is because the Party leaders want the power and know they won’t be the ones hurt.
      They use their power to lie to useful idiots, and the more gullible parrot it back.

      • Corlyss

        Hey, Gnome! Love your Travelocity ads!

    • Corlyss

      I bet you think it matters to either the Dems or the public on the subsidies whether it “works” or not. The Dems can lie about it because the media won’t hold them accountable. And the public don’t care as long as it keeps getting money. Welfare has not worked to decrease poverty for 60 years. But it has been a spectacular success for increasing the rolls of brain-dead Democratic voters. We not only still have gargantuan poverty programs that don’t work; they are expanding exponentially.

  • Corlyss

    Medicaid is an unfunded mandate that should have been declared unconstitutional 60 years ago.

  • Corlyss

    What a shock! Wholly owned house organ of the Democratic party suddenly espouses Party line on single-payer health care. How will journalism survive?!

  • MFinn

    Progressives have a habit of creating new rights of various kinds. The idea that health care is such a human right is exactly that. If this is accepted, their programs and logic make perfect sense.

  • Jane the Actuary

    “Medicaid for all”? Consider that the local children’s hospital, which is constantly fundraising, classifies accepting Medicaid patients’ state reimbursements as a form of charity care because the reimbursement levels are so low. The only way a Medicaid for All expansion would work is if the benefits were sufficient for the very basics, but sucky enough for anyone to afford it to elect to buy a supplmentary policy. I played around with this concept a while back:
    but I really doubt it would work, since I doubt that a middle-class American, hearing about the wonders of single-payer elsewhere, would be able to grasp the concept that if you want to avoid the waiting list, you need to buy supplementary insurance.

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