Connect with us

Politics

Pandemic Relief Bill Fulfills Biden Promise to Expand Obamacare, for Two Years

Published

on

[ad_1]

WASHINGTON — President Biden’s $1.9 trillion coronavirus relief bill will fulfill one of his central campaign promises, to fill the holes in the Affordable Care Act and make health insurance affordable for more than a million middle-class Americans who could not afford insurance under the original law.

The bill, which will most likely go to the House for a final vote on Wednesday, includes a significant, albeit temporary, expansion of subsidies for health insurance purchased under the act. Under the changes, the signature domestic achievement of the Obama administration will reach middle-income families who have been discouraged from buying health plans on the federal marketplace because they come with high premiums and little or no help from the government.

The changes will last only for two years. But for some, they will be considerable: The Congressional Budget Office estimated that a 64-year-old earning $58,000 would see monthly payments decline from $1,075 under current law to $412 because the federal government would take up much of the cost. The rescue plan also includes rich new incentives to entice the few holdout states — including Texas, Georgia and Florida — to finally expand Medicaid to those with too much money to qualify for the federal health program for the poor, but too little to afford private coverage.

“For people that are eligible but not buying insurance it’s a financial issue, and so upping the subsidies is going to make the price point come down,” said Ezekiel Emanuel, a health policy expert and professor at the University of Pennsylvania who advised Mr. Biden during his transition. The bill, he said, would “make a big dent in the number of the uninsured.”

But because those provisions last only two years, the relief bill almost guarantees that health care will be front and center in the 2022 midterm elections, when Republicans will attack the measure as a wasteful expansion of a health law they have long hated. Meantime, some liberal Democrats may complain that the changes only prove that a patchwork approach to health care coverage will never work.

“Obviously it’s an improvement, but I think that it is inadequate given the health care crisis that we’re in,” said Representative Ro Khanna, a progressive Democrat from California who favors the single-payer, government-run system called Medicare for All that has been embraced by Senator Bernie Sanders, independent of Vermont, and the Democratic left.

“We’re in a national health care crisis,” Mr. Khanna said. “Fifteen million people just lost private health insurance. This would be the time for the government to say, at the very least, for those 15 million that we ought to put them on Medicare.”

Mr. Biden made clear when he was running for the White House that he did not favor Medicare for All, but instead wanted to strengthen and expand the Affordable Care Act. The bill that is expected to reach his desk in time for a prime-time Oval Office address on Thursday night would do that. The changes to the health law would cover 1.3 million more Americans and cost about $34 billion, according to the Congressional Budget Office.

Representative Frank Pallone Jr. of New Jersey, who helped draft the health law more than a decade ago and leads the House Energy and Commerce Committee, has called it “the biggest expansion that we’ve had since the A.C.A. was passed.”

But as a candidate, Mr. Biden promised more, a “public option” — a government-run plan that Americans could choose on the health law’s online marketplaces, which now include only private insurance.

“Biden promised voters a public option, and it is a promise he has to keep,” said Waleed Shahid, a spokesman for Justice Democrats, the liberal group that helped elect Representative Alexandria Ocasio-Cortez and other progressive Democrats. Of the stimulus bill, he said, “I don’t think anyone thinks this is Biden’s health care plan.”

Just when Mr. Biden or Democrats would put forth such a plan remains unclear, and passage in an evenly divided Senate would be an uphill struggle. White House officials have said Mr. Biden wants to get past the coronavirus relief bill before laying out a more comprehensive domestic policy agenda.

The Affordable Care Act is near and dear to Mr. Biden, who memorably used an expletive to describe it as a big deal when he was vice president and President Barack Obama signed it into law in 2010. It has expanded coverage to more than 20 million Americans, cutting the uninsured rate to 10.9 percent in 2019 from 17.8 percent in 2010.

Even so, some 30 million Americans were uninsured between January and June 2020, according to the latest figures available from the National Health Interview Survey. The problem has only grown worse during the coronavirus pandemic, when thousands if not millions of Americans lost insurance because they lost their jobs.

Mr. Biden has already taken some steps to address that. In January, he ordered the Affordable Care Act’s health insurance marketplaces reopened to give people throttled by the pandemic economy a new chance to obtain coverage. He also took steps to restore coverage mandates that had been undermined by his predecessor, including protecting those with pre-existing medical conditions.

The stimulus bill would make upper-middle-income Americans newly eligible for financial help to buy plans on the federal marketplaces, and the premiums for those plans would cost no more than 8.5 percent of an individual’s modified adjusted gross income. It would also increase subsidies for lower-income enrollees.

The White House and Democratic backers of the bill say its health care provisions represent the most significant expansion of the Affordable Care Act since it was passed, and perhaps the only expansion politically possible. With an evenly divided Senate, they note, there is very little chance of passage for a more fundamental restructuring, like Medicare for All.

“I understand the desire to really overhaul the system and make it simpler, but I think there is also the political reality of what can be pushed through,” Dr. Emanuel said.

Health care remains a powerful political selling point for Democrats with voters, who consistently give Democrats an edge when asked which party they trust most to handle the issue. Republicans have spent the last decade trying to undermine the Affordable Care Act in the courts and trying to repeal it in Congress — without success.

“I think that argument has been fought and lost,” said Whit Ayres, a Republican pollster, conceding that the repeal efforts are over, at least for now, with Democrats in charge of the White House and both houses of Congress.

Republicans have always said that their plan was to repeal and replace the health law, but after 10 years they have yet to come up with a replacement. Mr. Ayres said his firm is working on “coming up with some alternative health care message” that does not involve “simply throwing everybody into a government-run health care problem.”

Yet polls show that the idea of a government-run program is gaining traction with voters. In September, the Pew Research Center reported that over the previous year, there had been an increase, especially among Democrats, in the share of Americans who say health insurance should be provided by a single national program run by the government.

The poll found that 36 percent of Americans, and 54 percent of Democrats, favored a single national program. When asked if the government had a responsibility to provide health insurance, either through a single national program or a mix of public and private programs, 63 percent of Americans and 88 percent of Democrats said yes.

The debate over Medicare for All was a stark dividing line between progressives and more mainstream Democrats during the 2020 elections. Mr. Sanders and Senator Elizabeth Warren of Massachusetts staked their candidacies on it, only to lose the nomination to Mr. Biden.

But in contested House primaries, support for Medicare for All helped give a boost to candidates like Jamaal Bowman of New York, Marie Newman of Illinois and Cori Bush of Missouri. All ousted Democratic incumbents last year in primary races that featured health care as a central issue.

“I would argue there is more momentum for Medicare expansion given the pandemic and the experience people are having,” said Mr. Khanna, the California congressman. “They bought time, but I think at some point there will be a debate on a permanent fix.”

[ad_2]

Source link

Continue Reading

Politics

In Washington, Policy Revolves Around Joe Manchin. He Likes It That Way.

Published

on

By

[ad_1]

WASHINGTON — If Democrats eliminate the filibuster, there is one senator who would have an outsized impact in the 50-50 chamber on issues that could reshape the nation’s future: infrastructure, immigration, gun laws and voting rights. That senator is Joe Manchin III of West Virginia.

There is also a senator whose opposition to eliminating the filibuster is a significant reason it may never happen. That senator, too, is Mr. Manchin.

“He should want to get rid of the filibuster because he suddenly becomes the most powerful person in this place — he’s the 50th vote on everything,” said Senator Chris Coons, Democrat of Delaware, sketching out the argument.

Mr. Manchin, however, does not see it that way. To the exasperation of Democrats, delight of Republicans and bewilderment of politicians who can’t understand why he wouldn’t want to wield more power, Mr. Manchin, a former governor of the state, isn’t budging.

“Sixty votes,” he said in an interview last week in his office, referring to the threshold required to advance most legislation, adding that he would not consider suspending the filibuster for certain bills, as some of his colleagues have floated: “You’re either committed or not.”

But with 18 people dead after two mass shootings within a week, a worsening migrant challenge on the border and Republicans trying to restrict voting in almost every state where they hold power, liberals believe this moment cries out for a different sort of commitment. At a time when they have full control of Congress and are confronting overlapping crises, many Democrats feel a moral and political imperative to act, process be damned.

That puts Mr. Manchin, 73, at the center of the most important policy debates in Washington — and has set the stage for a collision between a party eager to use its majorities to pass sweeping legislation and a political throwback determined to restore bipartisanship to a chamber that’s as polarized as the country.

Mr. Manchin believes that ending the legislative filibuster would effectively destroy the Senate. He recalled his predecessor, Robert C. Byrd, telling him that the chamber had been designed to force consensus.

Mr. Manchin has expressed willingness to support a “talking filibuster,” in which lawmakers have to actually hold the floor, perhaps for many hours, to block a vote. But he has not yielded on getting rid of it altogether and on an array of issues, including voting rights and gun control, his admonition is less about any particular policy end and more about making sure the legislation has support from both parties.

More broadly, Mr. Manchin’s resistance to ending the filibuster has ripened fundamental questions about which version of Congress would be more dysfunctional: a body stymied by gridlock or one that can pass legislation only by scrapping longstanding guidelines so it can push through party-line votes?

“You can’t make the place work if nothing significant is getting passed,” said Representative Ro Khanna, a leading progressive from California.

Mr. Manchin worries that the short-term benefit of ditching the filibuster would backfire for Democrats over the long term.

“I’m concerned about the House pushing an agenda that would be hard for us to maintain the majority,” Mr. Manchin said about the progressive legislation that House Democrats are stacking up at the Senate door. As for pressure from the left, he said, tauntingly: “What are they going to do, they going to go into West Virginia and campaign against me? Please, that would help me more than anything.”

To a growing number of his Democratic colleagues — and not just liberals — it’s naïve to keep putting hope over history, and believe, as Mr. Manchin said about gun legislation, that Republicans may say, “Listen, it’s time for us to do the reasonable, sensible thing.”

Of course, few in a Senate that depends on Mr. Manchin for a 50th vote will say outright that their colleague is indulging in fantasy.

“Joe’s focus, I believe, is bipartisanship, and I agree with the starting point,” said Senator Richard J. Durbin of Illinois, before lowering the boom: “They weren’t going to give us a single vote,” he said about the stimulus bill.

A former high school quarterback who friends say still relishes being at the center of the action, Mr. Manchin is something of a unicorn in today’s Congress. As a pro-coal and anti-abortion Democrat, he reflects a less-homogenized era when regionalism was as significant as partisanship and senators were more individual actors than predictable votes for their caucus.

Twice elected governor before claiming Mr. Byrd’s seat, he’s the only lawmaker standing in the way of an all-Republican congressional delegation in West Virginia, a state that former President Donald J. Trump carried by nearly 40 points last year. And he is an unlikely majority-maker of the Democratic Senate.

“We really are the big tent,” said Senator Debbie Stabenow of Michigan, before knowingly adding: “Now it’s a lot of work when you have a big tent, right? But that’s the way we have a majority.”

While out of step with his national party on some issues, and written off by parts of the left as little better than a Republican, his politics are more complex, even confounding, than they appear at first glance.

He provided the deciding vote on two of the biggest liberal priorities of this era — blocking repeal of the Affordable Care Act in 2017 and on passage of the nearly $2 trillion stimulus bill this month — while also twice voting to convict an impeached president wildly popular in his home state.

And while he may admire Mr. Byrd’s dedication to Senate tradition, Mr. Manchin has not emulated his predecessor by leveraging his power to focus relentlessly on steering spending projects back to West Virginia.

When Mr. Manchin was holding out on a single amendment that was delaying passage of the stimulus bill, White House aides were perplexed because his price for supporting the measure was not additional money for his impoverished home state. His main request, West Wing officials said, was to pare back spending and consider Republican input that could have made the bill appear more moderate.

Mr. Manchin said President Biden warned him in a phone call that the progressive left in the House might balk if the bill were significantly trimmed. “I said, ‘Mr. President, all we’re trying to do is put some guard rails on this,’” he recalled.

He was less happy about Vice President Kamala Harris’s effort to nudge him on the legislation by making an appearance on a television affiliate in West Virginia to promote the bill without forewarning him. The clip went viral and, Mr. Manchin said, prompted cleanup conversations with Mr. Biden and the White House chief of staff, Ron Klain.

As for any pressure that he may feel on the filibuster, Mr. Manchin said he had reminded Senator Chuck Schumer, the majority leader, of how essential he was to providing Democrats a majority.

He said he had told Mr. Schumer, “I know one thing, Chuck, you wouldn’t have this problem at all if I wasn’t here.”

He is not the only impediment to the sort of expansive liberal agenda preferred by many congressional Democrats or even the only one still defending the filibuster. Other Senate Democrats, including Kyrsten Sinema of Arizona, also share his reluctance.

Yet none are as eager as Mr. Manchin to restore a bygone day of collegiality. And perhaps, more to the point, none are as happy as him to talk about the need to do so as he navigates representing a once-heavily Democratic state that had been shifting to the G.O.P. even before Mr. Trump arrived on the scene.

He crossed the aisle last year to endorse his closest Republican ally, Senator Susan Collins of Maine, and is already co-hosting bipartisan lunches with her. He is plotting the post-pandemic restoration of his pizza-and-beer parties on the boat he calls home while in Washington. (It’s called “Almost Heaven,” the opening lyric to John Denver’s ode to West Virginia.)

Although some of his colleagues relish the ideologically-charged prime-time cable news programs, Mr. Manchin prefers another Washington institution that also flourished in less-polarized times: the Sunday morning show.

In the fashion of many former governors who grow exasperated with Washington’s glacial pace, at times he can barely contain his impatience. He’s repeatedly mused about leaving the Senate and trying to reclaim his old job in Charleston.

But those who know Mr. Manchin well believe he likes the attention that he receives in the capital, the same as he did as a signal-caller in Farmington, W.V., where he grew up near Nick Saban, the legendary football coach at the University of Alabama and a lifelong friend of Mr. Manchin.

“You’re in the hot seat when you’re a quarterback, but it’s pretty satisfying when you make progress,” said Nick Casey, a Manchin ally and former chairman of the West Virginia Democratic Party. Mr. Casey said the senator, who sustained an injury that cut short his playing days, was “the greatest QB who never got to start at West Virginia University — just ask him.”

Steve Williams, the mayor of Huntington, W.V., who served with Mr. Manchin in the state legislature, said: “This is the closest he has been to how he could be as governor, actually driving the agenda, pulling people together.’’

It’s the last part that most animates the senator. Happily bantering with reporters as he positions himself as a lonely, if well-covered, voice for comity, he shifts questions from policy to process.

“Why don’t you ask people when was the last time they took time to talk to some of the people on this side?” Mr. Manchin told a CNN reporter this week. “Try to convince them, or work with them. Have you had dinner with them? Have you had a lunch with them? Have you had a cup of coffee with them? Try something.”

A number of anti-filibuster Senate Democrats, though, are more focused on what Mr. Manchin’s support of the “talking filibuster” could portend.

“I think that gives us a lot of room for discussion,” said Senator Elizabeth Warren of Massachusetts, adopting a glass-is-half-full perspective.

What does seem clear is that Mr. Manchin is not going to switch parties.

“I don’t think that’s going to happen, although we’d welcome him with open arms,” said Ms. Collins, who has tried in the past to persuade her friend to join Republicans.

It’s not difficult to see why Mr. Manchin remains in his forefathers’ party. A Catholic of Italian descent, he sought John F. Kennedy’s desk when he arrived in the Senate, displays a picture of the slain president in his office lobby and can recall hearing that Massachusetts accent in his kitchen when Kennedy’s brothers came to his parents’ house during the West Virginia primary in 1960.

“Joe reminds me a lot of the old conservative Democrats in Texas,” said Senator John Cornyn, Republican of Texas. “They were born Democrats. They’re going to die Democrats.”

As for the filibuster, Mr. Coons, who was sworn in alongside Mr. Manchin in 2010, said liberals shouldn’t get their hopes up.

Recalling a conversation with somebody who knows Mr. Manchin well, Mr. Coons said this person told him: “If the ghost of Robert Byrd came back to life and said the future of West Virginia itself is on the line he might … think about it.”

[ad_2]

Source link

Continue Reading

Politics

C.D.C. Funding Gun Violence Research For First Time in Decades

Published

on

By

[ad_1]

That was the argument he used to help persuade Congress to appropriate money for gun violence research in 2019. The research itself was never banned outright, and in 2013, weeks after the massacre that killed 26 people at the Sandy Hook Elementary School in Connecticut, President Barack Obama directed the C.D.C. to reconsider funding studies on gun violence.

The agency commissioned a report from the Institute of Medicine and the National Research Council outlining priorities, but little changed. By 2019, after Democrats reclaimed the House, liberal organizations like MoveOn.org were petitioning Congress to repeal the Dickey Amendment. Nearly every House Democrat signed on.

But Dr. Rosenberg argued it should remain intact, to “provide cover for Republicans and gun-loving Democrats who can put money into the science and tell their constituents, ‘This is not money for gun control.’ ”

Representative Rosa DeLauro, a Connecticut Democrat who chaired the House subcommittee that oversees the C.D.C.’s budget at the time, said she put $50 million into the appropriations bill that year, but the Senate, controlled by Republicans, eliminated it. The two chambers agreed on $25 million as a compromise, but she said she hoped to double the funding this year.

Dr. Naik-Mathuria, the Houston trauma surgeon, said she would like to see Washington address the problem of gun violence as a matter of injury prevention, not politics. She began researching methods to reduce gun violence about six years ago, she said, after seeing “kids come in dead because they shot themselves in the head when they found a gun at home.”

Her current study is aimed at determining risk factors for gun violence for children and adults, and her past work has led to some changes in medical practice, she said.

Pediatricians in Texas, she said, are hesitant to talk about gun safety out of concern that “it would anger parents or become political.” So she and her group made a broader safety video that tucked in messages about gun safety — like keeping guns locked and stored — with tips like how to keep children away from poison.

[ad_2]

Source link

Continue Reading

Politics

Who Are Gavin Newsom’s Enemies?

Published

on

By

[ad_1]

There’s still time for a lot to change: If the organizers of the recall effort reach the signature threshold, the vote to recall Mr. Newsom and to choose his successor — both would be done on a single ballot — probably wouldn’t occur until near the end of the year.

That recall effort is being led by Orrin Heatlie, a conservative and a former sergeant in the Yolo County Sheriff’s Department, who as recently as last year shared anti-vaccination and anti-L.G.B.T.Q. views online. But the endeavor has the backing of a number of deep-pocketed political action committees, most of them right-leaning.

Randy Economy, a political consultant and talk-radio host, serves as the lead adviser to Recall Gavin Newsom, the group organizing the effort. He said the governor’s behavior and demeanor had made the recall necessary. “It’s because of Gavin Newsom himself, and the way he conducts himself every day since he’s become governor,” Mr. Economy said in an interview. “It’s all been more about his image and self-aggrandizing, as opposed to fixing the problems.”

Mr. Newsom’s approval rating isn’t nearly as low as Gov. Gray Davis’s was in 2003, when voters ousted him in a recall. Arnold Schwarzenegger, running as a moderate Republican, was the beneficiary of that effort, winning the recall election and going on to serve as governor for more than seven years.

California politics are different — and decidedly more Democratic — than they were 18 years ago. Democrats now have a 2-to-1 advantage in terms of voter registration across the state. Just because there is a Republican-led effort does not mean that a Republican will be the one to ultimately benefit. Mr. Economy, who volunteered in 2016 for Mr. Trump’s presidential campaign but has also worked for Democrats in the past, insisted that his team’s goal was not partisan in nature.

“Our job is not to pick the next governor; our job is to make sure that this governor’s recalled and removed from office,” he said.

The state is light on prominent (let alone popular) G.O.P. politicians, and some ambitious Democrats already appear ready to run through the open door. All of which points to a possible irony: Even if it were to become only the second successful recall effort in California history, the push — led by conservative interests — could ultimately lift up another Democrat, possibly one to the left of Mr. Newsom.

[ad_2]

Source link

Continue Reading

Trending