GOP can’t fix Obamacare; Dems lack a plan

Health care “repeal and reform” is a mess, and both parties must share the responsibility for what now appears to be a national crisis.

It’s worth recalling the essential elements of the Affordable Care Act – Obamacare – that have led to the crisis.

The ACA extended health insurance coverage to tens of millions of people who could not be assured of decent medical care because they couldn’t pay for it. They would be required to buy insurance in the marketplace, but would receive financial help to pay for it.

Obviously, expanding coverage with government financial help requires more public funds, so the ACA provided for tax increases on the wealthiest individuals and on employers providing luxury, “Cadillac” insurance plans.

If people did not have employer-provided plans, they would turn to state market places in which insurers would compete for their business. However, there could be no public, nonprofit option available as a competitor and a backstop, because congressional Republicans blocked it.

The ACA worked, but not entirely well. Millions more gained coverage. But some states, like Maine, refused federal aid to extend low-income coverage. Costs rose because of uncertainty in Washington about federal funding. Some insurers dropped out of state markets. The wealthy fretted.

President Obama did a poor job selling a major new policy, and the GOP attacked it successfully, gaining control of Congress. Then, more than 50 times, it voted outright repeal of the ACA without an alternative, knowing that Obama could prevent their gesture from ever becoming law.

Finally, Republicans gained control of both houses of Congress and the presidency. Though President Trump made generous promises about a replacement, he had no proposal, leaving the solution to congressional Republicans who could pass a bill without a single Democratic vote.

As David Brooks, the New York Times columnist wrote, many Republicans ignored conservatism, with which they were identified, for a simple solution: reduce the number of people covered and the coverage, while eliminating the tax increases supporting the ACA.

This approach is consistent with a broader GOP policy that calls for reducing the size of government and cutting taxes. Reducing coverage saves money. It does not matter that millions would lose or be denied health insurance and find themselves forced back into emergency rooms for their care.

Part of their “repeal and replace” policy would allow younger people with fewer health problems not to purchase coverage, reducing the insurance pool supporting the costs of older citizens.

These reforms would all take place by modifying, but not repealing, the ACA. Hard-line conservatives thought they did not go far enough and opposed the proposed changes. Moderate Republicans thought they cut off too many people and they, too, opposed the proposed changes.

Result? No bill that can command the nearly unanimous Republican support required.

Meanwhile, conservative institutions have come up with reform proposals. They start by accepting that all people should have insurance coverage. They suggest reducing costs by lowering the income cap for Medicaid eligibility, cutting any federal subsidy for help above that level.

People should be allowed to use their health savings accounts to buy prepaid care, under which a medical procedure would be priced as a whole instead of by each provider in the process. And the “Cadillac” tax on luxury plans would remain.

Congress would also lift its prohibition on Medicare conducting competitive bidding for drugs. That would save the program billions that could support health coverage.

The conservative view is that reforms need to be made that can survive a change in political control in Washington. Otherwise, if the voters don’t like the GOP “reforms,” they will elect Democrats to repeal the repeal.

What’s wrong with the Democrats? They are acting just as Republicans did. They have not said a word about the changes to ACA they would propose to fix its problems. They hope to gain support simply by opposing the Republicans.

The obvious leader should be Barack Obama, who should lead in developing ACA improvements instead of washing his hands of Washington. A former president, even one with a namesake program, staying in the fray is unusual, but Trump proves these are unusual times. Other Democrats could accept his leadership, because they know he can’t run again.

Nothing can be expected from the White House that simply wants to take credit for whatever is passed. Everybody needs to accept almost universal coverage, but there should be Republican and Democratic alternatives from which both sides could negotiate.

The risk of failure not only threatens the health care system, but government itself.

Can there be too much democracy? Legislators veto voters.

Is there such a thing as too much democracy?

Voters in many states are more often deciding major issues that have been dodged by state legislatures.  In Maine, three recent questions, decided by popular vote, have come under legislative review this year. 

The clash between the Legislature and voters on boosting taxes to pay for education has led to the state shutdown crisis. Voters adopted a three percent surcharge on the highest incomes to pay for an earlier referendum decision, adopted several years ago but ignored by the Legislature.  That vote set the amount of state payments to school districts for education, but it was never funded.

Republicans favor reversing the voters’ surcharge legislatively, because they oppose the tax increase.  Schools would get less than the voters intended.  Their demand to block the tax increase without making up the funding loss has been the underlying cause of the legislative deadlock.

State Supreme Court justices said that ranked-choice voting, adopted by voters, was not constitutional.  Should it be repealed or should the Constitution be amended?  The Legislature became entangled in how to deal with this complicated mess. 

The voters also set a higher minimum wage and applied it to people who usually receive tips.  After many servers expressed concern that they might receive less total income, the Legislature repealed that part of the voters’ minimum wage law. 

It’s not surprising that the use of direct votes on major issues is becoming more controversial.  Some seek to make it more difficult for citizens to place items on the ballot, the way issues like these were initiated.

In a pure or direct democracy, voters themselves make the laws.  But the U.S. is a republic, a system of representative democracy in which voters choose people who will make the laws.

About half the states allow for some direct democracy.  Voters propose laws, a process known as initiative.  Through referendums, they adopt laws or veto laws passed by state legislatures.  In almost all states, voters must approve constitutional amendments.

The Maine Legislature usually sends to referendum proposals that have been launched by initiative.  Occasionally, it also sends its own bills to voters rather than deciding the issues.

The Legislature can deal with an initiated proposal by sending its own alternative to the voters at the same time.  But it then may risk helping passage of an idea it really opposes, so it often avoids offering an alternative.

A complaint about referendums is that they oversimplify complex issues, making them yes-or-no questions.  The proposal cannot be amended or improved in the legislative process.  With political issues having become so complicated that laws may run hundreds of pages, can they be reduced to “yes” or “no?”

Because legislators may believe voters will hold them responsible for their vote on a controversial issue, their decision may boil down to a simple “yes” or “no.”  That’s easier to explain than getting into a bill’s details.  So a legislative vote may be much like a referendum.

The frequent use of referendums, as is customary in California and increasing in Maine, may strip them of their special place compared with bills passed by the Legislature. 

Questions about the role of legislators themselves may be contributing to the increased use of direct democracy.  Should they represent of the views of citizens or are they selected to exercise their own best judgment?

In famous speech in 1774, British legislator Edmund Burke told voters he would not be their representative but would use his “mature judgment” in Parliament.  He concluded, “Parliament is not a congress.”

In the U.S., some members of Congress, usually conservatives like Burke’s view.  But the U.S. has a congress, not a parliament, with a House of Representatives, which should make the intent clear.

The recent battles over the Affordable Care Act illustrate the point.  Some Republicans oppose the expansion of Medicaid, because they dislike the higher taxes on the wealthy used to support the program.  Other Republicans, notably representatives from states that have increased Medicaid, don’t want to repeal the expansion.

If state voters oppose the “mature judgment” of their representatives, even when they refrain from action, should they be able to act?  And does legislation adopted by the voters rank higher than other laws?

These issues raise the question whether legislatures should give deference to citizen-voted laws, leaving any change to a second popular vote, perhaps in a special election.  That could have avoided this year’s unfortunate legislative wars.

Or legislatures could try to be more representative, while showing the “mature judgment” to tackle tough issues.

Growing gap between rich, middle class as populism flops

The income gap between the rich and everybody else is behind the growth of populism in the U.S. and Europe, according to new political analyses.

On one side are the rich and on the other is the middle class. The poor rarely are mentioned these days, either because it is disgraceful to be poor or because government wants to cut back on helping them.

Deep political divisions are likely to be about money. Many among the rich want to keep it and get more, while everybody else treads water or falls behind. Some who are losing out have become populists, seeking political power in hopes of boosting their incomes.

Here’s an example. Unemployed coal miners support President Trump’s push to revive coal mining. It’s all about recovering jobs for miners who have lost theirs to competing resources. It’s certainly not about anybody’s preference for coal.

Complicating the split is the fact that many people who say they are in the middle class aren’t. “Stop pretending You’re Not Rich” was the title of a recent commentary by Richard Reeves in the New York Times.

Reeves grew up in class-conscious Britain but discovered classes were more firmly established in the U.S. than there. In Britain, the upper economic class flaunts their status, while in the U.S., the rich are in denial.

The wealthy are not only the now-famous top one percent who own more of the economy than the bottom 90 percent. Some high-income people who consider themselves members of the middle class are rich. They may join in blaming the superrich for income inequality, but they have gained more than the much larger, true middle class.

The rich are a self-renewing group. While the American myth is that people succeed based on merit, the rich pass on their privileged opportunity to their children. There’s nothing wrong with that, but it tends to create an upper class. They can gain access to housing and the best schools. And they can benefit from special tax breaks.

Writing in London’s Financial Times, Edward Luce carries the theme further. Somewhat surprisingly, he noted, “France has done a better job at keeping its left-behinds above water than its Anglo-Saxon rivals (U.S. and Britain).”

Working age males are more likely to find jobs in France than in the U.S. And the income gap is smaller there.

Luce’s key point is that not only do the U.S. and the U.K. have a market economy, but they also have a “market society.” We may consider that system promotes “individual freedom,” but it means people must fend for themselves. Some of the wealthy, while opposing big government, have designed it to favor their pocketbooks.

This split has spurred many of the less privileged to turn to movements promising change and the kind of policies they want. For example, they believe immigrants take good jobs, not merely entry-level positions, away from them and want it stopped.

Trump’s surprise electoral victory seemed to send the message that the ignored middle-class was on the path to power and control. The simple idea that Trump would bring change was enough to help him to win.

In Britain, anti-immigration voting led to Brexit, designed to stop immigrants from Eastern Europe. In the Netherlands and France, populists threatened to win the national elections, but failed. The tough British Conservative Party position on Brexit and government spending cost it a parliamentary majority.

Populism has tapped into a belief that government overreaches. In response, the president and the GOP Congress kill Obama’s rules on the environment and consumer protection. But Trump struggles as he finds keeping political promises is much harder than making them, even with his party controlling Congress.

In the Washington Post, Ishaan Tharoor writes that “right-wing populists” are now in retreat. They have created chaos, the columnist says, which is leading to a revival of interest in government action on the economy, aimed at reducing inequality.

In the Netherlands, France, Britain and Germany, right-wing populism has been halted or pushed back. Nowhere has it brought back the middle class, economically or politically.

Meanwhile, social democrats like Bernie Sanders in the U.S. and Jeremy Corbyn in the U.K. have been expanding participation. Recently, increased support for Democratic in normally solid Republican congressional districts has raised doubts about the much-heralded populist message of the 2016 elections.

The experiment with a “market society,” with as little government as possible, is not producing the promised result of greater prosperity for all. Will the political reaction against right-wing populism taking place in Europe reach America’s shores?

What the Georgia congressional election shows about ranked-choice voting

Georgia’s Sixth Congressional District just completed a run-off election for the vacant seat in the U.S. House of Representatives.  The record of that race reveals much relevant to the consideration of ranked-choice voting.

The first round of the election took place on April 18.  In a traditionally solidly Republican district, Democrat Jon Ossoff won 48 percent of the vote in a crowded field.  The second place finisher was Republican Karen Handel with 19 percent. 

Most of the rest of the vote was divided among other Republicans.  That’s not surprising, because they were all vying to be the GOP winner or at least the survivor getting to a run-off in the belief, correct as it turned out, that a Republican would hold the naturally GOP district.

If Georgia used the Maine system, with a plurality winner and no second round, Ossoff might have lost if the GOP had put up just one candidate, probably after holding a primary.  He might have won only if there had been a third candidate.

The total participation in the April round was 192,569.

If Georgia used ranked-choice voting, it’s also possible the Republican candidate would have won.  She might have been the second choice of all of the other Republicans, giving her 98,196 to Ossoff’s Democratic 94,201 votes, composed of his own and the second choice votes of the other Democratic voters.  (There were a handful of independent voters, so numbers don’t exactly add up.)

Handel would have had 51 percent to Ossoff’s 49 percent.

But it is also possible that, with a plethora of GOP hopefuls, Handel might not have picked up enough second choice votes to win or to win by more than a plurality.  The only way she could win a majority if she did not get all the second-choice voters she needed was to simply dump some votes and voters from the count. 

That’s how ranked-choice voting can work.  It can turn a real plurality into a phony majority by eliminating some voters.

But Georgia does not use ranked-choice voting.  In fact, no state does.  Like 10 other states, it uses a run-off.  It was held on June 20.

Handel won 52 percent of the vote and Ossoff held his 48 percent.  She won.

The number of participants was 259,486.  That’s 35 percent more than in the first round.  So much for any claim that run-offs inevitably have lower turnouts.   

Run-offs can do better for participation and democracy than ranked-choice voting.

What does Georgia show that may be relevant to Maine’s consideration of voting?

First, the plurality system may produce a different result from either a run-off or ranked choice voting.  So the threshold question is whether Mainer wants to abandon plurality elections.  That’s probably the first question that ought to be put to voters and that would require a constitutional amendment.

Second, if Maine voters want change, they should consider the widely used run-off as well as the new and untried ranked-choice voting.  After a favorable vote to amend the Constitution, they could make this choice.

Third, nobody is dropped from the voting process by the run-off system, but votes are eliminated in ranked-choice voting.

Fourth, ranked-choice voting is more costly than a run-off, according to the Secretary of State.

Fifth, the winner is selected after a clear contest between candidates by using either the plurality or the run-off, while the computer makes the choice, hidden from voters, in ranked-choice voting.  Plurality and run-offs depend on campaigns designed to convince voters not a short-cut counting system.

Finally, Mainers should avoid seeing the need for ranked-choice voting in terms of the elections of Gov. LePage or Gov. Baldacci.  Any change would last decades or centuries with unknown results.

Well-informed? Not by government, blogs, tweets

The gap between the people and their government continues to grow.  The sense that government exists to serve the people keeps eroding.

Many government leaders don't want a well-informed country, and they are supported by a new artificial media.

Last week, Sen. Angus King asked two top national intelligence officials about their conversations with President Trump.  They refused to answer, not because of legally protected presidential conversations, but because, as one said, he simply felt it would not be “appropriate.” 

King answered, “What you feel isn't relevant, admiral.”  He scolded a public official deciding on his own what was appropriate to disclose to a senator and to the citizens for whom he supposedly works.

What the admiral said was normal in Washington.  What King said was the shocker.  A senator wanting an unclassified answer from a federal employee, but greeted by a self-centered refusal, is what made news.

The exchange shows much of the business of government belongs to insiders. The people who are running the government on behalf of the public appear not to care that the survival of a true democratic system depends on an informed population. 

Nothing shows this better than the fate of “sunshine” laws adopted years ago.  In Maine, requests from the public for information that were supposed to be answered quickly, pile up for months. They should get a higher priority than the work those in charge insist on using as an excuse to delay or block answers.

Like Maine's Freedom of Access Law, the federal Freedom of Information Act is riddled with exceptions that government has given itself.  The broad reach of those laws has been whittled down by the excessive delays and myriad exceptions.

When government keeps as much as it can under wraps, leaks inevitably occur.    

Government officials don't like leaks.   They prefer to act free from public review, which might limit their actions.  They see government as being independent of citizens, and sometimes even as an adversary.

Some leaks are inevitable.  As policy is developed, those whose views are rejected seek a way to get them out to the public.  The occasional whistle blower will take the risk of leaking word of illegal or outright lying by public officials. 

Despite the certainty that there will be some leaks in a country denied much government in the sunshine, some politicians fail to adjust to reality and are ready to pursue leakers with great vigor if few results.

We have seen the curious situation of former FBI Director James Comey giving his own unclassified notes of a conversation with President Trump to a friend to reveal rather than releasing them himself.  Though that's a bit unorthodox, it not really a leak.

Trump has been angered by word filtering out about his in-house statements and activities.  Without leaks, his political vulnerability would be less.  So he attacks leaking, trying to draw attention away from the underlying issue of his policy-making by tweet.

In a way, Trump's daily tweets may be seen to make him the most open president ever.  But he also wants to completely control the discussion and disclose only what he wants public, but that policy only encourages leakers.  Trump uses Twitter, he says, because it's just like owning his own newspaper.

Ultimately, finding out about what government does not want citizens to know and helping citizens control their government depends on the media.

Much is made of the First Amendment.  But it only protects the media from government control.  Freedom of the press depends more broadly on the press itself and the public's use and defense of it.

To promote their views, Trump and friends rely on electronic media, usually blogs, that produce false news, but can easily gain visibility.  Comey's congressional testimony was twisted by one blog supporting Trump and the incorrect version gained worldwide circulation. 

His allies attack what they call the Main Stream Media, meaning newspapers and broadcasters paid to report independently.  They see the MSM as being as biased, justifying the right-wing bloggers creating their own version of the news.

Such attacks can undermine or even discredit the media.  That makes it all the more important for the MSM to do its job undeterred.  The media must find audiences and advertisers who will pay for independence, understanding that sometimes they will like the product and sometimes they won't.

The effort to keep citizens in the dark grows stronger.  In the end, it's people like Angus King or the MSM, on behalf of all citizens, that must press government to be open and responsible.