Category Archives: The Right

What Trump Might be doing Right – Letters

Some very good responses to Peggy Noonan’s editorial of 12/29/2018, where she tried to encourage “Trump insiders” to “speak up – on the record”.

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Peggy Noonan asks “Trump insiders” to speak candidly about how the administration conducts the people’s business (“Trump Insiders, Come Out of the Shadows,” Declarations, Dec. 29). Two years are indeed enough time to evaluate the conduct of our government—including the duplicity in Congress and the vigilante style of the Justice Department and the IRS. Yet Ms. Noonan focuses her ire on President Trump while overlooking these and other malefactors.

When the press stretches facts about events on Capitol Hill and in the bureaucracy, when the Justice Department decides to obfuscate facts and ignore subpoenas, when we learn that Congress has a secret slush fund to silence sexual-harassment accusers, these scandals often are made public by Trump insiders willing to speak honestly about what Americans have long suspected.

When Defense Secretary Jim Mattis resigned his post, we heard his message. The former general is in the fight to win, as is expected of a fine career officer. Yet others in the administration argue candidly that it is futile to fight a war for 18 years without rules of engagement sufficient to defeat our enemy. Experience tells us that peace does not come through empty promises and plane loads of cash.

There are indeed many books about the chaos in the Trump administration. But there also are many others authored by supporters of the president, willing to put their reputations on the line in defense of the president’s accomplishments and his right to govern.

Ms. Noonan suggests that honest Trump insiders are cowed by the president’s operatives, becoming “figures of “obloquy.” I am not a Trump insider but I am not afraid to speak up on the president’s behalf. I voted for him to expose the inner sanctum we call our government and shed light on the corruption we all know exists. He has persevered to the point of friction and beyond, and that is where true leaders go.

CONNIE LOVELL
Pinehurst, N.C.

Ms. Noonan wants to learn more about the inner dealings of the Trump presidency. Specifically, she wants to see those working with President Trump to share their experiences, and to “put their name on it.”

Might I ask Ms. Noonan what she expects this to accomplish? All positive accounts from individuals “in the know” at the White House will be ridiculed and dismissed by the mainstream media—that’s a certainty. Any unflattering portraits of the president will be embraced by the same media outlets and featured in lead news stories, followed by endless panel discussion about a possible Trump impeachment.

Rather than waste time on such an exercise, why not challenge the mainstream media to do something radical: Report on the president’s policy failures and accomplishments. That is what matters most.

PHIL RULAND
Newport Beach, Calif.

Ms. Noonan worries about the rumors swirling around President Trump’s behavior and how he spends his time. She ponders, among other things, whether the president actually spends hours watching television each day. Her concern reminds me of Abraham Lincoln’s response when advised that Gen. Ulysses S. Grant was a drunkard and should be fired. Reportedly, Lincoln wistfully replied, “I wish I knew what brand of whiskey he drank so I could send a barrel to my other generals.”

To paraphrase President Lincoln regarding the concerns about President Trump’s TV viewing habits, I wish I had a list of the TV shows he watches so I could send it to Republican members of Congress. Ms. Noonan mistakenly considers it a problem that President Trump is keeping his campaign promises, albeit in a heavy-handed, erratic and graceless manner. The real problem is a refined and oh-so-polite Republican establishment too timid and clueless to convey its message effectively or keep its political promises.

LARRY JENKINS
Madison, Wis.

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Trump has no Ideas??

Oh how I wish Republicans would learn how to sell what they have accomplished? They are absolute _ _ _ _ _ _ _ s.
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WSJ 11/5/2018
Americans say health care is a leading concern in Tuesday’s election, and voters say they trust Democrats over Republicans by double-digit margins. Yet the Trump Administration has put together an impressive suite of reforms that allow consumers more freedom and personal choice, not that you’ll read about it anywhere else.

Last month the Trump Administration rolled out a rule on health-reimbursement arrangements that would allow employers to offer workers tax-exempt dollars to buy insurance in the individual market. The Obama Administration banned this via regulation as part of the Affordable Care Act.

The Administration’s thinking is that these arrangements will be most attractive to small firms that lack the economies of scale that make offering insurance affordable. About 30% of workers at firms with three to 24 employees are covered by employer health benefits, down from 44% in 2010, according to Kaiser Family Foundation data. Eight in 10 companies with fewer than 200 employees offer only one plan.

Health reimbursements would be a cheap and easy option for, say, startups. This is also a way to offer more individuals the tax break on health care that employer insurance receives. Ending this economic distortion for everyone would be preferable, but equal treatment is a step forward.

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The reflexive response from Democrats is that this is another effort to undermine the Affordable Care Act, but they need a new script. The rule will draw more young and healthy workers into the individual market, which currently skews toward the sick or those poor enough to be eligible for tax-credit subsidies. Reimbursements should make the ObamaCare exchanges more stable, which is what Democrats claim to want.

The rule includes guardrails to prevent employers from dumping sick employees onto the exchanges, and to prevent a person from getting both employer contributions and public subsidies. The Administration expects that some 800,000 employers will provide reimbursement arrangements to more than 10 million employees. Some three million will have been buying coverage on the individual market, meaning the rule should save the fisc money on increasingly expensive tax credits.

By failing to repeal ObamaCare, Republicans can’t address all of its dysfunctions. But at the margin by expanding choices they are making the individual market better, not worse, even as Democrats accuse them of sabotaging ObamaCare. Other new Trump options include short-term plans and association health plans. And unlike ObamaCare, the government isn’t coercing you to buy these products.

Speaking of association plans, the returns are coming in on the Democratic claim that allowing The Administration is improving the individual market by expanding insurance choices.

Employers to band together to offer coverage is “junk insurance.” The plans are still nascent, but look at what the Las Vegas Metro Chamber of Commerce is offering: nine plan choices; dental, vision and life coverage available; pre-existing conditions covered; and more, with premium rates locked in for two years.

This is no surprise. The selling point of association plans is that businesses can pool risk and cut overhead costs. Businesses want to offer generous coverage that helps to attract workers in a tight labor market.

There may also be more relief ahead with the recent announcement that Health and Human Services rescinded a 2015 guidance for Section 1332 waivers. This is the Affordable Care Act’s waiver process for states to opt out of parts of the law. But Democrats designed the waivers to ensure that only progressive fantasies like single payer in Vermont could win approval. The Obama crowd then restricted the statute further in regulation.

The Trump Administration will interpret this in more rational ways, versus Obama guidance that applied the standards down to how plans would affect subpopulations in the state. The guidance was so prescriptive that most states didn’t bother coming up with ideas. The question now is how many enterprising Governors will decide they can do better than the status quo even within the restrictions.

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You haven’t heard about all this because Democrats want to define the election as a choice between them and Republicans who supposedly want to deny insurance to people with lung cancer. [And because the Republicans are so STUPID that they don’t know how to capitalize on what they have accomplished.] But political control of health insurance is not the only way to care for the sick. The GOP tends to favor block grants for high-risk pools that subsidize those who need help paying for expensive treatments.

ObamaCare set up an interim high-risk pool to cover anyone with pre-existing conditions who had been denied coverage, at least until the exchanges went live. Peak enrollment: 115,000, even as Democrats claim now that 130 million people have pre-existing conditions and are at risk from Republican policy.

The GOP’s incremental progress on healthcare freedom would have been hard to imagine a year ago when it failed to repeal and replace ObamaCare. Repeal is still desirable given the law’s fundamental flaws. But the Administration is working within the law’s limits to allow as much freedom as possible. If these products prove to be popular, Democrats may find it harder to eliminate the choices to stand up single payer.

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The GOP Entitlement Caucus

My respect for the Freedom Caucus has slipped in a major way. It will take a long time for Republicans to recover from the damage they have done.
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WSJ 3/28/2017

The full dimensions of the GOP’s self-defeat on health care will emerge over time, but one immediate consequence is giving up block grants for Medicaid. This transformation would have put the program on a budget for the first time since it was created in 1965, and the bill’s opponents ought to be held accountable for the rising spending that they could have prevented. The members of the House Freedom Caucus who killed Obama-Care’s repeal and replacement claim to be fiscal hawks. Most of them support a balanced budget amendment. Yet they gave zero credit to a reform that would have restored Medicaid—a safety net originally intended for poor women, children and the disabled—to its original, more limited purposes. Over the years liberal and some otherwise conservative states opened Medicaid benefits to new populations. And in 2010 ObamaCare added working-age, able-bodied adults above the poverty level. The result is that Medicaid now insures more than 72 million people, or one of every five Americans. In six states it’s one of every four or higher. Medicaid is now the third-largest program in the federal budget and the fastest growing. Federal outlays are nearly three times higher today than in 2000, as the nearby chart shows.

Republicans had a rare opening to change the projected trajectory, by limiting the federal government’s open-ended commitment. The federal government “matches” between 50% and 74% of costs for the pre-ObamaCare population, while new Medicaid earns 90%-95%. This formula rewards states that spend more and means they are less accountable for controlling spending or allocating resources toward high-quality care for the most vulnerable.

These disincentives, combined with price controls and low provider reimbursement rates, produce the worst health outcomes of any insurance in the U.S. A pioneering New England Journal of Medicine study in 2013 found that Medicaid “generated no significant improvement” across measures like mortality, high blood pressure or diabetes compared to the uninsured.

The House bill would have transitioned to a per-capita block grant that would grow with an index of medical inflation. The change would have broken the direct link between state spending and federal subsidies and started to make more of a defined contribution. In exchange, Governors would have gained reform flexibility. Federal Medicaid rules strictly limit state freedom to try new ideas, and the poor would be better off if decisions about their welfare are made locally instead of in Washington. States would have been better off as Medicaid crowds out other state priorities like education and public safety.

The bill wasn’t perfect. Per capita block grants that rise with medical inflation is insufficient fiscal discipline, and the bill would have added to the political pressure to join new Medicaid in the 19 states that haven’t. Block grants also would have been delayed until 2020, and the danger of waiting is that they get overturned by a future Congress or become a new version of the old “sustainable growth rate” recipe in Medicare—an orphan that Congress defers year after year.

But the Freedom Caucus decided to wait not until 2020 but forever. A fragile compromise that could attract majority support was rejected in favor of sustaining Medicaid’s march into insolvency. Republicans may not get a better chance for decades to modernize Medicaid in a way that helps the poor and taxpayers, and voters would be right to doubt the Freedom Caucus’s evanescent fiscal bona fides.

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The ObamaCare Republicans

These folks have lost almost all credibility with me.
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WSJ 3/25/2017

House Republicans pulled their healthcare bill shortly before a vote on Friday, and for once the media dirge is right about a GOP defeat. This is a major blow to the Trump Presidency, the GOP majority in Congress, and especially to the cause of reforming and limiting government.

The damage is all the more acute because it was self-inflicted. President Trump was right to say on Friday that Democrats provided no help, but Democrats were never going to vote to repeal President Obama’s most important legislation. And that’s no excuse. Republicans have campaigned for more than seven years on repealing and replacing Obama-Care, and they finally have a President ready to sign it. In the clutch they choked.

Speaker Paul Ryan and Mr. Trump worked together and to their credit to broker a compromise between the GOP’s moderate and conservative wings. Their bill worked off the reality that the U.S. health system has changed under ObamaCare and thus an orderly transition is necessary to get to a free-market system without throwing millions off insurance. The GOP also is a center-right coalition with competing views and priorities. The bill had flaws but was the largest entitlement reform and spending reduction in recent decades.

That wasn’t good enough for the 29-or-so members of the House Freedom Caucus who sabotaged this fragile legislative balance. When one of their demands was met, they dug in and made another until they exceeded what the rest of the GOP conference could concede. You can’t have a good-faith negotiation when one party doesn’t know how to say yes—or won’t.

The Washington chorus now claims Mr. Ryan made a mistake by leading with health care, and perhaps in retrospect he did. But he was responding to demands for immediate repeal by the same conservatives who later abandoned him. They wanted a repeal-only vote that had no chance of passing, which is why Mr. Ryan and Senate Republicans worked on the compromise of repeal and replace.

The critics assailed the bill as “ObamaCare Lite,” but the result of their rule-or-ruin strategy will now be the ObamaCare status quo, and Mark Meadows (North Carolina), Jim Jordan (Ohio), Louie Gohmert (Texas) and the rest own all of its problems. Please spare everyone your future grievances about rising health spending or an ever-larger government.

The grand prize for cynicism goes to Senator Rand Paul, who campaigned against the bill while offering an alternative that hasn’t a prayer of passing. “I applaud House conservatives for keeping their word to the American people and standing up against ObamaCare Lite,” said Dr. Paul. “I look forward to passing full repeal of ObamaCare in the very near future.”

There will be no such repeal in this Congress, and probably not in any other. Republicans run the government and that means they are responsible for what happens in health care. Messrs. Trump and Ryan are right that the ObamaCare markets are imploding, and prices will rise and choices will shrink again next year on present trends. Republicans can try to blame Democrats, but they’re in charge. Health and Human Services Secretary Tom Price can use regulation to improve insurance markets at the margin, but the bill would have given him more reform tools. The Trump Administration is inevitably invested in improving ObamaCare instead of standing up a replacement, and the voters harmed by rising premiums and declining choices may punish Republicans in the 2018 midterms.

This failure also reveals the unfortunate skills gap between Democrats and modern Republicans in practical legislative politics. Democrats have their Bernie Sanders faction, which claimed to “oppose” ObamaCare in 2009-10 for lacking a government-run public insurance option. But the far left voted for the bill anyway because they concluded, rightly, that a new entitlement was a great leap toward single-payer national health care.

An ideal free health-care market is never going to happen in one sweeping bill. The American political system is designed to make change slow and difficult, thank goodness. Republicans have to build their vision piece by piece, carefully gauging how to sustain their policy gains politically—the same way Democrats expanded the welfare and entitlement state over the last century.

But much of the current conservative establishment profits from fanning resentments, not governing. Legislative compromises don’t help Heritage Action raise money for its perpetual outrage machine. An earlier generation of leaders at Heritage understood that the goal of winning elections was to achieve something. The current leaders seem happy with failure.

Heritage was joined in opposition by the Club for Growth and the Koch brothers’ political machinery, also on grounds that the bill was imperfect. But good luck finding any comparable chance to shrink government. This demonstration of GOP dysfunction will make Members even more skittish about taking other difficult votes, including tax reform.

Mr. Trump said Friday he wants to move forward on cutting taxes, and Ways and Means Chairman Kevin Brady wants to do the same. We wish them luck and support the effort. But health reform is about a single industry. Tax reform implicates every industry and its denizens are the definition of the Washington swamp. Success on health care would have produced momentum and confidence that Republicans could fulfill their promises. Now Democrats and the swamp rats smell blood.

Perhaps Mr. Trump and the GOP can recover from this debacle, but as an opening act to a new Presidency the collapse of his first legislative campaign is ominous. In business Mr. Trump liked to “get even.” He’s got some scores to settle with the Freedom Caucus.

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