Category Archives: The Right

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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The Spoils of the GOP’s State Conquest

At the end of the article Ms. Sharp tells of the harrassment that conservatives like her receive. Not that you would read about it in the New York Times….
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WSJ 12/10/2016 By Kyle Peterson

In the war of ideas, a think tank is like a munitions factory, churning out the matériel to push the trench line a few miles forward. As luck would have it, Republican state lawmakers will be well equipped next year when they begin one of the largest conservative offensives in recent memory. Come January the GOP will hold “trifectas”—total control of both legislative chambers and the governorship—in 25 states, up from 10 in 2009.

If lawmakers have any questions about where to begin, one place with answers is the State Policy Network, a federation of 65 freemarket think tanks ranging from Anchorage, Alaska, to San Juan, Puerto Rico. “At the end of the day, people want jobs. They want security. That’s our bread and butter,” says Tracie Sharp, the group’s president. “We feel like for such a time as this, we’ve built up this network. We need to really run. This is a state moment.”

She seems to mean that in two ways. The first is the obvious: What can conservatives get done in capitals nationwide, and how can her think tanks help? Ms.

Sharp says that lawmakers, especially in small states, are hungry for economic analysis: “If I raise taxes, what, really, does it do? Does it create jobs or does it drive jobs out?”

That doesn’t necessarily mean producing dusty policy reports. “In the early days, there was a lot of ivory tower, highfalutin, white paper stuff,” Ms. Sharp says. “That is one way I think the network has really evolved in the last 10 years is to be able to communicate and message the ideas to the average American.”

Take Tennessee, where earlier this year the network’s Beacon Center led what its president called an “all-out siege” on the state’s Hall Tax, a 6% levy on investment income. Beacon made a football-themed video ad arguing that the tax hurt seniors and drove jobs to Florida. The think tank then used what’s called “geo-fencing” to serve the ad to cellphones only within a certain set of coordinates— the capitol building.

It did the trick. In May the governor signed legislation that will phase out the Hall Tax by 2022. When the network’s think tanks gathered in October to compare notes—what’s working in one place that could be adapted to another?—the Beacon Center presented an hour-long case study.

“This Hall Tax,” Ms. Sharp says, “has got people inspired now.”

The second opportunity is that states could help untangle some of the legislative knots in Washington, D.C. As the new Congress contemplates repealing ObamaCare, perhaps the biggest challenge is how to avoid pulling the rug out from under Americans relying on it. “Whoever’s going to drive this has to give a very clear answer for that,” Ms. Sharp says. “You’re dealing with needy, chronically ill people that no one wants to see tossed out without insurance. They have to be taken care of.”

Here’s the kicker: “I think it can be best done locally, or state and locally.” The gist is that if Congress wants to send Medicaid back to the states through block grants, an idea floated in Paul Ryan’s “Better Way” agenda, Republican governors and legislatures will be ready.

Ms. Sharp expresses similar sentiments about Donald Trump’s promised $1 trillion spending on roads, bridges and airports: “There are better ways to build infrastructure: Devolve.”

State think tanks are still relatively new, founded in earnest beginning in the late 1980s. But the network has sprawled since then, from 26 groups in 1991, to 54 in 2008, to 65 today with four more in the works. Combined revenues hit $80 million two years ago, and total staff has nearly doubled in the past six years to 525. “We have groups that are 20, 25, 30 years old, because we’ve built a durable infrastructure,” Ms. Sharp says.

“I think that is perhaps confounding to the left,” she adds.

“They have been trying to launch state-based efforts over time. They usually are centrally controlled from a D.C. hub—this is my experience. They tend to have one or two donors. And then the tide changes, the donor changes their mind, and then it just doesn’t take root.”

Anyone wondering whether an advantage in the states truly matters should look at this year’s Electoral College map. In Wisconsin, union membership is down 133,000 since 2010, the year before Gov. Scott Walker’s Act 10 overhaul passed. Donald Trump’s margin of victory there? Less than 30,000. In Michigan, public-union membership is down 34,000 since 2012, the year before Gov. Rick Snyder’s right-to-work law kicked in. Mr. Trump’s margin? Only 11,000.

Ms. Sharp says she had always felt these two states were only “thinly blue,” and that the GOP has been put on better footing by the unions’ slide. “When you chip away at one of the power sources that also does a lot of get-out-the-vote,” she says, “I think that helps—for sure.”

So what can Republicans realistically accomplish in the next few years? A quick survey of think tankers in states where the GOP gained on Nov. 8 suggests that the mood averages somewhere between bullish and giddy. Visions of tax cuts and tort reforms are dancing in their heads.

• Kentucky: “Republicans now control the Kentucky House of Representatives for the first time since 1921,” says Jim Waters, the president of the Bluegrass Institute. The GOP flipped 17 of the chamber’s 100 seats and defeated the sitting Democratic speaker.

With all the levers of power in Republican hands, right-to-work legislation looks like a shoo-in.

Also likely, he thinks, is a law establishing charter schools.

Kentucky is one of only a handful of states without charters.

“The Republicans need to grab this opportunity,” Mr. Waters says. “Our biggest concern is that the Republican leadership will be too timid.”

Somehow that seems unlikely: Gov.

Matt Bevin has already suggested calling a special session in 2017 to revamp the tax code—and maybe even eliminate the income tax.

• Missouri: A new Republican governor, Eric Greitens, will replace term-limited Democrat Jay Nixon. “I think that we’re going to see bills that have been vetoed in the past, like right to work, go through quickly,” says Brenda Talent, the CEO of the Show-Me Institute. Last year the Republican House tried to override Gov.

Nixon’s right-to-work veto but fell short by 13 votes.

Expanding charter schools, Ms.

Talent predicts, will be an “easy lift,” and tackling corporate welfare is a possibility. “To give you an idea of the magnitude of the problem,” she says, “you could eliminate the corporate income tax in the state simply by eliminating economic development tax credits.”

• New Hampshire: With the election of the first GOP governor in 12 years, add this to the pile of potential right-to-work states.

“The odds certainly are better than they’ve ever been,” says J. Scott Moody, the CEO of the Granite Institute. In 2011 the Democratic governor vetoed a right-to-work bill, and the House could not muster the votes to override.

• Iowa: Republicans retook the Senate, defeated the incumbent Democratic majority leader, and regained full control for the first time since 1998. Don Racheter of the Public Interest Institute says flatter tax rates are likely, as is a goal long-sought by social conservatives: defunding Planned Parenthood. In April the Republican House passed a bill to block Medicaid dollars from flowing to groups that provide abortions, but the language was stripped out by the Democratic Senate two days later.

“Now,” says Mr. Racheter, “I think that’ll happen.”

• Pennsylvania: In October the GOP House fell three votes short on a bill to move newly hired public workers away from traditional pensions. As it happens, on Nov. 8 Republicans picked up three additional seats. “Every indication we have,” says Charles Mitchell, president of the Commonwealth Foundation, “is pension reform is coming back and it’s coming back soon.” The legislature may also put on the Democratic governor’s desk a “paycheck protection” bill, which would bar the government from collecting union political funds.

“The dynamic has shifted considerably,” Mr. Mitchell says. “A lot of these issues were laughed out of the room, even under the last Republican governor.”

• Minnesota: A gain of six seats in the Senate put the legislature under total GOP control. “We’ve got about a $1.4 billion budget surplus,” says John Hinderaker, president of the Center of the American Experiment. “I think our Republican legislators understand that if they don’t provide some tax relief people are going to say ‘Well, why the hell do we bother voting for Republicans?’ ” The best targets for repeal, he suggests, are the state’s taxes on commercial property and on Social Security benefits. There’s also MNsure, the ObamaCare exchange.

When open enrollment began Nov.

1, Minnesotans saw rate increases up to 67%. “Something is going to be done. Something’s got to be done,” Mr. Hinderaker says. “This is why the Republicans won the election, in large part.”

• Illinois: Democrats kept the House but lost their supermajority, which will give Republican Gov. Bruce Rauner’s vetoes a bit more bite. It may also strengthen his hand in negotiations to end the 18-month budget stalemate.

“You’re starting to get the liberal chattering class in Illinois saying ‘Come on Democrats, why don’t you just agree to one thing that he wants to do,’ ” says Diana Rickert, vice president of communications at the Illinois Policy Institute.

She adds that there is more grumbling than ever—even from fellow Democrats—about Michael Madigan, the powerful House speaker who has held that office, excluding a two-year hiatus, since 1983. “We’re trying to dismantle a political machine that’s been in place for 40 years,” Ms. Rickert says. “It takes time. But we are making a lot of progress.”

None of these victories is assured. “I want to be clear: Sure, a lot of Republicans got elected,” Ms. Sharp says.

“That’s no guarantee that they’ll do the right thing. That’s where our work is so important.”

What imperils those efforts is Democratic zeal to force nonprofits like the network’s think tanks to turn over the names of their donors. “We expect no fewer than 20 states in this next cycle to put forth some sort of disclosure bill,” she says.

This is pitched as transparency, but Ms. Sharp says few people realize how much harassment conservative groups receive.

In 2011, during a dispute over a subsidy for an NHL hockey team, the president of the Goldwater Institute in Arizona had her home vandalized. “Someone gutted a rabbit and smeared the entrails across her front steps,” Ms. Sharp says. A year later the network’s headquarters in Arlington, Va., were broken into and ransacked.

The political left—or at least the segment of it that wields power— hasn’t been very sympathetic. But if anything can convince liberals of the unwisdom of forced donor disclosure, perhaps it’s President Donald Trump. Consider this recent phone call: “An ACLU chapter in a state,” Ms. Sharp says, “called the state think tank and said, ‘Hey, things have changed—we really want to talk about donor privacy.’ ” Mr. Peterson is an associate editorial features editor at the Journal.

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