Monday, March 27, 2017

Problem Solvers updates

Tongue in cheek, last October (I believe he was explaining that it was "not harmful" for Trump not to have paid any taxes for two decades; yes, I heard that he paid some in 2005, no, that doesn't answer all my question). Via Proud Democrat.

A couple of notes to tack on to Saturday's post on the failure of the Ryan tax cut health care initiative:

First, just that I can't help bragging about it when Dr. Krugman looks like he's channeling me two days later:

One important answer would be to spend a bit more money. Obamacare has turned out to be remarkably cheap; the Congressional Budget Office now projects its cost to be about a third lower than it originally expected, around 0.7 percent of G.D.P. In fact, it’s probably too cheap. A report from the nonpartisan Urban Institute argues that the A.C.A. is “essentially underfunded,” and would work much better — in particular, it could offer policies with much lower deductibles — if it provided somewhat more generous subsidies....
What about the problem of inadequate insurance industry competition? Better subsidies would help enrollments, which in turn would probably bring in more insurers. But just in case, why not revive the idea of a public option — insurance sold directly by the government, for those who choose it? At the very least, there ought to be public plans available in areas no private insurer wants to serve.
There are other more technical things we should do too, like extending reinsurance: compensation for insurers whose risk pool turned out worse than expected.
(I didn't mention the public option, limiting myself to the semi-public options of co-ops and the Multistate program jointly run by Blue Cross/Blue shield and the government, but yes, this would be a great idea, if those Problem Solvers really want to get down to solving problems.)

Something else I started wondering connects to Trump's telegraphing that he's going to take the Affordable Care Act off life support as it sinks into its apocalyptic end—


That's very funny, but in reality it's neither exploding nor imploding, and to kill it off, the administration is going to have to administer some poisons—as for instance pulling advertising during the next Open Enrollment period, the way they attempted to do during the last one, and issuing new waivers and rule changes to starve it.

Does anybody else think this is impeachable? The president swears to "take care that the laws be faithfully executed." Trump seems determined to sabotage this particular law. It's one thing to ask Congress to excuse him from executing the law, but he's tried that and failed. It's quite another to work on bringing it down from inside the executive offices—"I don't like it and I'm not doing it."

Incidentally, I just got a grip on why Ryan kept insisting that the ACA replacement was an essential precondition for the rest of any Republican agenda, thanks to Armando/DKos:

It's because, as I keep telling you, the Ryan health care bill wasn't a health care bill, it was an $880-billion tax cut paid for by an $880-billion cut in Medicaid funding. Obamacare was just Ryan's excuse and his way of getting Trump on board along with everybody for whom personal hatred of Obama is the chief motivation for everything they do.

In order for the tax "reform" [thanks, Jim] program to be passed in the Senate under reconciliation rules, with a bare majority, so they can do it without any Democratic votes, it too will have to be revenue-neutral, meaning any cut in taxes would have to be matched with a cut in spending, but Medicaid (serving the poor) is where all the money Ryan can touch is. Having failed to cut Medicaid, he's lost the opportunity to make significant spending cuts at all, and in that way there's no point for him in reforming the tax system; it would simply lock in the amount of revenue collected where it is, and he needs (for the satisfaction of his own personal demons, and for the Kochs, and for the Tea Party–style congresspersons who keep him in office) to lock it in at a trillion or so dollars less.

And his other, crazed plan to eliminate the corporate income tax with a VAT to be paid by consumers, made Trumpy-looking by its disguise as a "border adjustment tax" pretending to be there to protect American manufacturing jobs (it's revenue neutral, simply shifting the bill from the Kochs to you and me), is also going nowhere.

Which means there's really not going to be any tax "reform" either, friends. Just more fail, as far as the eye can see.
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