washington, dc

The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

Month: March 2012

ACA at Two: Already a Life-Saver, Cost-Cutter

On the even of the Supreme Court Ruling on the Affordable Care Act, Jonathan Cohn has a New Republic article calling attention to the impressive track record of the legislation — even though some of it’s key provisions have not yet kicked in. Cohn explains:

…Already more than two million young adults have gotten health insurance through their parents’ policies…Millions of Americans have consumer protections that, for those unlucky to need them, have made a real difference in their lives.
Of course, it won’t be until 2014 that we see the really big changes in health insurance coverage –the expansion of Medicaid to include everybody with income below 300 percent of the poverty line, the creation of a marketplace with subsidies where individuals and small businesses can get affordable insurance without discrimination. Undoubtedly this helps explain the public’s ambivalence.

As for cost-containment, there are some compelling indications the ACA is working well:

The Affordable Care Act isn’t simply about making insurance more widely available. It’s also about re-engineering the health care industry, so that it operates more efficiently–providing treatment that is higher quality, less expensive, or both. Its primary means for doing so is a series of changes to the way Medicare pays for treatment. The idea, as Sarah Kliff explains in the Washington Post, is to move from a system that rewards volume (i.e., the number of procedures performed) to a system that rewards value (i.e., the quality of care provided).
…Medicare is actually saving money….Maybe the clearest sign of change is on the bottom line: Medicare spending has been coming in lower than projections…. Paul Ginsburg and Chapin White, two widely respected experts from the relentlessly non-partisan Center on the Study of Health System Change argue that slow growth explains only part of the change. Writing in the New England Journal of Medicine recently, they suggested the Affordable Care Act–and the incentives its putting in place–are a major reason Medicare is starting to save money.
Harvard’s David Cutler, another highly respected economist, has been saying this was possible for a long time. “It is absolutely not just the recession,” Cutler, who was an original architect of what became the Affordable Care Act, said via e-mail. “The ACA is having an impact, as are changes like greater cost sharing. There is a real question as to whether we are entering an era of low cost growth.”
…More than five million seniors and people with disabilities have saved more than $3 billion on prescription drug costs, according to the Department of Health and Human Services….Highmark, a nonprofit insurer in Pennsylvania, is getting into the business of providing care directly through clinics of integrated medical professionals. Historically, such systems have provided some of the lowest cost, highest quality care in the country.

Cohn concedes that “it is far too soon to know the full impact” of the law, and adds “For now, though, popular health care remains a dream–even as successful health care reform starts, slowly but surely, to become reality.” With such a promising beginning, an adverse Supreme Court ruling would be a national tragedy that does more damage to the health of Americans than any decision in the high court’s history.


Unfinished Rights Revolution, As Well As Demographics Closing in on GOP

Ira Glasser, former executive director of the ACLU, asks a good question in the title of his HuffPo article, “What Are Conservatives Trying to Conserve?” Glasser references Jonathan Chait’s New York Magazine article, noting that “demographic changes in the United States will before too long spell doom to the political influence and hegemony of conservatives,” and adds that there is a parallel dynamic at work against the continuation of conservative policies:

…Chait’s emphasis on demographic shifts is powerful and mainly on target, but there is a broader historical context to his analysis that complements, extends and better explains the hysteria dominating the current rhetoric of the Republican party. In other words, there is content to all of this.

Glasser explains that the march of modernity, driven by a range human rights movements he cites, had a far-reaching effect on the social transformation of recent decades, and is still having a powerful impact:

The explosion of rights between 1954 and 1973 radically altered the rules of the game and, perhaps more importantly, the perceptions of those who lost their privileges (many of whom had little else)…To a very demonstrable extent, I think, the conservative movement of the last 30 years…may be seen as a panic response to a crumbling world and to the rights expansions of the ’60s that struck like a tsunami, washing away all the prior governing arrangements. …
…What conservatives were desperately trying to conserve was not the values at America’s origin (the Bill of Rights was, after all, ratified in 1791), but rather the privileges and powers of 19th century and early 20th century America. This is what has fueled the reactionary politics of the past three decades, and it is what we are seeing now in the Republican base and its candidates.
…It is true that demographic changes affect this struggle. But demographic changes did not cause the struggle, nor do they lie at its roots. It is also true, I think, that the views represented by the likes of Rick Santorum are fading, and that his screams against the changes he cannot prevent are like a death rattle. That doesn’t mean they can’t do damage, doesn’t mean they can’t temporarily prevail. But they know their time is passing and that the next generation will not react with shock to the changes that shock Santorum, because they will not experience them as changes, because they will have gotten used to them, because they grew up with them…The vision of life that Rick Santorum clings to will end, or diminish to a point where it is not politically viable. Chait is right that the Republican right wing knows this; he is right that they see this as their last shot (it may not be; I wouldn’t celebrate victory quite yet)
…This is about more than demographics: it is about fundamental social change and the reaction to it. And the fundamental changes at stake and at issue are mostly about rights, the rights won by submerged and subordinate groups roughly between 1954 and 1973, and the privileges and powers lost or limited, or perceived to be lost, by those who benefited, however unjustly, from the subordination of others.

It’s ironic that the expansion of ‘freedom’ conservatives claim to cherish will likely become the source of their demise as a dominant political force. With favorable demographic tail winds, the freedom movements of the 21st century will have increasing influence — and that’s good for Democrats.


From Keyser Soze To Economic Fundamentalists

As part of my occasional series of posts alerting TDS readers to items I’ve written for the Washington Monthly that are strategic in nature, here’s a couple from today:
* Press coverage of key campaign staff as godlike figures is a sure sign a campaign has locked down a party nomination. That’s happening with Mitt Romney, as evidenced by a revealing account of reporters cozying up to Romney campaign manager Matt Rhoades, who is getting the Keyser Soze treatment.
* Nate Silver conducts an impressive demolition of the credibility of “economic fundamentalists” whose election forecasts have gone awry. It raises a broader question about the very different assumptions that journalists and analysts bring to the table in discussing elections.


Political Strategy Notes

Ezra Klein’s “Wonkbook: Absolutely everything you need to know about health-reform Supreme Court debut” provides as good an introduction to the hearings as you are likely to find.
it’s an ad, but “Seniors and the Affordable Care Act” does have some good talking points for Dem candidates directed at highest turnout constituency.
Louise Radnofsky’s “Camping Out for a Ticket In” in the Wall St. Journal takes a look at the unsavory spectacle of people hustling for a limited number (60) of available free tickets to the Supreme Court’s hearings on the Patient Protection and Affordable Care Act, including hired place holders ($36 hourly) and scalping ($600). Although there is no acceptable reason why the proceedings will not be televised, “The court has said it will provide, on its website, audio recordings of the arguments a few hours after they wrap up for each session.”
Joshua Miller spotlights “Five Races in Which the Health Care Debate Will Matter” at CQ Politics.
ProPublica has an interesting widget in “A Tangled Web: Who’s Making Money From All This Campaign Spending?” by Al Shaw, Kim Barker and Justin Elliott, showing who get how much from whom and for what.
Tomasky argues for delayed White House support of gay marriage: “I would argue that it makes sense to win first and then do it. If he did it in a campaign context, many people would ascribe the move to other motives, and it would be the topic of heated debate. But if he does it in a second term, no one will be the least bit surprised.”
The Fix’s Aaron Blake reports that GOP primary turnout is up slightly.
Isolde Raftery’s “What Gender Gap? Washington State Has a History of Women Who Lead” in The New York Times sheds light on how one state over comes male domination of politics. “Nationwide, women’s groups point out the glaring gender disparity in public life, noting that there are only 6 female governors and 17 female senators. Across the country, women make up 23.6 percent of state legislatures.” She cites the late settling of the west as a factor in reducing the male advantage, along with the state’s “breed of tough, activist women.”
Despite the GOP’s recent blunders regarding reproductive rights, Vicki Needham warns at The Hill that “Slower jobs growth for women voters could cost Obama in election.” Needham notes that “women are the only group for whom employment growth lagged behind population growth from 2009 to 2011…During that time, female employment grew by 0.9 percent and lagged behind growth in the population of working-age women by 1.5 percent…That has led to jobs gains of only 600,000 — from 65.5 million to 66.1 million — for women, compared with 2.6 million for men during those two years, the survey showed.” She acknowledges, however, that Obama still has a strong edge in the polls with women voters.
Ryan as Romney’s ticketmate? Unlikely in my view. Strategic considerations will probably compel Mitt to look southward, where he has been underperforming. Maybe Rubio (FL + Latino cred), DeMint (tea party pander) or Chambliss (oozes southerness).


Huck on Track to Rule Wingnut Radio

For an insightful read about the future of wingnut talk radio, check out The Daily Beast’s “Mike Huckabee Brings on Rush Limbaugh’s Decline” by former Bush II speechwriter David Frum. It seems that the 30 sponsors bailing in the wake of Limbaugh’s ‘slut’ tirade may not be his most worrisome concern, as Frum explains:

…On April 2, Limbaugh will face a more-serious challenge. That’s when the new Mike Huckabee show launches on 100 stations in Limbaugh’s very own noon-to-3 time slot.
Huckabee’s competition threatens Limbaugh not only because Huckabee has already proven himself an attractive and popular TV broadcaster, but also because Huckabee is arriving on the scene at a time when Limbaugh’s business model is crashing around him.
To understand the power of Huckabee’s challenge to Limbaugh, you have to understand the strange economics of talk radio. Most talk-radio programs offer radio stations this deal: we’ll give you three hours of content for free. (Some programs–cough, Glenn, cough, Beck–have actually offered to pay radio stations to accept their content.) Those three hours will include 54 minutes of ad time. That ad time is split between the radio station and the show: each gets 27 minutes to sell.

But Limbaugh, Frum notes, was able to charge for his content and rake in big bucks in advertising — until 2009, when his listeners began shrinking to the point where they are now about half as many as three years ago. Limbaugh responded by cranking up his “TSL” ratings, ‘time spent listening’ — by pandering to his hard core base, getting them to listen longer. Frum adds:

That imperative explains why Limbaugh kept talking about Sandra Fluke for so long. He was boosting his TSL to compensate for his dwindling market share. Few things boost TSL like getting the old folks agitated over how much sexy sex these shameless young hussies are having nowadays. (And make no mistake: Limbaugh’s audience is very old. One station manager quipped to me, “The median age of Limbaugh’s audience? Deceased.”)
……Limbaugh’s audience not only skews old; it skews male. It was already 72 percent male in 2009–more male than that of almost any other program on radio or TV. Advertisers are not nearly as interested in talking to old men as to middle-aged women. If Huckabee can draw such women to his new program, as he has drawn them to his TV show, he will reshape the market.
…Limbaugh’s advertisers and his stations had already begun to feel ripped off. To quote my station-manager friend again: “I don’t mind paying for content. But I do mind paying for trouble.” So advertisers revolted against the TSL strategy, with Sears, JCPenney, and many other sponsors dropping the show. Many of the local advertisers who buy their ads from the local stations rather than from the syndicators have been ordering that their purchased minutes be placed on some less-controversial program.

Enter Huckabee.

Limbaugh’s calculation that his core advertisers must return always rested on the assumption that there was nowhere else to go. Suddenly, in the worst month of Limbaugh’s career, somewhere else has appeared: a lower-priced alternative, with big audience reach and a host an advertiser can trust never, ever to abuse a student as a “slut” and “prostitute.”
The new Huckabee show’s slogan is “more conversation; less confrontation.” “I don’t want it to be a show that every day, every hour, pushes everyone’s buttons to raise their blood pressure,” Huckabee says. “I figure the cost of high blood pressure is enough already.”
Huckabee’s politics are emphatically conservative of course, both on social and economic issues. Yet his politics differ in important ways from those of the Limbaugh-influenced Republican electorate…The less-strident Huckabee approach arises both from his experience as a long-serving governor in a Democratic-leaning state and from Huckabee’s famously genial temperament. “I have to believe that there are people who are highly opinionated but who actually find it informative and engaging to find out what the other side is thinking,” he says. “And not through a shouting match, but through an adult-level, civil conversation.”

While it is gratifying to see Limbaugh tank, Dems should hold the high-fives for a while. Huckabee is a shrewder reactionary than Limbaugh, and may be even more aggressive about pushing the wingnut agenda in electoral politics, albeit with more subtlety. In addition, Huckabee does have a certain gift for the soundbite put-down, as evidenced by his “We’ve had a congress that spends money like John Edwards in a beauty shop” zinger (this and other Huck quips here) during the early ’08 campaign. It’s not hard to imagine Huckabee besting the four current GOP presidential contenders, had he decided to enter the fray. His comments to the contrary, he may be laying the groundwork for a 2016 run.
Huckabee’s Achilles’ Heel, however, is his tendency to blather, a weakness which has damaged many ‘shock jock’ careers, from Imus to Limbaugh and a host of lesser-knowns in between. Last fall, Huckabee ‘jokingly’ (wink, wink) suggested creating confusion about election day at a pancake breakfast/rally in Mason, Ohio, as Molly Reilly tells in her HuffPo report::

“Make a list,” said Huckabee, referring to supporters’ family and friends. “Call them and ask them, ‘Are you going to vote on Issue 2 and are you going to vote for it?’ If they say no, well, you just make sure that they don’t go vote. Let the air out of their tires on election day. Tell them the election has been moved to a different date. That’s up to you how you creatively get the job done…The crowd laughed at Huckabee’s remarks. In 2009, he made a similar joke in Virginia, saying, “Let the air our of their tires … keep ’em home. Do the Lord’s work.”

Whether Huckabee refrains from advocating voter suppression on the air waves in his new gig remains to be seen. It’s good that Limbaugh is beginning to fade away like Glenn Beck. But Dems have always had a weaker talk radio echo chamber than Republicans — and the GOP’s edge may soon get even sharper.


Obama’s recent State of the Union speech can provide a solution to progressives’ most difficult dilemma in the 2012 election – how to combine legitimate criticism of Obama with active, passionate opposition to Republican extremism.

by James Vega
As progressives face the 2012 elections, they find themselves struggling with a profoundly difficult dilemma.
On the one hand, progressives clearly recognize the extraordinary danger presented by Republican extremism. The possibility of additional conservatives being added to the supreme court is, by itself, more than sufficient reason to conclude that the GOP must not be allowed to win in 2012 but there are equally serious threats to the survival of the New Deal social safety net, to basic worker and citizen rights and, for millions of Americans, to the continued right to vote itself. Both opinion data and progressive commentary show that only a very small fraction of 2008 Democratic voters are willing to sit out the 2012 election or support a Nader-style third party.
Read the entire memo.


Thomas Jefferson’s Religious Philosophy: A Profound and Inspiring Progressive Response to Rick Santorum and the Religious Right

A note from Ed Kilgore:
Rick Santorum’s recent comments on religion have elevated a number of core ideas of the religious right to a central place in the current national debate and have presented progressives and Democrats with a formidable challenge to their views.
In response to this challenge I am pleased to offer the following thought-provoking study of Thomas Jefferson’s religious philosophy as well as a companion communications campaign that illustrates how to put the study’s conclusions into action.
Read the entire memo.


How High Court Ruling Could Backfire on GOP

At WaPo’s ‘The Fix,’ Aaron Blake has an interesting read, “On health care, Supreme Court loss could be electoral win.” Blake believes the GOP’s glee about the upcoming Supreme Court ruling on the ACA could backfire — in an unexpected way. Blake explains:

…Some Republicans are worried that their big challenge to Obama’s health care law could backfire come election time.
Obama, of course, does not want to see his signature initiative overturned by the Supreme Court, which holds oral arguments on the bill next week and should render a decision by late June. And Republicans who have long railed against the bill would certainly be overjoyed to see the bill struck down.
But in an electoral milieu (yes, we just used that word) in which winning is often based more on voting against something rather than voting for it, losing at the Supreme Court may be the best thing that could happen to either side — and particularly Democrats.
“In a perverse way, Obama is helped if it is overturned, because then he can use it to rally his base,” said GOP pollster Glen Bolger. “If it is not overturned, then Republicans have a frying pan to bash over the Democrats’ head…”

That last point may be a bit of a stretch. It’s just as easy to imagine the GOP looking like whiners, grumbling about a pro-Republican court saying the law is sound. Plus it may be overstating the intensity of opposition to the mandate — many who don’t like it may be willing to at least give it a try, especially if the High Court says it’s OK.
In addition, don’t forget that polls indicate many who opposed the bill wanted a stronger role for government. Asked “What, if anything, do you think Congress should do with the health care law? Expand it. Leave it as is. Repeal it.” in a Pew Research poll conducted March 7-11, 53 percent said “expand it” (33 percent) or “leave it as it is” (20 percent), with just 38 percent supporting repeal.
Blake is on more solid ground, however, in arguing:

Republicans already hate the law, and if it gets struck down, there’s nothing to unite against. Obama may pay a price from his political capital for enacting a law that is eventually declared unconstitutional, but all of a sudden, the bogeyman disappears, and the GOP loses one of its top rallying cries.
The Democratic base, meanwhile, would be incensed at the Supreme Court, which has generally tilted 5-to-4 in favor of conservatives on contentious issues, and could redouble its efforts to reelect Obama so that he could fill whatever Supreme Court vacancies may arise.

Blake argues less persuasively that Republicans will still put energy into repealing the law, even after the Supreme Court’s ruling. Seems to me that this would be a huge loser for the GOP. The public was tired of the legislative debate a long time ago. I would agree with Blake’s assessment, however, that Dems may “have more to gain than Republicans do” in terms of the election — even with an adverse ruling.