This is a post I wanted to do yesterday; but then decided I didn’t want to profane the Fourth by writing anything political. For at least one day a year, we ought to be able to show some unity.But I just finished reading Larry Diamond’s fascinating and disturbing book: Squandered Victory: The American Occupation and the Bungled Effort To Bring Democracy To Iraq. And it left me absolutely livid about the fact that Donald Rumsfeld is still Secretary of Defense.You should read Diamond’s book; if you don’t have time, he wrote an earlier and much briefer version of his basic argument in Foreign Affairs last fall.Diamond, probably America’s top expert on democracy-building, spent several months working for the Coalition Provisional Authority (the Pentagon-run U.S. occupation entity) in early 2004. And he came away with an indictment of the early and continuing mistakes, mostly attributable to Rumsfeld and his top civilian aides, that we and the Iraqis continue to pay for today.Most of his litany of errors is familiar, but Diamond puts them, and their consequences, together in a way that takes your breath away. Totally aside from the decision to invade in the first place (which Diamond opposed), Rumsfeld’s Big Mistake was his stubborn determination to go into Iraq with about one-third the number of troops that every military and civilian expert told him would be necessary to secure the country. As a result, Coalition troops could do little or nothing to deal with (a) the systematic looting and lawlessness that destroyed what was left of Iraqi civil authority, and paralyzed the economy; (b) a massive influx across unprotected borders of Iranian and Sunni Jihadist agents and fighters; (c) the formation of a vast array of sectarian armed militias, fueled by another bad administration decision to disband the Iraqi army; (d) a decisive erosion of Coalition credibility among Kurds and Shi’a who remember their abandonment by the U.S. to Saddam’s vicious reprisals after the First Gulf War; and (e) a security situation that made reconstruction efforts physically impossible.Aside from that Big Mistake, Diamond catalogues a bunch of subsequent blunders, including an inability to take seriously and accomodate the pro-democracy views of Grand Ayatollah Sistani, probably the most important figure in Iraq; an abrupt 180-degree shift in policy from a breezy assumption that the U.S. could turn Iraq over to exiles like Ahmed Chalabi, to a reluctance to relinquish control at all; and a consisent pattern of doing the right thing, if at all, several months too late.Even the famous “purple-finger” election of January 2005, Diamond says, carried the potential seeds of disaster, thanks to a Bush administration decision in favor of a national proportional representation system, with no provision for local districts. This decision guaranteed Sunni under-representation in Iraq’s first popularly elected government, while eliminating any incentive for the kind of inter-communal political parties that might have emerged in mixed-population areas of the country.Diamond hasn’t give up hope about prospects for the ultimate emergence of a stable Iraqi government, but has laid out an urgent series of U.S. policy changes (which the DLC recently endorsed) necessary to make it possible, including a decisive repudiation of the idea that we want a permanent military presence there.We all know George W. Bush cannot admit mistakes, though he is capable, now and then, of unacknowledged flip-flops. His single biggest mistake with respect to Iraq, before, during and after the invasion, was his and Dick Cheney’s categorical trust in Donald Rumsfeld and the people around him. I for one will have trouble expecting things to get better in Iraq until such time as Rummy walks the plank. Maybe the White House will suddenly announce that Rumsfeld is desperately needed for another job–perhaps some presidential commission on what the military should look like if and when we colonize space. After all, they’ve already found ways to offload Wolfowitz, Feith and Bolton.But any way you look at it, Rummy’s got to go, especially if this president ever intends to make something other than a very bad joke of his 2000 pledge to introduce “a responsibility era.”
TDS Strategy Memos
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By Ed Kilgore
March 24: The Republican Case Against Medicaid Expansion Continues to Crumble
There’s another turn in a story we’ve all been following for over a decade, so I wrote it up at New York:
The Affordable Care Act was signed into law 13 years ago, and the Medicaid expansion that was central to the law still hasn’t been implemented in all 50 states. But we are seeing steady, if extremely slow, progress in the effort to give people who can’t afford private insurance but don’t qualify for traditional Medicaid access to crucial health services. The U.S. Supreme Court case that upheld the ACA also made Medicaid expansion optional for states. Twenty-four states accepted the expansion when it became fully available at the beginning of 2014, and that number has steadily expanded, with the most recent burst of forward momentum coming from ballot initiatives in red states like Missouri, Nebraska, Oklahoma, South Dakota, and Utah. Now a 40th state is in the process of climbing on board: North Carolina. As the Associated Press reports, legislation is finally headed toward the desk of Governor Roy Cooper:
“A Medicaid expansion deal in North Carolina received final legislative approval on Thursday, capping a decade of debate over whether the closely politically divided state should accept the federal government’s coverage for hundreds of thousands of low-income adults. …
“When Democratic Gov. Roy Cooper, a longtime expansion advocate, signs the bill, it should leave 10 states in the U.S. that haven’t adopted expansion. North Carolina has 2.9 million enrollees in traditional Medicaid coverage. Advocates have estimated that expansion could help 600,000 adults.”
So what changed? Basically, over time the fiscal arguments North Carolina Republicans used to oppose the expansion began sounding increasingly ridiculous, AP suggests:
“GOP legislators passed a law in 2013 specifically preventing a governor’s administration from seeking expansion without express approval by the General Assembly. But interest in expansion grew over the past year as lawmakers concluded that Congress was neither likely to repeal the law nor raise the low 10% state match that coverage requires.
“A financial sweetener contained in a COVID-19 recovery law means North Carolina also would get an estimated extra $1.75 billion in cash over two years if it expands Medicaid. Legislators hope to use much of that money on mental health services.”
In other words, the GOP Cassandras warning that the wily Democrats would cut funding for the expansion in Congress once states were hooked turned out to be absolutely wrong. Indeed, the very sweet deal offered in the original legislation got even sweeter thanks to the above-mentioned COVID legislation. States like North Carolina appeared to be leaving very good money on the table for no apparent reason other than partisanship, seasoned with some conservative hostility toward potential beneficiaries. In this case, GOP legislators finally reversed course without much excuse-making. The AP reports:
“A turning point came last May when Senate leader Phil Berger, a longtime expansion opponent, publicly explained his reversal, which was based largely on fiscal terms.
“In a news conference, Berger also described the situation faced by a single mother who didn’t make enough money to cover insurance for both her and her children, which he said meant that she would either end up in the emergency room or not get care. Expansion covers people who make too much money for conventional Medicaid but not enough to benefit from heavily subsidized private insurance.
“’We need coverage in North Carolina for the working poor,’ Berger said at the time.”
That, of course, has been true all along. Final legislative approval of the expansion was delayed for a while due to an unrelated dispute over health-facility regulations. And the expansion cannot proceed until a state budget is passed. But it’s finally looking good for Medicaid expansion in a place where Democrats and Republicans are bitterly at odds on a wide range of issues.
There remain ten states that have not yet expanded Medicaid; eight are Republican “trifecta” states (Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee, Texas, and Wyoming) and two others have Republican-controlled legislatures (Kansas and Wisconsin). Perhaps the peculiar mix of stupidity and malice that keeps state lawmakers from using the money made available to them by Washington to help their own people will abate elsewhere soon.