As you probably know if you’ve been following the presidential campaign news, Barack Obama released his long-awaited health care reform proposal earlier this week, and it’s getting decidedly mixed reviews from the chattering classes. Two progressive blogger/journalists with pretty good street cred on health care issues, Ezra Klein and Jon Cohn, have published quite similar takes, praising many of the details of the plan but decrying its timidity in challenging the health care status quo–most particularly its failure to provide universal coverage (other than for children). On the positive side, it does indeed seem that Obama’s plan represents sort of a greatest hits collection of incremental health care reform ideas. It picks up John Kerry’s underappreciated 2004 proposal for federal reinsurance of catastrophic health costs, which could have a big impact on rising insurance premiums. It adopts the federal employee health plan model for a national insurance purchasing pool, which makes abundant good sense substantively and politically. It calls for a federally-driven shift towards prevention and chronic disease management, along with IT investments to help control costs and improve quality, which ought to be a point of agreement among those who may disagree on financing mechanisms and/or the role of public and private sectors. It includes a direct assault on health care industry abuses through federal regulation, instead of treating such abuses as an unavoidable byproduct of for-profit involvement in health care. It does cover all kids, which makes sense if you aren’t going to cover everybody. And it provides very robust subsidies to make voluntary health insurance affordable to as broad a segment of the uninsured as possible, along with an employer mandate to avoid erosion of existing coverage. Those are a heap o’ positives, but the negatives, most especially the plan’s failure to include a universal individual mandate for health insurance, and its complexity, are likely to get more attention, on both substantive and political grounds. Substantively, the plan obviously fails to fundamentally overhaul the current system, with its patchwork of public and private programs, its heavy reliance on economically damaging and arguably regressive employer-based coverage, and its failure to cover everyone. And politically, the plan will reinforce claims that Obama isn’t quite the transformative, great-leap-forward progressive so many have seen in him. One particular problem for Obama is that his plan superficially resembles the Massachusetts initiative signed by Republican presidential candidate Mitt Romney, with the crucial exception that Massachusetts did include a universal individual mandate for coverage (underfunded, to be sure, but still in place). Another is that Obama’s plan achieves less than universal coverage at a pretty steep price tag, given its lavish subsidies to tempt rather than force individuals into obtaining insurance. Beyond the initial reactions, perceptions of Obama’s plan will be crucially influenced by his rivals for the Democratic presidential nomination. John Edwards is already in a position to exploit Obama’s incrementalism on health care, given his own comprehensive universal plan, which not only embraces an individual mandate for coverage but also provides a stronger Medicare-style public option attractive to Democrats who favor a single-payer system. Given Edwards’ competition with Obama for the support of left-leaning Democrats, this could become an important point of distinction between the two candidates, at least among activists. But the other shoe that will soon drop is Hillary Clinton’s; she’s slowly rolling out a very thorough and comprehensive health care reform proposal, building on her unquestioned expertise in this field. Still under wraps is what she would do to achieve expanded coverage. If she goes for a universal plan (which is quite likely), then Obama will begin to look like an incrementalist outlier among those who care about policy details.
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Editor’s Corner
By Ed Kilgore
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April 16: Brian Kemp Is Cynically Using Voter Suppression To Win Back MAGA Support
When an underwhelming primary rival to Brian Kemp announced his candidacy I took a look at the Georgia governor’s comeback strategy and wrote it up at New York.
Until March 25, Georgia governor Brian Kemp was looking pretty finished politically. Very publicly and vociferously blamed by Donald Trump for ratifying Secretary of State Brad Raffensperger’s certification of Joe Biden’s victory in Georgia on November 20, Kemp was persona non grata in MAGA country. He had already been periodically in Trump’s doghouse over his handling of the pandemic in his state, and before that, over his rejection of the Boss’s instruction that he appoint Representative Doug Collins to an open U.S. Senate seat. But getting in the way of the 45th president’s attempted election coup was the final straw: Trump has been publicly and privately vowing to take down Kemp in next year’s Republican gubernatorial primary, as recently as the RNC donor retreat in Florida last weekend. During his brief campaign appearance in Georgia before the January Senate runoffs that ended in defeat for his party, Trump even called on Collins to challenge Kemp in 2022, which wasn’t exactly a Georgia GOP talking point. Nor was Trump’s later suggestion that Kemp should resign.
Kemp managed to keep his mouth shut in the face of all these provocations, grimly promising to support Trump in 2024 and generally taking his medicine. But his comeback strategy became apparent when he made a big show of signing Georgia’s highly controversial new election law on March 25. It’s unclear whether he deliberately courted the appearance of racist impropriety, though he did sign the bill under a painting of a plantation and barred a Black Democratic legislator from his office during his remarks on the bill. (State Representative Park Cannon was subsequently manhandled by state troopers who wrestled her out of the Georgia Capitol to be arrested on multiple felony counts.)
As anger over the legislation mounted (echoing the anger over Kemp’s own voter-suppression measures as Georgia’s secretary of State, the job he insisted on keeping during his narrowly successful 2018 gubernatorial campaign) and major corporations joined the criticism of the law, Kemp was able to adopt a pose that is legal tender for a GOP pol at present: victim of “race card” politics backed by “woke” corporations. As the Associated Press reported, it was very clear to Georgia Republicans what the man who had labeled himself a “politically incorrect conservative” in 2018 was up to:“[T]he sweeping election law could be one of Kemp’s last hopes to rekindle a bond with Republicans who remain fiercely loyal to Trump and will be a critical force in next year’s GOP primary. The legislation, which Kemp signed into law, could give him an opening to persuade Republicans that he is an outsider, willing to stand up to Democrats, corporate leaders, and sports leagues who have derided the measure as an affront to democracy that is based on false claims and needs to be rewritten.“’This is an absolute godsend for Brian Kemp,’ said Brian Robinson, a Republican consultant and former top aide to Kemp’s predecessor, Nathan Deal.”
Kemp has eagerly been making the rounds of conservative media outlets to defend the new law, struggling, no doubt, to hide his glee at the liberal criticism it has attracted. The furor is helping him back home where it matters as well, as the Atlanta Journal-Constitution’s Greg Bluestein observes:
“In recent weeks, Kemp has been a mainstay on conservative cable TV shows and enjoyed raucous receptions at grassroots meetings across the state, seemingly dissuading better-known Republican rivals such as former U.S. Rep. Doug Collins, whom Trump once recruited to run.”
Morning Consult reports that Kemp’s job-approval rating among Georgia Republicans rose from 59 percent in mid-March to 74 percent in early April. Nonetheless, a well-known Georgia pol close to Trump has now announced a 2022 primary bid against the governor. But his identity could be a blessing in disguise to the incumbent.
Vernon Jones is a Black former state legislator and county CEO who endorsed Trump’s reelection last year and has more recently switched parties. He got a lot of MAGA attention, particularly after his featured role at the GOP National Convention. He has really taken to his new career in Republican politics, speaking at the notorious January 6 “Stop the Steal” rally in Washington and basking in the affection of the Big Man (“When are you announcing? When are you announcing?” Trump said to Jones at Mar-a-Lago last week).
Jones’s announcement made it clear that he’s the former president’s surrogate.
Jones, however, is a risky proposition as Trump’s instrument of vengeance against Kemp. Aside from the fact that he’s a career Democratic politician from a jurisdiction (the Atlanta inner suburb of Dekalb County) that your average rural Republican wouldn’t visit on a bet, he has always had some issues, as Bluestein explains, calling him “a uniquely polarizing figure in state politics”:
“Jones launched his political career in the early 1990s in the Georgia House before winning the first of two terms as DeKalb County’s chief executive officer in 2000. His stint was marked by controversy …
“[H]is angry outbursts and clashes with other local officials dominated headlines, as did more serious allegations …
“[A] wide-ranging special grand jury report released in 2013, after Jones left office, recommended an investigation against Jones and other DeKalb officials into possible bid-rigging and theft when he was chief executive, painting a picture of a culture of corruption that spanned from his office to workers and contractors in the watershed department.”
Worse yet, Jones was accused of rape in 2005. His successful defense was that the intercourse in question was part of a consensual three-way sexual encounter. This is still not a great look for candidates in the Christian-right- dominated Georgia GOP. And speaking of the Christian right, Jones had a problem with a vote in the legislature against a “fetal heartbeat” abortion ban Kemp had championed in 2019. On the eve of his candidacy, Jones executed a straight-out flip-flop on abortion, stating he now believed zygotes should be protected “from the moment of conception.”
You get the sense that Jones will serve as an irritant to Kemp but not a serious threat unless Trump himself forcefully intervenes in the race (and/or if a more formidable Trump-backed candidate, like Collins, who is reportedly mulling a Senate race, jumps in). And even then, Georgia Republicans will remember that Trump had strongly endorsed Kemp during the last gubernatorial primary. MAGA bravos looking for a pound of flesh may instead focus on Raffensperger, who has drawn an actual member of Congress as his 2022 primary opponent, along with the rival he barely defeated in 2018.
If Kemp does escape, he will likely face a rematch with his nemesis, voting-rights activist Stacey Abrams. And in that contest, all the treasure he has stored up in Republican circles by boasting of his commitment to “election integrity” may earn him a backlash from the voters he and his party have sought to bedevil.