Congressional Republicans

The Search for an Obamacare Alternative

Congressional Republicans have failed so far to offer a comprehensive alternative to Obamacare, but there is a surge of support on the campaign trail to look at a single-payer health care system.

Congressional Republicans have failed so far to offer a comprehensive alternative to Obamacare, but there is a surge of support on the campaign trail to look at a single-payer health care system.

While congressional Republicans continue to look for an Obamacare replacement, others are stepping up with alternatives they may like even less but may appeal to a significant segment of the U.S. population.

Democratic presidential candidate Bernie Sanders has been a consistent voice for a single-payer national health care system, which could be a simple as having everyone enrolled in Medicare. His support for a single-payer health care system is credited by some political observers for his strong showing in early Democratic presidential polls as he challenges Hillary Clinton, who also has a reputation for health care reform.

The single-payer system Sanders has supported on the presidential stump is estimated to cost $15 trillion over 10 years. But Sanders and like-minded supporters say a single-payer system would eliminate $5 trillion in “administrative waste" in that same period. The plan would be paid for by what is described as a “progressive” payroll tax

A Colorado group has placed Initiative 20 on that state's 2016 general election ballot to create ColoradoCare. Under this universal health care coverage proposal, people who live or earn money in Colorado could choose their providers, but medical bills would be paid by the state.

Backers of the Colorado initiative would pay for ColoradoCare through a 10 percent payroll tax, which would generate an estimated $25 billion per year. Under the plan, employers would pay two-thirds of the 10 percent payroll tax and employees the remaining one-third. Self-employed individuals would pay the entire 10 percent on their net income, according to The Denver Post.

The concept of a national single-payer health care system has been floated before and generally beaten back because of fears of an even larger federal bureaucracy, increased health care costs and higher taxes. Hillary Clinton’s proposed health care reform measure stopped short of a single-payer system, as does the Affordable Care Act, which tries to reduce the number of people without health insurance by creating a government-managed marketplace.

While it is easy to point at warts in Obamacare, it is much harder to come up with a plan to replace it, which is why congressional Republicans have voted scores of times on repeal and zero times on a substitute. One reason for the difficulty is that the U.S. health care system has lots of parts. There is the part where workers and their families receive health insurance offered through their employer. Then there is Medicare, Medicaid, the Veterans Administration, Indian Health, federally funded clinics, school clinics, psychiatric care and alternative care such as naturopathy and chiropractic.

The complex health care system and health insurance coverage only partially overlap, which sometimes leads to awkward and expensive health care delivery, such as children from low-income families being forced to seek care in a hospital emergency room instead of a school clinic or people suffering from mental illness receiving prescriptions for psychotropic drugs from primary care physicians.

One of the underlying appeals of a single-payer system is its promise to consolidate the silos in the health care delivery system and eliminate (or at least shrink) the disparity between health care delivery and health insurance.

Skeptics question whether a single-payer health care system would live up to its promise in the United States, where many people are accustomed to a broad range of choices in providers and some providers decline to serve patients in a public health program because of lower fees. Skeptics also doubt Americans are willing to pay higher taxes and hand over more control of their lives to the federal government.

While those arguments have prevailed in the past, progressives such as Sanders and the Initiative 20 backers in Colorado are saying that tinkering with the health care system is not enough to stem rising health care costs and ballooning insurance premiums. They say if you want an alternative to Obamacare, here’s one to consider.

In the absence of another comprehensive alternative, the single-payer system appears to be gaining some momentum as a policy option.

The Intractable Trade Issue

Oregon Senator Ron Wyden finds himself in the middle of a high-stakes debate over a major free-trade agreement with Asian Pacific partners and the rules by which the Obama administration will need to follow to negotiate the deal. Photo by  SenateEnergy .

Oregon Senator Ron Wyden finds himself in the middle of a high-stakes debate over a major free-trade agreement with Asian Pacific partners and the rules by which the Obama administration will need to follow to negotiate the deal. Photo by SenateEnergy.

Oregon Senator Ron Wyden finds himself in the middle of a major trade policy debate that could affect the ultimate fate of a Trans-Pacific trade agreement sought by the Obama administration.

Oregonian political reporter Jeff Mapes says Wyden, despite a history as a free trader, is the cause of a delayed hearing on so-called fast-track authority for the administration to negotiate a trade deal.

According to Mapes, the hang-up is over how many senators it would take to retract fast-track authority. Congressional Republicans want 67 senators, while Wyden wants 60. Wyden's view matters because he is the ranking Democrat on Senate Finance, the committee that would scrutinize any trade deals.

A free trade agreement with Asian Pacific partners is viewed as one of the major legislative opportunities this Congress for Republicans to work with President Obama in his final two years in office.

Wyden isn't retreating from his free-trade position, even though he has been pressured to do so from organized labor leaders, including Oregon AFL-CIO President Tom Chamberlain. Mapes says Wyden is trying to find middle ground.

For example, Wyden has agreed with opponents that trade pact negotiations are too secretive. "Transparency, congressional accountability ... and enforcement is really the key to coming up with a sensible, bipartisan trade agreement," Mapes reports Wyden as saying. Wyden says he wants a "good deal."

Senate Republicans seem less worried about how trade negotiations are conducted. That is somewhat ironic in light of the controversial letter 47 GOP senators sent this week to Iranian officials expressing their strong desire to approve any nuclear arms limitation deal negotiated by President Obama. 

Trade agreements have special importance to the West Coast and Oregon. The Port of Portland is one of the largest export platforms on the West Coast, which Wyden has acknowledged.

"People want to buy our wheat, they want to buy our computers, our wine," Wyden told Mapes. "The Oregon brand is just on fire all over the world and we ought to be able to get our exports, particularly, into Asia. ... If I could get in a sentence for my economic philosophy, it is  grow things in Oregon, make things in Oregon, add value to them in Oregon and then ship 'em somewhere."

However, Wyden, who is up for re-election in 2016, faces electoral pushback. Chamberlain, while crediting Wyden for working hard to reach out to both sides of the debate, said the senator's position for fast-track authority and a Trans-Pacific trade deal could cost him official labor backing next year.

Democracy for America has sent out a large mailing urging Oregon Congressman Peter DeFazio to challenge Wyden. DeFazio said he has no interest in running against Wyden. 

Related Link: In free-trade fight, Ron Wyden emerges as key negotiating figure in Congress

Picture of Gridlock

President Obama's State of the Union Address didn't appeal to Republicans, but may have been intended as the first salvo in the 2016 election.

President Obama's State of the Union Address didn't appeal to Republicans, but may have been intended as the first salvo in the 2016 election.

It was easy to spot who was who last night at President Obama's next-to-last State of the Union Address to Congress. The people standing up and cheering were fellow Democrats. The people sitting down were Republicans.

After the speech, GOP spokesmen said Obama needs a "reality check" because many of his proposals, such as raising taxes on wealthy Americans, won't fly in the new Congress controlled by Republicans. Democrats said Republicans can't admit that the economy is rolling and are unwilling to tackle issues such as wage stagnation that hobble middle and lower income Americans.

You could say the packed House chamber was the picture of gridlock in Washington, DC.

A close-up of that picture was visible as the TV cameras showed the respective reactions from Vice President Joe Biden and House Speaker John Boehner who were seated behind Obama during the speech. Biden nodded in agreement and rose repeatedly to applaud. Boehner clapped his hands tepidly a few times and mostly grimaced as Obama spoke.

Republicans say Obama failed to acknowledge voter repudiation of his policies that led the GOP to majorities in both the House and Senate. They also say he missed opportunities to identify areas of potential compromise, such as steps to strengthen Medicare.

Obama did cross swords with his own party by asking for fast-track authority to negotiate new international trade agreements in Europe and Asia, which many Republicans support. But he promised vetoes on legislation that tried to undo his executive actions on immigration.

Despite the closing section of Obama's speech where he said Washington is better than gridlock, there was little in his text or delivery to suggest he was willing to budge on his political priorities. Many observers called his speech the first salvo in the 2016 election.

When Obama mentioned he has no more election campaigns, some congressional Republicans applauded. Obama, with a smile on his face, shot back, "I know because I won both of them." The President also looked directly at the concentration of Republicans in the chamber when he ticked off positive economic indicators and said something to the effect of "That's good stuff."

For their part, Republicans invited Israeli Prime Minister Benjamin Netanyahu to speak from the same podium as Obama did. Netanyahu has objected to the deal the Obama administration is trying to cut with Iran to prevent it from becoming a nuclear power. Boehner pointedly told reporters he extended the invitation to Netanyahu without notifying Obama.

The President's speech and Republican reactions follow what has become a political ritual. Now that political points have been made and battle lines drawn, it is still possible Obama and GOP congressional leaders can do some of the country's business.

A Lame Duck Congressional Cromnibus

A lame duck Congress is reduced to passing a tax bill that expires almost as soon as it passes and a spending bill that seeks to single out the Department of Homeland Security.

A lame duck Congress is reduced to passing a tax bill that expires almost as soon as it passes and a spending bill that seeks to single out the Department of Homeland Security.

The lame duck Congress appears on the verge of passing a tax bill that would expire January 1, 2015 and considering something called a "cromnibus," a plan to keep the federal government's doors open while placating conservative Republicans.

The tax bill, which would extend 50 expiring tax benefits, was once a promising measure. But the omission of an earned income tax credit, the threat of a presidential veto and the looming GOP congressional majority in the next Congress left negotiators little wiggle room. They chose the lowest common denominator – extending the tax provisions through 2014, but ending January 1, 2015.

That means tax credits, such as the one that benefit electric motorcycle manufacturers like Brammo in Ashland, Oregon, won't be unplugged, at least for now.

The cromnibus has a similar political lineage.

Just last month, House and Senate Appropriations staff were well on their way to negotiating framework for a 2015 omnibus spending bill. Thanks to a bipartisan deal crafted last December by Senator Patty Murray (D-WA) and Representative Paul Ryan (R-WI), domestic and national security spending levels were set for fiscal years 2014 and 2015. The deal gave Congress a funding road map for fiscal 2015 and allowed House and Senate Appropriations panels to write nearly all of their fiscal 2015 bills with comparable top-line spending levels, leaving less to negotiate.

Unfortunately, optimism for an omnibus measure faded after President Obama issued an executive order on immigration to protect five million undocumented immigrants from deportation. Many Republicans insist the executive actions are an abuse of constitutional power and are turning to the appropriations process to block Obama's efforts. 

To appease these members of the GOP, House Appropriation Chair Harold Rogers (R-KY) is crafting a "cromnibus" package. This measure would fund all of government operations and spending through the end of fiscal 2015, except for Homeland Security. A separate three-month continuing resolution would be provided for the agency, buying time for the GOP to determine how to block the executive orders in the new Congress.

Still, a group of vocal conservatives is pushing House GOP leaders to attach a policy rider to the cromnibus that explicitly prevents funding for executive actions on immigration. Such a move would be dead on arrival in the Senate. For now, the clock is ticking as appropriators race to finalize a plan that will pass both chambers by December 11 and prevent a government shutdown. 

Ultimately, the outcome of the lame duck session will give the best indication of how well the new Republican majority will work with President Obama. If Republicans prefer to play hardball with a possible government shutdown on December 11, the stage will be set for a tumultuous two years of governing.

Members of Congress returned to DC with a hefty to-do list that includes the National Defense Authorization Act, which has a strong history of bipartisan support and is on track to pass again this year.

Poll Reflects a Seething, Alienated Public

Americans aren't happy. They see the country headed on the wrong track. They aren't satisfied with the economic recovery. They have low opinions of the President and Congress. They think America is in decline. They believe a widening gap in incomes undermines the idea of opportunity for all.

Those are some of the findings from a poll conducted this month by Hart Research Associates for NBC News and the Wall Street Journal. Hart interviewed 1,000 American adults, including 350 respondents who only have a cell phone, which yielded a broad spectrum of participation, including 11 percent from adults between the ages of 18 and 24. 

The public rarely has an opportunity to see raw poll results from a credible pollster. Hart Research was founded by Peter Hart in 1971. In addition to work for Democrats, Hart Research has conducted surveys for nonprofits and social causes. Since 1989, Hart has teamed with a leading Republican pollster to conduct polls shared with the public. 

Some of the findings in the latest poll aren't surprising and don't veer from recent trends. The last time Americans thought the country was headed in the right direction was April 2009 and even then it was a 43-43 percent tie.

Much is made of declines in approval ratings for President Obama, but they aren't as severe as some suggest. The August poll showed 42 percent of respondents approved of Obama's handling of the economy, compared to 53 percent disapproving. However, the low-water mark for Obama came in May 2011 when his approval rating was just 37 percent. It was 39 percent as recently as last December.