Tag Archives: affordable care act

If everyone voted, progressives would win

In preparation for the 2016 presidential election, Democrats appear united around one candidate, while the Republican contest remains far from secured. Many on the left, who view Hillary Clinton’s stances as a tame brand of liberalism, have attempted to draft Sen. Elizabeth Warren, D-Mass., to run. But the progressives do not need a charismatic leader. Instead, they need to invest in unleashing the disgruntled progressive majority. A longer-term strategy for progressives should be to strengthen unions and boost turnout among politically marginalized populations.

“If everybody in this country voted,” the economist John Kenneth Galbraith said, “the Democrats would be in for the next 100 years.” There is strong evidence to support his claim. A 2007 study by Jan Leighley and Jonathan Nagler found that nonvoters are more economically liberal than voters, preferring government health insurance, easier union organizing and more federal spending on schools. Nonvoters preferred Barack Obama to Mitt Romney by 59 percent to 24 percent, while likely voters were split 47 percent for each, according to a 2012 Pew Research Center poll. Nonvoters are far less likely to identify as Republican, and voters tend to be more opposed to redistribution than nonvoters.

In a recent nationwide study, Stockton College professor James Avery found a strong correlation between the electorate’s class bias and the Gini coefficient, a commonly used measure of inequality. In short, the lower the turnout, the higher the class bias and the greater the support for policies that lead to inequality. His study builds on previous research by political scientists Christopher Witko, Nathan Kelly and William Franko showing how class bias in voting reinforces economic inequalities. Their findings are not confined to the U.S. Around the world, voter turnout is correlated with redistributive policies. For example, the turnout of low-income voters has been linked toregressive state tax systems and higher social spending.

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In “Regular Voters, Marginal Voters and the Electoral Effects of Turnout” University of Chicago professor Anthony Fowler found that marginal voters — those whose willingness to cast a ballot is affected by factors such as weather and the timing of elections — support liberal candidates. He estimates that 72.8 percent of those who do not vote because of weather support the Democratic Party. In fact, weather may have contributed to Electoral College victories for the Democrats in 1960 and the Republicans in 2000. He examined gubernatorial elections, which can coincide with a presidential election or a midterm year, and found that 68.2 percent of those who don’t turn out for midterm elections support Democrats. Among the 34 million people who were registered with a party but did not vote in the 2010 midterms, 63.1 percent supported Democrats, according to Fowler. And gubernatorial elections that coincide with the presidential race “increase turnout by 17.4 percentage points and the Democratic candidate’s vote share by 6.4 percentage points,” he said.

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High voter turnout benefits Democrats, but studies also show that it increases volatility and harms incumbents. The anti-incumbent effect is particularly important, because it means that all incumbent politicians, including Democrats, may be partly disinclined to support policies that will boost turnout. Democrats might also have to worry about a more progressive challenger swinging potential votes away from the party.

But can turnout be swayed? Evidence suggests so. A study of 170 countries by the International Institute for Democracy and Electoral Assistance found that electoral structures dramatically affect turnout. (See figure 19.) Measures such as no-excuse absentee voting, expansive early voting and Election Day registration have increasedturnout. But in the United States, research suggests that the more black people in a county — a group that tends to vote for Democrats — the fewer early voting sites there are.

Regardless, a simple get-out-the-vote strategy is not enough. In a 2005 seminal study, political scientist Adam Berinsky found that reforms that make it easier for registered voters to cast ballots increase the socioeconomic bias of the electorate. Get-out-the-vote campaigns increase turnout only among individuals with already high propensity to vote. While these voters may still be liberal, electoral reform is needed to increase registration among nonvoters, particularly the poor. In 2012 only 52.7 percent of those with income below $10,000 were registered to vote, compared with 83.5 percent of those earning more than $150,000, according to U.S. census data. In order to address the gap in voting between those in the top and bottom income brackets, electoral reforms must affect registration.

This is why Election Day registration (EDR) and “motor voter” laws are critical to improving electoral participation. For example, in a report released last month, Demos found that if all states used a “motor voter” system, which allows voters to register at local DMVs, it would increase registration by 18 million. These measures have reduced political inequality, particularly in states with registration bias. EDR consistently leads to higher turnout.

Changing the composition of the electorate is the easiest way to shift policy to the left.

Progressives can also improve their electoral prospects with better information. First, there is the evidence from the Kaiser Family Foundation that Americans are least likely to know that reforms they support are included in the Affordable Care Act and most likely to know that reforms they oppose are included. “If the public had perfect understanding of the elements that we examined,” a group of researchers wrote in 2012, “the proportion of Americans who favor the bill might increase from the current level of 32 percent to 70 percent.” In another recent study, Fowler and Michele Margolis exposed participants (through fake op-eds) to simple facts about Republican and Democratic policy platforms on social and economic issues such as the earned income tax credit, minimum wage, abortion and same-sex marriage. “When uninformed citizens receive political information, they systematically shift their political preferences away from the Republican Party and toward the Democrats,” the researchers said.

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Changing the composition of the electorate is the easiest way to shift policy to the left. As John B. Judis and Ruy Teixeira point out, what they call the “emerging democratic majority” has always existed but just hasn’t voted. Instead, Democrats should mobilize the marginalized progressive majority. There was a time when progressives saw voting rights as essential to their strategy. In 1992, California Gov. Jerry Brown told Bill Clinton that his campaign would have Brown’s “full endorsement” if Clinton supported a $100 cap on political contributions, a ban on PACs, universal registration, same-day registration and an Election Day holiday. As Joan Didion points out in “Political Fictions,” Clinton did not receive Brown’s endorsement because at the time the more centrist Democratic Leadership Council’s strategy was to “jettison those voters who no longer turned out and target those who did.”

That strategy limits the liberalism of the Democratic Party because those who less consistently turn out tend to be more liberal than those who do. In addition, it alienates low-income people, further depressing turnout and creating a self-reinforcing cycle of people becoming increasingly alienated from established politicians and increasingly unlikely to vote. Democratic politicians are wary of policies to boost turnout because of its anti-incumbent effect and the possibility of progressive challengers.

Now with Democrats on the defensive across the country, conservatives fighting full franchise and progressives realizing the limits of hero leftism, there may be an effort to mobilize the marginalized progressive majority. If they are persuaded to weigh in at the ballot box, they can sway the agenda that Democratic leaders support. As a truly great progressive, Franklin Delano Roosevelt, once said to his progressive base, “I agree with you. Now make me do it.”

This piece originally appeared on Al Jazeera.

The Rise of the React-o-Cons

The rise of “reform conservatives” has drawn an increasing amount of attention. The wonky right has been treated most recently to a lauding article in the New York Times, following a critical take by E.J. Dionne in Democracy.  Some writers have gone as far as declaring Republicans the party of ideas. But reform conservatism fails to reach the holy grail of modern conservatism, wedding support of the family with adoration for the free market.

Cracks have already formed in the reformicon facade. There is little willingness to challenge the insanity of the Republican Party, so environmental issues have gone entirely ignored. Attempts to bend a fundamentally flawed theory of poverty into wonky centrist plans have collapsed under the weight of their own absurdity. When foreign policy is broached, and itrarely is, the result is embarrassing. (Conservative writer Scott McConnell worries, “it is more than a little disconcerting to see neoconservatism be welcomed back into the public square under the false flag of Burkean moderation.”  The reformicons, if they care about immigration (it didn’t garner a mention in their famous “Room to Grow” plan), did nothingto halt recent Republican self-destruction on immigration. The most substantive challenge they appear willing to make toward the party’s right-most wing is banalities about inflation.

Instead, reform conservatism sticks to “wonky” economics plans, where attempts to distinguish themselves from centrist Democrats fall away. Had the Obama administration chosen to push for a more progressive plan (which likely would have failed to pass), then the reformicons may well have proposed something very much like the Affordable Care Act. Obama instead chose the conservative route: expand already existing programs and keep the private insurance system broadly in place. The fact that Obama’s plan was drawn from Heritage documents and implemented previously by Republicans is inconsequential — the important point is that it is philosophically conservative. That is, it prefers market mechanisms when possible and expands old bureaucracies (Medicaid) rather than create new ones.

In fact, the Obama administration has shown a consistent preference for conservative policy proposals — ones that don’t throw the baby out with the bathwater but rather leave already existing structures in place, but reform them subtly. His administration has preferred, where possible, to delegate power to the states and to use market mechanisms rather than government decree to reach policy goals. (Witness his recent plan for curbing global warming, which relies on federalisminnovation and market mechanisms, rather than command and control.) His foreign policy has been restrained compared to the naive sentimentality of the previous administration and he has shied away from crusading on social issues, preferring to silently advance transgender rights.

Because of Obama’s conservatism, the “reformers” have been forced to take on an increasingly reactionary tone. Yuval Levin, for instance, according to the generous Sam Tanenhaus, sounds rather more reactionary than reformist:

For all [Levin’s] temperateness of tone, and for all the meticulously reasoned arguments that he has shepherded into the pages of National Affairs, Levin justly says his ideas are radical. He envisions not just a shrinking or scaling-back of government, but an entire re-imagining of it.

This longing to roll back time and go to a long-gone utopia is not a conservative impulse, but rather a reactionary one. We see this impulse when Ramesh Ponnuru seeks to obliterate the conservative Affordable Care Act on the basis of a radical (and almost entirely unsupported) reading of a single sentence. This is not the attitude of someone who, as Burke might suggest, attends to “the faults of the state as to the wounds of a father, with pious awe and trembling solicitude.” Instead Ponnuru resembles the impetuous “children of their country, who are prompt rashly to hack that aged parent in pieces, and put him into the kettle of magicians, in hopes that by their poisonous weeds, and wild incantations, they may regenerate the paternal constitution, and renovate their father’s life.”

Most reformicon (react-icon?) proposals still hold to the old Reaganite dogma that “the government isn’t the solution to the problem, the government is the problem.” Instead of “tax cuts,” the new right-wing buzzword is “tax credit.” Reading their foundational document, “Room to Grow,” you wonder whether the reformicons might try to solve terrorism with “tax credits” as well; the phrase appears 21 times in the manifesto, and “credit” 81 times (abortion and gay rights go unmentioned, guns are mentioned once). Given that immigration is the single biggest issue that faces the Republican Party, one would expect a chapter, or even a paragraph, on the subject — she would be wrong. Sadly, for reform conservatives, the Obama administration has already begun expanding tax credits and has signaled its intent to do more, meaning that reformicons generally substitute real change for the Taco Bell effect.

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From the beginning, “reform conservatism” had deep troubles. For one, its thinkers have made no secret that their goal is to somehow save the odd Republican coalition of social conservatives, foreign policy hawks and business conservatives. These contradictions are most obvious in the conflict between business libertarian conservatives and social conservatives, and expose the deepest failings of reform conservatism.

The most famous and influential reform conservatives all cut their teeth in the culture wars. Ponnuru first graced the national spotlight after calling Democrats the “party of death,” and blundering through an interview with Jon Stewart. Yuval Levin worked with Robert P. George who believes marriage can only exist where penile-vaginal intercourse does. (This is not a caricature of his argument). Ross Douthat is known for his radical Catholicism. (He supports allowing businesses to discriminate against gays and compared the contraception mandate to sterilization.) All of them swarm at a chance to rue the rise of single mothers. But their “family-friendly” values are tough to reconcile with the market — one of the most anti-family institutions (there is a reason the Atlas Society, which exists to forward Randian ideas, harbors an open disdain for the family).

Hobby Lobby, which could be seen as another instance of market relations inserting into family life (the decision of when to begin one), is instead seen as a victory of “religious liberty.” This conclusion is not foregone, but rather justified, rather explicitly, as a way to maintain an uneasy alliance between religious radicals and the more libertarian business wing of the Republican Party. As Julia Azari writes,

The religious liberty-contraception question provides an opportunity for three important factions within the Republican Party – ideological libertarians, business interests, and social conservatives – to agree on something.

Someone actually concerned about families might worry about Hobby Lobby’s policy towards pregnant women, which is certainly not Christian and barely civilized:

When a very pregnant Felicia Allen applied for medical leave from her job at Hobby Lobby three years ago, one might think that the company best known for denying its employees insurance coverage of certain contraceptives—on the false grounds that they cause abortions—would show equal concern for helping one of its employees when she learned she was pregnant.

Instead, Allen says the self-professed evangelical Christian arts-and-crafts chain fired her and then tried to prevent her from accessing unemployment benefits.

That is unsurprising: The question at hand in Hobby Lobby was not religious liberty, but corporate power. The goal is not “family,” but rather exclusion of certain groups from the public sphere. We don’t need to look too far back to find conservatives who understand that the deepest threat to the family is not the government but the market. Marxist conservative Christopher Lasch writes,

The sentimental veneration of motherhood, even at the peak of its influence in the late nineteenth century, could never quite obscure the reality that unpaid labor bears the stigma of social inferiority when money becomes the universal measure of value … children pay the price for this invasion of the family by the market.

The greatest threat to the civic institutions that the reformicons praise so highly are also threatened by the market: “all that is solid melts into air.” Pope John XXIII writes in “Mater et Magistra,”

We therefore consider it Our duty to reaffirm that the remuneration of work is not something that can be left to the laws of the marketplace; nor should it be a decision left to the will of the more powerful. It must be determined in accordance with justice and equity; which means that workers must be paid a wage which allows them to live a truly human life and to fulfill their family obligations in a worthy manner.

And yet the reformicon proposal for getting the long-term unemployed hired is to reduce their wages — further degrading them.

America is one of the only countries in the world that does not offer paid maternity leave. Because of this, paid leave is a luxury in America that is available to all wealthy and most middle-class women but denied the poor. Only 5 percent of women in the retail sector have access to paid maternity leave. A study by Linda Houser and Thomas Vartanian finds that only 11 percent of private sector workers reported paid family leave through their employers, and only 5 percent of women in the bottom quarter of wages report access. The reformicons aren’t interested in what almost every other country (and some states) have done: guaranteed paid leave. In the “Room To Grow” essay on work-family balance (the only one, notably, written by a woman), Carrie Lukas rejects the idea of paid leave, arguing that, “Knowing that any worker facing a medical issue could take up to three months of paid leave creates a significant new risk for employers.” The reformicon dogma  can be summed up quite simply as “money over everything.”

When family and marketplace meet, reformicons will prefer markets. They therefore lack proposals to deal with rampant wage theftscheduling abuse and the massive gender pay gap. The gender pay gap will cost women in retail $381 billion over the next six years, a recent Demos report finds. Given that 40 percent of women in retail contribute 40 percent or more of their family’s income, reducing that gap would be a benefit to working families. It’d be great to hear some reformicon proposals — instead we get decepticon denialism.

The failure of reform conservatism to forward actually family-friendly policies is probably its most glaring deficiency. As Christ once said, “No one can serve two masters, for either he will hate the one and love the other, or he will be devoted to the one and despise the other. You cannot serve God and money.” I’ve noted these contradictions before: Rubio and Ryan want to expand opportunity and reduce inequality; the only way to do that (at least the way every other country has done so) is to strengthen government programs. The best way to strengthen the family is to remove the market from family life. It is corporations, not government, that schedule workers and it is laissez-faire that has eroded the middle class for the past four decades. In Dionne’s essay, he notes that some of the reformicons have recognized their ideological contradiction, but he summarizes the failure to correct it accurately, “Even when they face up to the contradictions in conservative ideology and acknowledge the market’s shortcomings, their solutions rarely challenge the market’s priorities …”

Eventually reform conservatism will collapse upon the weight of its own contradictions. Ronald Reagan, like an unwitting best friend setting up a bad blind date, formed an increasingly unmanageable coalition. The initial spark has died and the elderly lovers are increasingly bickering. Vitriolic hatred of Obama is a weak attempt at coalition maintenance. The dirty fact is that very few policies can make all the parties of this increasingly fractious coalition happy. Reform conservatives have tried to brush these issues under the carpet, but eventually voters will want red meat, something Republicans simply cannot deliver and remain a viable party. Without a symbolic enemy to rally around the coalition will fall apart, which is why the reformicons are neither particularly interested in actually existing policy or conservatism.

Originally published on Salon.

The Affordable Care Act Is An Okay Law That Has Been Sabotaged

The Affordable Care Act isn’t a perfect law. It’s not even a good law. But it’s better than what we had before and it’s worth fighting for.

The law has not worked as well as expected. Three of the problems with the ACA roll-out were not to due to the law itself, but rather, Republican intransigence. First, the Medicaid expansion was hurt by the Supreme Court ruling that made the expansion optional for states. Twenty-five governors (almost all Republican) have refused to push forward with the expansion, even though it will be paid for almost entirely with federal funds. This leaves millions of poor Americans without health insurance (and will likely end up costing the states more money). Second, many of those same governors refused to set up healthcare exchanges, meaning that the HHS had to for them. The HHS requested an additional $1 billion (far below the $5 billlion the CBO estimated would be needed) to set up the exchanges, which congressional Republicans denied. Third, right-wing organizations have been attempting to persuade young people to opt-out of the program, claiming that they will be better off without healthcare. This is bad for both the young people and the system. The young people will still be treated (just like the poor without Medicaid), but their treatment will place an expensive burden on the system and because they aren’t paying for premiums, meaning the cost of other plans on the exchange may rise.

Even with Republican support, the bill would have trouble. Obama, being a conservative, has tried to modify the system rather than overthrow it. He has followed the advice of Burke, who cautioned legislators to “approach to the faults of the state as to the wounds of a father, with pious awe and trembling solicitude.”

But conservatives are pretending that the bill is a radical overthrow of the healthcare system, rather than a few minor incremental changes which it is. The bill leaves the health insurance system largely intact, expands already existing programs and implements a collection of pilot projects that can easily be expanded.

Conservatives argue that the failure of Healthcare.gov proves that the government can’t do anything. That strikes me as a little absurd. The argument is that the government that sent a man to the moon, built the Hoover dam and National Highway System, rebuilt Europe, runs the wildly successful and efficient SNAP program and has become the most successful military in the world has lost its legitimacy because of a glitchy website. If anything, the government should be doing more projects in-house and avoiding the costly contractors who screwed up the whole program.

The Human Genome Project cost the government $3.8 billion dollars but generated $796 billion in economic gains. The project is expected to bring about returns of 140 to 1 to the public. Research by Kenneth Flam finds that, “eighteen of the twenty five most important breakthroughs in computer technology between 1950 and 1962 were funded by the government, and in many cases the first buyer of the technology was also the government.”

In every other country, government-run systems produce far better results for far cheaper. The United States spends twice as much of its GDP on healthcare than the OECD average. The U.S. gets little in return; Britain pays 40% less for slightly better outcomes. The U.S. healthcare system leads the industrialized world in administrative costs and wastes and estimated $750 billion dollars each year due to unnecessary procedures, inflated prices, excess administrative costs and poor delivery systems. The system also leaves 40 million people uninsured, which is unique among developed countries.

The fact that the failure of Healthcare.gov has garnered so much press is quite frankly shameful. Especially when there has been so much good news from the program: the rate of uninsured people in Oregon has dropped 10%, the recent Medicaid expansion in Ohio will give 273,000 people access to health insurance, many state-run exchanges are working fine and there is evidence that Obamacare is slowing down the growth of healthcare costs. Guys, even a Fox News contributor  has admitted the programs is working!

So don’t be fooled by all the horror stories. Obamacare is far more than merely a website; the NHS survived for decades before the invention of the internet. The program has already chalked up some important success and will continue to in the future. The hullabaloo about the website is just a reflection of the media cycle. The good parts get ignored while the minor failure of a website becomes front page news. Man bites dog and all.