Today’s the day that some important, initial provisions of the Affordable Care Act (ACA) go into effect.  Given that a majority of the 23% of Missourians who participated in last August’s primaries voted to challenge the ACA, and that state GOPers are still making wild claims about what it will or won’t do, clear, simple, unbiased explanations of the law’s provisions are more important than ever, and that’s exactly what the video below offers. It’s produced by the Kaiser Family Foundation Health Reform Source, an excellent resource, by the way, and it offers a succinct, easy to understand, nine minute summary of the provisions of the ACA and the controversies that surround them:  

http://c.brightcove.com/services/viewer/federated_f9?isVid=1

As Think Progress notes, it’s ironic that on what is essentially ACA day zero, Congressional Republicans released their “Pledge to America,” the GOP plan for the 112th Congress if they take charge after November. An important part of their agenda is the repeal and “replacement” of the ACA. This should not come as a suprise to us in Missouri; state GOPers  have been throwing tantrums since the legislation passed. Its repeal is even included in Roy Blunt’s corporate giveaway list jobs plan:

Repeal and Replace Obamacare – The Democrats’ Government Takeover will cost at least a trillion dollars, according to the Congressional Budget Office.  I’m for repeal of this massive spending bill and replacing it with common sense health care solutions that will create jobs and drive down health care costs.

Oddly enough, though, as The Wonk Room‘s Igor Volsky observes, most of the replacements to ACA provisions that the GOP document puts forward are all already included in the ACA itself. We have to assume that these are also the replacements that Roy Blunt is speaking about in his jobs plan since they echo his past proposals. What is not included, though, is:

… how Republicans plan to offset the $140 billion deficit increase that will result from repealing the ACA or how they’ll lower health care spending. The Congressional Budget Office estimated that the GOP’s previous very similar health care plan  – presented by House Minority Leader John Boehner (R-OH) as an alternative to the House health care bill – would increase the number of uninsured to 52 million in 2019 and reduce the deficit by only $68 billion over the 2010-2019 period.

Since the national GOP “Pledge” and Roy Blunt’s very compatible “Jobs Plan” are both really big on railing about deficits – at least in the abstract – it’s surprising that neither address this concern. Perhaps the best characterization of the “Pledge,” and one that can be equally applied to Blunt’s jobs plan, comes from a conservative blogger, Erik Erikson of RedState, who charged that “This document proves the GOP is more focused on the acquisition of power than the advocacy of long term sound public policy.” Well Duh! Maybe more Missourians should keep that in mind when they see ads dinging Carnahan for supporting health care reform.

FiredUp! has done a great job of chronicling Lieutenant Governor Peter Kinder’s lawsuit against the Patient Protection and Affordable Care Act (PPACA). Just go to the FiredUp! Website and search “Peter Kinder suit” and you’ll get the whole ugly story. It seems obvious that the suit is a maneuver to spark some enthusiasm on the part of Missouri’s roiling Tea Party masses for a future run by Kinder for governor. If so, perhaps he should reconsider.

In the wake of last night’s primaries, Think Progress notes that:

Every single health care plaintiff in a contested primary for governor lost their election – hopefully this will inspire future candidates to abandon their counterproductive opposition to health reform.

Wanna bet Knder won’t get the message that opposing “Obamacare” isn’t the way to the governor’s mansion?  Poor baby’s in too deep for anything but denial.

Missouri was one of 45 states to request and receive a 1 million dollar grant to improve oversight of the insurance market.  The grants, part of the Patient Protection and Afordable Care Act (PPACA), are meant to help states put into place a regulatory infrastructure that will “help improve the oversight of proposed health insurance premium increases, take action against insurers seeking unreasonable rate hikes, and ensure Missourians receive value for their premium dollars.”

Worried that the PPACA gave too much power to private insurers? Well these grants are a first step toward insuring that they don’t abuse that power and hike rates arbitrarily:

The Health Insurance Premium Review Grants are one element of a broad effort under the Affordable Care Act to reduce the unreasonable premium increases proposed by some insurers today.  Additional resources from this $250 million program will be available in subsequent years to further strengthen State health insurance premium review procedures.

I know that there is a noisy but small cadre of Missourians who voted for Proposition C because it they believe that the PPACA curtailed curtails their “liberty” to do themselves and everybody else over; I am equally sure that many of these same Missourians espouse a cloud cukoo land concept of free markets and will be up in arms about  efforts to introduce common sense regulation to what is currently a rogue insurance industry that wields outsize power at the state level:

In many states, it is the insurance industry that largely control the regulatory process, funneling money to key state lawmakers and squelching efforts to expand government oversight of premiums, a review of state regulations and campaign donations shows.

“The pressure that the industry can bring to bear in state legislatures is unbelievable,” said J. Robert Hunter, a former insurance commissioner in Texas. “They pretty much get what they want.”

We call the people who want to prolong this situation Tea Partiers or Republican wingers – and we will have to make just as much noise as they do and hope that a few of our saner state politicians develop some backbone. We have lots to loose if they don’t because, particularly if paired with prior approval authority, the Health Insurance Premium Review Grants could go a long way toward leveling the playing field for consumers and bringing health care costs down. And who, Tea Party imbibers aside, could object to that.  

Actually, even those states pandering to Tea Partiers may be reconsidering.  According to the Wonk Room, 19 of the 22 states that are suing the federal government over health care reform are quite happy to accept Health Insurance Premium Review Grants.

Title edited slightly

Republicans lost on health care and the Missouri GOP has responded with predictable temper tantrums in order to impress their Tea-Party addled constituents:

–Republican Governor wannabe, Lieutenant Governor Peter Kinder, is planning to (maybe) file a pseudo official lawsuit against the Obama health care reform, the Patient Protection and Affordable Care Act (PPACA).

–Rep. Todd Akin (R-2), man of action that he is, isn’t waiting around like Kinder, but has just signed on to an amicus brief in support of the lawsuit against the PPACA that the Republican governor of the State of Virginia has filed.

–Roy Blunt (R-7) has announced his support for legislation to “repeal and replace” the “onerous” PPACA by bringing back the much ridiculed earler GOP “alternative,” and repackaging it as a new Republican proposal.  HR 5424, the Reform Americans Can Afford Act, which is cosponsored by Todd Akin and Blaine Luetkemeyer (R-9), would cut access to health care, drive up the deficit, reduce the life of the Medicare trust fund by 10 years, and reopen the “donut hole” for prescrption drugs. (As far as reform goes, a bit unclear on the concept perhaps?)

–Not to be outdone by the GOP federal congressional delegation, the state’s GOP dominated lege wants Missourians to vote to opt out of health care reform this August.

Just the usual political games you may be thinking – but perhaps not, after all, such smart political moves as some GOPers thought a month or so ago. As Slate reporter, William Salatan observes:

Tales of death panels and warnings about losing your doctor can now be falsified. (That’s what happened to the early scare stories about Social Security and Medicare.) And Republicans who denounce the program and promise to repeal it will no longer be bashing an abstraction. They will be proposing to take away existing, tangible benefits… .  

… why assume that lockstep Republican opposition will discredit the health care program? Maybe the opposite will happen: Lockstep opposition will discredit Republicans.

Apparently the Democratic National Committee not only agrees with this assessment, but has enough confidence in it to go on the offensive.  Which brings me to a great new DNC ad that will soon begin airing:

Update:  Speaking of tangible benefits, my husband just forwarded a message from his employer detailing the changes in our health care coverage that have resulted from passage of the PPACA, and needless to say, it’s all good. Now just let the Republican try to take it away.

Our Republican dominated state legislature couldn’t manage to pass a meaningful ethics bill, but, as I am sure you know by now, they did join Arizona and Florida in placing an essentially empty measure on the ballot (the August Primary ballot in Missouri) that is meant to nullify the Patient Protection and Affordable Care Act (PPACA), known popularly as Obamacare*. Three states, Virginia, Idaho and Utah have already enacted similar legislation. So Missouri must be coasting on the leading edge of a cresting wave of anti-Obamacare sentiment, right?

Wrong! A recent report notes that of the 40 states identified by the health insurance industry front group, The American Legislative Exchange Council (ALEC), as likely to take steps to oppose the federal legislation, 24 have rejected anti-PPACA legislation – including such deeply red states as Alabama, Georgia and Mississippi. In seven states the legislation has been tabled or otherwise put out of its misery, and three states, Texas, Rhode Island, and Montana, never got around to doing anything at all. Meanwhile, plans for implementation are proceeding apace in all 50 states – including Missouri which seems to have a few adults left in government.

If Missourians vote for this amendment next August, they will have identified themselves with a very small and retrograde group of states – and while it is fun to go along with the crowd, it’s not so much fun to crawl out on the bleeding edge practically alone and find out you’re a laughing stock – but, of course, that’s a risk folks run when they jump to “defend” the Constitution before they have taken the trouble to figure out just what the Constitution actually says.

So where does this leave our anti-Obamacare stalwart, Lieutenant Governor Peter Kinder, and the weirdly anonymous donors (insurance industry or industry stooges?) who are financing his intended lawsuit against the PPACA? FiredUp! has suggested that Kinder may be getting cold feet or, at the very least, stalling for political advantage. It is, though, becoming more and more apparent that this paticular pander is akin to shooting at a moving target, and, in the end, he may not get all the bang that he expects for his donated bucks – or any bang at all perhaps?

* Obamacare … yes, I know that the Teople (i.e., Tea Party People) use it as a pejorative, but I like the term and see nothing wrong with it. Obama’s a relatively good guy as far as I’m concerned, and he should get credit for taking this issue on and getting something, imperfect as the PPACA may be,  out of our ossified, corporate-owned congress. Calling the PPACA Obamacare can be seen postiviely as one way to recognize his role.