Biden is opening up Obamacare enrollment again

 

Doug Mills/Getty Images

VOX President Biden signed an executive order Thursday reopening federal health insurance exchanges through the Affordable Care Act, creating a three-month window for people to enroll in federally subsidized insurance. [Vox / Dylan Scott] The executive order is targeting people who are eligible for the ACA, potentially after having lost their insurance, but were not aware of their options. The administration is coupling the announcement with an ad campaign. [Vox] The exchanges will be open on Healthcare.gov from February 15 to May 15. Typically, the sign-up period is late in the year, unless someone can prove a major life change. Losing your job qualifies, but the administration is assuming many people who lost their jobs last year were unaware of the opportunity to sign up. [The Washington Post / Amy Goldstein] In a contentious Democratic primary dominated by debates over health care, Biden campaigned on his promise to strengthen the ACA. Thursday’s executive order represents his first step in that direction. [CNN / Tami Luhby] Former President Trump undermined the ACA by declining to reopen exchanges despite the requests of Democrats and health experts, and by reducing funding for advertising the program. Uninsured rates rose under Trump for the first time in years, even before the pandemic. [The Hill / Jessie Hellmann] Biden is also directing the federal government to reexamine any policies that could undermine the ACA or Medicaid. He also revoked the global gag rule that restricts US aid to international organizations that provide abortion services. [ABC News / Molly Nagle]

Obamacare, in Its First Big Test as Safety Net, Is Holding Up So Far

Job losses and the loss of insurance have typically gone hand in hand. This year, more Americans are staying covered.

NY TIMES

In past recessions, the uninsured rate would surge. Now, for the first time, Americans are experiencing a recession with the Affordable Care Act in place.

The health law’s expansion of Medicaid and its offer of subsidized health plans have provided a new safety net for those who have lost their jobs and their health insurance.

The Affordable Care Act gave states the option to cover poor residents through Medicaid, and it offered tax credits to help low- and middle-income Americans buy health insurance. Since the coronavirus pandemic set off job losses this spring, enrollment in both programs has been growing. Experts say sign-ups would probably be higher still if not for Trump administration moves that included slashing the A.C.A.’s advertising budget and declining to have an additional sign-up period when the pandemic hit.

State Medicaid enrollment, according to one report, had an 11 percent increase between February and September in the 36 states that have released data. Another paper, from Manatt Health, shows those gains concentrated in states that have participated in the health law’s Medicaid expansion, with an enrollment growth rate of 22.2 percent between February and November.

Sign-ups for plans in marketplaces run by the federal government are up 6.6 percent compared with last year, according to a new federal tally. It is the only year during the Trump administration when enrollment increased, and amounts to a half-million more people seeking coverage from the federal marketplace. The total is still down compared with 2016, the last year the Obama administration was running the program.

Final government estimates of the uninsured rate are months away, but at least one survey, from the research group the Commonwealth Fund, shows the share of Americans without coverage was holding steady through the spring. The Affordable Care Act is a crucial reason for that.

“We’ve seen both the important security that it provides and a lot of the remaining holes in the safety net cast into stark relief in this twin crisis of dire health need and economic recession,” said Kate Baicker, the dean of the Harris School of Public Policy at the University of Chicago.

Charts based on an analysis of census data by Matt Bruenig, the president of the People’s Policy Project, show how the overall health insurance landscape has changed since the Affordable Care Act took effect. In 2009, 16.7 percent of Americans lacked health insurance, and, for those of working age, the poorer you were, the more likely you were to fall in that category.

Medicaid enrollment among low-income Americans has since surged, particularly in states that expanded their programs, reducing the disparities. Enrollment in subsidized private coverage has also grown among those earning slightly more. As the population has aged, more people have also become eligible for another public program: Medicare. The 2020 chart shows survey results collected early in the year, so these numbers do not reflect the impact of the Covid recession. (There have been slight changes in census methodology in the intervening years, but they should not skew the patterns in a major way.)

Mr. Bruenig said he was struck by how many low-income people remained uninsured, a sign, he said, that the new system was not yet reaching everyone it was designed to help.

While data is still coming, there are early signs that the Affordable Care Act is making health coverage less dependent on employment.

In a paper published in October, Dr. Benjamin Sommers and Dr. Sumit Agarwal looked at what happened to the health insurance status of Americans who lost a job. Before the Affordable Care Act, these newly unemployed workers experienced a 4.6-percentage-point increase in their uninsured rate.

After the law took effect, the association between job loss and higher uninsured rates disappeared.

Early, incomplete evidence suggests the law is serving that function during the coronavirus economic downturn. A federal report last month showed an increase in marketplace sign-ups this spring as the unemployment rate mounted. Between January and May, Healthcare.gov had about 150,000 more enrollments than usual.

A recent analysis of insurance industry data by Kaiser Family Foundation researchers found that roughly two million to three million Americans lost their job-based coverage between March and September. During the same period, around five million enrolled in Medicaid.

“When the economy suffers, the Affordable Care Act plays an important role in making sure people can still maintain insurance coverage in ways that didn’t exist before,” said Cynthia Cox, a vice president at the foundation. But Ms. Cox said that, even with this cushion, millions of Americans remain uninsured amid a public health crisis. Many of those people, she said, are eligible for free coverage, a sign that the programs aren’t reaching everyone they could.

Ms. Cox also noted that fewer workers have lost job-based coverage than in past downturns. That may be because the workers most affected by this recession never got their coverage at work. Or perhaps more employers are trying to keep workers covered during this emergency, even as they face fiscal stress.

“This is different than it was in the past, in part because of employers, but in part because of the A.C.A.,” she said.

There are other ways that the Affordable Care Act is showing weak spots as a safety net program. While most Americans who buy coverage through the marketplace get a significant subsidy, they may still struggle to pay any share of a premium during this economic downturn.

“Covid has created more people who potentially can enroll, but those are the exact same people who have household budgets that are incredibly tight right now,” said Joshua Peck, co-founder of Get America Covered. “These are the people who are deferring mortgage payments. Adding health insurance is a pretty big challenge.”

Affordable Care Act programs can be hard to navigate, potentially discouraging even those who qualify for substantial financial help. Establishing eligibility often requires income checks and other paperwork. Annual A.C.A. sign-up periods are typically limited to six weeks in most states. People who lose a job are eligible for a brief special enrollment period, but not everyone knows that. Besides cutting advertising, the Trump administration also cut the budget for outreach and for help picking a plan.

In California, which has invested heavily in advertising and outreach, and has offered more opportunities for the newly uninsured to sign up, enrollment in Medicaid and marketplace coverage is even higher, hinting at what the programs’ enrollment numbers might look like if the federal government were working harder to connect people with new coverage options.

“You can’t be a safety net, but then be asleep at the switch, and say we won’t do anything,” said Peter Lee, who runs California’s insurance marketplace, Covered California. That marketplace opened for sign-ups this spring and summer, and increased its marketing budget to help people learn about their options. Hundreds of thousands of people enrolled during those months, he said. Enrollment continues for 2021 plans.

Besides catching patients who have lost job-based coverage, the Affordable Care Act has aided doctors and hospitals, who saw their revenue plummet early in the pandemic as patients deferred and delayed medical care. Having more Americans with health coverage means more dollars flowing to those health providers.

“They’re receiving revenue for many patients who otherwise would have been uninsured,” said Cindy Mann, a partner at Manatt Health who previously ran Medicaid for the Obama administration. “That’s helped sustain them in a challenging environment.”

OBAMACARE & CALIFORNIA GROW THE AMERICAN ECONOMY

PAUL KRUGMAN, NY TIMES

Two impossible things happened to the U.S. economy over the course of the past year — or at least they were supposed to be impossible, according to the ideology that dominates half our political spectrum. First, remember how Obamacare was supposed to be a gigantic job killer? Well, in the first year of the Affordable Care Act’s full implementation, the U.S. economy as a whole added 3.3 million jobs — the biggest gain since the 1990s. Second, half a million of those jobs were added in California, which has taken the lead in job creation away from Texas.

Were President Obama’s policies the cause of national job growth? Did Jerry Brown — the tax-raising, Obamacare-embracing governor of California — engineer his state’s boom? No, and few liberals would claim otherwise. What we’ve been seeing at both the national and the state level is mainly a natural process of recovery as the economy finally starts to heal from the housing and debt bubbles of the Bush years.

But recent job growth, nonetheless, has big political implications — implications so disturbing to many on the right that they are in frantic denial, claiming that the recovery is somehow bogus. Why can’t they handle the good news? The answer actually comes on three levels: Obama Derangement Syndrome, or O.D.S.; Reaganolatry; and the confidence con.




Not much need be said about O.D.S. It is, by now, a fixed idea on the right that this president is both evil and incompetent, that everything touched by the atheist Islamic Marxist Kenyan Democrat — mostly that last item — must go terribly wrong. When good news arrives about the budget, or the economy, or Obamacare — which is, by the way, rapidly reducing the number of uninsured while costing much less than expected — it must be denied.

At a deeper level, modern conservative ideology utterly depends on the proposition that conservatives, and only they, possess the secret key to prosperity. As a result, you often have politicians on the right making claims like this one, from Senator Rand Paul: “When is the last time in our country we created millions of jobs? It was under Ronald Reagan.”

Actually, if creating “millions of jobs” means adding two million or more jobs in a given year, we’ve done that 13 times since Reagan left office: eight times under Bill Clinton, twice under George W. Bush, and three times, so far, under Barack Obama. But who’s counting?

Still, don’t liberals have similar delusions? Not really. The economy added 23 million jobs under Clinton, compared with 16 million under Reagan, but there’s nothing on the left comparable to the cult of the Blessed Ronald. That’s because liberals don’t need to claim that their policies will produce spectacular growth. All they need to claim is feasibility: that we can do things like, say, guaranteeing health insurance to everyone without killing the economy. Conservatives, on the other hand, want to block such things and, instead, to cut taxes on the rich and slash aid to the less fortunate. So they must claim both that liberal policies are job killers and that being nice to the rich is a magic elixir.

Which brings us to the last point: the confidence con.

As a number of observers have pointed out, however, for big businesses to admit that government policies can create jobs would be to devalue one of their favorite political arguments — the claim that to achieve prosperity politicians must preserve business confidence, among other things, by refraining from any criticism of what businesspeople do.

In the case of the Obama economy, this kind of thinking led to what I like to call the “Ma! He’s looking at me funny!” theory of sluggish recovery. By this I mean the insistence that recovery wasn’t being held back by objective factors like spending cuts and debt overhang, but rather by the corporate elite’s hurt feelings after Mr. Obama suggested that some bankers behaved badly and some executives might be overpaid. Who knew that moguls and tycoons were such sensitive souls? In any case, however, that theory is unsustainable in the face of a recovery that has finally started to deliver big job gains, even if it should have happened sooner.

So, as I said at the beginning, the fact that we’re now seeing mornings in blue America — solid job growth both at the national level and in states that have defied the right’s tax-cutting, deregulatory orthodoxy — is a big problem for conservatives. Although they would never admit it, events have proved their most cherished beliefs wrong.

KRUGMAN: Secret Deficit Lovers

N.Y. TIMES

What if they balanced the budget and nobody knew or cared?

 

O.K., the federal budget hasn’t actually been balanced. But the Congressional Budget Office has tallied up the totals for fiscal 2014, which ran through the end of September, and reports that the deficit plunge of the past several years continues. You still hear politicians ranting about “trillion dollar deficits,” but last year’s deficit was less than half-a-trillion dollars — or, a more meaningful number, just 2.8 percent of G.D.P. — and it’s still falling.

 

So where are the ticker-tape parades? For that matter, where are the front-page news reports? After all, talk about the evils of deficits and the grave fiscal danger facing America dominated Washington for years. Shouldn’t we be making a big deal of the fact that the alleged crisis is over?

Well, we aren’t, and once you understand why, you also understand what fiscal hysteria was really about.

First, ordinary Americans aren’t celebrating the deficit’s decline because they don’t know about it.

That’s not mere speculation on my part. Earlier this year, YouGov polled Americans on fiscal issues, asking among other things whether the deficit had increased or declined since President Obama took office. (In case you’re wondering, the pollsters carefully explained the difference between annual deficits and the level of accumulated debt.) More than half of those polled said it had gone up, while only 19 percent correctly said that it had gone down.

Why doesn’t the public know better? Probably because of the way much of the news media report this and other issues, with bad news played up and good news downplayed if it’s reported at all.

This has been glaringly obvious in the case of health reform, where every problem with the Affordable Care Act has been the subject of headlines, while in right-wing media — and to some extent in mainstream news sources — favorable developments go unremarked. As a result, many people — even, in my experience, liberals — have the impression that the rollout of Obamacare has been a disaster, and have no idea that enrollment is above expectations, costs are lower than expected, and the number of Americans without insurance has dropped sharply. Surely something similar has happened on the budget deficit.

 

But what about people who pay a lot of attention to the budget, the self-proclaimed deficit hawks? (Some of us prefer to call them deficit scolds.) They’ve spent the past few years telling us that budget shortfalls are the most important issue facing the nation, that terrible things will happen unless we act to stem the flow of red ink. Are they expressing satisfaction over the fading of that threat?

Not a chance. Far from celebrating the deficit’s decline, the usual suspects — fiscal-scold think tanks, inside-the-Beltway pundits — seem annoyed by the news. It’s a “false victory,” they declare. “Trillion dollar deficits are coming back,” they warn. And they’re furious with President Obama for saying that it’s time to get past “mindless austerity” and “manufactured crises.” He’s declaring mission accomplished, they say, when he should be making another push for entitlement reform.

All of which demonstrates a truth that has been apparent for a while, if you have been paying close attention  Deficit scolds actually love big budget deficits, and hate it when those deficits get smaller. Why? Because fears of a fiscal crisis — fears that they feed assiduously — are their best hope of getting what they really want: big cuts in social programs. A few years ago they almost managed to bully the nation into cutting Social Security and/or raising the Medicare eligibility age; they even had hopes of turning Medicare into an underfinanced voucher program. Now that window of opportunity is closing fast.

But isn’t the falling deficit just a short-term blip, with the long-run outlook as dire as ever? Actually, no. Falling deficits right now have a lot to do with a strengthening economy plus some of that “mindless austerity” the president condemned. But there has also been a dramatic slowdown in the growth of health spending — and if that continues, the long-run fiscal outlook is much better than anyone thought possible not long ago. Yes, current projections still show a rising ratio of debt to G.D.P. starting some years from now, and uncomfortable levels of debt a generation from now. But given all the clear and present dangers we face, it’s hard to see why dealing with that distant and uncertain prospect should be any kind of policy priority.

So let’s say goodbye to fiscal hysteria. I know that the deficit scolds are having a hard time letting go; they’re still trying to bring back the days when Bowles and Simpson bestrode the Beltway like colossi. But those days aren’t coming back, and we should be glad.

OBAMA AND THE COMING ELECTION

ELIZABETH DREW, N.Y. REVIEW OF BOOKS

—August 27, 2014

The most important question in this year’s midterm elections is whether the Republicans will gain control of the Senate while retaining their majority in the House. That could make Congress still more belligerent toward the president. It would not only continue to block progress on pressing national needs but also prevent him from shoring up the progressive faction on the Supreme Court against what a possible Republican successor would do.

Also uncertain is to what extent the Democrats can reverse the enormous gains the Republicans made in 2010, when they took over both the governorships and the legislatures of twelve formerly Democratic states. They now control twenty-six states, which has had major substantive effects on national policy. For example, twenty Republican-dominated states have refused to expand Medicaid coverage to their poorest citizens or to set up their own health insurance exchanges under the Affordable Care Act.

As of now, the turnout this November is predicted to be uncommonly low, even for midterms, which traditionally attract fewer voters than do presidential elections. Midterm voters are older, whiter, and, since they include fewer and fewer veterans of the New Deal era, over time they have come to represent more conservative values than the voters in presidential contests.

Republicans have been remarkably successful in blocking bills supported by Obama, and this in turn has helped convince voters that his accomplishments are meager. Frustration with the gridlock in Washington and feelings of discouragement about the future have led to a particularly sour electorate, which also takes a dim view of the Republican Congress. (In recent polling, no more than 19 percent approved of it.) The sour mood could well affect the turnout; and a small number of voters could determine how the country is governed for the next two years.

With the president’s job approval dropping below 50%, Republicans are trying to identify his party’s candidates with him. And since for the first time his rating for likability is below 50 percent, the president now has less to fall back on. It’s often difficult for politicians of the president’s party to deflect the attacks on him. It’s even more unlikely to happen if they don’t try.

As expected, the Republicans are attacking incumbents who supported Obamacare—or they are demanding that would-be Democratic senators say whether they would support it, but the fact is that congressional Republicans have given up even pretending that they would repeal it. Though Obamacare is by now generally working, it remains deeply unpopular. Yet voters don’t list it as among their top concerns. It turns out that it’s the president’s name in the nickname for the law—Obamacare, a Republican invention that the president had no choice but to embrace—that’s highly unpopular, and even Republicans aren’t challenging the health care law’s most popular reforms. So Democratic candidates are loath to extoll Obamacare as such, and many of them are offering up the less than rousing line that it needs to be fixed but not ended.

Probably not since Richard Nixon have so many candidates shied away from being in the presence of their party’s president when he shows up in their states—though they welcome his strenuous fund-raising efforts on their behalf. It’s often said that the president should socialize more with Republicans, but they, too, don’t want to be seen in his presence and often turn down White House invitations; John Boehner has been forbidden by the House Republican caucus to negotiate with Obama on his own. Yet the public perception is that the failure of Washington to solve major problems during the past six years falls on the president as well as on those actually responsible—the Republicans. In fact, no president in history has faced such intransigence from the opposition party. It’s undeniable that the president’s race has a significant part in the destructive ways in which he is talked about and opposed.

Obama has on occasion fretted aloud that the focus in the news on the gridlock and dysfunction in Washington diverts attention from what he’s been able to achieve. When he’s long gone from the White House it could well become apparent that despite the odds Obama was responsible for notable achievements, among them Obamacare; getting gay marriage widely accepted; beginning to turn federal energy policy toward a more environmentally conscious set of policies; the Dodd-Frank bill’s restraints on Wall Street, however limited, with its rules still being argued over; and the establishment of the Consumer Financial Protection Agency championed by Elizabeth Warren.
Obama did much to pull the country out of the deep recession he inherited, including a rescue of the automobile industry, but a lot of people still don’t benefit from the improved economy, or have dropped out of the labor market, or have been forced into part-time jobs and lower wages.
No doubt it would have been beneficial if more money had been approved for rebuilding the nation’s crumbling infrastructure, but the votes in Congress weren’t there, just as they weren’t for a single-payer health system, and no amount of presidential rhetoric or arm-twisting—about which there is a fair amount of mythology—would have made a difference.

It’s been evident for quite a while that a certain chilliness on Obama’s part has affected his relations with Congress, but it’s also questionable how much substantive difference this has made. A Cabinet officer said to me, “He’s a loner, and one result is that few Democrats are willing to take the hill for him.” Obama rose swiftly in politics and essentially on his own—he’d been on his own for most of his life—and political camaraderie is of little interest to him. His golfing foursomes are most often made up of junior White House staff and close nonpolitical friends from Chicago. This might not make much difference in the number of bills passed but it has had one very serious effect on his presidency: the Democrats’ unwillingness to praise, defend, much less celebrate the president has left the field clear to his multitude of attackers.

Obama tended to proceed on the theory that if he made some concessions to the Republicans—say, by speeding up deportations of undocumented immigrants—they might be more cooperative; but this hasn’t worked out. It’s true that he is innately cautious, and it’s also true that it is a lot easier to declare what he should have done than to show how he could actually have gotten the votes for that. Little is as simple in the Oval Office as it is to outside critics.

 

Obama has been beset by the same problem on foreign policy. And as a result of his own actions (or inactions), Obama is accused of often overthinking an issue until too late, of being too slow to act, of allowing events to dictate his responses. It might seem that after eight years of George W. Bush’s rash and disastrous actions, caution would be welcome.

But the Ronald Reagan–John Wayne myth of bold, simple solutions lies deep in the American psyche. It was all so much simpler during the cold war; and the country became accustomed to simpler rhetoric. When Obama acts, or declines to, his critics—be they John McCain or an editorial writer or one of a myriad of foreign or defense policy “experts” who pop up on television—can urge from their comfortable perches that he should do more. But when McCain and his pal Lindsey Graham argue that the president should use greater force in Libya, Syria, Iraq, Ukraine, or wherever, they aren’t required to explain the downside risks, or what they would do next if their strategy failed.

When the president authorized air strikes against ISIS in Iraq in August, the usual Republicans inevitably said he wasn’t going far enough and some Democrats began to fret aloud that he might get too involved. Though some leading Democrats quickly drew a line at the use of American ground troops, the president is as reluctant as anyone else to use them. An official who has dealt with him on policy in the Middle East says, “Avoiding another Iraq is his guiding principle.”



The difficult situation Obama was in, politically as well as militarily, over ISIS made all the more jarring Hillary Clinton’s comment that if he had taken her advice and armed the “moderate” Syrian rebels, ISIS might not have developed. It also raised serious questions about both her political and strategic judgment.
An oddity about Mrs. Clinton’s complaint that the president allowed a vacuum in Syria in which ISIS could develop is that ISIS is an offshoot of al-Qaeda in Iraq (AQI) and it first emerged there as a result of Iraq’s dysfunction; so it’s questionable whether it could have been stamped out in Syria, much less by arming “moderate” forces. Bruce Riedel, a former high-level CIA official specializing in the Middle East and North Africa, a presidential adviser, and now with the Brookings Institution, told me, “ISIS’s base and stronghold is still in Iraq—the critics are in the wrong battlefield when they claim helping in Syria would have prevented ISIS.”
Mrs. Clinton’s efforts in the face of widespread criticism to smooth things over with the president weren’t likely to cause him to forget the whole thing. He can do a slow burn with the best of them. Moreover, the Clinton camp had been trying for weeks to call attention to her disagreement with the president over Syria, among other differences with him. Obama may recall that when he was first elected president and it became known that he was considering Clinton for the nomination for secretary of state—undoubtedly on the theory of “keep ’em in the corral”—Senator Edward Kennedy warned him that he was about to make a very serious mistake that he would come to regret: that the Clintons are about themselves.

Bruce Riedel [above] reaffirms the president’s view of the risks of arming “moderates” in Syria. Riedel said in a recent Brookings forum: “If you think you can give weapons only to the good guys, forget it. The bad guys will get them.” Later, he told me, “The president has had a very clear policy toward Syria: stay out of it at any cost. His governing policy is to avoid getting tangled up in situations in the Middle East and North Africa that can turn out to be disasters.” But ISIS may force his hand to get more and more involved in Syria with air strikes and special forces and perhaps drones, as he has already done in Iraq.

 

A problem for the public is that the president occasionally sends confusing signals—doing a little of what he’d adamantly said shouldn’t be done, or feinting in the direction of more involvement without wanting to follow through. The president more than once moved toward greater involvement in Syria while at the same time seeking to make sure that it wouldn’t happen. In 2012 he drew a “red line” on the Assad regime’s use of chemical weapons against its own citizens and then was much criticized when he didn’t follow through after Assad used them.

Unfortunately for the president, such criticism is based on a partial recollection of what happened. After Assad defied him and used chemical weapons, Obama felt pressed to respond. But rather than go ahead with bombing in Syria, with all the risks of getting further drawn into a civil war he was trying to avoid, he took the famous long walk on the White House grounds with his chief of staff, Denis McDonough, to whom he’s said to feel closer than anyone else he works with—other than, of course, the ever-present Valerie Jarrett—and decided to put the issue to Congress by asking its permission to bomb in Syria.
There’s little reason to doubt that he did this in the knowledge that the permission was unlikely to be forthcoming. But the outcome was more felicitous than that. Obama accepted an offer by the Russians to negotiate the removal of the chemical weapons from Syrian hands. Since the Russians are allied with the Syrian government, Obama’s threat seems to have been more credible to Assad than to his American critics.



Another example of Obama fuzzing his declared policy actually concerns supplying weapons to the Syrian rebels. On two occasions—once in 2012, under pressure from Hillary Clinton, CIA Director General David Petraeus, and Defense Secretary Leon Panetta to arm the rebels, and again in June of this year—the president, rather than issuing a formal statement from the White House, had the CIA e-mail halfhearted requests to Congress for relatively small amounts for arms for “moderate” rebels fighting the Assad regime.
Predictably, on both occasions, Republican and Democratic members of the intelligence and foreign relations committees were skeptical, asking such questions as: How do you know whom to give the weapons to, and how does this fit our general policy of not getting drawn into the Syrian civil war? The administration had no good answers, and as the president appeared to hope, only a small and insignificant number of weapons were sent to Syrian rebels.

As when he said “Assad must go,” Obama’s occasional resorting to unsupported rhetoric contributed to the impression of a weak and indecisive leader. The improvised nature of the president’s foreign policy is only partially of his own doing. McCain and Graham notwithstanding, there can be no one-size-fits-all foreign policy now (nor do they represent the views of even the majority of Republicans on Capitol Hill). The disparate nature of the challenges—from Putin’s adventurism to ISIS’s rise—makes it difficult for a president to enunciate a clear, single policy. As Riedel put it, “‘Don’t do stupid stuff’ is as smart an organizing first principle as any.”

 

But it’s the sense of ad hoc policy-making that causes the public to wonder if the president knows what he’s doing. The former defense and foreign policy official Leslie Gelb [above] wrote recently in The Daily Beast:

Mr. Obama always says a lot of smart things…. Much more than most foreign policy blabbermouths, he is attuned to the underlying centrality of politics in most world problems, and to the need to seek diplomatic solutions…. Once there is any kind of crisis, he doles out little pieces of policy daily…. Obama may view this as making sensible decisions in a step-by-step manner. To those trying to understand what he’s doing, they simply can’t follow him, let alone understand how the pieces and the day-to-day changes mesh.

 With rare exceptions, moreover, the sixth year of a presidency is usually one that favors the opposition party. People have tired of the man in the White House. The Democratic pollster Peter Hart says that people have made up their minds about Obama and are unlikely to change them before November. Finally, by various measurements Republicans are more fired up than Democrats about voting this time. This could be the decisive factor in many-to-all of the races.
Though a few of the twenty-nine Republican governorships might change hands, Republicans will still dominate the statehouses; but the rightward trend at the state level has already been blunted, and may be more so as of this election. As of now, at least one Democratic governor, Pat Quinn of Illinois, is seen to be in serious trouble. Illinois’s crisis of overpromised and underfunded pension is the most acute in the country and the state is nearly bankrupt.

In most of the Democratic-controlled states that the Republicans took over in 2010, they adopted the agenda of the pro-business organization ALEC, which included tax cuts, reduced spending, particularly on education, and also model laws for voter ID and relaxed gun control. But John Kasich, the Republican governor of Ohio, for example, wised up and began to move away from this essentially unpopular agenda, and so he is in a strong reelection position. Scott Walker, of Wisconsin, who has demonstrated presidential ambitions, hasn’t been quite as agile and is in a tight race, though his Democratic opponent is at a serious funding disadvantage. The two deeply conservative Republican governors in eastern states—Tom Corbett of Pennsylvania and Tea Party member Paul LePage of Maine—are highly unpopular (Corbett has the distinction of being the most unpopular governor in the country) and widely expected to go down to defeat.
Rick Scott of Florida is in a close race with Charlie Crist, a Republican turned Democrat.



But probably the most interesting governorship race is in Kansas, where the incumbent Sam Brownback [above] gave full vent to his extremely conservative fiscal and social views. Kansas is now deeply in debt. Brownback also tried to purge the more moderate Republicans in his state legislature. This caused over a hundred leading Republicans to oppose him for reelection this year. If Brownback loses, this would confirm that the country simply isn’t ready to be governed by a highly conservative agenda.

But there are reasons to hold back on prognosticating what will happen in November. There’s still plenty of time for an issue to blow up and have an impact on the outcome. In 1980 the race between Ronald Reagan and Jimmy Carter was quite close heading into the final weekend. Then, going into that weekend, it suddenly became clear that the Iranians wouldn’t release the American hostages then that they had been holding captive for over a year. This failure lit the fuse under a growing frustration with Carter, with the result that Reagan carried forty-four states. Moreover, nine incumbent Democratic senators were defeated in the undertow of the last-minute “wave.” Since the president is on the defensive over a number of issues, his party is more vulnerable to a wave of opposition votes that can still develop at any time up to election day.

One reason for the widespread view that the Republicans would likely take over the Senate is that the election map and math in 2014 favor them. The Democrats have twenty-one incumbent senators up for reelection, several in red or purple states, while the Republicans have fifteen, almost all of them in safe Republican states.



Should the Republicans take over the Senate, then Mitch McConnell, particularly loathed by Democrats for his obstructionist tactics and his wintry personality, would become majority leader. To appeal to the Republican base, McConnell recently said that were he to become majority leader he would favor more government shutdowns—a total reversal of his previous position against them for fear they would hurt his party. As of August, McConnell was facing a stiff challenge by Alison Lundergan Grimes, though he has a record of pulling out victories at the last minute, sometimes with ads that are particularly nasty. But his popularity in Kentucky has hit an all-time low. Of the six Senate seats the Republicans need to pick up in order to capture a majority, three seats held by Democrats who have chosen to retire have for some time been considered by pollsters and analysts to be lost to the Republicans: South Dakota, West Virginia, and Montana. There’s no reason to doubt them on this. In the remaining seven close races where the Democratic incumbent faces a strong challenge or there’s an open seat—Louisiana, Arkansas, North Carolina, Colorado, Iowa, Alaska, and Michigan—the analyses have gone back and forth on how the Democrat is doing. At times Mark Pryor of Arkansas, Mary Landrieu of Louisiana, Mark Udall of Colorado, and Mark Begich of Alaska have been believed to be in peril, only to be resuscitated as “doing better.”



The Democrats’ highest hopes of capturing a previously held Republican seat have been placed on Michelle Nunn, [above] the former executive director of George H.W. Bush’s Points of Light volunteer association and daughter of the popular former senator Sam Nunn. But Michelle Nunn faces another scion of Georgia’s political aristocracy, David Perdue. While the demography of Georgia has been moving toward the Democrats, the most reputable analysts now say that the state hasn’t yet changed enough for a Democrat to win it this year.

Whether or not the Republicans take control of the Senate, the ground there has already shifted to the right. While national Republican officials boast that not one of their incumbents was defeated by a Tea Party challenger—and unlike in the last two elections they had avoided nominating any goofballs (doing so had cost the party six seats)—the victories of what are called “mainstream” Republicans over Tea Party challengers haven’t been without cost to the party’s standing in the next presidential election. For one thing, some of the victories weren’t so thumping as to warrant discounting the Tea Party’s effect on the GOP. In most cases the incumbent had to move to the right in order to prevail.
The Republicans are so uncertain of victory in elections to federal offices that they’re still resorting in several states to passing laws that make voting more difficult for minorities and other groups who would ordinarily vote for the Democrats. Some of these laws are even stricter than those adopted in 2012. Democrats might appear to have issues that could drive their voters to the polls. These would include Republican efforts to deprive women of their own reproductive decisions and opposition to such measures as raising the minimum wage and making unemployment insurance last longer.
Still, largely because of the president’s unpopularity, the Democratic candidates have been having problems finding their voice. Most of their races are focused on the vulnerabilities of their opponents, making for a thus far unedifying election. The result is that a midterm election with national implications so far has no overall national theme.

Unknown at this point is the effect of the unprecedented amounts of outside money being poured into many of the races. It’s estimated that the Kentucky race alone will cost $100 million, the highest amount ever for a state contest. In addition, numerous members of the more militantly liberal Democratic wing have been holding back support of their party’s candidate because of impurities they find in the president’s or candidate’s positions. Democrats “disappointed” in Obama could help elect a Republican Senate. The odds may be stacked against the Democrats this November, but whether they can stave off a loss of control of one half of Congress is still up to them and their would-be supporters.

OUCH! Rebooblicans Find Typo in Obamacare, Try to Kill People With It.

The Washington Post:

Ouch! It’s been a tough day for Obamacare. A major pillar of the health-care law crumbled under the gavel of one federal appeals court on Tuesday, while a separate panel affirmed the legality of its billions of dollars in government subsidies. The three-judge panel of the D.C. Circuit Court of Appeals struck down premium subsidies used by 36 states, ruling that the Affordable Care Act doesn’t allow the IRS to dole out the subsidies in federal insurance exchanges, and that customers must pay out of pocket for the full insurance cost. The ruling is the result of a wording glitch in the ACA—as written, it says subsidies should be paid to those who purchase through an “exchange established by the state.” This restricts premium tax credits to state-run exchanges. Hours later, the Fourth Circuit Court of Appeals in Virginia upheld the subsidies saying the plaintiffs’ reading “bespeaks a deeply flawed effort to squeeze the proverbial elephant into the provebrial mousehole.”

 

N.Y. TIMES

The disagreement, called a circuit split, means that we are still a long way from any possible concrete actions. The cases will be appealed further, either for reconsideration by the appeals courts that issued the ruling, or go to the Supreme Court. The Obama administration will not reconsider its regulations, which interpreted the law to say that tax credits could be offered in every state, until the case is final. Because of the time involved, the approximately 5 million people in those states who have already signed up for insurance using the subsidies will almost certainly continue to receive them this year, although it is theoretically possible that they could be pulled back by the courts.

        

The Possible Reach of the Ruling

The D.C. Circuit’s decision has the potential to affect most enrollees in 36 states that use the federal insurance exchange.



                                                70 – 80%   80 – 90%   90%+   State-based exchange

 Source: Kaiser Family Foundation       

Percent using a subsidy

in federally run or partnership exchanges

State-based

exchange

70 – 80%

80 – 90%

90%+

A similar circuit split occurred in an earlier challenge to the Affordable Care Act, which was decided by the Supreme Court in 2012; the administration then proceeded in implementing the law as if it were unchallenged until the case was completely settled.

It’s always hard to predict what this Supreme Court will do on major cases — few people predicted its decision in the big 2012 Affordable Care Act case — but it is clear that the court does not move quickly. This case is likely to be hung up in litigation for a year or more, even if it is appealed immediately.

 Here are some possible next steps:

All the judges on the D.C. Circuit could decide the Halbig v. Burwell case. There is a process called “en banc” review in which the case would be reargued before all of the 11 judges on the D.C. Circuit Court, and the Obama administration has said it will ask the court for such a review. A majority of the judges would have to agree to rehear the case for it to be reconsidered in this way. Appellate courts rarely accept cases for en banc review, but this is a big one. Many legal experts think that the full court would view the government’s position more favorably than the two judges who ruled against them in the original decision on Tuesday; legal questions don’t necessarily break down along political lines, but Democratic appointees outnumber Republican appointees on the court and include four new judges recently appointed by President Obama.

 The law’s challengers could ask the Fourth Circuit to reconsider King v. Burwell. Same rules apply, and the Fourth Circuit also has more judges appointed by Democrats than Republicans.

 Decisions will be issued by other courts. The plaintiffs in the Virginia and D.C. cases are not the only ones challenging tax subsidies in the Affordable Care Act. Two trial court cases raise similar issues, one in Oklahoma and one in Indiana. Those cases could also go to appellate courts. Oklahoma is in the 10th Circuit; Indiana is in the 7th. Depending on the outcomes of the various rulings, all the courts could end up agreeing, or there could remain a disagreement between different circuits.

Either side — or both — could appeal the rulings to the Supreme Court. The Supreme Court can pick which cases it wants to hear; four judges must vote to take a case for it to be added to the court’s schedule. The Supreme Court generally rejects most petitions for a hearing but tends to intervene when circuit courts disagree about a substantive issue of law. The current disagreement between the D.C. and Fourth Circuits is a good example of the type of split that usually gets its attention.

The Supreme Court could decide the case. In addition to deciding whether tax subsidies can be used in states without their own exchanges, the court would face another question if it ruled in favor of the challengers: What happens to the tax credits that have already been handed out?

Congress could act. The legal question came up because of ambiguities in the drafting of the Affordable Care Act that made it unclear when tax subsidies should apply. If it was so inclined — a big if, in this polarized climate — Congress could fix the language and clarify who is eligible for the federal money.

States could act. Right now, 36 states are relying on the federal government to run at least parts of their insurance marketplaces, meaning that their residents could lose access to tax credits if the D.C. Circuit case is upheld. But any of those states could choose to switch to a state exchange, where the law is clear that the tax credits do apply. A few states are already working on switching from federal to state exchanges. Others might consider a similar shift, though the change would be difficult and potentially expensive.

Alex Wong/Getty

 MICHAEL TOMASKY, DAILY BEAST

It’s truly extraordinary, the lengths modern conservatism will go to to ensure that more members of what Dickens called “the surplus population” will die. First, refuse to set up state-run exchanges, so that the poor and working-class people of your state who are desperate to buy subsidized health insurance have to go to the federal exchange. Next, after your own decision not to set up an exchange has made the existence of the federal exchange necessary, you scour the Affordable Care Act and find one sentence that left out one or two words that could enable you to discredit the federal exchange.

Then you sue, claiming that the federally facilitated exchange, which exists because legislators had to plan around what they knew would be your own inaction and hostility, is illegal! Then, you get a couple of aggressively activist judges to agree with you. All that’s needed now is for John Roberts to get back on the team, and the deed will be done: Millions of people will be at risk of losing their no-longer-subsidized insurance, or see their rates shoot up to levels they simply can’t afford. And some, or many, will surely die sooner than they would have. What a legacy.
It’s revolting beyond words. Actually, not really beyond words. I have few. Orwellian, Malthusian, barbarous, depraved…I think you get me. But will it work?

The Justice Department will request that Tuesday’s decision, by a three-judge panel of the D.C. Circuit, be heard en banc by the full panel. The full panel has seven judges appointed by Democrats and four named by Republicans. A. Raymond Randolph, the senior judge who sat on the three-member panel and who made his ideological contempt for the ACA crystal clear during oral arguments, can also participate if he wishes, as can Harry Edwards, another senior judge who dissented Tuesday. That makes for an 8-5 majority that will almost surely reverse the three-judge panel.

They will be doing so, by the way, not because of politics, but because of law. Brian Beutler explained it well in his New Republic piece. The long and short of it hinges on the question of whether the language in the ACA is “ambiguous” on the point of whether the federal government is allowed to operate an exchange. If it is ambiguous, that’s good enough to let the law stand.

What Randolph and Thomas Griffith, the other conservative judge who ruled with him, essentially did was to take one sentence of a law that runs to thousands of pages and play gotcha. What judges are supposed to do is look at statutory language in context and think about the drafters’ actual intent. But hey, don’t take it from me. Take it from a certain Supreme Court justice, who wrote in a decision just last month of the “fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme.” That was Antonin Scalia.

But these were strange words, coming from Scalia. The context was his majority opinion in last month’s case about the EPA’s regulation of greenhouse gas emissions, which was a complicated and split verdict, albeit one that ultimately gave the EPA most of what it was asking for under the Clean Air Act. More typically, Scalia is a textualist. You can tell what that means, I’d wager, without me even explaining it, and in this case, it ain’t good: “I can’t read legislators’ minds. I can go only by the words in the bill. If they left out a word, they left out a word. Tough.”

 

In fact, there are other sections of the ACA, say several experts, that clearly at least imply the presence of or need for a federal exchange. And plain common sense tells you that Congress didn’t pass this huge and elephantine—and federal—law, whose very point was to enable more Americans to purchase health coverage, with the expectation that said coverage would be limited to the citizens who happen to live in some states but not others. It is facially, as they say in the law business, absurd.
But with this Supreme Court, who knows? Anthony Kennedy, the one we usually count on for a little decency, voted to dismantle the ACA the last time. John Roberts saved the day, in a backhanded sort of way. Roberts would have an opportunity to get his textualist ticket, revoked by conservatives after his decision to uphold Obamacare, re-stamped for life.

More than 5 million Americans have purchased subsidized insurance through the federal exchange. If the Supreme Court does its worst, these Americans will see their premiums increase by 76 percent, according to a study cited by Nathan Pippenger in his blog at the Democracy journal web site (I edit the journal, but not his blog). Clearly, many of those people will drop their coverage. So just as America has started down the road of joining every other advanced country in the world in trying to insure its whole population, here comes conservatism and the Republican Party to say: “No. We’re not like the rest of your so-called advanced world.”

If they succeed, their dismantling of the ACA will dwarf everything else that has happened in our era. The GOP will be known for years to come as the party that literally ripped security out of the hands of millions of people who so briefly and tenuously had it. They call themselves the “party of life.” And as with most of what they say, the opposite is the truth.

Why Obamacare isn’t getting any more popular — and probably won’t

WASHINGTON POST

In just one week, a barrage of national polling has reached the same verdict: Obamacare's Rocky Balboa-esque announcement that 8 million people have signed up for health care has done absolutely nothing to reverse the law's basic and long-standing unpopularity.
A new high of 55 percent disapproves of the law in a Pew Research Center/USA Today poll. And the Kaiser Family Foundation's tracking poll, a Post-ABC poll and a NBC News/Wall Street Journal poll last week all found little lasting changes from earlier this year -- when the law was at the heart of its implementation struggles.

The stagnant numbers would seem to fly in the face of the strong publicity the law earned by passing 7 million and then 8 million sign-ups. For a law that had experienced almost nothing but bad news for months, one would think a little good news would lead to at least a little recovery.
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What's more, Americans' biggest complaints about the health law are pretty well etched in stone. They existed well before the Web site's troubles, and the number of Americans who sign up for the law was never the root of the opposition. This was laid out clearly in the new Pew poll.

80 percent said a major reason for their opposition was "too much government involvement in health care"

76 percent said the law is "too expensive for the country"

58 percent cited the law's requirement that everyone must have health insurance

57 percent feared their "own health care may suffer"

Asked for their No. 1 reason for disliking the law, 42 percent cited "too much government involvement."
This particular complaint will be almost impossible for the law to overcome. It doesn't matter how well the government-run insurance marketplace works, if someone fundamentally opposes the whole idea of a government-run marketplace in the first place. In fact, news of 8 million signups in government-run marketplaces may only serve to remind some of the tightening nexus between government and the health insurance market. If you don't like Obamacare, having more people sign up might make you like it less rather than more.
Other complaints about the law are also hard to combat. The mandate for individuals to buy health insurance has long been one of the law's most unpopular features, and while certain aspects of it have been delayed (for small employers to offer plans, for instance), it's not going anywhere. And concerns about the law's costs, which are widespread, will be especially hard to overcome going forward. Even if the law succeeds in reducing the growth rate of health-care costs, it's almost certain the actual costs of health care will continue to go up -- something the law will be blamed for by the vast majority of people who have already decided that they don't like it.
And then there's the whole matter of whether people even processed the good news about Obamacare.
The Kaiser poll from last week actually showed that about three times as many people thought the sign-ups for the law came in below goals (57 percent) rather than above them (21 percent). (The Congressional Budget Office set a goal for enrollments at 7 million.)

What's perhaps most striking is that 43 percent of people correctly stated that the law signed up 8 million people, but less than half of them knew that this exceeded expectations.

HOW BAD FOR OBAMA AND THE DEMOCRATS?

MICHAEL TOMASKY, N.Y. REVIEW OF BOOKS

In the end, around seven million Americans signed up for Obamacare by the March 31 deadline, either through the federal exchange or through one of the fourteen exchanges set up by states (plus one in Washington, D.C.) that chose to run their own. That’s the target administration officials hoped for last fall, and considering the enrollment period’s hideous rollout, it came as quite a surprise to most commentators in Washington that it was reached. Republicans and conservatives spent months predicting that few would sign up, and that the law would simply perish of its own Rube Goldberg weight. But the “death spiral” of the Affordable Care Act, so anticipated on the Fox News Channel, failed to materialize.
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....younger people are said to account for 27 percent of all enrollees—not what the administration had hoped for, but enough, according to a Kaiser Family Foundation study from last December, to avoid the substantial hikes in insurance premiums that would result if there were not an adequate number of relatively healthy young people in the insurance pool.¹
This is all good news for the administration, but what really matters is not how many people sign up for coverage, but how many actually end up paying for it over an extended period. Any household hit with an unanticipated expense—a major car repair, a sudden need to buy a child a new computer—might skip an insurance payment that month. Or a healthy person might sign up, not use the insurance for a year, and stop paying or cancel. These fluctuations, too, will have an impact on premium rates by 2015, when some fear we’ll be in for substantial rate hikes, even though a provision in the law requires insurers to provide extensive justification for increases greater than 10 percent.

Bob Williams, left, and Serena Perez join with others to show their support for the Affordable Care Act in front of the office of U.S. Rep. Mario Diaz-Balart and Sen. Marco Rubio (R-FL) on April 23, 2014, in Doral, Florida. (Photo by Joe Raedle/Getty Images

 The truth is that we won’t know for years the actual percentage of enrollees who are sick. The reason we won’t know, it’s worth recalling, is embedded in the law itself. Insurers can no longer ask applicants questions about their health or any preexisting conditions they may have. And precisely because the law’s authors knew this little catch-22 would arise, they built “shock absorbers,” or risk mitigation provisions, into the law, by which the government would share some of the risk of loss that insurance companies assume (and conversely would be rewarded a portion of excess profits).
In sum, while reaching the enrollment target was a good start, much about the law’s impact is up in the air and will remain so for some time. But the self-anointed political experts who fancy themselves to be Washington’s arbiters of the conventional wisdom need judgments and need them now. Among that group, the verdict was long ago rendered. The law is a disaster for Democrats. This has been the view for months, indeed years, and it congealed fully in early March after the special congressional election in a Florida swing district near Tampa Bay, where the Republican, David Jolly, defeated Democrat Alex Sink by less than 2 percent (a libertarian third candidate took nearly 5 percent).
Inevitably, this narrow win in a low-turnout race was declared “a referendum on Obamacare.” But if you looked closely, some data suggested that the health care issue actually helped Sink marginally and made the result a little closer than it might have been. Geoff Garin, Sink’s pollster, told me afterward that Jolly’s “repeal Obamacare” position was more unpopular than Sink’s “keep it and fix it” position. Sink’s support improved when respondents were reminded of the specific consequences of repeal—i.e., that insurers could use preexisting health status to refuse to issue a policy, reimpose lifetime caps, charge women more than men, and so on.

 It has been said for months now that Obamacare will be the most important factor in this fall’s elections. Certainly, Republicans have vowed to make it so (the House took its fifty-second vote to repeal the law in March). Far from forcing Republicans to reconsider their approach, the meeting of the enrollment target merely led them to dismiss the numbers as phony.
They do so in part because when it comes to Senate elections they are benefiting from a very promising map. Democrats must defend incumbencies in Louisiana, North Carolina, Alaska, and Arkansas, while trying to compete in two other red states, West Virginia and South Dakota, where incumbent Democrats are retiring. In all six of those states, Obamacare’s approval ratings, not to mention those of Obama himself, are well below the national average. So it probably makes a certain sense for the GOP, and outside groups funded by the Koch brothers and others, to inveigh against big-government socialism as much as possible.

Americans for Prosperity Foundation Chairman David Koch is seen speaking in Florida last year. (Phelan M. Ebenhack / Associated Press )

But the odd thing about Obamacare is this: while people dislike the word and the abstract idea of it, they favor most of its particular provisions in large numbers. This seeming contradiction is, of course, an old reality in American politics. We might recall that Bill Clinton was fond of saying that the American people are “rhetorically conservative and operationally progressive.” Clinton was leaning on the research of Lloyd Free and Hadley Cantrill, the political scientists who identified this tendency back in 1967. Most people are seduced by conservative rhetoric—about cutting back spending, taxes, and government generally, say—but when they’re presented with a list of programs and asked which ones they’d cut, it turns out they kind of like many liberal programs.

And so it is with the Affordable Care Act. The name itself has become symbolic of the interfering state, so it polls poorly. But when people are asked about its specific provisions, numbers tend to resemble those from a Kaiser poll in mid-March: approval of extension of dependent coverage, 80 percent; of closing the Medicare prescription drug “doughnut hole,” 79 percent; of providing subsidy assistance to help people purchase coverage, 77 percent; of Medicaid expansion, 74 percent; of guaranteed issue, 70 percent. The only major plank that polled below 50 percent in the Kaiser survey was the individual mandate, at 35 percent. The mandate, along with people’s general suspicions that Obamacare is going to increase rates, is the act’s true Achilles heel.

Still, the rest of the provisions should help Democrats, if they’re not afraid to use them. To a Republican candidate thundering about repeal it can easily be said: “So, you want insurers to be able to deny sick people coverage? You want to allow them to throw people off their rolls if their care costs too much?” Another potentially useful rejoinder centers on the expansion of Medicaid. States refusing to accept federal money to operate their own exchanges for the poorer people who qualify for Medicaid are saying good-bye to billions. According to a December 2013 study by the Commonwealth Fund, Texas is sacrificing $9.6 billion; North Carolina, $2.6 billion; Florida, $5 billion; Georgia, $4.9 billion. That’s depriving citizens of a lot of money.

.Photo: Chip Somodevilla/2014 Getty Images

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With the enrollment success, Obamacare may well be turning a corner. If Democratic candidates can make the conversation about the act as specific as possible, most of them should be able to fight the issue to a draw. In some states with contested Senate races, Michigan and perhaps Colorado for example, they might even gain an advantage from it.

Still, the Democrats cannot feel relieved about November. It’s likely to be quite bad for them. Senators up for reelection this fall were elected (or reelected) in 2008—a big Democratic year. The party won eight Senate seats in that election, an unusual amount in this day and age. So now, in a nonpresidential year, the bill is coming due. The bright side for Democrats is that 2016 augurs very favorably indeed, because 2010, the year of the Tea Party, was a year in which a number of Republicans won seats that are normally Democratic. If Republicans capture the Senate in 2014, most of the experts on elections appear to think the Democrats may well win it back in 2016.

For this year, Republicans have a strong advantage, and in many cases, they don’t even need to say “Obamacare.” Simply saying “Obama” should work well enough.

Obama’s unpopularity—since last fall, polls have typically found his disapproval number to be six or seven points higher than the approval figure—has a few different sources. Certainly the slow economic recovery, with persistent high unemployment, is the main reason. In a mid-March NBC/Wall Street Journal poll, a staggering 57 percent of respondents said they believed the country was still in a recession (whereas economists say the recession ended five years ago). There was also the screwed-up launch of Obamacare itself; the many millions spent inaccurately attacking the new law; the lack of any dramatic result in foreign policy; and the determination of congressional Republicans to oppose nearly every Obama initiative, resulting in a dysfunction that inevitably leads many average citizens to pin some blame on the president.
 
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 In Alaska, Democrat Mark Begich [above] is still given a decent shot at winning reelection. But Obama’s approval rating there was 33.5 percent as measured by Gallup over the course of 2013 (the national average was 46.5 percent). In Arkansas, where the experts give Democrat Mark Pryor very little chance of hanging on, the president had a 34.9 percent approval rating. In Louisiana, where Mary Landrieu is likely to be challenged by a GOP House member, Obama stood at 40 percent.

 Two closely contested states where the Democrat could beat the Republican are made all the more interesting because both are in the South, and in both cases the Democrat is a woman. In Georgia, Michelle Nunn, daughter of Sam Nunn, will face a challenger to be decided in a May 20 primary (the Republican incumbent is retiring). Georgia is known as a right-wing state, but the three leading GOP contenders might put that proposition to the test. One, Paul Broun (pronounced “Brown”), has said that the theories of evolution and the Big Bang both come “straight from the pit of hell.”
The more tantalizing thought for Democrats is the prospect of beating Mitch McConnell in Kentucky. Some Democrats get along personally with members of the other party, but more than a few Democrats seem to loathe McConnell. The Democrat who will face him is Alison Lundergan Grimes, the thirty-five-year-old secretary of state. She appears to be running a highly competent campaign. She leads McConnell in most polls, if only by a couple of points. Of course, McConnell has not spent millions of dollars attacking her yet, so she’ll need to hold up to the kind of rough-housing that’s to be expected. But Kentucky is not a Republican state in the way some old Confederate states are—for example, every statewide officeholder (at the state level, not federal) is a Democrat. Governor Steve Beshear embraced Obamacare, and it seems widely accepted in his state.

Alison Lundergan Grimes

 If Lundergan Grimes or Nunn can win, and if at least one of the troika of Begich, Hagan, and Landrieu can hold on, the Democrats will retain control. A Republican majority would require a serious tidal wave. This could happen if key Democratic groups—young people, single women, and Latinos in particular—don’t vote.

Turnout is fate in midterm elections. Democrats have long suffered from this reality. Back in 1994, for example, the year the Republicans won fifty-four House seats after running on Newt Gingrich’s “Contract with America,” turnout was 39 percent, substantially down from 1992’s 55 percent. The falloff occurred mostly within groups that leaned Democratic—lower-income households, for example.

Today, with our increased polarization and a political discourse more and more defined by cultural cleavages, those groups whose participation drops off are more strongly Democratic than they were twenty years ago, while the groups whose voting rate stays high—elderly white voters, notably—are more Republican than they were. This means that the decline that was bad for Democrats two decades ago could be catastrophic for them now.

Democratic strategists understand this and say they’re committing unprecedented resources to getting their vote out. They’ve given this project a name, the Bannock Street Project, which was the street in Denver where Senator Michael Bennet’s turnout operation was based in 2010. Bennet successfully held a Tea Party opponent at bay that year, partly because Colorado was one of two states (Harry Reid’s Nevada was the other) where the Democrats invested in getting out the vote.
They will now try to do in ten states what they did that year in two. The goal is to spend $60 million on field operations alone in those states, with four thousand paid staff out knocking on doors. If that materializes, it ought to be enough to hold off at least a couple of Republicans.

Guy Cecil, center, head of the Democratic Senatorial Campaign Committee, at a strategy meeting in Washington with Anne Caprara, political director, and Matt Canter, deputy executive director. Credit Stephen Crowley/The New York Times

The Supreme Court’s April 2 McCutcheon v. FEC decision might well complicate these calculations. Now—starting this fall—wealthy donors can spend nearly limitless aggregate amounts on federal elections. Until the decision, a single wealthy donor could not spend more than a total of $123,200 during a particular election season. Now that donor can pump $6 million into a single congressional election, backing as many other candidates as he or she pleases by means of contributions to the political parties and to PACs that will steer the money to candidates.
This change may not alter the habits of such billionaires as Sheldon Adelson, the Las Vegas magnate who poured, via Super PACs and other means, at least $100 million into the 2012 elections, according to Trevor Potter, a lawyer and former federal election commissioner who supports reform (not as John Roberts defines it). Potter says that it’s “the top two-hundred members of the donor class” who will be the key beneficiaries here. And aren’t they more Republican than Democratic? “Yes, that’s probably true,” Potter says.

Whatever the effects of the decision, the problem Democrats will face is one of motivation. Conservative base voters will be eager for victory—the mere fact that Barack Obama remains president is effrontery enough as far as they’re concerned. With a serious prospect of turning the Senate red, these voters will almost certainly show up in considerable numbers. It’s hard to say, in contrast, what will galvanize Democratic groups. It’s not impossible to think now that rank-and-file Democrats could be feeling much greater pride of ownership of the Affordable Care Act by November and will go to the polls in its defense. But generally speaking, fear and loathing are much greater motivators.

Paul Ryan, (R-WI), at the Capitol in Washington, on April 7, 2014

J. Scott Applewhite/AP

As it happens, the Republicans may have handed Democrats just such ammunition in the form of Paul Ryan’s new budget, which he released the day after the Obamacare numbers came in. The budget would rip $5.1 trillion over ten years out of the domestic budget while increasing defense spending, and it would alter Medicare for those now under fifty-five, getting the camel’s nose of privatization under the tent, as it were. As I write, House Republican leadership was planning on forcing a vote on the budget, which would put them all on record in support of attacking (as the Democrats will surely put it) Medicare in an election year.

At some point, Democrats would be well advised to focus their voters’ minds on what a Republican Senate majority would mean. The Senate could join the House in its fishing-expedition investigations into the IRS “scandal” and Benghazi (with Hillary Clinton leading every Republican presidential hopeful by double digits, the desire to visit any discomfort they can upon her will be strong). Remember also that under Democratic control, the Senate has simply refused to take up many bills passed by the House. In GOP hands, the Senate will bring all those votes to the floor—draconian budgets that might pressure Obama into accepting deep cuts, and votes to repeal Obamacare (Obama will veto those, so the law won’t be threatened in any real way).

There is also the question of nominations. If there’s a Supreme Court vacancy, it seems possible to many observers that Republicans simply wouldn’t permit any nominee named by Obama to get a hearing. Nominations to lower courts and executive branch positions will meet a similar fate. Then there’s the prospect of the pretended threat of impeachment, a ploy to distract the president and strip him of authority. Obama’s final two years as president would almost surely be a tougher grind than the previous six. Perhaps far tougher, difficult as that might be to imagine.

 A somewhat mitigating factor: in five remaining states, Tea Party rightists are challenging establishment conservatives in the primaries. I say “remaining” because the challenge of that sort in Texas, against John Cornyn, ended with Cornyn’s easy win over the Tea Party’s Steve Stockman on March 4. The other five primaries will take place between May 20 and August 7, and the most notable incumbents being challenged from the right are McConnell and Lindsey Graham.
For the most part, these results aren’t likely to affect the partisan balance of the Senate. These primaries are all happening in states (except Kentucky) where the odds of a Democrat winning a Senate election are slim indeed.

But by the morning of August 8, we’ll have a sense of how much life is left in the Tea Party movement, and whether it can continue to strike fear into more mainstream conservatives. The Republican Party swears that it is fighting the extremism within its ranks. McConnell even said in early March that “we are going to crush them everywhere.” And he might be right about that—generally, these five incumbents will have too much money and will have dispensed so many favors to so many constituents over so many years that they can survive challenges from outsiders. The polls so far show a close race only in Mississippi.
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The intraparty fight will then be transferred to the presidential race. Inside the Beltway these days, Kentucky Senator Rand Paul [above] has been anointed the front-runner now that Chris Christie’s image as a transpartisan truth dispenser has suffered evidently irreparable damage. (At least for now; in politics, who really knows?) Paul is a Tea Partier who has moved into the top tier in recent polls of Republicans asked to name their preferred GOP candidate. But he typically trails Hillary Clinton by ten points or more. He is bound to make the leaders of the party establishment nervous, and they’ll try to find a candidate to beat him.

But the Republican establishment might not call the shots the way it has for decades. With Christie no longer the establishment front-runner, the contest for the White House doesn’t really have one right now. And most of the likely candidates—Rand Paul, Ted Cruz, Marco Rubio, Wisconsin Governor Scott Walker—are quite far to the right. So any obituaries of the Tea Party this August might end up being premature.