Thursday, November 30, 2023

The Democrats’ weak link

 I’ve written a couple of articles about Republican weaknesses in the upcoming election over the past few weeks. Despite favorable polling at the moment, the abortion issueremains an Achilles heel for the party and Donald Trump’s recent resurrection of the effort to repeal Obamacare may turn out to be a similar weakness. 

That doesn’t mean that Democrats will cruise to another election victory, however. The Democrats have problems of their own that the party must deal with and that voters will have to consider. 

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The economy is one of the obvious considerations. So far, the economy is doing wellwith inflation coming under control the stock market is flirting with record highs, and unemployment is low. Even gas prices, an economic measure that directly affects a large number of Americans, have fallen for more than 60 straight days. The problem is that consumers haven’t yet noticed the good news and are still in bunker mode. 

The good news for Democrats is that it seems increasingly likely that the Fed will pull off the soft landing that avoids a recession. Even though some economists are still forecasting a recession, those predictions have been off the mark so far with the economy chugging stubbornly along. If Biden’s luck holds, consumer confidence is likely to be much stronger by Election Day.

There’s also immigration. The border has been a perceived weak area for President Biden, but this weakness might be somewhat offset by a proposed deal that would tie border security funding to a Ukrainian aid package.

The big weakness is not going to be Hunter Biden. The claims about Hunter didn’t resonate with voters in 2020 and three years later, Republicans still haven’t found a smoking gun that connects Hunter’s activities to any crime by Joe. Rep. Lisa McClain (R-Mich.) admitted as much on Fox Business earlier this week when she was asked, “Have you been able to identify any actual policy changes that Joe Biden made as a result of getting money from China?”

“The short answer is no,” McClain replied, despite a claim by James Comer (R-Ky.),who leads the impeachment inquiry, back in May that Republicans already had this evidence. 

Facing a subpoena, Hunter has offered to testify in a public congressional hearing, but House Republicans want to keep the matter behind closed doors in a private deposition. Given the conflicting and inflammatory statements sans evidence coming out of the inquiry, I don’t blame Hunter for wanting his testimony to be a matter of public spectacle record, and if Republicans choose not to take him up on it, it will be hard to sway skeptical members of Congress and voters to back the impeachment effort or even convince them that Biden is corrupt. The investigation is at a point where Republicans must decide whether to poop or get off the pot. 

Aside from the economy, there is one big issue where Democrats are out of the mainstream in the same way that Republicans are swimming against the tide when it comes to abortion and gun rights. The big weakness for the Democrats is their position on treatment of transgender children. 

While Democratic positions on the issue of “gender-affirming care” are not monolithic, there is a wealth of polling that shows that Americans are very skeptical of policies that favor transgender people, especially when it comes to medical interventions. One of the most detailed and recent polls that looked at the issue was a Pew Research survey from last June. Among the poll’s findings:

  • 60 percent say gender is determined at birth (up from 56 percent in 2022 and 54 percent in 2017)

  • 58 percent support mandating that transgender people compete on sports teams that match their birth gender (17 percent oppose)

  • 46 percent favor bans on medical care for gender transitions (31 percent oppose)

  • 43 percent say the pace of change for gender identity issues is too fast (26 percent say too slow)

  • 78 percent say transgender people face discrimination

  • 69 percent say that it is important to use a transgender person’s pronouns (18 percent say it isn’t important and 12 percent say it shouldn’t be done)

  • 64 percent say that trans people should be protected from discrimination (up from 60 percent in 2022 and 54 percent in 2017)

If the polling seems inconsistent, welcome to American public opinion. We can draw some broad conclusions, however. Even though most Americans believe that gender is a biological reality, most also believe that trans people should be respected and that they should not be discriminated against. The biggest opposition to the trans movement seems to be on issues that involve children, such as medical gender reassignment treatments on minors and in sports. 

Transgender issues may provide an opening for Republicans, but it is an issue where they should tread carefully. Republicans should avoid attacking trans people directly but focus their efforts on regulating medical treatments and mandating that biological boys cannot cross over to girls’ sports. 

It’s going to be tough to go that far and no farther though. The risk is that Republican firebrands will cross the line into overt bigotry and turn off moderate voters in swing states and districts. To some extent, I’d say that this isn’t a risk but a certainty. The question is how broad the problem will be. 

If Republicans can control their radical fringe, the issue is an opportunity to paint Democrats as social radicals and anti-science. And this isn’t just a matter of conservative pundits parading their scientific opinions, Forbes reported last June that a number of European countries are acting to restrict “gender-affirming care” for minors on the grounds that “longitudinal data collected and analyzed by public health authorities in Finland, Sweden, the Netherlands, and England have concluded that the risk-benefit ratio of youth gender transition ranges from unknown to unfavorable.”

This should be the focus of the Republican message. The party’s candidates and surrogates should stress that they have sympathy for the mental anxiety that gender confusion can cause but that scientific data has found that medically altering a person’s gender can make the problem worse. If possible, they should do this without uttering words like “pervert” or “groomer.”

Regulations and restrictions on medical treatments for minors have a long history, both in the US and Europe. Campaigning for a nationwide ban against the use of hormone blockers and sexual reassignment surgeries for minors is not fanatical, transphobic, or cruel. 

It’s also reasonable to advocate that biological boys compete against other biological boys in school sports. No matter what gender is claimed, DNA and the male physical makeup create an unfair advantage for trans women over biological women. 

Republicans are more in step with public opinion on these issues, but that does not mean that they constitute emergencies. Despite the headlines and the angst, the New York Times reported in 2022 that even though the population of young people who identify as transgender has “nearly doubled in recent years,” the share of minors who are transgender is still less than 1.5 percent of those age groups. Newsweek estimated that the number of transgender athletes was less than 100 nationwide.

Even though there are comparatively few trans people, the issue of transgender rights is a contentious one. Republicans currently have a more mainstream position on the issue so we’ll definitely see the topic come back up as the election nears. 

Republicans should remember, however, that being a small minority does not mean that trans people lack humanity. The focus should be on helping them find the best medical and psychological help to navigate their condition rather than singling them out for harassment and ridicule. 

The key is look to the scientific evidence and present it in a kind and caring way. In other words, don’t be a jerk. 

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Here’s a second look at another piece on the transgender issue that I wrote back in July.

From the Racket News



Tuesday, November 28, 2023

Obamacare in the crosshairs... again

 “The cost of Obamacare is out of control, plus, it’s not good Healthcare. I’m seriously looking at alternatives.”

The statement above was not made back in 2016. It’s from a Truth Social post by Donald Trump last weekend. The former president added, “We had a couple of Republican Senators who campaigned for 6 years against it, and then raised their hands not to terminate it. It was a low point for the Republican Party, but we should never give up!”

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For those who don’t remember, Obamacare, officially known as the Affordable Care Act, was signed into law back in 2010. The program was plagued with problems during its 2013 rollout. Democrats suffered in elections from 2010 through 2016 in large part due to the law’s unpopularity. When Republicans rose to power in 2016, a key part of their platform was the promise to repeal Obamacare… which they didn’t have a plan to do.

Throughout 2017, Republicans tried to cobble together a plan to… do something to Obamacare since they didn’t have the votes to repeal it. Even with majorities in both houses of Congress, there weren’t enough Republicans to end a Democratic filibuster, and the details of plans to reform the ACA kept running afoul of moderate Republican swing votes in the Senate. Ultimately, the last reform plan, branded as a “skinny repeal,” was voted down with Senator John McCain casting the deciding vote.

One thing that Republicans did accomplish was to transform public opinion on Obamacare. A law and program that had heretofore been very unpopular suddenly flipped in late 2016 and, for the first time, approval rose above the water level. Today, Americans in the Kaiser tracking poll approve of Obamacare by a margin of about 20 points.

Since the death of “skinny repeal” in July 2017, Obamacare has been conspicuously absent from Republican talking points. It’s an especially obvious omission for those of who remember that “Repeal Obamacare” was the almost single-minded rallying cry of Republicans from 2010 through 2016.

Enter The Former Guy with a post that hints at another war on the ACA. That sound that you hear is Democrats chortling with glee.

Over the past few months, Democrats have had plenty of things to sweat about. There were a raft of polls showing that Trump was competitive with or leading President Biden. Americans are still feeling the pinch of inflation, even as the Fed brings it under control. The new Gaza war added to international unrest that already included the Ukraine war and Chinese saber-rattling in the Pacific.

One of the few things that Democrats had going for them was the albatross around the GOP’s neck, the abortion issue paired with the Dobbs decision. Now, the question is whether the presumptive Republican nominee is about to hand the Democrats another club with which to beat the GOP about the head and shoulders.

Obamacare celebrated its 10-year birthday this year to little fanfare. The dearth of analytical pieces delving into whether the Affordable Care Act worked may answer the question with their absence, but the Wall Street Journal recently ran an op-ed noting that Senators Elizabeth Warren (D-Mass.) and Mike Braun (R-Ind.) were complaining that insurance companies were buying other healthcare companies to vertically integrate the healthcare supply chain. This enables insurers to evade the ACA’s medical loss ratio profit cap by shifting profits to their subsidiaries.

Did Obamacare work? I think that depends on who you ask and what you expected it to do. The Affordable Care Act was ostensibly passed to help rein in healthcare costs. Analyses of the ACA range from finding “little evidence that they had produced the changes necessary to ‘bend the cost curve’” to claims that the law saved $2.3 trillion. A more median view estimates that the ACA saved at least some money and helped to slow the growth of healthcare spending.

A second goal was to eliminate the problem of uninsured Americans. Again, the results are mixed. The Kaiser Foundation reports that about 17 percent of Americans were uninsured in 2012. By 2022, that was down to just over 10 percent. That’s an improvement but a far cry from a solution to the problem.

For the record, I opposed the ACA and thought that the Supreme Court decision upholding the individual mandate was deeply flawed. In general, I oppose top-down solutions and mandates in favor of market-based approaches. I do think that the American health insurance system, based as it is upon healthcare that is tied to employers, is still badly in need of an overhaul that breaks that nonsensical link.

Obamacare proponents can point to changes made since the law’s inception for its failures. For example, in 2017, Republicans were successful in repealing the penalty associated with the ACA’s individual mandate. For those who don’t recall, the individual mandate was the requirement that every American buy health insurance and was one of the most unpopular provisions of the law. These tweaks almost certainly did have some effect on the success of the law in achieving its goals.

To be fair, the horror stories about the ACA never came to fruition either. A decade in, there are no death panels, no rationing of care, and no long waits for procedures as experienced in other “socialized medicine” countries. Republicans will claim that their tweaks to the law prevented these problems.

In 2024, however, the question won’t be whether the ACA is working, but whether people want the ACA to go away. Since 2017, the answer has been no. The onus will be on Republicans to bend the approval curve back toward the negative. They weren’t able to do that six years ago.

A big part of that difficulty was the lack of a coherent plan for what was to come after Obamacare. Apparently because no one expected Donald Trump to win in 2016, there was no Republican plan to reform healthcare. For the remainder of Donald Trump’s term, we kept hearing that a healthcare plan and an infrastructure bill were only a few weeks away. We’re still waiting.

If Republicans want to talk about messing with Obamacare, they would be well advised to construct a plan that at least sounds palatable to the voters who have come to rely on the Affordable Care Act for their health insurance. This year, the Obamacare exchanges set a record high for enrollment at 18.2 million, a small share of the country, but the prospect of the government tinkering under the hood of health insurance plans, including employer-based plans, is likely to be a turnoff for voters. Democrats learned this the hard way in 2010.

My instincts tell me that Trump’s new Obamacare onslaught will play well with the Republican base, for which Obamacare has never ceased to be a foe. That may give Trump a further edge in the primary, not that he needs one with an advantage of more than 40 points over his nearest opponent.

Or maybe not. The flip side is that low-income Republicans may have come to rely on the program for their insurance. I’ve seen firsthand that Republicans will decry social programs and entitlements… until you start talking about Social Security reform. We may find that Obamacare reform is a similar third-rail issue, but even then, I have my doubts that it would cause Republican voters to sour on Trump. Such is the strength of the personality cult.

However the issue plays in the primary, it seems likely that general election voters won’t be too keen on rolling back ACA reforms unless Republicans can come up with something that sounds better. I can guarantee that Donald Trump did not ensure that such a well-crafted plan was in place before posting his Truth Social message.

This lack of preparation is a main reason why Democrats are salivating at the possibility of Trump running on a platform of repealing Obamacare. The issue is a classic example of Republicans running on issues that rev up the base but hurt them in the general election.


From the Racket News