Tom Daschle on Obamacare and Washington dysfunction

REUTERS/Gus Ruelas
Former Senate Majority Leader Tom Daschle

Former Sen. Tom Daschle (D-South Dakota) praised and defended the Affordable Care Act at the University of Minnesota’s Humphrey School on Friday and threw out a few ideas for getting past the gridlock in Washington.

Daschle was interviewed by Vin Weber, with whom he served in the U.S. House in the early 1980s. The hottest news of the Affordable Care Act that day was that the U.S. Supreme Court would take a case that could blow another hole in the law’s fabric. Many of those who buy health insurance through the exchanges set up by the Obamacare law qualify for subsidies.

Because of some ambiguous language in the statute, opponents of the law are arguing that the subsidies should be available only in the 16 states (like Minnesota) that set up their own exchanges. The majority of states declined to do that. Qualifying residents of those 36 states can participate in federally run exchanges. In the new case (King v. Burwell), the Supreme Court will consider whether the subsidies for which many Americans who purchase health insurance through the “exchanges” qualify should be denied to those in states that do not operate their own exchanges. If the Supreme Court agrees with the plaintiffs and limits the subsidies to the minority of states that operate their own exchanges, it will be a huge blow to the overall fabric and reach of the ACA.

Weber asked Daschle whether he believed the language in question was intended by the authors of the ACA to treat state-run exchanges differently for this purpose. Daschle said no, it was unimaginable that such a difference was intended. The ambiguity was created by a drafting error. He said that in normal times, after a major complex law passes, Congress follows up with what is called a “technical corrections” bill to clean up just these kinds of accidental ambiguities. But because of the extraordinary partisan warfare over the ACA, it wasn’t possible to do a technical corrections bill.

Daschle, whose Senate career included service as majority leader, was an early and strong supporter of President Obama’s 2008 campaign and was Obama’s first choice to be secretary of Health and Human Services. If he had been confirmed, he would have been on the front lines of the implementation of the ACA, but his nomination was derailed by disclosure of his failure to adequately report and pay taxes on some benefits he received during his post-Senate career as a lobbyist. (Daschle still works as a lobbyist.)

In his remarks Friday, Daschle was very hard on the oft-repeated nostrum that the U.S. health care system was the best in the world before Obamacare, noting several colossal indicators to the contrary. The United States, he said, did not rank in the top 10 in the world in any of the major indices of health, and ranked, for example, 51st from the top in infant mortality.

On the climate in Washington, Daschle expressed no great confidence that a new era of compromise and functionality was about to break out, but he did have a few suggestions. One was that the Senate meet more. The demands of perpetual campaigning have created a new normal in which senators “leave [Washington] on Thursday, come back on Tuesday, and try to govern on Wednesday.” He suggested that instead, the Senate commit to five-day work weeks in Washington and, if they have to spend that much time back home, take a week off from Senate sessions every month. (He also said that senators in the last two years of their terms generally spend 60-70 percent of their time fundraising for their campaigns.)

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Comments (24)

  1. Submitted by Paul Brandon on 11/10/2014 - 03:13 pm.

    So the Supremes may decide that

    they know better than the people who wrote the law what the law means. Nothing like legislating from the bench!

    And of course the Right Wing will argue that -their- health care is the best in the world, and all those people who can’t afford it (and we know who -they- are) don’t count.

  2. Submitted by Rachel Kahler on 11/10/2014 - 04:16 pm.

    Daschle

    I wish Daschle was still in government. He was one of the best things to come out of South Dakota and was a great asset. I would venture to guess that many South Dakotans rue the day that they were convinced John Thune could do a better job.

  3. Submitted by Ron Gotzman on 11/10/2014 - 04:51 pm.

    Paul – Your guy….

    You can’t do it political, you just literally cannot do it. Transparent financing and also transparent spending. I mean, this bill was written in a tortured way to make sure CBO did not score the mandate as taxes. If CBO scored the mandate as taxes the bill dies. Okay? So it’s written to do that,” Gruber said. “In terms of risk rated subsidies, if you had a law which said that healthy people are going to pay in, you made explicit healthy people pay in and sick people get money, it would not have passed. Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really really critical to get for the thing to pass. Look, I wish Mark was right that we could make it all transparent, but I’d rather have this law than not.”
    The Obama care architect

    • Submitted by Todd Hintz on 11/10/2014 - 10:22 pm.

      Insurance

      Ron, you are railing on about how insurance works at its most fundamental foundation. Even though you didn’t have didn’t have an accident in today’s snow storm, you’re paying car insurance to cover the people who did. So it goes with health insurance too. Healthy people pay today to cover those who are sick, because some day they too will be the sick person and need the coverage that insurance provides.

      I’m sorry, but do you not know the basic tenants of how insurance works?

      Everyone is going to need health coverage at several points in their lives: when they’re born, if the have any sort of illness or accident at all, and towards the end of their lives. I’m sure you’ll disagree with this assessment, but I would rather pay in a little bit of money each month rather than get socked with a huge bill after the surgery. One is a couple hundred dollar expense, while the other can easily run into hundreds of thousands of dollars and bankrupt a person.

      Which would you prefer?

      • Submitted by Ron Gotzman on 11/11/2014 - 06:52 am.

        I know how insurance works

        The quote is from the Obama care designer. According to him, the law is filled with deception and lack of transparency. The voters are called stupid by this man.

        Do you know how politics works?

        Of course – if you like your plan – you can keep your plan. If you like your doctor – you can keep your doctor. Your insurance will go down $2500. Is this true – or did your guy B.O. lie to the people from the start?

        I guess lying is fine as long as the political objective is achieved. Once again – he is your guy!

  4. Submitted by Ray Schoch on 11/10/2014 - 08:09 pm.

    First of all…

    I’m with Rachel on Tom Daschle. Good man, good politician, who made a serious mistake and paid a high price for it. I tend to say the same thing about Gary Hart in Colorado, who occasionally has a blog post on HuffPost. Both men understand policy on the big stage, both are smart and articulate, and both can safely be ignored by a fact-free right wing.

    The ACA is amazingly complicated because, first, it’s a Republican plan, which Republicans then had to disavow when it was adopted by “that guy” in the White House. Disavowal required, and still requires, some impressive ethical and intellectual gymnastics. Second, it’s complicated by all the modifications – by which I mean changes to suit the preferences of insurance industry and other lobbyists – that had to be made to secure its passage.

    Single-payer, government-run health care would be far more efficient and effective, but Republicans are, and have been, determined never to cooperate with “that guy” in the White House about anything important. It’s not about what might be good for the country, but about who has the power, and, not necessarily in second place, who has the money.

    Finally, it’s a sad commentary on the state of the Republic when Senators spend the majority of their time raising money, which always, especially in large doses, comes with strings attached. Capitalism requires a degree of this from all of us, but there’s nonetheless a fairly ugly word for people who sell themselves for money, or power, or media attention…

  5. Submitted by Dennis Tester on 11/10/2014 - 09:25 pm.

    Daschle is wrong

    “Weber asked Daschle whether he believed the language in question was intended by the authors of the ACA to treat state-run exchanges differently for this purpose. Daschle said no, it was unimaginable that such a difference was intended.”

    Actually, that was the plan and Daschle knows it. The democrats wanted to withhold subsidies from states who didn’t build their own exchange and to use that fact as political leverage with that state’s citizens. Alas, it didn’t work.

    “What’s important to remember politically about [Obamacare] is if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits – but your citizens still pay the taxes that support this bill. So you’re essentially saying [to] your citizens you’re going to pay all the taxes to help all the other states in the country. I hope that that’s a blatant enough political reality that states will get their act together and realize there are billions of dollars at stake here in setting up these exchanges. But, you know, once again the politics can get ugly around this.” – Jonathan Gruber, Obamacare architect

    https://www.youtube.com/watch?v=GtnEmPXEpr0#t=1886

    Daschle claims the ambiguity was created by a drafting error. Yeah, right.

    I don’t think SCOTUS is going to buy Tom’s version of events and the primary support beam of Obamacare is going to come crumbling down.

    • Submitted by Paul Brandon on 11/11/2014 - 09:28 am.

      Gruber was a consultant

      he did not write the legislation (Congress does that).
      For the full quotation (warning; it’s about an hour) providing more context, see
      http://www.snopes.com/politics/medical/gruber.asp
      Hopefully the Supremes (or at least their clerks) will do their homework.

      Remember, anyone can post anything to Youtube.

      • Submitted by Peder DeFor on 11/12/2014 - 07:34 am.

        Consultant

        Yep, he was only a consultant. And I’m sure that if a video surfaced of Paul Wolfowitz saying that the Bush administration fooled the ‘stupid’ American public, this video would be quietly discarded, right? I mean, with Gruber you have *repeated* instances of a man who was intimately involved with the process making claims against his own interest. The reasonable person would think that he’s probably being honest. In fact, you’d have to work pretty hard to dismiss this.

        • Submitted by Paul Brandon on 11/12/2014 - 09:25 am.

          Again, the Romney link

          Gruber was also a consultant to Romney on the Massachusetts plan.
          And I don’t recall him saying that he had made any outright lies in his proposals.
          For that matter, he didn’t say that he had fooled the American public; just that many Americans don’t do a careful analysis of government policies and don’t realize all the implications of those policies.

          • Submitted by Peder DeFor on 11/12/2014 - 01:15 pm.

            Fooling the Public

            Paul, here’s the quote.
            “This bill was written in a tortured way to make sure CBO did not score the mandate as taxes. If CBO [Congressional Budget Office] scored the mandate as taxes, the bill dies. Okay, so it’s written to do that. In terms of risk rated subsidies, if you had a law which said that healthy people are going to pay in – you made explicit healthy people pay in and sick people get money, it would not have passed… Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really really critical for the thing to pass….Look, I wish Mark was right that we could make it all transparent, but I’d rather have this law than not.”
            (Taken from here: http://reason.com/blog/2014/11/10/watch-obamacare-architect-jonathan-grube )

            He’s saying that the bill was written in a certain way to avoid an honest appraisal from the CBO. He’s saying that the part where healthy people pay more to benefit sick people was hidden from the public. This bill was under intense scrutiny for months so to just pass this off as carelessness on the part of the voters is ridiculous.

  6. Submitted by Pavel Yankovic on 11/11/2014 - 06:56 am.

    Mr. Daschle..

    is the perfect person to comment on the dysfunction in Washington DC. He was a willing participant and contributor to it for many years.

  7. Submitted by Jon Kingstad on 11/11/2014 - 12:09 pm.

    Dysfunction = Right wing involvement

    Let’s be clear here. The only dysfunction in Washington is the dysfunction created by the right-wing cabal which temporarily has recaptured control in one of the three branches of government in Washington DC.

    Now, after six years of having failed to block the ACA, Obama’s signal legislative achievement, and having failed to come up with a single idea of how health care might be improved and costs controlled for the majority of the people in this country, the right wing has mounted a cynical campaign in the courts. The campaign seeks to eliminate the tax credits being granted to ACA users in those 34 states whose Republican governors refused to implement the ACA exchanges. Did you follow that? The Cato Institute, whose “director of health policy studies” helped to dream up this deceitful and cynical strategy, explains its King v. Burwell case here:

    http://www.scotusblog.com/2014/11/symposium-seven-myths-about-king-v-burwell/

    The ACA has been popular in states without exchanges (like Mitch McConnell’s Kentucky) where tax credits using the ACA have been available despite the refusal of right wing governors to create exchanges. The Cato Institute argues that the IRS did an end run around the ACA by expanding the tax credits to those states even though the ACA itself may explicitly not allow this. So by attacking IRS rules which allow tax credits in those states, the Cato Institute will succeed in ending ACA benefits in 34 states.

    Huge amounts of legal and judicial resources have been deployed by the right wing to make a political point which will end costing the citizens affordable health care by denying citizens tax credits which would be available if the right wing governors of those states would simply create the exchanges. They can then blame the Democrats and “liberals.” This strategy is completely motivated by politics to deceive and confuse the public. It is completely regardless of the public welfare or interest of the people in this country.

    Whatever Tom Daschle’s faults, he at least had a positive and constructive plan about improving health care and health insurance in this country. His ideas about single payer or universal health care are ideas which deserve to be tried in law.

  8. Submitted by Peder DeFor on 11/12/2014 - 07:46 am.

    Infant mortality is a terrible way to compare the US health care system with other countries. Different countries count miscarriages differently and that screws up the statistics. From what I can see, if you limit the data to babies after 24-27 weeks of gestation, the US drops to 5th best.
    In other words, if the US would simply stop trying to save younger babies, their rating would increase, even though this would mean more deaths. I can’t imagine that anyone would see this as a health improvement.
    I’m not going to argue that the US has the best health care system (though I’m sure that argument can be made) but using infant mortality rates as a yardstick is problematic at best.

    • Submitted by Paul Brandon on 11/12/2014 - 09:31 am.

      There are many possible measures

      According to the WHO, the United States ranks 34th in longevity (just behind Costa Rica).
      Guns can’t account for all of that ;-).
      And again this is partly a public health issue rather than a medical treatment one, but the dividing line gets fuzzy.
      But whether we rank 5th or 34th, that’s hardly the world’s best.

      • Submitted by Peder DeFor on 11/12/2014 - 01:02 pm.

        How to Measure?

        That’s probably why the rich and powerful around the world all fly to Costa Rica for their health care. 🙂

        I completely agree that the lines are fuzzy. Yep, 34th in longevity at 79.8 years. If we improved by two full years, we’d be tied for 16th with Norway. Two more years of improvement (four total) and we’re in third place. Does anyone feel ashamed that people in the United States only live (almost) 80 years instead of living 84? I doubt that they do.
        Any real measurement would balance things like longevity, cost (including taxes), access to service, innovation and mortality rates for common diseases. And probably a dozen other factors too. This is one of those cases where the use of a single stat is almost certainly cherry picked and misleading.

        • Submitted by Paul Brandon on 11/12/2014 - 07:22 pm.

          Actually

          Many Americans do fly to Costa Rica for affordable health care.

          • Submitted by Tom Karas on 11/15/2014 - 07:35 am.

            rich and powerful

            Thats what it takes to make best use of the ‘system’ that was in place. All herald the rich and powerful.

            • Submitted by Peder DeFor on 11/16/2014 - 07:29 am.

              Best System

              Tom, I don’t think you understood what I was saying. I wasn’t saying that the good medical care was only available to the rich and powerful, I’m saying that the system was so good that it when people with virtually unlimited resources could pick anywhere in the world for care, they chose the US. I was thinking of the Mayo Clinic in particular. Mayo serves people of all income levels, from the very poor to the unimaginably wealthy.

  9. Submitted by E Gamauf on 11/12/2014 - 09:25 am.

    America – Best diet, best schools, best medical care

    “In his remarks Friday, Daschle was very hard on the oft-repeated nostrum that the U.S. health care system was the best in the world before Obamacare, noting several colossal indicators to the contrary.”

    * Those super-sized burgers aren’t so healthy after all.

    • Carbonated sugary drinks destroy your teeth.

    * The schools are pathetic (at least that’s what everybody alludes).

    * People have travel by the busload to Canada for their prescriptions.

    Who hates medical care?

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