You don’t have to be a reader of this
space to know that Landrieu is in trouble, continuing to post polling metrics with
which, absent some unanticipated major large error by the prime opposition,
seldom if ever an incumbent Senator has won. Maginnis dances around that fact –
trotting out one poll that shows her in a toss-up while ignoring another
theoretically in terms of its administration more favorable to her that shows
her slipping behind outside the margin of error for likely voters – and then
writes off her decline in poll numbers over the last many months not as a
function of the internal
contradictions of the Patient Protection and Affordable Care Act
(“Obamacare,” for which she was the decisive vote) becoming ever more visible,
or of making unforced errors (such as backing controversial Pres. Barack Obama
nominees), or of her inability to find any issue where she can distinguish herself
from her major competitor Rep. Bill
Cassidy (in part because Obama
keeps negating her narrative), but as a function of the interest group Americans
for Prosperity’s campaign highlighting for the most part her key role in and
full-throated defense of passing Obamacare.
There’s truth to that only
insofar, as anyone who studies political campaigns and/or works in them, as
there is truth in the advertising campaign itself. And that’s why it’s been
effective: people know Landrieu was the reason both the state and country got
inflicted with Obamacare and they know (with some ads using a clip of her
saying this in the Senate) she said it would let people keep health plans they
liked when in reality they could not. And because this truth does not change,
in a state whose population loathes Obamacare, it’s going to continue to hurt
her.
But Maginnis dismisses this and
in fact declares the worst is behind her. Instead, he argues her problems come
not from issue preferences, but from messaging. He claims two messages spread
by her campaign or allies can make for a turnaround in fortunes. One is that
Cassidy is “bought-and-paid for by the richest of the rich” – despite the fact
that according to the Gallup
Poll’s early March numbers the two categories (“gap between rich and poor”
and “wage issues”) of replies from respondents when queried about the country’s
most important problem that would best fit this scores a whopping 6 percent. It
might be a point or two higher in Louisiana given its populist history, but
that pales in comparison to the numbers for the top three – unemployment/jobs
at 19 percent, dissatisfaction with government at 18 percent, and economy in
general at 17 percent – all of upon which, because Obama is seen as the author
of these problems and Landrieu is seen as joined with him at the hip, she
remains very vulnerable. Maginnis is as self-deceived
as the Alex Sink campaign if he thinks this will have anything more than
the most marginal of effects on this contest. (And, potentially
it even can boomerang.)
However, he thinks the
fourth-most mentioned Gallup issue – “health care” at 11 percent – can give
Landrieu traction if she combines the issue of Medicaid expansion with the
class warfare angle. As much as Louisianans dislike Obamacare, they seem
to like the idea of expansion (even if most know nothing about what it
would mean or what it would cost, but the idea of “free stuff” does make the
populist heart beat faster), and so Maginnis hypothesizes that Landrieu could
leverage this in that the same outside interests (and falling into the lazy
thinking endemic on the left regarding it faith that some kind of bogeymen, not
its ideology, is what causes it to fail) are lobbying at the state level to
prevent expansion from going forward.
Never mind that to string together
all of this gobbledygook – evil rich oppose Landrieu, evil rich oppose
expansion, people support expansion, therefore expose all this to the people
and they support Landrieu – in a way that voters can internalize easily (and on
an issue few care about) in a convincing fashion would make Svengali look like
an amateur, and as the linchpin of a defining issue that could resurrect
Landrieu’s campaign, it’s laughable to take it seriously. In fact, one is
tempted to think maybe Maginnis was on deadline and couldn’t think up anything interesting
and attention-grabbing (the theme here being that Landrieu’s enemies by their actions
could help her get reelected) and so in order to grab as many eyeballs with as
little substance as possible he ran with the first outrageous thing he could
create.
Except that, if one reads his
more extensive justification of the strategy, he seems to believe it. To wit:
The federal government would
bear the full cost of expansion for the first three years, with the state's
share gradually rising to 10 per cent by year ten. The governor says that would
cost the state $1.5 billion over that time, but reputable authorities dispute
his numbers. The non-partisan Public Affairs Research Council points out that
the high estimate would hold only if the Legislature or Congress dramatically
increases the Medicaid rates paid to doctors and hospitals, which is very
unlikely for this Legislature or this Congress. With a more moderate increase,
the costs would more likely wash out, according to a study by the state
Department of Health and Hospitals. Numbers aside, expanding Medicaid would
provide wider access to care and prescription drugs and lead to healthier
outcomes for the unhealthiest population in the land. Is that worth something?
But for anyone who knows anything
beyond the surface of the expansion issue, this paragraph displays both
incredible ignorance of the issue and selectively so in order to try to make its
argument. Let’s pick off the flaws in order.
First, the state’s share does not
go to 10 percent by year 10, it gets there by year 6. This is why, in all four
scenarios studied by the state, over that timespan the state ends up paying
more than by not expanding and leaving indigent care up to the current practice
of showing up at a hospital which then requests uncompensated care
reimbursement from the state. And by then the loss to the state is accelerating
at an average (of all scenarios) of 15 percent annually.
Secondly, while Maginnis
criticizes the $1.5 billion loss estimate, he fails to point out under all
scenarios, even the most optimistic, with a loss figure of $68 million for 2023, the
state loses money. Yet he tries to pound the square peg into the round hole by
bringing in the PAR
analysis of last year to say the not “very unlikely” numbers of the “more
moderate” increase “would more than likely wash out” the increased expense – wording to that effect
never appearing in the PAR report nor DHH’s.
Apparently, to make this
inferential leap he is taking PAR’s noting that Children Health Insurance
Program cost-share numbers will be lowered under next fiscal year’s
federal reauthorization. But’s that independent of expansion, and, even so, any savings
to the state even under PAR’s most optimistic scenario for CHIP rebasing would
be more than swallowed up by expansion by 2023. In short, neither PAR nor DHH’s
efforts say what he wrote. And, in reality, another rate change very likely to
happen (which the PAR piece ignores) as Obamacare continues to cost much more
than anticipated would be future blending of rates to rebase the state’s current match at
a higher level – making a bad decision on the basis of cost to expand
exponentially worse.
The third and final bad error
Maginnis makes in analysis stems from casting aside financial considerations (“numbers
aside”) to argue that expansion would “lead to healthier outcomes” for the
newly-covered population. Except that the most comprehensive research on the
matter shows this exactly
not to be the case; Medicaid use did not improve health outcomes, users of
it actually were worse off than the uninsured, and they actually were more
likely to use emergency rooms for primary care than the uninsured – kicking out yet another prop
from the rationale for expansion and Obamacare that these would reduce
emergency room visits. That Maginnis seems blissfully unaware of this research
and thereby reported a false claim shows exceptional ignorance on his part
about the issue …
… unless this piece wasn’t just something pulled together out of the air by a writer whose information on the subject
didn’t go past Angry Left talking points but in fact was a test drive – of the
material the left wants to use in trying to savage Cassidy to save Landrieu.
Remember, Maginnis’ stock in trade comes by collecting tidbits from political
movers and shakers. He could have been talking with Democrat and liberal elites
and was told this was the direction he might expect to see them head, and he
put it together with other musings in his piece, his similar worldview to theirs
leading to a semi-regurgitation of the fact-impaired argument for Medicaid
expansion he presents without giving it another thought.
It is, of course, an opinion piece
he produced, but the problem for him (and his recently brought-aboard partner
Jeremy Alford) is that he relies upon clients paying for the goods he produces,
including state media outlets who pay for his stuff like this. And even if much
of that is of the gossip variety – who’s running against who, who’s got it in
for who, who’s supporting or opposing what and why, etc. – such a transparently
poor, even misleading, piece of analysis must lead one to question the quality of what else he
reports. And that can’t be good for business.
1 comment:
Keep at it Prof....just shows that the roaches don't like it when the light is on.
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