Tuesday, March 1, 2011

Political Compromise and the Impending Presidential Election of 2012: whither negotiation on PPACA?

Keywords of Terms: Politicking; PPACA; Health Insurance law; Republicans; 2012 Presidential elections; Compromise; Fiscal Budget; Budget Gap;

Compromise is an important part of politicking. Until recently, after a legislation is signed into law, compromises were unimaginable in American politics. Yesterday, some of us were taken aback when President Obama offered to back legislation that would enable states to request federal permission to withdraw from some of the Patient’s Protection and Affordable Care Act's (PPACA) mandates schedule for 2017 in 2014. Many of the central provisions of the law were expected to take effect in 2014, at which time most Americans are expected to obtain health insurance coverage; and, many employers of certain size, expected to offer coverage to workers or pay a penalty. As New York Times frames it, this august flair from the Whitehouse is meant to appease disgruntled governors! Today’s blog looks at the implication of this pronouncement on the Presidential election of 2012.

As contained in the Patient’s Protection and Affordable Care Act, waivers or exceptions on any of its provisions can only begin in 2017. With the new olive branch, Mr. President is accommodating the following for any state as long as it can prove that it meets the coverage and affordability options in the law by 2014: 1) introduce new options for coverage; 2) have some flexibility in choosing whether to make some Medicaid recipients purchase insurance through exchanges; and, 3) seek a waiver for individual mandate. To many of us, this looks like a first step in watering down the provisions and or, accomplishments of the Act. First, the President negotiated away the Public plan or option; second, he identified somewhat with denials of insurance coverage for women where issues of their life and death are concerned, even when public funds were not going to go into purchasing the health insurance on the proposed insurance exchange; and today, he is identifying with a legislation that would allow states to apply for waivers in 2014 instead of 2017.

Compromise of this nature is hardly contemplated by many past Presidents for several and probably legitimate reasons, including the need to maintain integrity of purpose, the need to encourage conviction in the provisions of the law and the intent of congress, and the essence of managing any criticisms from naysayers regarding the provisions in the law. No voter likes a flip flopper; it hardly works in tough economic environment. Notwithstanding the criticisms from the right, many reasonable Americans will tell you the provisions in the law are the right thing for this country at this time. In summation, the need for Presidents to be proactive on bills they have already agreed to most, if not all their provisions, and signed them into laws, are better left untouchable to maintain integrity of the law. When President Obama used the slogan, a change you can believe in three years ago while running for the Whitehouse, many of his supporters were not looking forward to, or seeking changes that seem to question the integrity of leadership of the office; or seem as if he is catting to the opponents because a couple of them are unsatisfied with the legislation, its provisions, or progressive stance.

When a leader wins at the game of politics, he is known or expected to take it all; all here, includes decks of political cards, expendable political capital, including raising legislation, passing laws and implementing their provisions without apologies. This is why voting and election results have implications, a concept that Mr. Obama is familiar with and has alluded to in the past. It includes ascertaining dominance of the opponent and making him or her walk with you or walk behind you, if necessary. Politics is a game of fundamental dynamics and reforms, dynamics that change things for the better or worse, depending on how a leader handles his or her choices in governance. Many supporters of the President are more convinced that the Patient’s Protection and Affordable Care Act is a suitable and necessary reform for the nation's health care system; and, the President is going to have to ‘talk the talk and walk the walk’ if he wants people to recognize, respect and appreciate his leadership. If Republican or some Democratic Governors have some reservations about the implementation of the Patient’s Protection and Affordable Care Act (PPACA), the President can allow them to vent, but not capitulate to their preferences. To concede an inch or to show an accommodation of the opponents of the health care reform law, is to compromise on principle in a time when leadership and firmness are called for.

Apart from available apparatus of government, political leaders are known to use mass media and multiple techniques, to broadcast the inherent benefit of their sponsored laws. However, alternative technologies and techniques can be useful if a political leader determines that it is in his interest to send an olive branch to his opponents or, to pretend to be in a compromise mood, when in reality, he isn’t. This time, the President chose to use the venue of the nation's governors' annual meeting to bear out his heart. The choice of President Obama to want to appease the disgruntled governors does not seem to sit well with the left. Rather than declare war on Republicans who have consistently repudiated his leadership, the President is bending over on an act he signed into law barely two years ago. Many of us in the left have been working to solidify and enforce the leadership style of President Obama, but occasionally, he continues to frustrate us, by throwing some piece of meat to the Republicans in the name of playing middle stream. Why he does this, many of us do not know. For many of us, it is better the president is an effective and accomplished leader rather than a poodle of some rightist extremists. We want the president to assert his leadership and ignore criticisms that have no basis. We want him to annihilate the republican power base if possible. One thing we do not want him to do, is whimper to republicans anytime they start their crocodile tears.

It is estimated by the office of management and budgets that States face up to five billion dollars revenue shortfall in the current quarter alone because of the slumping economy, poor tax base, unemployment and inefficient tax collection apparatus. About 82 billion dollars of the impending State's budget gaps in the current accounting period has been adduced to the low revenue collection base and except there are some tax increases, the cost pressures that state governments will face may become too difficult for some states governors; and or, probably subsume many of them. The increasing cost of health care at the States' level has been determined to be one of the reasons of the budget gaps; however, rather than embrace the Patient's Protection and Affordable Care Act that will help cut the health costs and supplement shortfalls in Medicaid share that would have come from State coffers, governors, especially the Republican ones, are trying to exploit their state's poor fiscal health for their political agenda; and this makes it look like we are in a no win situation.

Some state governors have used the circumstance of poor fiscal health of their state to diminish barging rights of public employees. Some of the Republican governors are seeking means to reduce public employee pays by instrumenting union bursting and labor degrading public policies. Yes, many states budgets are in dire situation, however raiding state pensions, failing to pay state's government share of employees pension fund and using aggressive policies to achieve fiscal health of a state is not the appropriate route to take. Elected officials, governors, lawmakers, mayors, county executives are voted by their constituents to lead; and where they fail to lead, they are usually booted out. Under this scenario, the President has an upper hand to call state governors to do what is in the best interest of their state residents without making up stories regarding a law that has not completely gone into effect. There are several provisions of the Affordable Care Act that have not gone into effect, and this makes one to wonder where the state governors are finding the so-called shortcomings of this law, except for their dubious political interests.

What Mr. President could have evaluated or directed governors to achieve is how do we deal with the fiscal issues that have continued to challenge state budget gaps without antagonizing public unions and state employees. This is a crucial question that needed to be addressed and not catapulting on a law that has been determined, based on the few provisions that had gone into effect, has been doing greater good to the public. Like in many laws in the past, there are always parts of the law that a segment of the public will have issues with. This is why we have the courts and opportunities for amendments to such laws, where the provisions are perceived as somewhat draconian for the critics. It hardly seems any provision of the Patient Protection and Affordable Care Act is draconian, except I am missing something. A few of us in the public are wondering if the President is not reading too much into criticisms from the governors; and or, if he is not setting a stage for his second term reelection with the new drive to be perceived as centrist rather than an accomplished leader on the issue of health care reform.

Our President needs to adopt strategies that are not overtly readable as being political or sequenced in line to the objective of a re-election, as he goes about managing the affairs of the state or administering and managing the executive power. The economic pressures on states is making some of the governors take what is considered in some sectors as underhanded actions regarding the handling of public employees unions in their states. Many of these governors and lawmakers will be held accountable for their actions come next year's election. 2012 Presidential election is around the corner, however, the President cannot afford to dilute his accomplishments in past two years of his governance just because we wants to go mainstream. Supporters of Obama's Administration has grown tremendously on the internet, so also are his critics; however, the President must still lead and not appear to be caving in or flip-flopping on issues of governance,  because he wants to pacify state governors or achieve centrist Plato in American politics!

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