For the past week, NBC News correspondent Chuck Todd endured withering criticism for suggesting it is not the media's job to expose Republican lies about the Affordable Care Act or, for that matter, anything else. But despite his assertion that the reporter's function is not to seek the objective truth but instead to serve as a stenographer for partisan talking points, Todd has from time to time actually shed light rather than heat. His recent contrast of the all-out GOP obstructionism of Obamacare to Democrats' contribution to the success of President Bush's Medicare prescription drug plan is one example.
Despite last week's embarrassment, Chuck Todd hasn't always represented a net subtraction from the sum of human knowledge. As the GOP's "Defund Obamacare" campaign ramped up over the summer, Todd used his NBC "First Read" column to actively illuminate rather than passively mislead. As he and his colleagues put it on July 9:
Here's a thought exercise on this summer morning: Imagine that after the controversial Medicare prescription-drug legislation was passed into law in 2003, Democrats did everything they could to thwart one of George W. Bush's top domestic achievements. They launched Senate filibusters to block essential HHS appointees from administering the law; they warned the sports and entertainment industries from participating in any public service announcements to help seniors understand how the law works; and, after taking control of the House of Representatives in 2007, they used the power of the purse to prohibit any more federal funds from being used to implement the law. As it turns out, none of that happened.That's exactly right. Despite their opposition to the Part D legislation, Democrats didn't just refuse to obstruct Bush's wildly unpopular and completely unfunded $400 billion windfall for insurers and pharmaceutical firms. In Washington and in the states, Democrats helped ensure the successful implementation of a Republican program whose 2006 launch even John Boehner acknowledged was "horrendous."
As you'll see below, Todd was right to highlight the polar opposite partisan responses to President Bush's Medicare Modernization Act of 2003 and President Obama's Affordable Care Act of 2010.
For starters, almost every Democrat (189 out of 205 in the House, 35 out of 46 in the Senate) voted against Medicare Part D 10 years ago. But unlike the Republicans who uniformly voted no to the ACA in 2010 because they feared what its success would mean for the GOP's political prospects, Democrats opposed Bush's Medicare Rx plan because it was unnecessarily complex and needlessly expensive for taxpayers. After all, the Medicare Modernization didn't just prohibit the federal government from directly negotiating with pharmaceutical companies for lower drug prices, but forced beneficiaries to purchase coverage from private insurers rather than expand the lower cost Medicare program to include the new benefit.
For those reasons and more, Medicare Part D was far more unpopular before it launched than Obamacare is now. But that changed over time. Now, 9 out of 10 seniors are happy with the program they once despised. In part, Democratic cooperation explains why.
After all, when the Bush administration spent millions of dollars on television ads beginning in 2004 to promote the new Medicare drug discount cards, Democrats didn't object. (They just asked that the Bush Department of Health and Human Services tell the truth.) Despite that history and the fact that HHS funds advertising for Medicare enrollment every fall, grandstanding GOP Senator Marco Rubio called for a halt to the current ACA TV spots, accusing HHS of "blatant misuse of federal dollars."
The same contrast applies to the so-called "navigators," the dozens of community groups, charitable organization, hospitals and non-profits that will Americans find health insurance now just as they helped the elderly find prescription drug plans. Now, Republicans on Ohio, Georgia, Texas, West Virginia and Florida are boasting about the efforts to block the work of the navigators in their states. As Georgia Insurance Commission Ralph Hudgens crowed:
"Let me tell you what we're doing [about Obamacare.] Everything in our power to be an obstructionist."As President Bush's former Secretary of Health and Human Services Mike Leavitt explained in July, the "navigators" were critical to the outreach campaign for Medicare Part D:
"We have passed a law that says that a navigator, which is a position in that exchange, has to be licensed by our Department of Insurance. The ObamaCare law says that we cannot require them to be an insurance agent, so we said fine, we'll just require them to be a licensed navigator. So we're going to make up the test, and basically you take the insurance agent test, you erase the name, you write 'navigator test' on it."
Before the program was implemented, only 21 percent of seniors had a favorable opinion of it, and 66 percent didn't understand what the reform would mean for them.Many of the same navigators then (like the AARP) are Obamacare navigators now. Ironically, President Bush and his Republican allies also counted on organization that doesn't exist anymore: ACORN.
So we spent 18 months devising and implementing a campaign to explain the prescription drug benefit, prepare seniors as well as partners -- such as community groups, churches, pharmacies, insurance plans and state and local governments -- and then sign people up. A national bus tour supported each phase. The summer before enrollment (the same period that the ACA is in now) we logged more than 600,000 miles and visited 48 states. As secretary, I made 119 stops in 98 cities. I learned that with a program like the ACA, you can't count on Washington to sell it. You have to reach people where they live, work, pray and play.
Nevertheless, the Bush administration rollout of the Medicare drug benefit for 43 million elderly Americans was a disaster. Ohio Congressman John Boehner admitted as much to Fox News in February 2006:
"The implementation of the Medicare plan has been horrendous,"As Ezra Klein recently recounted, in a rare moment of candor the future Speaker was right:
In 2006, the bill went into effect. It was a disaster. Computer systems didn't communicate with one another. Seniors were confused. Some of the poorest and sickest enrollees -- "dual eligibles" who qualify for aid under both Medicare and Medicaid -- weren't able to get their drugs. It was so bad that in his 2006 State of the Union address, Bush "said nothing about the new Medicare prescription drug program, an initiative Republicans once hoped to trumpet but has angered many seniors in its implementation," reported the Washington Post.Unlike Republicans like Tim Huelskamp (R-KS) and Jason Chaffetz (R-UT) who have announced they will not answer constituents' calls for help with Obamacare, Democrats took a different approach. As then Senator Hillary Clinton reasoned in 2006:
"I voted against it, but once it passed I certainly determined that I would try to do everything I could to make sure that New Yorkers understood it, could access it, and make the best of it."When Wisconsin Senator Kohl, the ranking Democrat on the Senate Select Committee on Aging asked his colleagues "to put aside any partisan thoughts to work together to get this program running," Democratic governors were already spending billions of dollars to help out.
As the Washington Post reported in January 2006, "Two weeks into the new Medicare prescription drug program, many of the nation's sickest and poorest elderly and disabled people are being turned away or overcharged at pharmacies, prompting more than a dozen states to declare health emergencies and pay for their life-saving medicines." Roughly 6.4 million seniors who just days earlier had gotten their prescriptions for free faced the prospect of going without because of untrained pharmacists and computer glitches. By January 16th, 2006, the New York Times reported, many states (most of them led by Democrats) came to their rescue. "About 20 states, including California, Illinois, Ohio, Pennsylvania and all of New England, have announced that they will help low-income people by paying drug claims that should have been paid by the federal Medicare program." Among the governors taking action were future Obamacare foes Tim Pawlenty and Mike Huckabee, who declared a health emergency in his state of Arkansas. The fiasco prompted the Bush administration to take drastic measures:
With tens of thousands of people unable to get medicines promised by Medicare, the Bush administration has told insurers that they must provide a 30-day supply of any drug that a beneficiary was previously taking, and it said that poor people must not be charged more than $5 for a covered drug.It's no wonder why Paul Krugman summed up the whole catastrophe as "D for Debacle."
The blame for that debacle has to be placed squarely at the feet of President Bush and his Republican allies who structured the Medicare Part D bill. But once the ill-conceived legislation was the law of the land, Democrats didn't stand in their way. They helped make it work. Democrats didn't go the Supreme Court, or refuse to accept coverage for millions in their states, or say no to enforcing new insurance rules or try to prevent the work of the navigators receiving federal grants to provide information and customer service to Americans.
As Chuck Todd explained in a rare act of journalism, only Republicans do that.