2016 Postmortem

Uncle Joe

(58,364 posts) Sat Jan 23, 2016, 10:22 PM Jan 2016

GOP Officials Publicly Denounce Bernie Sanders’ Obamacare Expansion, Quietly Request Funding

The conventional wisdom on Senator Bernie Sanders of Vermont is that he’s a charming if impractical dreamer, a pie-in-the-sky socialist who’s good at inspiring young people and aging hippies, but hopeless at the knife fighting that real-life politics requires.

Despite the inherent limitations of a self-described democratic socialist who eschews the norms of Beltway fundraising, the Democratic presidential candidate from Vermont has won legislative victory after victory on an issue that has been dear to him since his days as Burlington’s mayor.

That issue is the simultaneously benign and revolutionary expansion of federally qualified community health clinics.

Over the years, Sanders has tucked away funding for health centers in appropriation bills signed by George W. Bush, into Barack Obama’s stimulus program, and through the earmarking process. But his biggest achievement came in 2010 through the Affordable Care Act. In a series of high-stakes legislative maneuvers, Sanders struck a deal to include $11 billion for health clinics in the law.

The result has made an indelible mark on American health care, extending the number of people served by clinics from 18 million before the ACA to an expected 28 million next year.

As one would expect, the program was largely met with plaudits from patients and public health experts, but it has also won praise from even the biggest Obamacare critics on Capitol Hill. In letters I obtained through multiple record requests, dozens of Republican lawmakers, including members of the House and Senate leadership, have privately praised the ACA clinic funding, calling health centers a vital provider in both rural and urban communities.

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http://www.sanders.senate.gov/newsroom/must-read/gop-officials-publicly-denounce-bernie-sanders-obamacare-expansion-quietly-request-funding

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Sanders’s place in health clinic history will be remembered for his forceful role in the winter of the health reform debate. In December 2009, tensions ran high as Congress inched closer to a final health reform deal. Sen. Harry Reid, D-Nev., tapped Sanders to help win support from liberals who thought the bill was too weak as well as from Democrats from rural states who were facing mounting pressure. More funding for community health centers, Sanders argued, was a win-win solution for both camps, since the program would ensure access to health care for even the most remote areas of the country while also helping those without insurance. Sen. Ben Nelson, D-Neb., among others, held out to the very last moment.

Two days before the Senate voted to break a Republican filibuster of the bill, Reid called on Sanders to make his case on the Senate floor. Sanders, in typical fashion, said the legislation was far from perfect, but thundered about the common-sense need for health centers, citing the acute demand for more primary care doctors, the cost-savings from patients who would otherwise use the emergency room for the common cold, the patient-centered model of clinics, and so on. Senate Democrats rallied and overcame the Republican filibuster.

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That relative invisibility has shielded health clinic funding from the hyper-partisan attacks faced by other provisions of the law. But it has also allowed Republican opponents of Obamacare to play a two-faced game. Every single congressional Republican has voted to repeal the entire bill, health center funding included. But many have taken credit for popular local health clinic programs funded by the ACA, without disclosing the source of the funds. Others have written letters expressing their support for the money.

As I reported previously for The Nation, Rep. Paul Ryan, R-Wis., among other Republicans, authored letters to the Obama administration to recommend ACA funding for local health clinics. Now, a new batch of letters, obtained through a Freedom of Information Act request, shows other requests by GOP leaders.

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https://theintercept.com/2015/07/06/gop-senators-support-sanders-obamacare-expansion/