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The shutdown, the debt and health care: a primer

WASHINGTON (AP) – These are complicated times in the affairs of Washington and the nation, with death stars everywhere and all of them a struggle to comprehend. The partial government shutdown, the debt limit squeeze just around the corner, sequestration, how they fit with the health care law, how they don’t _ it just goes on.

So we’ve cooked up some questions about this grim galaxy and taken a stab at answers:

Q: Which is better, “Obamacare” or the Affordable Care Act?

A: When late-night comedian Jimmy Kimmel asked people this question, they thought they could choose between the two, and they opted for the nice-sounding Affordable Care Act as the way to go in health care.

They are, of course, the same. Opponents of President Barack Obama’s health care overhaul came up with the catchy nickname “Obamacare” and it spread to the point that even Obama uses the term sometimes. The difference is in how people say it. Republicans tend to spit it out. Obama says Republicans will stop calling it “Obamacare “when it becomes really popular.

On the other side of this, there’s been a strong trend in Washington in recent decades of giving backslapping names to laws. Even laws have spin now in their titles. It’s like naming your baby Precious.

When Franklin Roosevelt set up public pensions in 1935, he didn’t call it the Happy Retirees Act or the Justice for Deserving Seniors Act or the Golden Years Contentment Act. He called it the Social Security Act. In those apparently more serious and less pandering times, perish the thought of a No Child Left Behind Act.

A nice title is no guarantee of results. Many people in both parties want to leave No Child Left Behind behind because they feel it’s leaving children behind.

The full name of Obama’s law is the Patient Protection and Affordable Care Act. Indeed, patients have new protections against losing their insurance. But the many questions about how affordable insurance and medical care will turn out to be aren’t put to rest by a law’s reassuring name.

There’s no doubt dressed-up labels help sell things, though. Orange roughy has done much better in the seafood marketplace since its name was changed from slimehead.


Q: Why are you calling it Obama’s law? Congress passed it.

A: Transcendent legislation comes to be associated with the president who proposed the idea and fought tooth and nail for it. The health care law is Obama’s just as the big tax cuts of the last decade were the Bush tax cuts, the Great Society laws were Lyndon Johnson’s and New Deal laws forever belong to FDR.


Q: The blogs I read, the politicians and commentators I listen to and the comics I watch say it’s outrageous for the Republicans to be fighting to kill “Obamacare” because it’s already The Law. They are really worked up about that.

A: Well. It’s Congress’ job to make new laws. New laws almost always change existing laws. Nothing is cast in stone _ see above on the No Child law. Democrats tried to change The Law giving tax cuts to the rich, a pledge in John Kerry’s 2004 presidential campaign.

On the other hand, people had many chances to stop the health care law before it sank roots They could have defeated Obama in 2008 when he was proposing it, or elected him with a Republican Congress to stand in its way. Instead they put Democrats in control of the House and Senate as well as the White House. In 2010, after the overhaul survived a brutal legislative struggle, people could have elected a GOP Congress, a prime chance to nip “Obamacare” in the bud. But they only gave Republicans the House.

After the Supreme Court with a slim conservative majority upheld the heart of the law, people could have defeated Obama last year or at least given the Senate to the GOP. A big part of Republican campaigns was a vow to roll back “Obamacare.” But people went with Obama and a Democratic Senate again. They again elected a divided government, and is it ever.

So, you asked for it, American people!


Q: What’s this got to do with the shutdown?

A: Changes to the health care law were the price set by Republicans, who control the House, of ending the budget impasse and reopening government. They’ve backed away somewhat on that, now calling for talks with Obama on the health overhaul and deficit reduction as a condition for ending the shutdown. Obama says solve the impasse now, talk later.

The health care law is on a separate money stream so it goes ahead despite the budget deadlock.


Q: New insurance markets set up by the law opened for business last week. Why were some politicians in both parties happy with the rollout?

A: Republicans were happy because it was a mess and they could barely hold back from saying, I told you so. Millions went unserved because of website hang-ups. Rep. Trey Radel of Florida said a 14-year-old could build a better website “in an afternoon in his basement.” This, they suggested, is what government health care looks like. See? (It’s actually private coverage sold through government-established gateways with government subsidies for many people.)

Democrats were happy because the chaotic debut suggested huge public interest in the markets. Like a new iPhone going on sale _ chaotic maybe but, wow. Shiny.

Time will tell if the snags are more from an incompetent system or a public hungry to sign up. People have six months to do so in the first round of enrollment

There’s no question public interest was intense. But people were window shopping, not necessarily buying, and with all the problems, they couldn’t see through the glass.


Q: Democrats like national parks and medical research as much as Republicans do, if not more. Why won’t they go along with Republicans who say let’s restore money for those things and more?

A: Leverage, for one reason. They lose it if only the most popular parts of government return to operation, and vital parts that are below the radar don’t. No one is clamoring for IRS tax audits to resume, as much as the government needs to stay on top of tax revenue. As it is, the majority of the government never closed, dampening the visible impact of the partial shutdown. Sequestration, the budget diet imposed on the government in the spring, also has been playing out largely invisibly. Apart from leverage, Democrats say it’s not right to cherry pick federal operations and the thing to do is get the government wholly back in business.

Based on what happened in the shutdown 17 years ago, Democrats think voters will blame Republicans for the shutdown. That’s got to figure into their reluctance to bend right now. In an Associated Press-GfK survey out Wednesday, 62 percent mainly blamed Republicans for the shutdown. About half said Obama or the Democrats in Congress bear much responsibility.

Still, lawmakers and Obama acted piecemeal to keep military salaries on track, the Pentagon is bringing back its civilian workers and pressure may grow to do more of that if Republican unity, already strained, doesn’t crack first.

Closed parks, disappointed tourists and howling tourist-related businesses are a visible sign of the deadlock’s impact on people. But it gets worse. Desperately ill patients who can’t be cured with conventional treatment can’t gain admission to clinical trials at the National Institutes of Health, their last best hope. People already in the trials are getting care.


Q: My eyes glaze over when I hear about debt default and the like. Make me care.

A: Politicians oversimplify things when they talk about the debt limit as if it’s a household credit card. Governments don’t operate like people who have jobs, grocery bills, car loans and homes to pay for. People don’t have to keep bridges from falling apart or field an army. Yet leaders can’t resist boiling everything down to family finances.

Well we can’t either. Try missing a mortgage payment and see what happens.

The government hit its debt limit in May and has been using various accounting moves not available to the average person to keep paying interest on its debt and look after other bills. Those maneuvers will be all played out on or about Oct. 17, says the government. Some Republicans accuse the administration of exaggerating the damage that will happen to the economy if the government doesn’t get more borrowing authority in time. But you can almost hear the nervous gulp when they make that case. It would be unprecedented for the country to default on its debt.

A Treasury Department report lists these consequences: “Credit markets could freeze, the value of the dollar could plummet, U.S. interest rates could skyrocket, the negative spillovers could reverberate around the world.” A default “has the potential to be catastrophic.”


Q: How can this all be resolved?

A: In short, someone has to blink. And someone will.

Republicans laugh off the president’s offer to talk about the health care law, spending cuts and more AFTER the government is reopened and the debt ceiling raised. Democrats say no dice to lifting the health care law’s tax on medical devices or attaching other preconditions to reopening government or solving the debt problem.

With the partial shutdown biting deeper by the day and especially with default looming, the pressure is on to move beyond Washington’s latest slimehead moment.

(Copyright 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.)