OK

And now for today's memo to Republicans and the media outlets determined to amplify GOP talking points. The troubled launch of the Affordable Care Act's enrollment period is neither Barack Obama's Iraq nor his Katrina (New York Times). Leave aside for the moment that one program is designed to reduce America's unnecessary body count while President Bush's bungling of the others added to it. To the degree that any calamity of the Bush years resembles the rollout of Obamacare, it was the disastrous launch of the GOP's Medicare Part D prescription drug program.

Consider this capsule summary of Bush's botched introduction of his Medicare Rx program:

The nonpartisan Government Accountability Office (GAO) ruled that some of the administration's ads promoting the new program were illegal while others were misleading. GAO investigators also found that the White House illegally withheld data from Congress on the cost of the new law. The Congressman who crafted the bill soon left Capitol Hill for K Street, where he made millions of dollars annually as a heath care lobbyist. The new federal web site allowing people to compare plans and prices was delayed by weeks, while just 300 customer service reps manned the phones to help new enrollees. Yet over six million people immediately lost their coverage, while hundreds of thousands more would be refused treatment because of malfunctions in the computer systems linking providers and insurers. In response to the mushrooming crisis, governors in mostly Democratic states spent billions to continue coverage for their residents, while the President pleaded with insurance companies not to cut off their current policyholders. Nevertheless, the White House sided with insurers and rejected bipartisan calls to delay the enrollment deadline even as public approval plummeted to 25 percent. It's no wonder John Boehner called the rollout of the President's signature domestic policy achievement "horrendous."
And yet, the differences between Medicare Part D then and the ACA now are just as telling. Most important, despite the fact that they overwhelmingly opposed the passage of President Bush's giveaway to drug firm and private insurance companies, Democrats in Washington and the states worked hard to ensure the troubled program's success. And the differences, as we'll see below, don't end there.

While the CBO projects that the Affordable Care Act will reduce the national debt over the next decade, the $400 billion Medicare Part D program was—and is—all red ink. As Orrin Hatch (R-UT) admitted in 2009, "It was standard practice not to pay for things."

While both laws passed the House by identical 220-215 margins, only the Republican actions in 2003 resulted in ethic charges. While Majority Leader Tom Delay (R-TX) extended the vote by hours and bribed fellow Republicans for votes, President Bush's Medicare chief Tom Scully was punished for trying to withhold the administration's much higher cost estimates from Congress.

While Republicans have tried to repeal the Affordable Care Act 47 times, Democrats sought to improve Part D by letting the government negotiate drug prices directly with the pharmaceutical firms. Other Democrats wanted to let the nation's 49 million Medicare recipients get their prescription coverage through the traditional government program and not from private insurers. Ironically, it was President Obama and his Affordable Care Act which has helped reduce President Bush's Medicare "donut hole," saving millions of seniors billions of dollars on their prescriptions.

Both programs spent taxpayer dollars on television advertising, but only Republicans demanded the Department of Health and Human Services halt the spots for Obamacare.

Both the ACA and Medicare Part D used "navigators," the dozen of community groups, churches, hospitals and non-profit groups helping with outreach and enrollment. But only Republicans have tried to undermine Obamacare's navigator program.

When President Bush's Medicare drug benefit launched on Jan. 1, 2006, millions of so-called dual eligible immediately lost their prescription. Democrats in the states and on Capitol Hill rushed to cover their costs until the Bush administration could remedy the crisis that hit 6.4 million seniors. (As Sen. Hillary Clinton put it at the time, "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." In contrast, the Republicans' united front against the expansion of Medicaid in 26 states has created a "coverage gap" that will leave over five million Americans needlessly uninsured.

Each year, thousands of Americans die unnecessarily due to a lack of health insurance. Studies estimate the number could be as high as 45,000 a year. With their all-out campaign to block the Affordable Care Act, Republicans at every level of government are essentially sentencing thousands of Americans to death. Unlike President Bush's Katrina response ("I don't think anybody anticipated the breach of the levees") and Iraq disaster ("Had we had to do it over again, we would look at the consequences of catastrophic success - being so successful so fast that an enemy that should have surrendered or been done in escaped and lived to fight another day"), that body count is knowable in advance.

All that's all on the Republicans.

Originally posted to Jon Perr on Fri Nov 15, 2013 at 12:09 PM PST.

Also republished by Daily Kos.

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