OPINION
6A
THE DAILY ASTORIAN • TUESDAY, OCTOBER 24, 2017
Founded in 1873
DAVID F. PERO, Publisher & Editor
JIM VAN NOSTRAND, Managing Editor
JEREMY FELDMAN, Circulation Manager
DEBRA BLOOM, Business Manager
JOHN D. BRUIJN, Production Manager
CARL EARL, Systems Manager
OUR VIEW
Responsible steps
needed to preserve
our health care
O
pen enrollment for Affordable Care Act coverage
starts Nov. 1 and runs through Dec. 15 for health care
policies starting Jan. 1, but it would be understand-
able if many Americans are unaware of these important dates.
They should at least review their current coverage, in order to
avoid being locked into something they don’t like for another
year.
The Trump administration has cut back on efforts to inform
people about deadlines and other matters pertaining to the
ACA — part of a strategy of sabotaging the national health
care system sometimes called Obamacare. The White House
also has axed billions in funds to subsidize insurance poli-
cies for Americans covered by the act, suggesting the pay-
ments amount to a taxpayer-funded subsidy for insurance
companies. (This is a valid point; the ACA was modeled on a
Republican-designed system in Massachusetts that was highly
accommodating to private insurers.)
None of this should come as a surprise, considering Donald
Trump and congressional Republicans ran for office on a plat-
form of undoing Obamacare. Unfortunately for ordinary cit-
izens, the haphazard way they are going about it is making
matters worse instead of better. There are so many changes
and uncertainties, it’s hard to keep straight what to do, what
will be covered and what it will cost. Since insurance depends
on sophisticated analysis of facts and risks, the marketplace
is reacting to all these open questions by raising prices on the
policies some Americans are legally obliged to buy.
Some good news
The good news in the Pacific Northwest is that coverage
options and financial assistance remain available to Oregon
and Washington state residents. The president’s elimination
of subsidies — apart from causing insurance companies to
raise premiums in anticipation — isn’t expected to have a dra-
matic impact on those who make up to 2 1/2 times the federal
poverty level. For a family of four, that comes to $60,750 in
2017. What they lose in more expensive premiums, they will
make up in income tax credits on those premiums.
This will end up costing the U.S. Treasury even more. “The
nonpartisan Congressional Budget Office forecast that end-
ing cost-sharing reductions would increase the federal deficit
by $194 billion over a decade, because the tax credit amounts
would increase and because more people would receive
them,” the Washington Post reported.
People in the next income tier — up to four times the fed-
eral poverty level — also make out OK in the short run,
thanks to bigger tax credits for popular silver healthcare
plans.
It is Americans in the highest tier — those ineligible for tax
credits — who will be hurt the most directly by rising premi-
ums. These premiums are becoming more and more crush-
ing, at the same time coverage becomes more limited. It’s
hard to imagine this trend being sustainable for the relatively
small percentage of people who buy their own policies, rather
than being covered through their employer or by Medicare or
Medicaid.
Last week, U.S. Sens. Lamar Alexander, R-Tennessee, and
Patty Murray, D-Washington, proposed a two-year extension
of subsidies in order to stabilize the insurance marketplace.
This is a smart idea, but the president appears to be against it.
Besides all the angst this causes for Americans wondering
what our health care laws will be from one year to the next,
the real significance of all these political gyrations is how it
discombobulates a huge segment of the U.S. economy, one on
which we rely for essential services. Hospitals like Columbia
Memorial, Providence Seaside and Ocean Beach — and all
their individual medical providers — depend on predictable
payments by private and public insurers. Medicare reimburse-
ments have declined and slowed for years. And now the pri-
vate leg of the health care platform is getting more and more
shaky. We all face a steep price for incompetent national
political management of this literally life-and-death business.
‘A lot of uncertainty’
Speaking about Trump’s subsidy decision, one industry
expert commented, “I think it will create a lot of uncertainty
— and it’s a cumulative uncertainty created not only by this
decision of this administration, but the executive order, the
question of will Congress step in, what will the agencies do.”
The ACA is far from perfect, but most people were get-
ting used to it. But jerking it all around is making it more
expensive and less reliable. This is not what any sensible per-
son wants to happen. It’s time for responsible steps to restore
health care predictability for all.
(For those with easy internet access, healthcare.gov
remains a convenient source of information. In Oregon, see
healthcare.oregon.gov.)
The Democrats and their labyrinth
By ROSS DOUTHAT
New York Times News Service
A
merica has two political
parties, but only one of them
has a reasonably coherent
political vision, a
leadership that isn’t
under the thumb
of an erratic reality
television star, and
a worldview that
implies a policy
agenda rather than
just a litany of grievances.
Unfortunately for the Democrats,
their vision and leaders and agenda
also sometimes leave the impression
that they never want to win another
tossup Senate seat and that they
would prefer Donald Trump be
re-elected if the alternative requires
wooing Americans who voted for
him.
Consider recent developments
in the state of Alabama, where the
Republican Party has nominated
a Senate candidate manifestly
unfit for office, a bigot hostile to
the rule of law and entranced with
authoritarianism.
And who have the Democrats
put up against him? An accom-
plished former prosecutor, the very
model of a mainstream Democrat —
and a man who told an interviewer
after his nomination that he favors
legal abortion, without restriction,
right up until the baby emerges blue
and flailing from the womb.
I know that certain of my readers
may not consider this an extreme
position, and imagine that people
who do consider it extreme are
also fitting out their wives with the
lovely blue dresses from Netflix’s
adaptation of “The Handmaid’s
Tale.”
But given that a clear majority
of Americans, women as well as
men, favor banning abortion after
20 weeks, it might behoove liberals
to bracket the Gilead scenario for
a moment and try to imagine what
it’s like to believe that at least
some abortions are tantamount to
baby-killing. And I mean really
make the imaginative leap: Imagine
that whenever a politician says,
“There shouldn’t be any restrictions
on the right to choose,” you hear, “I
think infanticide should be legal in
America.”
Would you vote for a candidate
who said that? I submit that you
probably would not — and you
might not even if his opponent were
also terrible in various ways. At the
very least you would be weighing
evils, and that weighing process —
“bigot or infanticide advocate? bigot
or infanticide advocate?” — might
plausibly induce you to put a bigot
in the Senate.
If the Democratic Party intends
to be competitive again in the South,
a region where many of its own
partisans call themselves pro-life, it
needs to take the imaginative leap
on abortion more often — as it did
AP Photo/Andrew Harnik
Democratic National Committee Chairman Tom Perez said party uni-
ty is crucial in the fight against President Donald Trump, whom he
lambasted as an “existential threat” to the nation.
In 2004, they had an agenda
well-suited to the American
electorate of 2016; having
moved leftward since, they now
have an agenda well-suited to
the American electorate of 2030.
in recruiting candidates who helped
build its last House majority way
back in the misty years of 2006-08.
But maybe Democrats do not
want to be competitive in the Bible
Belt. No retreat on feticide, no com-
promise with Gilead! Fair enough.
Then presumably they should want
to make up ground with more secu-
lar voters somewhere else — among
all the lapsed Catholics and former
Mainline Protestants scattered
around the Midwest, for instance.
Some of these voters pulled
the lever not once but twice for
Barack Obama and then voted
Trump in part because of anxieties
about recent immigration. So are
the Democrats trying to dispel the
impression that their party favors
open borders? No, quite the oppo-
site: As Vox’s Dara Lind pointed
out this week, in the Trump era,
no less than the Obama era, the
Democrats are rejecting enforce-
ment proposals many of them
would have championed a decade
ago — again, not coincidentally, the
last period when they had control
of Congress. Wooing immigra-
tion-wary Midwestern voters, like
doing outreach to pro-life moderates
in Alabama, is apparently not worth
the compromises required.
Now I am a cultural conserva-
tive, so naturally issues like abortion
and immigration are the places
where I would like the Democratic
Party to move closer to the center.
One could argue instead that
Democrats should stick with pro-
gressive orthodoxy on social issues
and choose Bill-Clintonian econom-
ics over single-payer flirtations, to
expand their recent gains among
the culturally libertarian and fiscally
conservative.
But the point is that a party
claiming to be standing alone
against an existential threat to
the republic should be willing to
move somewhat, to compromise
somehow, to bring a few of the
voters who have lifted the GOP to
its largely undeserved political suc-
cesses into the Democratic fold.
Instead, the Democrats are still
relying on arc-of-history beliefs and
long-term demographic trends. But
those trends do them no political
good if they move left faster than
does a leftward-moving country.
In 2004, they had an agenda well-
suited to the American electorate of
2016; having moved leftward since,
they now have an agenda well-
suited to the American electorate of
2030.
If current trends continue, the
Republicans will nominate a ticket
of Roy Moore and Tomi Lahren in
2024 — and the Democrats, secure
in their historical destiny, will
counter by replacing their platform
with a loving commentary on John
Lennon’s “Imagine.”
As much as the country needs
a conservatism with some idea of
what it’s doing, some theory of the
common good, it needs a liberalism
that stops marinating in its own
self-righteousness long enough
to compete effectively for rural,
Southern and Midwestern votes.
But you can’t always get what
you need.
WHERE TO WRITE
• U.S. Rep. Suzanne Bonamici
(D): 439 Cannon House Office
Building, Washington, D.C., 20515.
Phone: 202- 225-0855. Fax 202-225-
9497. District office: 12725 SW Mil-
likan Way, Suite 220, Beaverton, OR
97005. Phone: 503-469-6010. Fax
503-326-5066. Web: bonamici.house.
gov/
• U.S. Sen. Jeff Merkley (D): 313
Hart Senate Office Building, Wash-
ington, D.C. 20510. Phone: 202-224-
3753. Web: www.merkley.senate.gov
• U.S. Sen. Ron Wyden (D):
221 Dirksen Senate Office Building,
Washington, D.C., 20510. Phone:
202-224-5244. Web: www.wyden.
senate.gov
• State Rep. Brad Witt (D): State
Capitol, 900 Court Street N.E., H-373,
Salem, OR 97301. Phone: 503-986-
1431. Web: www.leg.state.or.us/witt/
Email: rep.bradwitt@state.or.us
• State Rep. Deborah Boone (D):
900 Court St. N.E., H-481, Salem,
OR 97301. Phone: 503-986-1432.
Email: rep.deborah boone@state.
or.us District office: P.O. Box 928,
Cannon Beach, OR 97110. Phone:
503-986-1432. Web: www.leg.state.
or.us/ boone/
• State Sen. Betsy Johnson (D):
State Capitol, 900 Court St. N.E.,
S-314, Salem, OR 97301. Telephone:
503-986-1716. Email: sen.betsy john-
son@state.or.us Web: www.betsy-
johnson.com District Office: P.O.
Box R, Scappoose, OR 97056. Phone:
503-543-4046. Fax: 503-543-5296.
Astoria office phone: 503-338-1280.
• Port of Astoria: Executive
Director, 10 Pier 1 Suite 308, Asto-
ria, OR 97103. Phone: 503-741-3300.
Email: admin@portofastoria.com
• Clatsop County Board of Com-
missioners: c/o County Manager, 800
Exchange St., Suite 410, Astoria, OR
97103. Phone: 503-325-1000.