You don’t have to be a reader of this space to know that Landrieu is in trouble, continuing to post polling metrics with which, absent some unanticipated major large error by the prime opposition, seldom if ever an incumbent Senator has won. Maginnis dances around that fact – trotting out one poll that shows her in a toss-up while ignoring another theoretically in terms of its administration more favorable to her that shows her slipping behind outside the margin of error for likely voters – and then writes off her decline in poll numbers over the last many months not as a function of the internal contradictions of the Patient Protection and Affordable Care Act (“Obamacare,” for which she was the decisive vote) becoming ever more visible, or of making unforced errors (such as backing controversial Pres. Barack Obama nominees), or of her inability to find any issue where she can distinguish herself from her major competitor Rep. Bill Cassidy (in part because Obama keeps negating her narrative), but as a function of the interest group Americans for Prosperity’s campaign highlighting for the most part her key role in and full-throated defense of passing Obamacare.
There’s truth to that only insofar, as anyone who studies political campaigns and/or works in them, as there is truth in the advertising campaign itself. And that’s why it’s been effective: people know Landrieu was the reason both the state and country got inflicted with Obamacare and they know (with some ads using a clip of her saying this in the Senate) she said it would let people keep health plans they liked when in reality they could not. And because this truth does not change, in a state whose population loathes Obamacare, it’s going to continue to hurt her.
But Maginnis dismisses this and in fact declares the worst is behind her. Instead, he argues her problems come not from issue preferences, but from messaging. He claims two messages spread by her campaign or allies can make for a turnaround in fortunes. One is that Cassidy is “bought-and-paid for by the richest of the rich” – despite the fact that according to the Gallup Poll’s early March numbers the two categories (“gap between rich and poor” and “wage issues”) of replies from respondents when queried about the country’s most important problem that would best fit this scores a whopping 6 percent. It might be a point or two higher in Louisiana given its populist history, but that pales in comparison to the numbers for the top three – unemployment/jobs at 19 percent, dissatisfaction with government at 18 percent, and economy in general at 17 percent – all of upon which, because Obama is seen as the author of these problems and Landrieu is seen as joined with him at the hip, she remains very vulnerable. Maginnis is as self-deceived as the Alex Sink campaign if he thinks this will have anything more than the most marginal of effects on this contest. (And, potentially it even can boomerang.)
However, he thinks the fourth-most mentioned Gallup issue – “health care” at 11 percent – can give Landrieu traction if she combines the issue of Medicaid expansion with the class warfare angle. As much as Louisianans dislike Obamacare, they seem to like the idea of expansion (even if most know nothing about what it would mean or what it would cost, but the idea of “free stuff” does make the populist heart beat faster), and so Maginnis hypothesizes that Landrieu could leverage this in that the same outside interests (and falling into the lazy thinking endemic on the left regarding it faith that some kind of bogeymen, not its ideology, is what causes it to fail) are lobbying at the state level to prevent expansion from going forward.
Never mind that to string together all of this gobbledygook – evil rich oppose Landrieu, evil rich oppose expansion, people support expansion, therefore expose all this to the people and they support Landrieu – in a way that voters can internalize easily (and on an issue few care about) in a convincing fashion would make Svengali look like an amateur, and as the linchpin of a defining issue that could resurrect Landrieu’s campaign, it’s laughable to take it seriously. In fact, one is tempted to think maybe Maginnis was on deadline and couldn’t think up anything interesting and attention-grabbing (the theme here being that Landrieu’s enemies by their actions could help her get reelected) and so in order to grab as many eyeballs with as little substance as possible he ran with the first outrageous thing he could create.
Except that, if one reads his more extensive justification of the strategy, he seems to believe it. To wit:
The federal government would bear the full cost of expansion for the first three years, with the state's share gradually rising to 10 per cent by year ten. The governor says that would cost the state $1.5 billion over that time, but reputable authorities dispute his numbers. The non-partisan Public Affairs Research Council points out that the high estimate would hold only if the Legislature or Congress dramatically increases the Medicaid rates paid to doctors and hospitals, which is very unlikely for this Legislature or this Congress. With a more moderate increase, the costs would more likely wash out, according to a study by the state Department of Health and Hospitals. Numbers aside, expanding Medicaid would provide wider access to care and prescription drugs and lead to healthier outcomes for the unhealthiest population in the land. Is that worth something?
But for anyone who knows anything beyond the surface of the expansion issue, this paragraph displays both incredible ignorance of the issue and selectively so in order to try to make its argument. Let’s pick off the flaws in order.
First, the state’s share does not go to 10 percent by year 10, it gets there by year 6. This is why, in all four scenarios studied by the state, over that timespan the state ends up paying more than by not expanding and leaving indigent care up to the current practice of showing up at a hospital which then requests uncompensated care reimbursement from the state. And by then the loss to the state is accelerating at an average (of all scenarios) of 15 percent annually.
Secondly, while Maginnis criticizes the $1.5 billion loss estimate, he fails to point out under all scenarios, even the most optimistic, with a loss figure of $68 million for 2023, the state loses money. Yet he tries to pound the square peg into the round hole by bringing in the PAR analysis of last year to say the not “very unlikely” numbers of the “more moderate” increase “would more than likely wash out” the increased expense – wording to that effect never appearing in the PAR report nor DHH’s.
Apparently, to make this inferential leap he is taking PAR’s noting that Children Health Insurance Program cost-share numbers will be lowered under next fiscal year’s federal reauthorization. But’s that independent of expansion, and, even so, any savings to the state even under PAR’s most optimistic scenario for CHIP rebasing would be more than swallowed up by expansion by 2023. In short, neither PAR nor DHH’s efforts say what he wrote. And, in reality, another rate change very likely to happen (which the PAR piece ignores) as Obamacare continues to cost much more than anticipated would be future blending of rates to rebase the state’s current match at a higher level – making a bad decision on the basis of cost to expand exponentially worse.
The third and final bad error Maginnis makes in analysis stems from casting aside financial considerations (“numbers aside”) to argue that expansion would “lead to healthier outcomes” for the newly-covered population. Except that the most comprehensive research on the matter shows this exactly not to be the case; Medicaid use did not improve health outcomes, users of it actually were worse off than the uninsured, and they actually were more likely to use emergency rooms for primary care than the uninsured – kicking out yet another prop from the rationale for expansion and Obamacare that these would reduce emergency room visits. That Maginnis seems blissfully unaware of this research and thereby reported a false claim shows exceptional ignorance on his part about the issue …
… unless this piece wasn’t just something pulled together out of the air by a writer whose information on the subject didn’t go past Angry Left talking points but in fact was a test drive – of the material the left wants to use in trying to savage Cassidy to save Landrieu. Remember, Maginnis’ stock in trade comes by collecting tidbits from political movers and shakers. He could have been talking with Democrat and liberal elites and was told this was the direction he might expect to see them head, and he put it together with other musings in his piece, his similar worldview to theirs leading to a semi-regurgitation of the fact-impaired argument for Medicaid expansion he presents without giving it another thought.
It is, of course, an opinion piece he produced, but the problem for him (and his recently brought-aboard partner Jeremy Alford) is that he relies upon clients paying for the goods he produces, including state media outlets who pay for his stuff like this. And even if much of that is of the gossip variety – who’s running against who, who’s got it in for who, who’s supporting or opposing what and why, etc. – such a transparently poor, even misleading, piece of analysis must lead one to question the quality of what else he reports. And that can’t be good for business.