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With Michele "Crazy Eyes" Bachmann leading the charge, freshmen Republican tea party whiners got their opportunity to register that all-important vote to repeal Obamacare yet again.

Because 2014 was so much like 2010, right?

The real news here is the narrowing margin. The last time the House voted, it was by a much wider margin than this. Only two blue dog Democrats joined the Republicans -- Jim Matheson (UT) and Mike McIntyre (NC) making the final count 229-195.

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This week, the New England Journal of Medicine published a major study of Medicaid in Oregon which has rapidly emerged of a Rorschach test of sorts. That is, partisans on either side of the political divide tend to see what they want to see in its results. While conservatives claim Medicaid expansion has been debunked by numbers showing little change in blood pressure, cholesterol, and diabetes over two years between those who did and did not gain access to Medicaid, liberals tout findings revealing "Medicaid improved rates of diagnosis of depression, increased the use of preventive services, and improved the financial outlook for enrollees."

Ultimately, as Ezra Klein, Kevin Drum, Aaron Carroll and Austin Frakt all conclude, the limited sample size, short-time frame and narrow measures of "health outcomes" make conclusions about the efficacy of Medicaid difficult to reach. But combined with other recent research, there is little question that Medicaid expansion will make the financial prospects and quality of life significantly better for the previously uninsured. As for the legion of Republican politicians instead insisting "no one goes without health care in America" because "you just go the emergency room," studies documenting the rapid disappearance of ER's and trauma centers show that GOP talking point is just a cruel joke.

Writing in the New York Times, Annie Lowrey provided a concise summary of what the NEJM paper says--and doesn't say--about the 10,000 out of 100,000 Oregonians who won the state's Medicaid lottery:

The Oregon Health Study released a new round of results on Wednesday, showing that Medicaid coverage does not seem to improve low-income adults' blood pressure, blood sugar or weight in a two-year time frame. It says nothing about the chance of diagnosis of, eventual health outcomes for or costs associated with any form of cancer, Alzheimer's, Parkinson's or dozens of other debilitating medical conditions. It also says nothing about health results outside of a two-year time frame...

Where it says something, it says a lot: it provides strong evidence that Medicaid recipients will spend more, use more tests, experience less depression, have fewer bills sent to collection agencies, and so on. It shows health insurance working just the way insurance is supposed to work: protecting the financial stability of the people purchasing it.

As it turns out, other recent analyses also had a lot to say about what happens when the uninsured gain coverage in ways similar to what will happen under the Affordable Care Act starting in 2014.

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Despite what Max Baucus said, Obamacare is not a 'train wreck' rolling toward a head-on collision. But Republicans are trying and will continue to try to make it as hard as possible to implement. This is not unlike what they did with Medicare back in the 60s when it was implemented. In fact, I expect them to take some pages right out of that playbook despite Medicare's obvious success.

Jonathan Cohn has an excellent article in The New Republic this morning outlining the potential pitfalls in implementation. There will be pitfalls. Make no mistake. There is no way to open up this system to everyone without glitches. Remember, there are balky insurers still trying to undermine it behind the scenes, and opportunistic politicians waiting to pounce on any failure, no matter how small, to capitalize in the 2014 midterms.

Cohn:

As even Obamacare’s most ardent defenders have said from the start, the law is far from ideal. The architects of reform had to make all sorts of compromises, just to get the law past lobbyists and obstructionist Republicans. And then, after finally enacting the historic legislation in early 2010, they had to spend most of the next three years fighting repeal. In Washington, Republican congressional leadership has repeatedly blocked funding for implementing the law. At the state level, conservative officials are at best indifferent to its success and at worse outright hostile to it. This last part is no small thing, given the leeway state officials have over the law's implementation. In states like Florida and Texas, officials have already indicated they won't be expanding eligibility for their Medicaid programs—depriving millions of health insurance.

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After last week's insanity with regard to the political end-run around the Affordable Care Act and subsequent withdrawal of what could have been a horrible political quandary for Democrats, Republican freshmen are making loud whining noises over the fact that they haven't yet had their chance to vote to repeal it.

Rep. Mick Mulvaney (R-SC) urged leadership to hold a repeal vote so freshman members can serve up the same anti-Obamacare talking points for their conservative constituents that more senior Republicans enjoy.

“If you’re a freshman — the guys who’ve been up here the last year, we can go home and say listen, we voted 36 different times to repeal or replace Obamacare. Tell me what the new guys are supposed to say,” he said. “We haven’t had a repeal or replace vote this year.”

“We have not had a chance as freshmen to do that,” said first-term Rep. Trey Radel (R-FL). “Even if it’s just symbolic — and even if we understand that process-wise we are not going to be able to say, okay we want repeal, it’s done, and it’s over. But this is the issue that so many people around the country who love the Republican Party are frustrated with.”

Poor babies. It breaks my heart that they're frustrated over not being able to brag about denying sick people access to health care. I know I will lose sleep over it every single night, won't you?

Of course, the reason they want the vote is because they're stupid enough to think that 2014 is going to be 2010 all over again, which it will not be. Evidently they didn't learn that in 2012, when people did not vote for full repeal of the ACA, and wholeheartedly embraced the principle that pre-existing conditions should not exclude people from getting health care.

They were able to get traction in 2010 because no one actually benefitted from the reforms passed at that time. It is three years later now, and many young people have access to health care because of the ACA, and many, many more people will be able to get health insurance and access to health care on January 1, 2014.

But hey -- let them have their vote, Speaker Boehner. I welcome such a vote, so that every nutcase Republican who voted for it can be ousted from office on 2014 by angry voters yelling at them not to touch their Obamacare.

I have to admit, Eric Cantor came up with a cynical, but politically effective way to hose Democrats over Obamacare last week. He came up with the idea of extending the federally-funded high risk pools for people with pre-existing conditions by pulling earmarked funds out of the Prevention Fund. The Prevention Fund was the brainchild of Senator Tom Harkin, who believes that public education and prevention efforts are as powerful as treating the diseases themselves.

Because funds for the federally-funded high risk pools have been exhausted earlier than expected, Eric Cantor hatched his plan. He would introduce a bill called the Help Sick Americans Now Act, which would extend the federal high risk pools with funds taken from the Prevention Fund. Democrats would then be forced to vote against a measure that would fund pools to insure them from now until January 1, 2014 when the pre-existing conditions exclusion disappears and the exchanges open for individuals to purchase health coverage.

It's important to point out that those who are already covered in the high-risk pools won't lose coverage, but because funding is exhausted, no new entrants can use that program. That means some people will be without access to insurance coverage for the next eight months or so, unless they are employed by someone who offers group insurance.

Ted Cruz and the Tea Party purists threw a hissy fit over it, and Buzzfeed has the leaked emails to prove it. Here are some snippets of the catfight:

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If there's one thing I can't stand, it's companies that claim to be "socially responsible" while they shove a knife into the backs of women across the nation. Eden Foods qualifies. It pretends it's a crunchy company, full of organic goodness and "social responsibility" but really, it's run by a libertarian who just doesn't like government regulations very much.

Michael Potter, Eden Foods' CEO, didn't care for the birth control mandate in Obamacare, so he paired up with the Thomas More Center, a conservative legal services non-profit, in order to weasel out of it on religious grounds.

Check out the image at the top. That small print up in the right hand corner says "Organic, Independently Owned, Socially responsible, And UNDER ATTACK. As if slapping the term "organic" on your packaging somehow makes your product magically attractive to liberals who object to eating pesticides with their green beans.

At any rate, Mr. Pious Potter's religious sensibilities were so rocked by the meanness of the birth control mandate that he felt compelled to go to court, where he swore his faith would just be too harmed by having to include birth control as a benefit to employees under the Affordable Care Act. Uh huh. Sure.

Salon interviewed Mr. Potter about his Catholicism and fervent religiosity, and they had quite a conversation. It began this way:

“I’ve got more interest in good quality long underwear than I have in birth control pills,” the unfamiliar voice on the phone said to me.

Oops, who was that masked man? It was Mr. Potter, calling the reporter to offer a comment to an earlier story about his quiet lawsuit. And then he went on...

It wasn’t that he was upset about my reporting or what his company was doing. He was just sorry my request for comment had gone unanswered due to an oversight. I accepted the apology, and asked why he said he didn’t care about birth control, since he filed a suit about it and all.

“Because I’m a man, number one and it’s really none of my business what women do,” Potter said. So, then, why bother suing? “Because I don’t care if the federal government is telling me to buy my employees Jack Daniel’s or birth control. What gives them the right to tell me that I have to do that? That’s my issue, that’s what I object to, and that’s the beginning and end of the story.” He added, “I’m not trying to get birth control out of Rite Aid or Wal-Mart, but don’t tell me I gotta pay for it.”

Oh, I see now. It's not about being Catholic or having a religious objection. At least, it's not if you're talking to a publication that is read by a mostly-liberal readership who might actually be a large chunk of those who consume your product. No, what it's about is having to pay for birth control coverage. Never mind that it's cheaper than maternity coverage. Oh, he had an answer for that contradiction too:

Potter replied, “One’s got a little more warmth and fuzziness to it than the other, for crying out loud.”

I guess that depends on who you ask. Women might disagree.

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Sooner or later, these right-wing corporations are going to learn the hard way. People do not like it when companies thumb their nose at the law and threaten to slash employees hours for the sole purpose of screwing them out of health care. After an Applebee's franchisee and Darden's restaurants felt the heat, you'd think they'd get a clue.

Alas, no. Regal Entertainment Group announced they were cutting employees' hours in order to deny them eligibility for health care under the Affordable Care Act. Fox News, of course, was quick to report this.

Regal Entertainment Group, which operates more than 500 theaters in 38 states, last month rolled back shifts for non-salaried workers to 30 hours per week, putting them under the threshold at which employers are required to provide health insurance. The Nashville-based company said in a letter to managers that the move was a direct result of ObamaCare.

“To comply with the Affordable Care Act, Regal had to increase our health care budget to cover those newly deemed eligible based on the law's definition of a full time employee.”

“In addition, some managers have requested guidance on what they should tell those employees negatively impacted and, at your discretion, we suggest the following,” read the memo obtained by FoxNews.com. “To comply with the Affordable Care Act, Regal had to increase our health care budget to cover those newly deemed eligible based on the law's definition of a full-time employee.”

“To manage this budget, all other employees will be scheduled in accord with business needs and in a manner that will not negatively impact our health care budget,” the message continues.

Fuck them and the horses they rode in on. Regal made billions last year, and they gave their CEO a hefty raise. I guess their health care budget allowed for a few extra million to fall into her pocket.

My reaction isn't unusual. Huffpost has an excellent sampling of Facebook posts from people letting Regal know their choice to screw employees forces a choice to stop spending money at their theaters.

I've grabbed a few more responses and posted them beneath the fold. In the meantime, pay their Facebook page a visit and let them know what you think of them. You'll feel better. I did.

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Obamacare is nearly upon us, kids. That means the PR firms for insurers are revving their engines and laying the foundation for the next big tea party riot at town hall meetings. We will have them shaking their fists at everything from Obamacare to education reform to gun laws.

Chaos is what they intend to make, and they're out of the gate with Ms. Disgraced Tobacco Lobbyist Betsy McCaughey, who should be jeered off any stage she's on instead of glorified by the likes of Mike Huckabee.

It's almost predictable now. A quick Google search shows Fox News let her out of her cell in August, 2009, again in December, 2010, and again in November, 2011. Even though by 2012 Obamacare's provisions were popular enough that it was an asset and not a liability in Obama's re-election, they're dragging her out again.

But now we're six months away from signing up for the exchanges, and we're eight months or so away from an end to pre-existing conditions. The monsters are hungry, clawing at the bars, so they let her out again to go at it on Huckabee for the entire show. Because I'm merciful (and so is Heather), we're just bringing you the best of the best.

To warm the audience up, they started with a little dose of IPAB, the panel that will actually work to contain costs, which they like to call a "death panel." Personally, I think there should be one panel for...never mind.

The heart of today's episode is "Oh noes, all the doctors are gone!!!! Dead seniors will be everywhere!" Added bonus: Spending more money automatically means better care. (insert audience groan here)

MCCAUGHEY: I wouldn't take my beloved dog to the vet that spends the least per animal, but I'm supposed to take my mother to the hospital that spends the least per senior. We have a lot of evidence that the hospitals that are the lowest spenders have higher death rates. For example, if you're a senior and you've had a heart attack, you have a less chance of making it home after that heart attack if you're in one of those lowest spending hospitals.

Yawn. YES. OH God, yes, please let's spend 20 percent of GDP on seniors' health care. Because better!

And then we get to the "ZOMG they're gonna keep you. Or not. Or release you early. Or not." Ultimately it's just a conversation indicating a consultation with a psychiatrist might be in order.

BLACKBURN: And that readmission policy will penalize the hospital if within thirty days you're readmitted and so the hospitals are going to be a little bit more judicious in how they approach that. But it all boils...

MCCAUGHEY: I think you used a misleading phrase though. It's recklessly denying care, because when you reward the hospitals that spend the least per senior, right, that means hospitals are not going to want to do the expensive procedures like a hip replacement or a knee replacement.

And the way they count this includes the thirty days after the patient is discharged, so hospitals are not going to want to prescribe that rehab you need after your knee surgery, or even that return trip to the cardiologist.

Betsy, you ignorant slut. Rehab services are not hospitalization services. They're rehab and even when they're done at a hospital people aren't admitted for it.

Holy God, someone please hand them a stick of reality?

Later in the show but not in this clip they start pimping Health Savings Accounts, which of course makes tons of sense because people have so much extra money to put into those HSAs which are limited by law to something that doesn't even cover prescription deductibles, much less hip replacements.

It must really drive insurers crazy to know that most employers will be keeping their employees' health insurance, that young adults age 19-26 are receiving needed, critical health care services, and Medicare spending has dropped by $500 billion without elderly folks dropping dead right and left all over the place. Why else would they drag out the same old dead, buried, withered, and dusty arguments over and over again?

Wake up, Fox News. Wake up, health insurers. Wake up Tea Party. Obamacare is here. And it's not going anywhere. Get over it.

Here's Steven Crowder, the Fox clown and fraud who picked a fight, videotaped it, then lied about it, using a typical SRWT construct: the "liberals say X."

It goes without saying, of course, no elected Democrats or liberals ever say or have said "X."

As for universal (not "free") health care, as anyone with a brain larger than a hamster's knows, the noted "liberal" Chief Justice John Roberts, along with 4 other members of the US Supreme Court, ruled Obamacare constitutional.

Moran.

Look what Aetna sent out to their brokers! A road map for delaying the inevitable effective dates of the Affordable Care Act provisions in order to squeeze all of their ill-gotten gains to the very last drop.

Aetna Email to Insurance Brokers

Aetna is encouraging their brokers to go to clients and renew their existing policies with an off-calendar effective date in order to delay the minimum policy requirements, premium limitations and pre-existing conditions provisions which take effect on January 1, 2014 or the renewal date of the policy. By changing the policy year to something other than December 31st, insurers will delay the effective date to the renewal for the year beginning in 2014 and ending in 2015.

Of course, this won't affect their large corporate clients, but only small businesses and individuals. What a surprise! Even less of a surprise is the more-than-obvious effort to make sure everyone is angry, the economy is slagged because small employers are slammed with higher premiums than before, and just in time for the 2014 midterms, too!

Did I mention that they're going to load up the costs to those employers for benefits they're not providing?

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