Professional Documents
Culture Documents
1NC
T Single Payer
Vote neg:
The governments of the fifty states and relevant sub-federal territories should
provide public health insurance options that:
State public options solve the case and don’t trigger ERISA preemption
Jon Walker 17, expert on politics, health care and drug policy, 5/2/17, “ROAD TO SINGLE-
PAYER: OVERCOMING HURDLES AT THE STATE LEVEL,”
https://shadowproof.com/2017/05/02/road-to-single-payer-healthcare-overcoming-hurdles-
at-the-state-level/
3) Keep goals and proposals within the legal restrictions. It would be possible for states to greatly expand the
use of public insurance without risking running afoul of ERISA . An all-carrot approach might
convince companies to ditch private insurance.
Rand found Oregon could create a strong public option without a federal waiver . It
would have lowered administrative costs and reimbursement rates, making it significantly
cheaper than private insurance. If it was open to all companies, it is likely many employers would
switch to it. It is not what many single-payer supporters want, but it is achievable in the short term . When
most of the state is covered by public insurance, additional reforms become easier .
1NC
Low Competition CP
-- require private insurers that offer Medicaid Advantage plans in such counties to
offer those plans on individual exchange markets
Competes---the CP’s not national health insurance because it’s nowhere close to
universally available
Solves the case, avoids the crowd-out DA, and avoids midterms because the CP’s
perceived as the GOP only bailing out red states
Gerard Anderson 17, professor in the Department of Health Policy and Management and
director of the Center for Hospital Finance and Management at the Johns Hopkins Bloomberg
School of Public Health, et al., 8/9/17, “Making The Exchanges More Competitive By Bringing
Medicare Into The Fold,” http://healthaffairs.org/blog/2017/08/09/making-the-exchanges-
more-competitive-by-bringing-medicare-into-the-fold/
With the GOP repeal drive on hold, members of Congress from both parties have declared that they want to
shore up the health exchanges. One of the top priorities is increasing competition
among insurers . Boosting the number of plans within the exchanges not only would
increase options for consumers ; it would also reduce the risk an exchange could end up
with no plans at all. Perhaps most important, it would likely lead to lower premiums as plans
competed to attract enrollees .
Yet in many counties, there’s little chance additional private plans will enter the exchanges . In what
is a highly consolidated industry, some of the dominant insurers have scaled back their involvement or left the
market entirely. According to the Kaiser Family Foundation, 70 percent of the 2,194 counties in the U nited
S tates have fewer than three health insurers participating in the individual health insurance exchanges.
The New York Times projects that in 2018, 45 counties will have no insurers participating in the exchanges, and 1,388 counties
(44 percent) will have only one. Most of these 1,433 counties are in rural America .
Obviously, exchanges don’t work when there are no participating insurers. But even when exchanges have a few
insurers, they offer limited choice, are likely to have higher prices , and face the risk of defections
leaving them with a single (or no) insurer. Ideally, exchanges should have four or more
insurers . Yet, at last count, just 354 counties (11 percent) met this standard. This hardly suggests a robust market.
The severe shortage of insurers in many of the exchanges poses risks to the goals of Republicans
as well as Democrats. For Democrats, the stakes are clear: The exchanges are the centerpiece of the ACA, and their continued
problems stand in the way of achieving its promise, as well as building broader support for the law among middle-income Americans
who are not eligible for Medicaid.
Yet Republicans should also want to boost plan participation and competition. Not only are the
exchanges weakest in rural “red” areas of the country , the fragility of the exchanges increases reliance
on Medicaid, which many conservatives view as less attractive than subsidized private insurance.
So increasing competition within the exchanges should be a bipartisan project. Yet the main proposal on the table—substantially
greater financial incentives to induce insurers to enter exchanges—would require big new federal outlays. Meanwhile, more
insurers are leaving the market, especially in rural America.
A Better Way Forward: Adding Medicare FFS And Medicare Advantage To The Exchanges
We think there is a better approach: allow Medicare to enter the market in counties where
fewer than three health insurers participate on the exchange . Introducing Medicare
wouldn’t require significant new spending. It would provide competition in counties with only one or two
insurers. And it would ensure that all counties would always have at least one insurance
option available. What’s more, Medicare could be used to provide new private plan options by
allowing Medicare Advantage private plans to offer coverage to nonelderly
Americans through the exchanges.
The main worry about the Medicare option is that it would displace private plans . Under
our proposal, however, Medicare would enter the exchanges only in counties that already
have a small number of plans, limiting potential “crowd out .” Any crowd out that did
occur, moreover, would be a result of consumer choices, not federal fiat. So
long as Medicare competes on a level
playing field—with the same subsidies and rules and a premium set to reflect local costs—it would
gain enrollees only by offering coverage more attractive than that offered by private insurers.
Indeed, the competition posed by Medicare could encourage insurers to improve their offerings and
gain market share as well. The exchanges are not a fixed pie: If they offer more diverse and affordable
options, more Americans are likely to buy coverage through them, allowing both the
public option and private plans to grow .
To be sure, private insurers will complain that Medicare has lower administrative costs and pays providers at lower rates than do
private insurers. But here again, adding Medicare to the mix wouldn’t prevent insurers from improving
their products. After all, private plans compete effectively against Medicare within Medicare
Advantage. Currently, they enroll approximately one third of all Medicare beneficiaries. If insurers are able to lower
their administrative costs and negotiate lower rates with local providers, they could do so within
the exchanges as well.
This brings us to the second element of our proposal: Since Medicare already features private plans, it should
be used not only to add a Medicare option, but also to expand the range of private options. Private insurers
that offer M edicare A dvantage plans in a region should be required to offer such plans
within the exchanges as well . Because many more private insurers participate in the
Medicare Advantage program than offer coverage in the exchanges, this would substantially
increase the number of private insurers in the small group and individual markets.
How Much Would Our Proposal Help?
How much would a Medicare option with Medicare Advantage plans increase competition? To form a rough estimate, we
examined the extent of competition in Zanesville, Ohio, the main city in one of the counties in
rural America without any insurers on the exchange . Using Medicare.gov’s Plan Finder tool, we found 21
Medicare Advantage plans operating there: three offered by Medigold, five by Anthem Blue Cross Blue Shield, four
by Humana, six by Aetna, and three by The Health Plan. Thus, if Medicare and Medicare Advantage plans were
exchange options in Zanesville, a subscriber would have access to 21 different Medicare
Advantage plans as well as traditional Medicare coverage.
The picture is roughly the same in most other rural counties in Ohio — our proposal would result in a major
increase in private insurance options alongside a new Medicare fee-for-service option.
1NC
Trade DA
As in the 1930s, when protectionist and isolationist US policies hampered global economic growth
and trade, and created the conditions for rising revisionist powers to start a world war , similar
policy impulses could set the stage for new powers to challenge and undermine the American-
led international order. An isolationist Trump administration may see the wide oceans to its east and west,
and think that increasingly ambitious powers such as Russia, China, and Iran pose no direct threat to the
homeland.
But the US is still a global economic and financial power in a deeply interconnected world. If left
unchecked, these countries will eventually be able to threaten core US economic and security
interests – at home and abroad – especially if they expand their nuclear and cyberwarfare capacities .
The historical record is clear: protectionism, isolationism, and “America first” policies are a recipe for
economic and military disaster .
1NC
Midterms DA
Failed GOP health care policy means Republicans can’t expand their Senate
majority now---the plan allows the GOP to pick up 10 seats for a total of 62
James Arkin 17, Real Clear Politics staff, 7/25/17, “GOP Fears Health Care Fail Could Thin
Senate Majority,”
https://www.realclearpolitics.com/articles/2017/07/25/gop_fears_health_care_fail_could_thi
n_senate_majority.html
Senate Republicans have a favorable electoral map in 2018, with far more Democrats up for re-election,
including in states President Trump won last year. But there is growing concern within the party that a failed vote
on Obamacare this week could imperil the GOP’s effort to expand the Senate majority next
year.
After months of negotiations and weeks of false starts, Republicans will finally move ahead Tuesday on a procedural vote to begin
debate on their Obamacare measure – though as of late Monday, it was unclear precisely what would receive a vote after the
procedural motion – repeal with a replacement, or repeal alone.
GOP leaders expressed confidence they would secure the votes to start debate on the measure Tuesday, and some Republican
senators said there was momentum in favor of the vote Monday evening. If GOP senators do vote to support debate, the political
consequences will shift based on how the bill is changed, and whether the final, amended version can pass the Senate.
Either way, there has been strong opposition from both the moderate and conservative wings of the party.
For the few Republicans up for re-election next year, including Sens. Dean Heller of Nevada and Jeff
Flake of Arizona, the vote could be central to Democrats’ efforts to defeat them . While most of
the senators opposed to the GOP plans are not up for re-election next year, the effort still has a significant impact
on the party’s chances in 2018.
The favorable map makes it unlikely that Republicans will lose their Senate majority – unlike the
House majority, which many Republicans admit could be in play next year. But there is concern that failure on the
measure could imperil their chances to knock off the 10 Democratic incumbents
running next year in states President Trump won .
In particular, Republican Sens. Rob Portman of Ohio and Shelley Moore Capito of West Virginia have been two of the
most vocal senators opposing the replacement plans, concerned about the impact Medicaid cuts could have on
their states. Neither is up for re-election next year, but Republicans had considered their Democratic colleagues, Sens.
Sherrod Brown of Ohio and Joe Manchin of West Virginia, to be two of the most vulnerable next year. Sen. Ron
Johnson of Wisconsin has also spoken out against the GOP plan, and Republicans plan to target Sen. Tammy Baldwin in her re-
election in the Badger State.
Josh Holmes, a Senate GOP strategist and former chief of staff to Majority Leader Mitch McConnell, said there was “no question”
that opposition from GOP senators made it more difficult to challenge Democrats in those states.
“There has, up until about four weeks ago, been an incredibly clear contrast between the Republican position on health care and the
Democratic support of Obamacare,” Holmes said. “To say that that has been muddled a bit, I think, is an understatement.”
Capito, Portman and Johnson have not backed away from their support for repealing and replacing Obamacare as a principle, but
Capito and Portman have expressed serious reservations about the party’s replacement plan. And despite voting in 2015 to repeal
the measure outright, with a two-year delay to craft a solution, both said they oppose that strategy now. They haven't indicated how
they'll vote on Tuesday's measure to proceed.
“The reality is that the president is going to sign this bill. I think that’s a big change,” Capito said in a local radio interview last week,
defending the switch in position. She emphasized that in a meeting with all GOP senators last week, Trump himself pushed for
repealing and replacing the ACA. “I don’t think that it’s a responsible way to repeal something, have everything fall off a cliff in two
years, have more people uninsured, have no plan in front of us. I want to see the plan in front of us so I can stay consistent with my
repeal-and-replace votes in the past.”
Trump spoke to thousands of Boy Scouts at a national jamboree in West Virginia Monday evening – and singled out the state's GOP
senator, saying Republicans "better get Sen. Capito to vote for it." He was scheduled for a campaign rally in Ohio Tuesday evening.
Democrats have noticed the GOP opposition and think it will be a useful tool in making the case
against the GOP efforts on Obamacare.
"The fact that even Republican senators are speaking out against the GOP’s health care plan
should tell you everything you need to know about how toxic their agenda will be on the campaign
trail,” said David Bergstein, spokesman for Democrats’ campaign committee.
Manchin and Brown have avoided politicizing their GOP colleagues’ position on the health care bill, focusing on their own
opposition to repealing Obamacare and the impact it would have in their state – though they have also proposed bipartisan
conversations to fix certain aspects of the law. But Manchin did express support for Capito’s position Friday.
“I’m just very proud of her,” Manchin said of Capito last week. “A lot of pressure was on her. She made a tough decision, but she
knows her state the same as I know my state – very, very well. This is something we talked about just couldn’t happen.”
Some Republicans think that opposition from Republican senators could help the case of challengers seeking Democratic seats. One
GOP strategist, who requested anonymity to avoid criticizing Republicans, said outsider candidates in West Virginia could use GOP
opposition to further their own case – arguing either in Ohio or West Virginia that with two senators voting against repeal, the state
needs to elect someone who would vote for the measure.
But in an interview on a local radio program last Friday, Rep. Evan Jenkins – one of two candidates running in the primary to
challenge Manchin next year – defended Capito’s position even while touting his support for the House repeal measure that passed
in May.
“You will not hear me criticizing Sen. Capito for the due diligence with which she is approaching this very difficult, challenging
issue,” Jenkins said. “She’s looking at the proposals being presented in the Senate, not from the House. I have a wonderful working
relationship with Sen. Capito and appreciate the hard work that she puts into it.”
His primary opponent, state Attorney General Patrick Morrisey, has also struck a similar position to Capito. In a local newspaper
interview after his announcement earlier this month, he said, “I would sit in for as long as it takes to repeal Obamacare, preserve
Medicaid and protect it for those who need it.”
But Morrisey was endorsed by the conservative group FreedomWorks, which sent an email last week labeling Capito a “fraud” –
along with Portman and Maine Sen. Susan Collins – for her opposition to the repeal-only strategy.
In Ohio, state Treasurer Josh Mandel is likely to face Brown in a campaign next fall. But Mandel has long opposed the state’s
Medicaid expansion – his website says he “did everything he could” to prevent the expansion – which puts him at odds with both
Portman and Gov. John Kasich.
Yetsome Republicans caution that if the health effort fails, it’s unlikely that it will be a central
campaign issue a year from now, particularly with an ever-changing news cycle and myriad issues to
focus on against Democrats in Trump states. If Obamacare isn’t a successful campaign issue for them,
Republicans say, they simply won’t spend television money advertising on it , and will seek other ways to
animate their base ahead of the midterms.
But Holmes, the former McConnell aide, argues it would have serious consequences for the party .
“The worst-case scenario for Republicans is they miss the opportunity to make conservative
reforms and as the insurance market collapses, they are forced to engage with Democrats on a
whole-sale insurance bailout,” he said. “From a policy perspective it’s a disaster, and from a political
perspective it’s a catastrophe.”
undo it .
This issue has never been litigated. Opponents can be expected to argue that Obama’s use of section 12(a) in this manner is
unconstitutional because it violates the so-called “nondelegation doctrine,” which basically holds that Congress cannot delegate
legislative functions to the executive branch without articulating some “intelligible principles.”
However, one could argue that Obama’s action was based on an articulation of intelligible principles gleaned from the stated policies
of the OCSLA, which recognizes that the “the outer Continental Shelf is a vital national resource reserve held by the Federal
Government for the public.” The law expressly recognizes both the energy and environmental values of the OCS. Thus President
Obama’s decision reflects a considered judgment that the national interest is best served by protecting the unique natural resources
of these areas, while at the same time weaning the nation from its dangerous dependence on fossil fuels.
The section 12(a) authority is similar in some respects to the authority granted by the Antiquities Act, which authorizes the president
to “reserve parcels of land as a part of [a] national monument.” Like the OCSLA, the Antiquities Act does not authorize subsequent
presidents to undo the designations of their predecessors. Obama has also used this power extensively – most recently, last week
when he designated two new national monuments in Utah and Nevada totaling 1.65 million acres.
Some laws do include language that allows such actions to be revoked. Examples include the Forest Service Organic Administration
Act, under which most national forests were established, and the 1976 Federal Land Policy and Management Act, which sets out
policies for managing multiple-use public lands. The fact that Congress chose not to include revocation language in the OCSLA
indicates that it did not intend to provide such power.
What can the new Congress do?
Under Article IV of the Constitution, Congress has plenary authority to dispose of federal property as it
sees fit. This would include the authority to open these areas to leasing for energy
development . Members of Alaska’s congressional delegation are considering introducing legislation to override Obama’s
drilling ban. But Democrats could filibuster to block any such move , and Republicans –
who will hold a 52-48 margin in the Senate – would need 60 votes to stop them.
On the other hand, Congress may be content to let President-elect Trump make the first move and see how it goes in court. If Trump
attempts to reverse the withdrawal, environmental groups contesting his decision would face some of the same obstacles as an
industry challenge to Obama’s action. It could be especially challenging for environmental groups to show that the claim is “ripe” for
judicial review, at least until a post-Obama administration acts to actually open up these areas for leasing. That may not occur for
some time, given the weak market for the oil in these regions.
In the meantime, this
decision is a fitting capstone for a president who has done everything within
his power to confront the existential threat of climate change and rationally move
the nation and the world onto a safer and more sustainable path .
1NC
Econ DA
Political resistance means the public option would be watered down, which is
worse than nothing
Robert Kuttner 9, professor at Brandeis University's Heller School for Social Policy and
Management, 6/26/9, “Debating the Public Option,” http://prospect.org/article/debating-
public-option
It's interesting and significant that the three co-founders of the Prospect are reprising the three major strands of progressive views
on health reform. Robert Reich is arguing that the Obama plan, with the public option, is the best practical brand of reform
available. Paul Starr, holding out for something that looks a lot like the Clinton plan, argues (convincingly in my view) that the
most likely form of the public option will backfire . And I continue to be the single-payer guy. We've been
having different versions of this friendly argument for two decades, as has the progressive community.
Reich says that single-player has "no skin in the game." Well, let's put some there, rather than being apologists for a threadbare cloak
of a public option.
Where Starr and I disagree is on both his diagnosis of Medicare for All, and on his optimism that "exchanges" could be designed in a
way that would meet his hopes (the exchanges sound a lot like the purchasing pools of the Bill Clinton plan that Paul Starr helped
devise).
Although Starr and Reich seem to disagree, they have one thing in common. They are both somewhat wishful about what it would
take politically to legislate the crucial details of either the Obama public option (Reich) or the exchanges (Starr) necessary to achieve
meaningful reforms. In order for the fine print in either approach to do the job, progressives would
need first to crush the industry influence in Congress that is very likely to hobble
either strategy . And both Reich and Starr are right that a weakened version of the Obama plan could
well be worse than nothing .
The political reality is that Medicare for All is no harder politically than a version of the
Obama plan that would meet all the tests that Reich and Starr apply. And it would be far simpler and more cost
effective.
The public option would not be available to people who get large-group employer
coverage
Jacob Hacker 17, the Stanley B. Resor Professor of Political Science at Yale, 7/26/17,
“Assessing the healthcare debate, with Jacob Hacker,” interviewed by Mike Cummings,
https://news.yale.edu/2017/07/26/assessing-healthcare-debate-jacob-hacker
Politics aside, what could be done to extend health coverage to more people?
I would argue that we should move toward the system I proposed in the 2000s, which provided
the template for the more progressive versions of what became the A ffordable C are A ct.
It’s worth remembering that President Obama initially supported a much more extensive and
robust system and what emerged from the legislative process had been whittled down to
something that could pass through the gauntlet of interest groups.
What did those more robust policies contain? They all had a public option — a health-
insurance plan modeled after Medicare that would be available to anyone who is seeking
coverage through the so-called health insurance exchanges. This would mean that anyone
who didn’t have coverage through their employer would have access to a
Medicare-like plan that offers a broad choice of physicians with reasonable rates and low
administrative costs.
Specifying the design details of employment eligibility’s key to assessing the plan’s
utility---the most likely versions are limited to people without large-group
employer coverage
Greg D’Angelo 9, Senior Research Fellow at the Heritage Foundation, 6/12/9, “A New Public
Health Plan: How Congressional Details Will Impact Doctors and Patients,”
http://www.heritage.org/node/14358/print-display
According to the Lewin Group, a nationally prominent econometrics firm, the two most crucial design details of
this new option are the size of employers eligible to buy into the new plan and the provider payment levels
used for reimbursement under the plan.[1]
These key issues are bound to be contentious in the upcoming debate over health care reform.[2] The
Obama campaign
proposal would have made individuals without employer coverage , the self-employed ,
and small employers (defined as fewer than 25 employees ) eligible for the public plan. But the
President never specified provider payment levels or the method for determining reimbursement rates for doctors, hospitals, and
other medical professionals for the thousands of medical services that would be delivered.[3]
Members of Congress and their staffs will thus have to hammer out these crucial details in legislation if a public plan is to be
introduced.
Unlevel Playing Field
If Congress creates a public plan modeled on Medicare--as some have previously proposed--the result, of course, would be to
undercut any pretense of a promised "level playing field" for competition with private health insurance.[4] Public plan premiums
would be 25-40 percent lower than private insurance premiums as the public plan would reimburse providers less than private
payers would--and often less than the cost of care delivered.
Payment rates for doctors and hospitals under public programs are set administratively, not by the market. They are, on average,
lower than private payment rates for similar care.[5] Medicare provider payments for hospital care are only 71 percent of private
rates, while Medicare provider payments for physician care are only 81 percent of private rates.[6] In other words, Medicare
payment levels are roughly 19-29 percent lower than private levels.
Congress's ability to impose low provider payments and artificially reduce the cost of the public option compared to private
insurance will increase enrollment in the public plan while crowding out, or displacing, existing private coverage.
Loss of Private Coverage
When considering a public plan modeled after Medicare, Lewin finds that the estimated reduction in the number of uninsured does
not vary greatly (observing a change of only 800,000 individuals) as eligibility for the plan is extended beyond small employers to
employers of all sizes.[7] Instead, there is a substantial increase in enrollment in the public plan and in the loss of private coverage.
If the public plan were opened to only small employers, enrollment in the public plan would
reach 42 .9 million , and 32 million Americans would lose their private coverage.[8] However, if the public plan is
opened to all employers, enrollment in the public plan increases dramatically to 131.2
million, and 119.1 million Americans would lose their private coverage.[9] In this particular case, of the 171.6 million
people who currently have private coverage, about 70 percent of them would lose the
coverage that they have today.[10]
More specifically, of the estimated 157.4 million Americans who have private employer coverage, up to 107.6 million people could
lose their private employer coverage, even if they like it and would prefer to keep it.[11]
Pandemics
The public option fails to expand coverage---it only matters to people who can
already buy insurance on the exchanges, and won’t control costs
Adam Gaffney 17, fellow in pulmonary and critical care medicine at Massachusetts General
Hospital, advisor to the board of the Physicians for a National Health Program, 7/19/17, “The
Case Against the Public Option,” https://www.jacobinmag.com/2017/07/trumpcare-
obamacare-repeal-public-option-single-payer
But here again lies one of the public’s option’s cardinal flaws: whatever it does for those buying insurance on
the Obamacare marketplaces (which I’ll return to in a minute), it does basically nothing for the large
majority of the nation not insured through them . The so-called “Obamacare” plans cover some
12.2 million enrollees — a substantial number of people to be sure, but still a very small fraction of the
population.
What would a public option do, for example, for the 28 .6 million US residents who are
uninsured? According to the Congressional Budget Office’s (CBO) 2013 scoring of a public option added to
the ACA marketplaces, the answer is nothing : the public option, the CBO estimated, “would have
minimal effects . . . on the number of people who would be uninsured.”
The goal of single-payer is to reduce that 28.6 million figure to zero; under the public option — at least according to this
admittedly old CBO score of one particular variation of the public option — the number wouldn’t so much as
budge . Perhaps a more ambitious public option could do a bit better. Nonetheless, it’s not clear that even a more
robust plan would be a step toward universal coverage.
And how about for the underinsured? The roughly half of the nation currently covered through their employer
saw a 2016 deductible that was 300 percent higher than a decade ago. Such cost-shifting of health care
costs to workers is a major cause of financial suffering, as well as deferred medical care. Yet the public option would do
nothing for the great majority of these families.
A longstanding aim of universal health care advocates — stretching back to the German Social Democrats’ 1891 Erfurt Program,
which called for “[f]ree medical care, including midwifery and medicines” — has been to eliminate out-of-pocket payments (for
example, copayments and deductibles) at the time of health care use. In Canada and the United Kingdom, this goal has largely been
achieved: most health care remains free when patients use it. The public option, however, would do little to nothing to bring us
closer to this goal.
Nor would the public option ameliorate existing deficiencies in the two big public insurance programs,
Medicare and Medicaid. Medicare, like private insurance, often imposes high out-of-pocket payments on enrollees, and it
excludes coverage for important health services like dentistry and long-term care. The partial privatization of the program (via
Medicare Advantage plans, which are managed by private insurance companies) has yielded little but colossal waste over the years.”
And while Medicaid has broader benefits and usually minimal out-of-pocket payments, as a result of its lower reimbursements, it
sometimes provides inferior access to providers (a vestige of its heritage as a “poor person’s program).
The public option wouldn’t address the inadequacies of either public program.
Finally, interms of global costs , the public option’s effect would again be quite minor , as single-
payer advocates have long noted. Eliminating both uninsurance and underinsurance would cost money ,
and reduced administrative spending ($503 billion dollars a year, according to one estimate) and reduced drug
costs ($113.2 billion a year) are typically cited as key sources of savings. But although a Medicare-like
public option may have lower administrative costs, only a small fraction of the efficiency
savings of single-payer would be achieved if the multi-payer framework persisted (and drug
prices wouldn’t be controlled on a system-wide level ).
Or as Physician for a National Health Program’s Don McCanne puts it, the “public option would be only one more
player in our wasteful, administratively-complex, fragmented system of financing care.” The
upshot? It wouldn’t generate anywhere near the savings needed to fund a truly universal
expansion of health care.
Alt causes – undocumented immigrants, religious groups, anti-vacciners
No impact to bioterror
Filippa Lentzos 14, PhD from London School of Economics and Social Science, Senior
Research Fellow in the Department of Social Science, Health and Medicine at King’s College
London, Catherine Jefferson, researcher in the Department of Social Science, Health, and
Medicine at King’s College London, DPhil from the University of Sussex, former senior policy
advisor for international security at the Royal Society, and Dr. Claire Marris, Senior Research
Fellow in the Department of Social Science, Health and Medicine at King's College London, “The
myths (and realities) of synthetic bioweapons,” 9/18/2014, http://thebulletin.org/myths-and-
realities-synthetic-bioweapons7626
The bioterror WMD myth. Those who have overemphasized the bioterrorism threat typically portray it as an
what their intentions are. The assumption is that terrorists would seek to produce mass-casualty weapons
and pursue capabilities on the scale of 20th century, state-level bioweapons programs. Most leading biological disarmament
and non-proliferation experts believe that the risk of a small-scale bioterrorism attack is very real and present. But they
consider the risk of sophisticated large-scale bioterrorism attacks to be quite small. This judgment
is backed up by historical evidence . The three confirmed attempts to use biological agents against humans in terrorist
attacks in the past were small-scale , low-casualty events aimed at causing panic and disruption rather than excessive death tolls. ¶
The second dimension involves capabilities and the level of skills and resources available to terrorists. The implicit assumption is that
producing a pathogenic organism equates to producing a weapon of mass destruction. It does not.
Considerable knowledge and resources are necessary for the processes of scaling up, storage, and
dissemination. These processes present significant technical and logistical barriers .¶ Even if a biological
weapon were disseminated successfully, the outcome of an attack would be affected by factors like the health of the people who
are exposed and the speed and manner with which public health authorities and medical professionals detect and respond to the resulting outbreak. A
medical countermeasures, such as antibodies and vaccination, can
prompt response with effective
We’d just respond to an attack by making the treatment free for everyone
Kimberly Ann Petersen 14, M.A. Candidate in Security Studies, Naval Post-Graduate School,
September 2014, “The Affordable Care Act: a prescription for homeland security
preparedness?,”
https://calhoun.nps.edu/bitstream/handle/10945/43979/14Sep_Petersen_Kimberly.pdf?seque
nce=1
Another way that a robust and accessible health care system aids homeland security is through
prevention. Vaccines are one of the tools used to prevent bioattacks, or at least to manage a successful
attack. Homeland security experts have long considered smallpox a potential bioweapon, hence the
stockpiling of the smallpox vaccine since 9/11. Smallpox is an infectious disease caused by the virus variola major or
variola minor. The more common and more virulent form, variola minor, has a mortality rate of about 30 percent.70 The disease
was present throughout the world for tens of thousands of years, but was eradicated via a worldwide vaccination program prior to
1980. The smallpox virus only exists now in laboratory stockpiles.71 One of the concerns post-9/11 was the stockpiles would be
pilfered and used to intentionally reintroduce the virus to humans. The U.S. currently has 300 million doses of smallpox vaccine in
stockpiles around the U.S.—enough to vaccinate nearly the entire population. Recently, the U.S. government purchased enough of a
new smallpox medication to treat two million people.72 However, for the vaccination process and the treatment process
to be successful in the event of an outbreak, the population will need access to health care providers.
The Department of Homeland Security’s fact sheet on what to do in the event of a bioterror directs us as follows: “People in the
group or area that authorities have linked to exposure who have symptoms that match those described should seek emergency
medical attention.”73
It is likely in the event of such a dramatic scenario as a smallpox attack, the U.S. government will
set up emergency distribution centers , where all people will receive prophylaxis antibiotics,
without regard for health insurance or payment , as outlined in the C enter for D isease
C ontrol’s Smallpox Response Plan and Guidelines. 74 So perhaps the smallpox vaccination program serves
as a model for universal health care access .
Monopolies
Antitrust suits solve insurance consolidation
WSJ 17, Wall Street Journal, “The ObamaCare Merger Deathblow”, 2-15-2017, Accessed via
ProQuest, https://www.wsj.com/articles/the-obamacare-merger-deathblow-
1487118188?mod=wsjde_finanzen_wsj_barron_tickers
The conceit that the five major commercial health insurers will consolidate to three seems to be
dissolving, as four of those insurers called off a pair of mega-mergers on Tuesday. The immediate
reasons were legal objections, but perhaps this retreat is a sign of hope for insurance
markets .
After 18 months of courtship among the Big Five starting in 2015, the outgoing Obama Justice Department's antitrust
division sued to block the $34 billion Aetna-Humana tie-up as well as Anthem's $48 billion
acquisition of Cigna. Federal judges blocked both transactions earlier this year. Anthem had planned to
appeal but on Tuesday Cigna pulled the plug after Aetna and Humana did the same.
This is due less to the legal merits than to the pliability of antitrust law that lets enforcers and
judges define a market as they see fit. The court's analysis of the Anthem "market" was limited to "national accounts" --
large businesses with more than 5,000 employees in at least two states, which is suspiciously specific.
The Aetna deal was meant to expand participation in Medicare Advantage, which allows seniors to opt for private plans. The trial
judge ruled that fee-for-service Medicare doesn't compete with Advantage plans, when the reason the Advantage alternatives exist is
to drive down premiums or improve quality through competition with traditional Medicare.
In theory, the mergers are justified by economies of scale and to build negotiating leverage against the increasingly consolidated and
sometimes oligopolistic hospital supersystems. ObamaCare promotes and rewards health-care consolidation on the premise
that larger conglomerates lead to efficiencies and are more responsive to government control.
By converting insurers into public utilities, the law reduced choice and eliminated most margins
for competition. Price controls suppress innovation and discourage new entrants. The ObamaCare business, which has left
most insurers underwater, was never the great profit-making opportunity that some imagined in 2009-2010. The CEOs pursuing
mergers were responding to ObamaCare's regulatory logic.
No competitiveness impact
Stephen G. Brooks and Wohlforth 16, Associate Professor of Government in the Department
of Government at Dartmouth College, William Wohlforth, Daniel Webster Professor of
Government in the Dartmouth College Department of Government, June 2016, “The once and
future superpower: why China won't overtake the United States,”
https://www.foreignaffairs.com/articles/united-states/2016-04-13/once-and-future-
superpower
After two and a half decades, is the United States' run as the world's sole superpower coming to an end?
Many say yes, seeing a rising China ready to catch up to or even surpass the U nited S tates in
the near future. By many measures, after all, China's economy is on track to become the world's biggest, and even if its growth
slows, it will still outpace that of the United States for many years. Its coffers overflowing, Beijing has used its new wealth to attract
friends, deter enemies, modernize its military, and aggressively assert sovereignty claims in its periphery. For many, therefore, the
question is not whether China will become a superpower but just how soon. But this is wishful, or fearful, thinking.
Economic growth no longer translates as directly into military power as it did in the
past, which means that it is now harder than ever for rising powers to rise and established ones
to fall. And China--the only country with the raw potential to become a true global peer of the
United States--also faces a more daunting challenge than previous rising states because of how far
it lags behind technologically . Even though the United States' economic dominance
has eroded from its peak, the country's military superiority is not going anywhere , nor is
the globe-spanning alliance structure that constitutes the core of the existing liberal
international order (unless Washington unwisely decides to throw it away). Rather than expecting a power
transition in international politics, everyone should start getting used to a world in which the
United States remains the sole superpower for decades to come. Lasting preeminence will help
the United States ward off the greatest traditional international danger, war between the world's
major powers. And it will give Washington options for dealing with nonstate threats such as terrorism and transnational
challenges such as climate change. But it will also impose burdens of leadership and force choices among competing priorities,
particularly as finances grow more straitened. With great power comes great responsibility, as the saying goes, and playing its
leading role successfully will require Washington to display a maturity that U.S. foreign policy has all too often lacked.
the wealth of nations
In forecasts of China's future power position, much has been made of the country's pressing
domestic challenges: its slowing economy, polluted environment, widespread corruption,
perilous financial markets, nonexistent social safety net, rapidly aging population , and
restive middle class. But as harmful as these problems are, China's true Achilles' heel on the
world stage is something else: its low level of technological expertise compared with the United
States'. Relative to past rising powers, China has a much wider technological gap to close with the leading power.
China may export container after container of high-tech goods, but in a world of globalized production, that doesn't reveal much.
Half of all Chinese exports consist of what economists call "processing trade," meaning that parts are imported into China for
assembly and then exported afterward. And the vast majority of these Chinese exports are directed not by Chinese firms but by
corporations from more developed countries.
When looking at measures of technological prowess that better reflect the national origin of the expertise, China's true position
becomes clear. World Bank data on payments for the use of intellectual property, for example,
indicate that the United States is far and away the leading source of innovative
tech nologies, boasting $128 billion in receipts in 2013--more than four times as much as the
country in second place, Japan. China, by contrast, imports technologies on a massive scale yet
received less than $1 billion in receipts in 2013 for the use of its intellectual property. Another good indicator of the
technological gap is the number of so-called triadic patents, those registered in the United States, Europe, and Japan. In 2012,
nearly 14,000 such patents originated in the United States, compared with just under 2,000 in China. The distribution of
highly influential articles in science and engineering--those in the top one percent of citations,
as measured by the National Science Foundation--tells the same story, with the United States
accounting for almost half of these articles, more than eight times China's share. So does the breakdown of Nobel
Prizes in Physics, Chemistry, and Physiology or Medicine. Since 1990, 114 have gone to U.S.-based researchers. China-based
researchers have received two.
Precisely because the Chinese economy is so unlike the U.S. economy, the measure fueling
expectations of a power shift, GDP, greatly underestimates the true economic gap
between the two countries . For one thing, the immense destruction that China is now
wreaking on its environment counts favorably toward its GDP, even though it will reduce
economic capacity
over time by shortening life spans and raising cleanup and health-care costs . For another thing,
GDP was originally designed to measure mid-twentieth-century manufacturing economies, and so the more knowledge-based and
global-ized a country's production is, the more its GDP underestimates its economy's true size.
A new statistic developed by the UN suggests the degree to which GDP inflates China's relative
power. Called "inclusive wealth," this measure represents economists' most systematic effort to
date to calculate a state's wealth. As a UN report explained, it counts a country's stock of assets in three
areas: "(i) manufactured capital (roads, buildings, machines, and equipment), (ii) human capital
(skills, education, health), and (iii) natural capital (sub-soil resources, ecosystems, the
atmosphere)." Added up, the United States' inclusive wealth comes to almost $144 trillion--4.5 times China's $32
trillion.
The true size of China's economy relative to the United States' may lie somewhere in between the numbers provided by GDP and
inclusive wealth, and admittedly, the latter measure has yet to receive the same level of scrutiny as GDP. The problem with GDP,
however, is that it measures a flow (typically, the value of goods and services produced in a year), whereas inclusive wealth measures
a stock. As The Economist put it, "Gauging an economy by its GDP is like judging a company by its quarterly profits, without ever
peeking at its balance-sheet." Because inclusive wealth measures the pool of resources a government can
conceivably draw on to achieve its strategic objectives, it is the more useful metric when
thinking about geopolitical competition . But no matter how one compares the size of the
U.S. and Chinese economies, it is clear that the United States is far more capable of converting
its resources into military might. In the past, rising states had levels of technological prowess
similar to those of leading ones. During the late nineteenth and early twentieth centuries, for example, the United States
didn't lag far behind the United Kingdom in terms of technology, nor did Germany lag far behind the erstwhile Allies during the
interwar years, nor was the Soviet Union backward technologically compared with the United States during the early Cold War. This
meant that when these challengers rose economically, they could soon mount a serious military challenge to the dominant power.
China's relative technological backwardness today, however, means that even if its economy
continues to gain ground, it will not be easy for it to catch up militarily and become a true global
strategic peer, as opposed to a merely a major player in its own neighborhood.
No China war
Bilahari Kausikan 16, Ambassador-at-large and policy adviser in the Ministry of Foreign
Affairs, and the Institute of Policy Studies' 2015/16 S R Nathan Fellow for the Study of
Singapore, “War is unlikely but distrust runs deep,” Feb 27 2016,
http://www.straitstimes.com/opinion/war-is-unlikely-but-distrust-runs-deep
This is not a question that should lend itself to facile answers. US-China relations defy simple characterisation. But it is certainly not "a
Clash of Civilisations". ¶ China could not have succeeded without the US. China's success is, in a very
fundamental way, also an American success, albeit a not entirely comfortable one for America. This perhaps adds in no small part to the complexity of the strategic adjustments
that are under way between the US and China. But whether it admits it or not, the US too has begun to adapt. There can be no "Clash of Civilisations" because we are now all
hybrids.¶ The inevitably irregular rhythms of economic growth ought to make us cautious about accepting simplistic characterisations of US-China relations as some variant of a
contrast between a rising China and a declining US. This posits a false dichotomy. China is certainly rising but the US is not in decline. All who have underestimated American
creativity and resilience have come to regret it. The changes in the distribution of power are relative, not absolute. The US is still pre-eminent in most indices of power and is
Before too long, China will reach a more
likely to remain so for the foreseeable future.¶ This is most obvious in the military realm.
symmetrical military equation with the US in East Asia. This will have very important implications for the maritime disputes in the
South China Sea. While military planners cannot ignore any contingency, war is not a very
probable scenario. Neither the US nor China is looking for trouble or spoiling for a
fight. The essential priorities of both are internal, not external . The most vital of all
Chinese interests is the preservation of Chinese Communist Party ( CCP) rule. Chinese leaders
sometimes talk tough. But they are not reckless .¶ As the sole global power, the US cannot retreat into complete isolationism.
Like it or not, the world will intrude and in East Asia specifically, there has been a fundamental consistency in US policy over the last 40 years or more that I expect will be
maintained.¶ But the political mood that has sustained contenders Donald Trump and Bernie Sanders in their unlikely presidential campaigns is disillusionment with
globalisation and working- and middle-class insecurity about their future in an increasingly unfamiliar and uncertain world. Whoever next occupies the White House will talk
and even act tougher. Butno American president can ignore the national mood, which is not for more
wars of choice .¶ If war between the US and China is highly improbable , is there or will there be a "new Cold
War" between the two? There will almost certainly be tense episodes. But I do not think this is
an appropriate metaphor to understand the US-China dynamic.¶ So where does all this leave us? I do not think it makes the strategic
adjustments any easier. But it does imply that the parameters within which the US and China must seek a new
accommodation are narrower than what we might have been led to expect by the media or the more
sensationalist sort of academic analysis .
No impact to nanotech or AI
Edward Moore Geist 15, MacArthur Nuclear Security Fellow at Stanford University's Center for
International Security and Cooperation, 8/9/15, “Is artificial intelligence really an existential
threat to humanity?,” http://thebulletin.org/artificial-intelligence-really-existential-threat-
humanity8577
Bostrom’s mistaken conflation of inference mechanisms with intelligence is also apparent in his
colorful descriptions of how intelligent machines might annihilate humanity . Simply
depriving AIs of information about the world is not adequate to render them safe, he claims, as they
might be able to accomplish such feats as solving extremely complex problems in physical science without the
need to carry out real-world experiments. In a scenario borrowed from Yudkowsky, Bostrom posits that a
superintelligence might “crack the protein folding problem” and then manipulate a gullible human into mixing
mail-ordered synthesized proteins “in a specified environment” to create “a very primitive ‘wet’ nanosystem, which,
ribosome-like, is capable of accepting external instructions; perhaps patterned acoustic vibrations delivered by a speaker attached to
the beaker.” It could then employ this system to bootstrap increasingly sophisticated
nanotechnologies, and “at a pre-set time, nanofactories producing nerve gas or target-seeking mosquito-like
robots might then burgeon forth simultaneously from every square meter of the globe (although more
effective ways of killing could probably be devised by a machine with the technology research superpower).” This
scenario
doesn't just strain a reader’s credulity ; it also implies a fanciful understanding of the nature of
technological development in which “genius” can somehow substitute for hard work and countless
intermediate failures. In the real world , the “lone genius inventor” is a myth; even smarter-
than-human AIs could never escape the tedium of an iterative r esearch and
d evelopment process.
ration on significant issues’. Moreover, Patrick (2010, p. 44) of the Council on Foreign Relations has cautioned that, ‘The
United States should be under no illusions about the ease of socializing rising nations. Emerging
powers may be clamoring for greater global influence, but they often oppose the political and
economic ground rules of the inherited Western liberal order, seek to transform existing
multilateral arrangements, and shy away from assuming significant global responsibilities’. In this
regard, Laidi has argued that despite their own heterogeneity, the BRICS actually share a common
objective in opposing Western liberal internationalist narratives that run counter to traditional state
sovereignty. Instead, they seek to protect their own prerogatives, independence of action and national
autonomy in an increasingly interdependent world (Laidi, 2012, pp. 614–615).
No risk of Russia war---neither side will escalate
Andrei Tsygankov 16, Professor at the Departments of Political Science and International
Relations at San Francisco State University, PhD from USC, “5 reasons why the threat of a global
war involving Russia is overstated,” Feb 19 2016, http://www.russia-direct.org/opinion/5-
reasons-why-threat-great-power-war-involving-russia-overstated
Experts and politicians are warning of high
The contemporary discussion of security interactions among major powers is depressing to participants and observers alike. us an increasingly
likelihood of a military conflict – possibly a nuclear one – between Russia and , on the one hand,
the U.S. or NATO ¶ In the West, many argue the dangers associated with a “resurgent”
, on the other.
Russia and vow to defend themselves from Russian President Vladimir Putin’s “aggressive” actions in Eastern Europe and the Middle East. Last month, U.S. Defense Secretary Ash Carter accused Russia of threatening the world order and starkly
they underestimate the dangers of the Cold War and overestimate those of today’s world ¶ .
Despite some attempts to present the Cold War as generally stable, predictable, and peaceful, this is not the time to feel nostalgic about it. Multiple crises from Berlin to Cuba and Afghanistan extended across much of the Cold War era. State propaganda on both sides
was reinforced by an intense ideological confrontation accompanied by drills and necessary preparations for a nuclear war. ¶ The Oscar-nominated film “Bridge of Spies” directed by Steven Spielberg reproduces some of that hysterical atmosphere in the United
States where the public was mobilized for any actions in support of the government. In the Soviet Union it was no different. For the world outside th e West and the U.S.S.R., this was not a peaceful, but rather an increasingly chaotic and violent time – the conclusion
whatever
well documented by scholars of the Third World.¶ Why today's world is less dangerous than the Cold War ¶ Today’s world, while threatening and uncertain, is hardly more dangerous than the Cold War, for the following reasons. ¶ First,
the rhetoric, major powers are not inclined towards risky behavior when their core interests are
at stake. This concerns not only the nuclear superpowers, but also Turkey. The prospect of countries such as
provocative actions , whether responding to Russia seizing the Pristina Airport in it is by International
June 1999, getting involved on Georgia’s side or providing support during the military conflict in August 2008 by lethal military assistance and
for Ukraine. Unless Russia is the clear and proven aggressor, NATO is unlikely to begin support Turkey and
World War III .¶ Russia remains a defensive power aware of its responsibility for
Second,
maintaining international stability. Moscow wants to work with major powers, not against them .
¶ the U S has
Its insistence on Western recognition of Russia’s interests must not be construed as a drive to destroy the foundations of the international order, such as sovereignty, multilateralism, and arms control. Third, nited tates
important interests to prevent regional conflicts from escalating or becoming trans-regional. Although its relative military capabilities are not where they
U.S. military and diplomatic resources are sufficient to restrain key regional
were ten years ago, the
escalate ¶ . Fourth, unlike the Cold War era, the contemporary world has no rigid alliance structure. The so-called Russia-China-Iran axis is hardly more than a figment of the imagination by American neoconservatives and some Russia conspiracy-
minded thinkers. The world remains a space in which international coalitions overlap and are mostly formed on an ad hoc basis.¶ Fifth, with the exception of the Islamic State of Iraq and the Greater Syria (ISIS), there is no fundamental conflict of values and
ideologies. Despite the efforts to present as incompatible the so-called “traditional” and “Western” values by Russia or “democracy” to “autocracy” by the United States and Europe, the world majority does not think that this cultural divide is worth fighting for. ¶
into concessions rather than to signal real intentions. When such pressures do not
various political and military
increasing frequency of exchanges between Obama and Putin including since December 2015 - their recent
phone conversation following the Munich conference - suggest recognition that the record of a growing
States have historical supremacy over health insurance regulation---the Court will
defer towards the states on ERISA questions
Elizabeth McCuskey 16, Associate Professor of Law, University of Toledo College of Law,
“Body of Preemption: Health Law Traditions and the Presumption Against Preemption,” 2016,
Temple Law Review, 89 Temp. L. Rev. 89
Commercial health insurance. Since the 1850s, states have been the primary regulators of
insurance ; therefore, they have supplied most laws governing private health insurance.343 Insurers did not cover health care,
however, until after 1908.344 The first two categories of true health insurance sprung up in the early 1930s: Groups of hospitals
offered prepaid services (known as “Blue Cross” model plans), and groups of physicians offered similar arrangements (known as
“Blue Shield” plans).345 Health insurance policies were rare until after World War II, when they became
ubiquitous and largely employer-sponsored because insurance offered as an employee fringe benefit was exempt
from the wartime wage and price controls.346
Over their roughly 150 years of insurance regulation, states have both exercised licensing authority over
insurers and have regulated issuance of policies.347 Since 1945 with the passage of the McCarran-Ferguson Act,348
some state insurance regulation has enjoyed a form of reverse preemption in which state
insurance law is supreme to federal law.349 The Health Maintenance Organization Act of 1973350 “marked the first
time that Congress created a direct federal role in the regulation of health insurance;” the legislation was “designed to supplement,
rather than replace . . . state functions” through federal funding and qualifications.351
State health insurance regulation thus can quite accurately be described as “primary” from its inception. The federal government,
however, unintentionally assumed a major role with the passage of the ERISA352 in 1974. Although passed primarily with pension
benefits in mind, ERISA applies to all employer-sponsored benefits, which has come to include health insurance. ERISA’s original
purposes were to safeguard employees’ pensions and to encourage the provision of pension benefits by establishing a uniform
system of federal regulation.353 To promote uniformity, Congress wrote into ERISA a “terse but comprehensive”354 provision
expressly preempting state laws that “relate to” any “benefit plan[s]”355 covered by the Act. ERISA thus preempts vast swaths of
state initiatives aimed at increasing access to employer-sponsored health insurance.356
ERISA’s savings clause exempts state regulation of “the business of insurance ” from
preemption under the statute.357 The difficulty of determining when state laws “relate to” employer-sponsored health
insurance (and are preempted) versus when they relate to the “business of insurance” (and are saved from preemption) has resulted
As the Supreme Court
in one of the most contentious preemptions in health law—perhaps in any law, period.358
has noted in ERISA contexts, health insurance is a “field[] of traditional state regulation ,” and
Congress must not have intended ERISA to “displace general health care regulation, which
historically has been a matter of local concern.”359 By that logic, the Supreme Court held that ERISA does not
preempt a state statute requiring hospitals to collect a surcharge from commercial insurers,
despite the impact on employer-sponsored insurance .360 On the other hand, the Court has held
that ERISA does preempt state law remedies for health insurers’ faulty eligibility and coverage decisions, despite state law’s
traditional role in supplying remedies.361
conflict in the modern era. Why then are there so few rivals engaging in cyber
warfare? Furthermore, why are the incidents and disputes limited to mostly defacements or
denial of service when it seems that cyber capabilities could inflict more damage to their adversaries?¶ Based on our
analysis, we find our notion of restraint is a better explanation of cyber interactions than any
conception of continuous or escalating cyber conflict. States will not risk war with their
cyber capabilities because there are clear consequences to any use of these technologies. States are not reckless,
but terrorists and other cyber activists might not be so restrained. The interesting result of the process is that while cyber terrorists will likely
proliferate, their ability to do damage will be limited due to the massive resources and conventional intelligence methods needed to make an operation
like Stuxnet successful.14 Stuxnet and Flame could be the harbingers of the future, but in reality it was a collusion of discrete events that worked out for
the attacker (Lindsay, 2013). With a will to attack, there must also come a way to attack. With such a high burden on luck and ability, it will be rare to
see such important disputes continue in the future.¶ The recently discovered cyber incidents of Red October and Flame represent the typical outcome of
cyber conflict.15 They are massive cyber operations, but have to date been used for information extraction and espionage purposes. Cyber conflict is in
our future, but these events will only be as devastating as the target allows them to be as long as the attacker is restrained by logic, norms, and fear of
retaliation. Restraint is clearly in operation for cyber conflict. Constraints can change the behavior of an actor into not
doing something it would usually do if left to its own devices. A
rival will not blatantly attack its adversary’s
infrastructure or secret government databases because that state may perceive the attack as it
would a physical attack and respond with an equally devastating cyber incident or even with
conventional military forces. There is also the fear of collateral damage which remains high for
many actors, and this simple limitation may prevent persistent cyber conflict from
becoming a reality. Another fear is cyber blowback, as noted by Farwell & Rohozinski (2011), in that tactics could be replicated and targeted
back towards the attacker.¶ The range of relations in the realm of cyberspace has yet to be determined, but it does seem clear that rivals
operate as rivals should. They are able to manage their tensions in such a way as to forestall violence yet
prolong tensions for long periods of time. Therefore, states have yet to employ widespread damage via cyberspace out of fear of the unknown. They
fear the escalation of the rivalry in the absence of a critical event like a territorial invasion. Malicious and
damaging cyber tactics seem not to be the norm. The best hope for reducing the possibility of cyber conflict in the future comes from strong institutions
capable of managing and restricting cyber-based disputes.
Solvency
Politics General
The politics of health care have gotten worse since the examples of watered-down
public options in 2009---makes our args more likely now
Ed Kilgore 16, politics writer for New York Magazine, 8/19/16, “Just a Reminder: Congress
Isn’t Going to Fix Obamacare — or Enact Single-Payer — Any Time Soon,”
http://nymag.com/daily/intelligencer/2016/08/congress-isnt-going-to-fix-obamacare-any-
time-soon.html
That is all well and good, but the very same political problems that prevented the adoption of a
public option (much less “Medicare for all”) in 2009 and 2010 when Democrats controlled Congress by
comfortable margins have gotten worse, not better . Yes, if Hillary Clinton is elected in November she has
already announced support for adding a public option to Obamacare, and there’s a decent chance she will bring a narrowly
Democratic Senate along with her. A Democratic House, however, remains a very long shot, and even if it happens, getting
something as controversial as an Obamacare “fix” through a closely divided Congress is at best
an even longer shot. Yes, in theory, something like an increase in insurance subsidies to lure the private companies back in
could be enacted via a budget reconciliation bill that is immune to a GOP Senate filibuster. But progressive Democrats who want to
abandon private insurance entirely aren’t likely to go along with that, and it’s doubtful a major structural reform
could be accomplished without the kind of legislation that could be filibustered (barring elimination of
the filibuster altogether).
In all likelihood, then, congressional Republicans will maintain their veto power over
any Obamacare “fix.” And there’s absolutely no evidence they’ll be interested in anything short of
the destruction of the whole A ffordable C are A ct. The lusty cheers with which they are greeting the
system’s current problems ought to show that to anyone under the illusion that the GOP is
concerned about the human cost of insufficiently available or affordable health insurance. It will be
astonishing if Donald Trump doesn’t make the repeal of Obamacare (and its replacement with something “incredible” down the
road, by and by) a presidential campaign issue down the stretch. If Republicans hold on to one or both congressional chambers, the
odds of anything good happening to Obamacare are virtually nil. If Trump somehow wins, the fate of Obamacare may be the least of
the country’s problems, but it will be a problem nonetheless.
Employers---2NC
Nature, Science, Scientific American, National Geographic — back in, say, 2005, about a potential bird flu (H5N1) pandemic, you wonder what planet they were on. Nature ran a special
section titled — “Avian flu: Are we ready?” — that began, ominously, with the words “Trouble is brewing in the East” and went on to present a mock
aftermath report detailing catastrophic civil breakdown . Robert Webster, a famous influenza virologist, told ABC News in 2006 that “society just can't
accept the idea that 50% of the population could die. And I think we have to face that possibility.” Public health expert Michael T. Osterholm of the University of Minnesota, at a meeting in Washington of scientists
brought together by the Institute of Medicine, warned in 2005 that a post-pandemic commission, like the post-9/11 commission, could hold “many scientists … accountable to that commission for what we did or
didn't do to prevent a pandemic.” He also predicted that we could be facing “three years of a given hell” as the world struggled to right itself after the deadly pandemic. And Laurie Garrett, author of what must be
the urtext for pandemic predictions, her 1994 book “The Coming Plague,” intoned in Foreign Affairs that “in short, doom may loom.” Although she followed that with “But note the may,” the article went on to
hysteria still goes on: Whether it's over the MERS coronavirus, a
paint a terrifying picture of the avian flu threat nonetheless. And such
whole alphabet of chicken flu viruses, a real but not very deadly in flu enza pandemic in 2009, or a kerfuffle like the one
in 2012 over a scientist-crafted ferret flu that also was supposed to be a pandemic threat. Along the way,
virologist Nathan Wolfe published “The Viral Storm: the Dawn of a New Pandemic Age,” and David Quammen warned in his gripping “Spillover” that
some new animal plague could arise from the jungle and sweep across the world. And now there's Ebola. Osterholm, in a widely read
op-ed in the New York Times in September, wrote about the possibility that scientists were afraid to mention publicly the danger they discuss privately: that Ebola “could mutate to become transmissible through
the air.” “The Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done,” he wrote. And Garrett wrote in Foreign Policy, “Attention, World: You just don't get it.” She
went on to say, “Wake up, fools,” because we should be more frightened of a potential scenario like the one in the movie “Contagion,” in which a lethal, fictitious pandemic scours the world, nearly destroying
civilization. But there were fewer takers this time. Osterholm's claims about Ebola going airborne were discounted by serious scientists, and Garrett seemingly retracted her earlier hysteria about Ebola by claiming
The scientific world has changed since 2005. Now, most scientists
that, after all, evolution made such spread unlikely.
easy adaptation of an animal disease to the human species. Furthermore, Racaniello insists that there are no
recorded instances of viruses that have adapted to humans, changing the way they are
spread. So we need to stop listening to the doomsayers, and we need to do it now. Predictions
of lethal pandemics have — since the swine flu fiasco of 1976, when President Ford vowed to vaccinate “every man, woman and child
in the United States” — always been wrong. Fear-mongering wastes our time and our emotions and
diverts resources from where they should be directed — in the case of Ebola, to the ongoing tragedy in West Africa. Americans have all but forgotten
about Ebola now, because most people realize it isn't coming to a school or a shopping mall near you. But Sierra Leoneans and Liberians go on dying.
Advantage 2
Competitiveness
1NC card
over time by shortening life spans and raising cleanup and health-care costs . For another thing,
GDP was originally designed to measure mid-twentieth-century manufacturing economies, and so the more knowledge-based and
global-ized a country's production is, the more its GDP underestimates its economy's true size.
A new statistic developed by the UN suggests the degree to which GDP inflates China's relative
power. Called "inclusive wealth," this measure represents economists' most systematic effort to
date to calculate a state's wealth. As a UN report explained, it counts a country's stock of assets in three
areas: "(i) manufactured capital (roads, buildings, machines, and equipment), (ii) human capital
(skills, education, health), and (iii) natural capital (sub-soil resources, ecosystems, the
atmosphere)." Added up, the United States' inclusive wealth comes to almost $144 trillion--4.5 times China's $32
trillion.
The true size of China's economy relative to the United States' may lie somewhere in between the numbers provided by GDP and
inclusive wealth, and admittedly, the latter measure has yet to receive the same level of scrutiny as GDP. The problem with GDP,
however, is that it measures a flow (typically, the value of goods and services produced in a year), whereas inclusive wealth measures
a stock. As The Economist put it, "Gauging an economy by its GDP is like judging a company by its quarterly profits, without ever
peeking at its balance-sheet." Because inclusive wealth measures the pool of resources a government can
conceivably draw on to achieve its strategic objectives, it is the more useful metric when
thinking about geopolitical competition . But no matter how one compares the size of the
U.S. and Chinese economies, it is clear that the United States is far more capable of converting
its resources into military might. In the past, rising states had levels of technological prowess
similar to those of leading ones. During the late nineteenth and early twentieth centuries, for example, the United States
didn't lag far behind the United Kingdom in terms of technology, nor did Germany lag far behind the erstwhile Allies during the
interwar years, nor was the Soviet Union backward technologically compared with the United States during the early Cold War. This
meant that when these challengers rose economically, they could soon mount a serious military challenge to the dominant power.
China's relative technological backwardness today, however, means that even if its economy
continues to gain ground, it will not be easy for it to catch up militarily and become a true global
strategic peer, as opposed to a merely a major player in its own neighborhood.
1NR
Midterms
AT: GOP Drilling
It controls their Trump arguments – he’ll work with republicans to do that but
only with a filibuster
Keith Goldberg 16, writer for Law360, 12/21/16, “Obama's 11th-Hour Offshore Drilling Ban
May Be Hard To Sink,” https://www.law360.com/articles/875398/obama-s-11th-hour-
offshore-drilling-ban-may-be-hard-to-sink
President-elect Donald J. Trump would likely face an uphill battle trying to undo outgoing President Barack
Obama's indefinite blockage of oil and gas drilling in large swaths of the Arctic and Atlantic
Oceans, though the resulting legal fight could clarify the currently untested limits of presidential authority under U.S. offshore law,
experts say.
Handing a major victory to environmental groups and many coastal lawmakers, Obama on Tuesday withdrew the entire U.S. portion
of the Arctic's Chukchi Sea and major portions of the Beaufort Sea from future drilling, as well as U.S. portions of the north and mid-
Atlantic Oceans. The withdrawn area covers 115 million acres in the Arctic and 3.8 million acres in the Atlantic.
In a presidential memorandum sent to the U.S. Department of Interior, Obama invoked his executive authority
under Section 12(a) of the O uter C ontinental S helf L ands A ct, a 24-word provision which simply reads, “The
president of the United States may, from time to time, withdraw from disposition any of the unleased lands of
the o uter c ontinental s helf.”
“ The provision , by itself, is unambiguous , so it's hard to see where there's any discretion on
the president's part that can be challenged,” Stroock & Stroock & Lavan LLP special counsel Gail Suchman said.
Though the timing and the size of the withdrawal made waves, Obama's use of his Section 12(a) authority isn't unprecedented.
Presidents dating back to Dwight Eisenhower have used the provision to withdraw OCS areas from
leasing; Obama himself withdrew three areas prior to Tuesday's decision.
There's no other language in the OCSLA that mentions the president's withdrawal authority
outside of Section 12(a). And the law's judicial review provisions are limited mainly to challenges of
regulations and permitting decisions by U.S. offshore regulators.
“There doesn't appear to be any discussion on whether you can challenge the actions of the
president under the provision,” Suchman said.
That may be why oil and gas industry groups appear to be turning to the incoming Trump administration, not the courts, in their
efforts to fight the withdrawal. The American Petroleum Institute, for one, has urged Trump to undo the withdrawal with a
presidential memorandum of his own, noting that President George W. Bush used his Section 12(a) authority to reverse OCS
withdrawals made by his predecessor, Bill Clinton.
“There isn't anything in there that prevents the president from withdrawing the withdrawal,” said Jason Hutt, who heads Bracewell
LLP's environmental and natural resources practice and frequently represents the oil and gas industry. “I suspect there will be a
legal fight over that, but I don't see it as insurmountable from a Trump administration's perspective."
Proponents of Obama's decision have already vowed to fight Trump in court if he attempts to undo it.
Their main argument will likely be that while there isn't any language in the OCSLA that prohibits a
president from reversing a previous withdrawal, there isn't any language that expressly says a
president can , like in similar statutes including the Antiquities Act.
“The proponents of Obama's action are suggesting the [OCSLA] provision is unidirectional,” Hutt said.
The Natural Resources Defense Council and Earthjustice, which back Obama's decision, have also noted that the Clinton
withdrawals reversed by Bush had specific time limits. No indefinite or permanent withdrawal under Section 12(a) has ever been
undone, the groups said in a November report.
But that doesn't mean it isn't possible, and the language of Section 12(a) offers that possibility, according to Hutt.
“The provision states 'from time to time.' It envisions that there's a temporal nature to the withdrawal, not a permanent withdrawal,”
Hutt said. “What would prevent Trump from saying, 'now is the time to withdraw the withdrawal'?"
It's issues like that which courts will likely have to wrestle with, experts say.
“It'sall about statutory construction,” Suchman said. “If there's no ambiguity, the court looks at the
exact words of the statute . There is nowhere in the statute, nothing specific, that says you can
put an area back for leasing.”
Given that no court has yet weighed in on the scope of Section 12(a) of the OCSLA, expect any legal fight to be a drawn-
out process, something supporters of Obama's decision are likely counting on , experts say.
"The very effect of those legal challenges is that there will be a delay in the ability of the Arctic and
Atlantic leasing program to move forward,” Hutt said. “That is the desired effect of the action taken by the Obama
administration.”
Instead of inviting a lengthy court battle, Trump could choose to work with the Republican-
controlled Congress to override the decision, experts say. That includes crafting legislation that
would make the Arctic and Atlantic areas available again for leasing, or amending the OCSLA itself to
expressly allow presidents to rescind previous withdrawals.
“All of those options are on the table,” Hutt said.
But with the Senate filibuster still in place, securing enough votes to advance such
legislation will be a challenge .
Republicans did propose -- Dems currently have the votes to filibuster drilling
legislation, but it’s close
Esther Whieldon 16, alternative energy reporter for Politico Pro, 11/18/16, “Obama cuts Arctic
waters from five-year drilling plan,” http://www.politico.com/story/2016/11/5-year-drilling-
plan-arctic-waters-obama-231615
Lawmakers in this Congress have proposed measures that would expand the program and allow
states to receive some of the revenues from the sales. Sen. Ted Cruz, for example, floated a bill, S. 791, that would reinstate most of
the Bush administration's draft offshore drilling plan for 2010-2015, but it never even received a hearing in
committee.
Earlier this week, the
Senate fell nine votes short of advancing a narrower measure from Sen. Bill
Cassidy (R-La.) that would have expanded revenue sharing associated with offshore energy
production. That suggests that offshore drilling legislation would similarly fall
victim to a Democratic filibuster next year, unless Republicans change the rules.
No ! – Warming
for the human species . The only historical precedent for a crisis of this depth and scale was the Cold War fear that we
were headed toward nuclear holocaust, which would have made much of the planet uninhabitable. But that was (and remains) a
threat; a slim possibility, should geopolitics spiral out of control. The vast majority of nuclear scientists never told us that we were
almost certainly going to put our civilization in peril if we kept going about our daily lives as usual, doing exactly what we were
already going, which is what climate scientists have been telling us for years. ¶ As the Ohio State University climatologist Lonnie G.
Thompson, a world-renowned specialist on glacier melt, explained in 2010, “Climatologists, like other scientists, tend to be
a stolid group. We are not given to theatrical rantings about falling skies. Most of us are far more comfortable in
our laboratories or gathering data in the field than we are giving interviews to journalists or speaking before Congressional
committees. When then are climatologists speaking out about the dangers of global warming? The answer is that virtually all of
us are now convinced that global warming poses a clear and present danger to
civilization .”
because hot, poor countries will probably suffer the largest reduction in growth (Fig. 5c). In our
benchmark estimate, average income in the poorest 40% of countries declines 75% by 2100 relative to a world
without climate change, while the richest 20% experience slight gains, since they are generally cooler. Models with delayed impacts do not project as
dramatic differences because colder countries also suffer large losses (Extended Data Fig. 5). ¶ We use our results to construct an empirical ‘damage
function’ that maps global temperature change to global economic loss by aggregating country-level projections. Damage functions are widely used in
economic models of global warming, but previously relied on theory for structure and rough estimates for calibration11, 12. Using our empirical results,
we project changes to global output in 2100 for different temperature changes (Fig. 5d; see Supplementary Information) and compare these to
previously estimated damage functions12. Commonly used functions are within our estimated uncertainty, but differ in two important respects.¶ First,
our projected global losses are roughly linear—and slightly concave—in temperature, not quadratic or exponential as previously theorized. Approximate
linearity results from the broad distribution of temperature exposure within and across countries, which causes the country-weighted average
derivative of the productivity function in Fig. 2a to change little as countries warm and prevents abrupt transitions in global output even though the
contribution of individual productive units are highly non-linear (see Fig. 1). Global losses are slightly concave in global temperature because the effect
of compounding negative growth declines mechanically over time (Extended Data Fig. 6e and Supplementary Information). These properties are
independent of the growth scenario and response function (Extended Data Fig. 6a). ¶ Second, the slope of the damage function is large even for slight
warming, generating expected costs of climate change 2.5–100 times larger than prior estimates for 2 °C warming, and at least 2.5 times larger for
higher temperatures (Extended Data Fig. 6b–d). Notably, our estimates are based only on temperature effects (or effects for which historical
temperature has been a proxy), and so do not include other potential sources of economic loss associated with climate change, such as tropical
cyclones15 or sea-level rise23, included in previous damage estimates.¶ If societies continue to function as they have in the recent past, climate
change is expected to reshape the global economy by substantially reducing global economic
output and possibly amplifying existing global economic inequalities, relative to a world without climate change.
Adaptations such as unprecedented innovation24 or defensive investments25 might reduce these effects, but social
conflict or disrupted trade—either from political restrictions or correlated losses around the
world—could exacerbate them.
AT: Trump
The U.S. will meet our Paris targets now under business as usual due to market
forces
David Goldwyn 17, Chairman of the Atlantic Council Energy Advisory Board; president of
Goldwyn Global Strategies, LLC, an international energy advisory consultancy; and is of counsel
to Sutherland LLC, January 2017, “The Outlook for Energy Under a Trump Administration:
Major Volatility Ahead,”
http://www.atlanticcouncil.org/images/publications/The_Outlook_for_Energy_Under_Trump
_web_0106.pdf
It is early yet to predict Mr. Trump’s policies and outcomes. They will be shaped by White House and agency personnel;
influenced by Congress, including Republicans who favor trade and some level of
environmental protection ; mitigated by the US judicial system; ameliorated by the long
term investment vision and risk tolerance of US utilities; and may face intense backlash
from citizens, partner nations, and even energy producers . Because of this, it is unlikely that
any of Mr. Trump’s domestic policy measures will have a material impact on the US fuel mix
or global energy markets i
n the next four years. (In contrast, the effect of these policies on US participation in clean energy innovation, on meeting G-7
goals of global decarbonization by 2100, on the Paris agreement’s target of no more than 2 degrees warming above preindustrial
levels, and on investment in climate science could be dramatic).
The economic drivers that led to the retirement of coal fired generation and the rise of renewables
deployment (low cost gas and the dramatic decline in the cost of wind and solar equipment) preceded the Clean Power
Plan ( CPP ). With the Investment Tax Credit (solar) and Production Tax Credit (wind) in place until 2020,
twenty-nine states utilizing renewable portfolio standards, California and the northeast organized into
emissions trading regimes, and the nine states joining a Zero Emission Vehicle Initiative, the U nited
S tates may reach its Paris Agreement target on a business-as-usual basis .14
Atlantic drilling breaks the carbon budget, collapses U.S. climate leadership, and
shatters the Paris framework
NRDC 15 – Natural Resources Defense Council, 10/22/15, “Here’s why President Obama must
block oil drilling in the Atlantic,” http://nrdc.tumblr.com/post/131699963632/heres-why-
president-obama-must-block-oil-drilling
This December, world leaders will convene in Paris to make one of the most important
decisions in human history : how the world is going to finally address the ever-growing climate
crisis.
President Obama has already made huge progress on climate change. The C lean P ower P lan will limit
dangerous carbon pollution from U.S. power plants for the first time ever, and he’s brokered a historic
climate accord with China. But now President Obama risks tarnishing his climate legacy by
leaving vast swaths of the Atlantic coast vulnerable to oil and gas drilling .
Early this year, the Obama administration proposed a five-year plan for drilling off America’s eastern seaboard. Here are five
reasons this is a terrible idea.
1. Disasters will happen.
Just as we’ve seen with oil spills in Alaska and the Gulf of Mexico, wherever
there is oil drilling, disasters will
follow. Drilling in the Atlantic —which has been off-limits—could have grave consequences
not only for marine habitats but also for millions of people living along the East Coast, from Virginia to
Georgia.
2. Oil can’t be un-spilled.
When the inevitable does occur, there’s no way to completely eradicate the mess left behind. Drilling
technologies have advanced over the years, but no new cleanup methods have been developed to keep up
with them.
Of the combined 211 millions of gallons that were spilled in the Exxon Valdez and Deepwater Horizon disasters, only 8 percent of the
oil was cleaned up. Nearly 30 years later, oil from the 1989 Valdez spill still clings to Alaskan beaches. And the Gulf continues to
struggle with the mess from the 2010 Deepwater Horizon incident. Why would we allow this to happen on our Atlantic coast?
3. The economic benefits aren’t worth the risks.
Oil spills are financial disasters as well. The Deepwater Horizon spill cost the Gulf of Mexico’s
commercial fishing industry almost $250 million. And over just three years, the tourism business lost $23
billion. Along the Atlantic coast, the tourism, fishery, and recreational industries employ almost one million people. The expense
of a spill in this area would be on a potentially unprecedented scale.
4. Itcould break the carbon budget .
In order to prevent an unsafe rise in global temperatures , scientists say we need to start
reducing our expansion of fossil fuels and begin converting to renewable energy. By opening
new sources of oil and gas to drilling, President Obama would be negating the positive
steps he’s taken to reduce carbon emissions .
5. We need to walk the walk, not just talk the talk.
As one of the world’s leading polluters, America needs to lead by example . If the
international community sees the U nited S tates as being hypocritical and not pulling our
own weight on climate action, it could hinder a global agreement . President Obama should
continue to take the reins on climate action and declare the Atlantic off-limits to drilling
once and for all.
AT: Dem Turnout
Health care’s the key issue currently motivating Dem voters who sat out of the last
midterm
GSG 17 – Global Strategy Group, public relations and research firm; specializing in research,
strategic communications, digital strategy, grassroots and grasstops organizing, marketing and
branding, April 2017, “Post-Election Research: Persuadable and Drop-off Voters,”
https://www.washingtonpost.com/r/2010-2019/WashingtonPost/2017/05/01/Editorial-
Opinion/Graphics/Post-election_Research_Deck.pdf
GSG and GHY conducted a survey of 803 registered voters nationwide from March 31st to April 5th, 2017,
conducting interviews with 401 midterm drop-off voters (voted for Clinton in 2016 but did not
vote in 2014 ) and 402 presidential drop-off voters (voted for Obama in 2012 but did not vote in
2016).
Understanding Drop-off and Persuadable Voters
A key commonality between turnout voters and Obama-Trump voters is that they are struggling
economically .
• Clinton and Democrats’ economic message did not break through to drop-off or Obama-Trump voters,
even though drop-off voters are decidedly anti-Trump .
• Drop-off voters already believe that Trump’s policies will benefit the wealthy over other groups, but there is more work to be done
to convince Obama-Trump voters that this is the case.
• Ensuring corporations pay their fair share of taxes, modernizing infrastructure, and increasing the development of renewable
energy are seen as economically beneficial by both groups.
Health care is a critical motivator for both Democratic drop-off voters and persuadable
Trump voters.
• Both groups identify cuts to Medicare, Medicaid, and other healthcare programs as policies that would
have a very bad effect on them personally.
• Among drop-off voters, items related to health care (increasing costs for seniors, cutting important programs,
and millions of Americans losing coverage) are frequently rated as very major concerns .
Ideology
Health care’s the biggest issue for 2018---voters are mad precisely because they
don’t think the plan will pass
Rachel Roubein 17, writer for The Hill, 7/17/17, “Poll: Americans see healthcare as most
important issue,” http://thehill.com/policy/healthcare/342336-poll-americans-see-healthcare-
as-most-important-issue
Americans view healthcare as the most important issue facing the country but are doubtful
Congress will pass legislation that will lower premiums and cover more people, according to a
Bloomberg poll released Monday.
With the GOP push to repeal and replace ObamaCare serving as the poll’s backdrop, 35 percent of Americans
surveyed indicated healthcare was their top issue, more than twice as many as any other
option . The other leading issues included unemployment and jobs (13 percent), terrorism (11 percent),
immigration (10 percent) and climate change (also 10 percent).
A majority, 64 percent, disapproves of how President Trump is handling healthcare, compared to 28
percent approving.
Senate Majority Leader Mitch McConnell (R-Ky.) has delayed a vote on healthcare legislation that leadership hoped would be this
week, as Sen. John McCain (R-Ariz.) recovers from an unexpected surgery. Without McCain, Republican leadership didn’t have
enough votes to begin debate on the bill because Sens. Rand Paul (R-Ky.) and Susan Collins (R-Maine) said they would vote against
a motion to proceed.
About 60percent of those surveyed believe it’s unrealistic legislation will pass in the next
several years that both lowers premiums and leads to more people with health coverage.
Conservative lawmakers have consistently pushed for a bill lowering health insurance premiums. A provision from Sen. Ted Cruz (R-
Texas) that was added to the revised version of the GOP plan lets insurers sell plans that don’t comply with ObamaCare’s coverage
regulations as long as they also sell a plan that does.
But the measure has received pushback from healthcare experts and insurers. In a strongly worded letter sent Friday, America’s
Health Insurance Plans — the major insurance trade group — and the Blue Cross Blue Shield Association warned that it is “simply
unworkable in any form and would undermine protections for those with pre-existing medical conditions, increase premiums and
lead to widespread terminations of coverage for people currently enrolled in the individual market.”
Bloomberg surveyed approximately 1,000 people over the phone from July 8 to July 12. The poll has a margin
of error of plus or minus 3.1 percent
AT: Public Option Link Turn
The GOP’s committing political suicide but fully enacting the public option saves
them
Chris Weigant 17, HuffPo political commentator, 6/28/17, “Democrats Should Bring Back The
Public Option,” http://www.huffingtonpost.com/entry/democrats-should-bring-back-the-
public-option_us_595449bee4b0f078efd98746
Up until now, congressional Democrats have been smart to merely stand on the sidelines
and watch Republicans flail on their “repeal and replace Obamacare” efforts. This follows the sound
political theory of: “When your opponent is digging his own grave, don’t interrupt him .” But at
some point in the near future, Democrats are going to have to offer up their own better ideas for what to do next on health care.
There are already many pushing for single-payer or (as Bernie Sanders likes to call it) “Medicare for all.” This, however, is quite
likely a bridge too far ― even within the Democratic Party. Instead of such a radical change, Democrats would do much better to
rally around a more transitional idea that was jettisoned during the drafting of the Obamacare law: the public option.
The biggest political selling point about this is that a public option would be just that ― optional . Call
it “Medicare for all, if that’s what you want,” perhaps. Or rebrand it entirely as something like “Medichoice,” to take its place
alongside Medicare and Medicaid. By doing so, Democrats could avoid a tsunami of Republican negative ads which screamed:
“Washington bureaucrats are going to force you into their plan!” But unlike universal single-payer, Medichoice might actually
have a prayer of garnering Republican votes and passing this Congress .
If the Senate Republican bill fails (which is by no means assured, even at this point), then Mitch McConnell has
already expressed an interest in working with Democrats to fix some of the worst problems with
Obamacare, because McConnell knows that if the system collapses at this point, Republicans
will be held accountable for letting it happen. Fixing Obamacare mostly means addressing the problems with the
individual market exchanges (a relatively small part of Obamacare, but also the most publicly visible). This could probably be quickly
accomplished with a good-faith effort by both parties, and it may indeed be all that happens to Obamacare for the next two years.
But Democrats should at least make the attempt at something more ambitious in these negotiations. Even
if they fail , they will at least have created a campaign platform for the 2018 midterm
elections ― a positive message of change instead of just “we’re not as bad
replacement (46 percent) ranks as a top issue just behind allegations of White House ties to
Russia and Trump’s decision to withdraw the United States from the Paris climate change pact.
Both parties see an advantage in the Obamacare repeal effort. For Republicans, it would be the fulfillment of a
longtime pledge to scrap an onerous health care law. For
Democrats , who are energized by the health
care issue after suffering through years of Obamacare attacks, it's their chance to tie Republicans to an even
more unpopular plan.
There’s a clear lack of enthusiasm on the Republican side for their party's Obamacare
replacement — which is being revised and massaged in the tougher-than-expected effort to get it through the Senate. Just
20 percent of Republicans said they would support a plan providing financial assistance for
health coverage to a lot fewer people, while about 42 percent would accept a plan subsidizing “somewhat fewer people”
that saves taxpayer money. And by a slight margin, Republicans oppose their party’s plans to roll back enrollment in Medicaid, a
program covering nearly 75 million low-income Americans.
Only about one in three Republicans favor allowing insurers to charge more to people with pre-existing medical conditions, a
practice that was banned by Obamacare and has complicated the repeal effort. Conservative Republicans have sought to ease that
protection to bring down health insurance costs for healthier people, but they haven’t been able to craft a policy that would prevent
costs from skyrocketing for sick people.
“From the core issue that they’re trying to push, [Republican lawmakers] have lost this battle,” Blendon said.
“ Their own constituency isn’t with them in this current debate .”
2NR
Midterms
UQ
Senate Democrats in red states will win reelection now by mobilizing anger over
GOP health care proposals
Alex Roarty 17, McClatchy writer, and Katie Glueck, 7/18/17, “Democrats giddy over GOP’s
health care flop,” http://www.charlotteobserver.com/news/politics-
government/article162255743.html
For the first time since November, Democrats are feeling good.
The GOP’s quest to repeal and replace Obamacare has collapsed. Its unpopular president is under investigation
by a special counsel. And the rest of the Republican Party’s legislative agenda is, at best, on shaky ground.
Now, Democrats are brimming with a new optimism about next year’s midterm elections. They
think the GOP’s stymied policy plan gives them a chance to make the case that Republicans — in
complete control of Washington — are incompetent , a potentially significant new line of attack for
a party in desperate need of winning over conservative voters in red states and battleground
House districts.
“Democrats are beginning to believe that we can be good at politics again,” said Adam Jentleson, a former top aide to onetime Senate
Majority Leader Harry Reid. “There’s still a heavy, high degree of trauma that still has not worn off from election night, but we’re
finding our footing step by step.”
Even if Congress tries to put health care behind it , top Democratic operatives say it will remain
a major issue for voters , especially those who voted for House Republicans in special elections earlier this year.
And even if the issue fades, they’re hopeful the loss will be offset by an angry conservative base that wonders why it should even turn
out for the next election.
Not even GOP strategists are sure the Democrats are wrong about that last point.
“Right now, it's devastating,” said one conservative strategist working on the midterms. If lawmakers don't find another way to
repeal the law, “it will be absolutely devastating. It's so myopic of Republicans in terms of how they're handling this, because where
they’re going to end up is back in the minority, like we were in ‘09.”
The Senate's health plan insures more Americans and reduces the deficit more than the House's plan did, but also cuts Medicaid
more drastically than any plan to date, according to the a report by the nonpartisan Congressional Budget Office.
The conservative base, this strategist said, doesn't understand how Republicans could vote multiple times to repeal the law under
President Barack Obama, but fail to reach the same consensus when the GOP actually has power to act.
"Why were they able to get it done under Obama, and they're not getting anything done now?" the strategist said. “The challenge
Republicans are going to have in turning out conservatives is like nothing we've seen since ‘06.”
Democrats and Republicans alike think the GOP still has time to resuscitate its agenda, maybe as early as later this summer when
the party has said it will take up tax reform as its next major initiative. Democrats also say they think Republicans will try again to
repeal Obamacare, whether in the coming weeks or even into next year.
But if they don’t, Republicans run the risk of going before voters next year with nothing to show for
their time in office .
And Democrats say that could change the nature of their attacks, switching from one focused on
the details of the GOP’s agenda to the party’s broader failure to govern effectively .
“This is what happens when you have a Republican Congress that is not used to governing,” said John Lapp, a Democratic strategist.
“Turns out health care is really hard, really difficult."
Lapp knows how potent a competence argument can be: He was the executive director of the Democratic Congressional Campaign
Committee in 2006, the last time House Democrats retook a majority.
That year, the party capitalized on the aftermath of Hurricane Katrina and the then-unpopular Iraq War to depict Republicans as
incompetent, an argument that — in part — helped them win a net of 31 seats in the House. (Democrats need to win 24 seats next
year to win a majority, though the map of battleground seats is more difficult this time around.)
Lapp and other Democrats say they don’t think a failed legislative agenda rises to the level of either of those events. But they added
that acompetence argument can reach red-state voters in red states and right-leaning
House districts, the kind Democrats need to win over in a year when they’re defending 10