This Week in Health Care
Monday marked the fifth anniversary of the signing into law of the Affordable Care and Patient Protection Act, which we usually abbreviate ACA and which Republicans are probably sorry they tagged with President Obama's name. If there is a Republican prediction about the ACA that came true, we don't know what it is. What we do know is that the ACA has been spectacularly successful. Among people enrolled in it, it's getting rave reviews, with 71% saying their coverage is "good or excellent," swamping the 19% who say it's fair and the 9% who say it's poor. Those averages are on par with the non-ACA part of the health insurance market, which by itself means the ACA outperforms Republican predictions. Politico adds:
"However, those newly insured through the exchanges are more satisfied with the cost of health care — with 75 percent saying so — versus 61 percent of all insured respondents who said they were satisfied with the cost of health care.
"A majority — 68 percent — who received insurance through the exchanges said they plan to renew their policy, while an additional 7 percent said they will look for a new policy, but through the exchanges."
Americans in general are still--thanks to multi-million dollar efforts to obfuscate the truth and a right-wing media only too happen to play along--more ambivalent. Vox.com points out, "If there's any area of consensus, it's in misperceptions of the law: 82 percent of Americans either say the price tag has gone up, or aren't sure (the law's price has actually decreased as compared with initial estimates), and only 13 percent know the law met its first-year enrollment goals." In general, Republicans are more confused about the law than Democrats (thanks to more faith in those right-wing media and the lies told by politicians like Sen. Ted Cruz (R/TX). "Republicans, for example, are 25 percent more likely to believe that undocumented workers can get financial help under Obamacare and 15 percent more likely to believe end-of-life panels exist."
The ACA is big government in action, like Social Security and Medicare. And big government in action has already drastically reduced the number of uninsured Americans while creating jobs, spurring entrepreneurship, and reducing the deficit.
Government can do big things. And those big things can help regular Americans have better lives. The success of Social Security, Medicare, and now the ACA are absolute proof of that. (Interestingly, conservatives oppose all three, on the grounds that...well, what grounds? That they're socialist? That they take money from the rich and use it to help the poor? It's hard to see a legitimate objection. The real issue is that they work, and they help those who need it most. That should be considered a positive by anyone who cares about their fellow Americans.)
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Congress is busy this week trying to pass a budget that both chambers can agree on. It might help if members were given calculators. House Rules Committee chair Rep. Pete Sessions (R/TX) could use one: “If you just do simple multiplication, 12 million [insured individuals] into $108 billion, we are talking literally every single [Obamacare] recipient would be costing this government more than $5 million per person for their insurance. It’s staggering….$108 billion for 12 million people is immoral. It’s unconscionable. ”
One hopes he's suitably embarrassed for speaking such idiocy on the floor of the United States House of Representatives (and we imagine he'll work on getting it scrubbed from the Congressional Record). The real number--if you do real multiplication--is in the neighborhood of $4500 per newly insured person, not $5 million. He was only off by a little.
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Rep. Cathy McMorris Rogers (R/WA) decided to celebrate the ACA's 5th anniversary by trawling for horror stories on her Facebook page. That's not what she got.
This Week in Veterans' Health
Last year, the New York Times made waves by reporting that US soldiers exposed to old, often discarded chemical weapons in Iraq between 2003 and 2008 had been denied appropriate medical care, denied Purple Hearts, and told to keep quiet about it. (Some on the right, still seeking justification for an unnecessary and wrongheaded war, claimed this was evidence that Iraq did have weapons of mass destruction, after all. Reading the NYT's report in full before reacting would have let them avoid embarrassment.)
Secretary of Defense Chuck Hagel appointed Under Secretary of the Army Brad R. Carson to "lead a Pentagon working group to identify service members who had been exposed to chemical weapons and to offer them medical screening and other support." This week, according to a new NYT piece, Carson, "apologized for the military’s treatment of American service members exposed to chemical weapons in Iraq, and he announced new steps to provide medical support to those with lingering health effects and to recognize veterans who had been denied awards."
The article's writer, ex-Marine and author C.J. Chivers, adds more detail on his own blog:
"But something else happened that was unusual for senior military leadership, which is often insulated from reality by staff and by the unrelenting information-polishing that goes with being atop a rigid chain of command. Mr. Carson said that any veterans who believed they had been exposed to chemical warfare agents, and were meeting obstacles to getting answers or care, should contact him directly. He said he will then personally become involved. No documentation in your medical record? Stalled Purple Heart application? Not on the access roster in the lobby at Walter Reed when arriving for a medical screening? Mr. Carson said he wants to know, and he will work on it himself. He was appointed late last year by Chuck Hagel, then the defense secretary, to lead a working group of all the services to address the many issues related to the exposed veterans, whose cases had been kept secret for years. And he said he can act only on what he knows.
"So, then, if you are a veteran who may have been exposed to sulfur mustard, sarin or chlorine, take a moment and cut-and-paste this email address: brad.r.carson.civ@mail.mil. It leads directly to the under secretary’s in-box, which from my experience I can say he checks himself and is not filtered by staff."
We applaud Hagel and Carson for responding quickly, and Carson for making himself personally available to help vets who need it.
This Week in Economic Predictions
It's not just in the area of health care that conservative predictions of disaster have failed to come true. In both the 2008 and 2012 campaigns--and in between--the right has made all sorts of predictions about the president's more progressive economic policies. They've all been wrong, unless somewhere a conservative came out and said, "Obama's misguided ideas are going to lead to a stretch of private-sector job growth unprecedented in the history of the country, record stock market gains, record corporate profits, the revival of the American auto industry, and a vastly decreased deficit." If one did, we missed it.
In fact--and this is a fact, not a theory--of the two competing economic approaches offered up by the predominant sociopolitical factions of our time, one works and one doesn't. We've tried both recently enough to compare the results. In a recent speech, President Obama described what happened:
"Because their theory does not change. It really doesn’t. It’s a theory that says, if we do little more than just cut taxes for those at the very top, if we strip out regulations and let special interests write their own rules, prosperity trickles down to the rest of us. And I take the opposite view. And I take it not for ideological reasons, but for historic reasons, because of the evidence.
"We know from the facts that are there for all to see that America does better, our economy does better, everybody does better when the middle class does better and we’ve got more ladders for people to get into the middle class if they're willing to work hard. We do better when everyone grows together -- top, middle, bottom. We do better when everyone has a chance not only to benefit from America’s success, but also to contribute to America’s success. And we know from more recent history that when we stray from that ideal it doesn't turn out well. We’ve now got evidence there is a better way, there is a better approach. And I’m calling it middle-class economics.
"For the first eight years of this century, before I came into office, we tried trickle-down economics. We slashed taxes for folks at the top, stripped out regulations, didn't make investments in the things we know we need to grow. At the end of those eight years, we had soaring deficits, record job losses, an economy in crippling recession.
"In the years since then we’ve tried middle-class economics. Today we’ve got dramatically lower deficits, a record streak of job creation, an economy that's steadily growing.
"So when we, the American people, when the public evaluates who’s got the better argument here, we’ve got to look at the facts. It’s not abstractions. There may have been a time when you could just say, well, those two theories are equally valid. They're differences of opinion. They could have been abstract economic arguments in a book somewhere. But not anymore. Reality has rendered its judgment: Trickle-down economics does not work. And middle-class economic does."
The economic ideas that are misguided are the conservative ones. Their only proven effect is to increase inequality. The rich get richer, but at the expense of the rest of us. If that's the goal, which we're becoming convinced it must be, then those ideas work.
We think that goal is the wrong one for America. We saw what vast inequality did in 1929. We saw what growing inequality did in 2008. And the truth is--a truth even conservatives should learn to recognize--even the rich do better when everybody does better. Those record stock market gains and corporate profits? Those benefit the rich more than the rest of us. The rich were hurt in 2008, but they've made up their losses and then some; the poor are still catching up.
Wages on the lower end of the spectrum are starting to rise, which is a sign that we've reached a state close to full employment, and businesses need to pay more to keep and attract workers. As they do, more Americans will be spending more money, which will benefit local communities and big corporations alike.
It's also worth noting that conservative "conventional wisdom" about big government's role in entrepreneurship is often wrong. As The Atlantic reports, "The evidence simply does not support the idea of a consistent tradeoff between bigger government and a more entrepreneurial economy. At least in some cases, the reverse is actually true. When governments provide citizens with economic security, they embolden them to take more risks. Properly deployed, a robust social safety net encourages more Americans to attempt the high-wire act of entrepreneurship."
The climate change debate is over, and reality won. Climate change is here, and anyone who denies it isn't stating a difference of opinion, but is just wrong. The same applies here: the debate is over. The outdated theory of tax cuts, spending cuts, and less regulation is bad for America, and doesn't even confer the greatest benefits on those few who prosper under it. Economic policy targeted toward the middle class grows the economy for all. Anyone who denies that is simply wrong.
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What it comes down to is this: one party wants government to serve Americans--to manage the economy in such a way that it grows instead of shrinks and meets the needs of the most possible people; to create large-scale programs like the ACA that address vital and widespread human needs; and to help in the many small-scale ways that government does, from educating our young to fixing potholes and plowing snow. The other party doesn't believe in government and wants primarily to demonstrate that it doesn't work, while also doing its best to distribute the nation's wealth to the already wealthy. Once, moderate Republicans were willing to run for office because they truly believed government could help, but that a more conservative approach was called for. Now moderate Republicans are essentially extinct. Extreme conservatism rules the party, and extreme conservatives have no use for functional government.
Are we saying that one party has the interests of Americans at heart, and the other doesn't? Yes. This doesn't apply to every elected official claiming that party, of course. Humans are human, and fallible, and both sides have their share of greedy, unprincipled leeches. But of the prevailing philosophies underlying the parties, or the broader swath of liberal/conservative thinking that they tend to represent, one is more interested in having a positive impact on the lives of Americans than the other. It's not hard to see which is which.
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Here's a conservative economist arguing that tax breaks for the rich should be ended and the money used to help lift the poor out of poverty. We agree. He loses points near the end of his piece, though, when he says we should move from an income tax to a consumption tax, thereby undercutting his own argument, because a consumption tax is much harder on the poor than an income-based one. Still, it's a start, and we'd like to see more conservative opinion-makers looking at real solutions to real issues from their own vantage point.
This Week in School
Here in the US, we spend more educating our kids than in any other country. But many countries get better results than we do. Why? The answers are multiple, but a lot of it comes down to this: Too many of our kids live in poverty. Too many live in neighborhoods segregated by race. We could spend less on education if we spent more on social programs that would lift more children out of poverty (the other benefits, including health, long-term career prospects, lowering crime rates, more stable marriages, and so on, would also be enormous).
Also, what we do spend isn't necessarily spent well. Education money is mostly controlled by states and localities, and those entities often make bad spending decisions (which is why block grants, so popular with conservatives as ways to disburse federal money, are so often terrible ideas). Spending more money schooling well-off kids doesn't really improve academic performance much, but spending more on poor kids does.
Here in TWiA's home state of Arizona, the first budget signed by new governor Doug Ducey (R) slashes spending on education. His predecessor and her legislature were inordinately fond--as he and the current legislature are--of tax cuts for the wealthy and for corporations, and as a result he's facing a huge budget deficit. Instead of taking a sensible approach that balances revenue increases and spending cuts, the conservatives running state government want to make it up largely by undercutting education, and therefore the state's future prosperity. At the same time, the budget cuts aid to poor families, making school spending that much more critical.
Their budget fits the conservative criteria: don't raise taxes on the rich even as you make it harder on the poor to get by, and privatize where you can (the budget throws $100 million at the private prison industry, for example), because taking money from the taxpayers and funneling it directly to for-profit corporations is always fiscally sound.
The ideological blinders of the right wing create short-sightedness that never fails to boggle the mind.
Side Note: For a more detailed discussion of segregation and opportunity, go here.
This Week in Neverending War
Depending upon whom you ask, President Obama caved to the neocons, or to the military brass, or to Afghanistan's new president, or to reality, when he froze the number of troops remaining in Afghanistan at 9,800 instead of going ahead with the planned drawdown. He took a lot of heat for sticking to the schedule President Bush had negotiated for withdrawal from Iraq, and the political leadership there wanted our troops out. This time, the Afghans want us to stick around for a while. The Pakistanis seem okay with the idea, as long as they know when we'll be out--and the Pakistanis are key to any negotiations with the Taliban. (A big reason for staying in Afghanistan is that we still have an active drone warfare program across the border in Pakistan, which would be harder to manage from elsewhere.)
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Speaking of war and neocons, we often argue that the people who were so disastrously wrong about Iraq should be roundly ignored when it comes to Iran. Here's a good illustration of why: John Bolton, the guy President George W. Bush appointed as Ambassador to the United Nations (an interesting choice, as Bolton's hatred of the UN was well-documented), wants another war, and he wants it now.
Bolton writes: "Rendering inoperable the Natanz and Fordow uranium-enrichment installations and the Arak heavy-water production facility and reactor would be priorities. So, too, would be the little-noticed but critical uranium-conversion facility at Isfahan. An attack need not destroy all of Iran's nuclear infrastructure, but by breaking key links in the nuclear-fuel cycle, it could set back its program by three to five years."
Great deal, Bolton. We turn Iran into a combination of Chernobyl and Fukushima and make its populace hate us for generations to come, in order to buy three years, because we oppose a deal that could put off its program for at least 10-20 years.
It should be noted that Bolton intentionally dodged Vietnam, later writing, "I confess I had no desire to die in a Southeast Asian rice paddy. I considered the war in Vietnam already lost," has no sons, and his only daughter--if there were a draft again, and women were eligible--is beyond draft age. Bolton has always loved the idea of sending other people's kids to war, but has never had to face it in his own life.
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Both houses of Congress have passed their respective budgets in time for them to take their spring vacation (though the two budgets still have to be reconciled in committee). They built in a...let's say, creative...means of raising defense spending. To get around the limits set by the sequester that they demanded, congressional Republicans tossed an imaginary $94 billion into an Overseas Contingency Operations (OCO) fund. This is how the Bush administration paid for its wars--instead of paying them through the regular budget process, so there would be some accountability, they created a "slush fund" they could raid at will. That way the American people never knew exactly how much we were spending, and none of it was counterbalanced by additional revenue or additional cuts. Basically, the money for two of the longest wars in our history were put on the national credit card, swelling the deficit and the debt (until Obama took office, at which time he insisted that was spending be accounted for).
Defense Secretary Ashton Carter isn't happy about it. "Current proposals to shoehorn [the Pentagon's] base budget funds into our contingency accounts would fail to solve the problem, while also undermining basic principles of accountability and responsible, long-term planning." He also doesn't like cuts for the State, Treasury, or Homeland Security departments, since all contribute to the overall national security effort.
The Pentagon can't simply react to what's going on in the moment. It needs to be able to plan, to prepare for contingencies. That requires that it know, well in advance, how much money will be available. Which means hewing to the ordinary budget process, not hiding money in the OCO, which is only funded year by year.
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In case you weren't confused enough by all that's going on in the Middle East, here's an article explaining why the US is fighting on the same side as Iran in Iraq but on the opposite side in Yemen.
This Week in 2016
Reaction is still rolling in on Sen. Ted Cruz's official entry into the 2016 presidential race (see our earlier roundup here). The Economist calls Cruz "dangerous," saying, "Mr. Cruz will not win the presidency, since he repels the swing voters who decide things. But he could still do harm. If he turns the Republican primary into a conservative purity contest, in which anyone softer on Mr. Obama is labeled a sell-out, other contenders may be dragged so far to the right that they become unelectable in the general election. That would be bad for the Republican Party and for America. Voters in 2016 deserve a choice between two grown-up candidates."
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And speaking of the despicable John Bolton, he's one of the top three foreign policy "experts" Cruz trusts. The others are the relatively mainstream neocon Elliot Abrams and utterly insane former CIA director James Woolsey, who started arguing on 9/12/01 that Iraq had been responsible for 9/11, and hasn't stopped since. "Dangerous," indeed.
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In 2008, the VP nominee, a former half-term governor whose name won't be mentioned in this space until she apologizes for equating the national (that her party is largely responsible for) with the horrors of slavery, tried to hit candidate Barack Obama with the charge of "palling around with terrorists." At press time, Cruz was slated to speak later that day (along with some other unsavory characters) to an organization sympathetic to white supremacists. Would Cruz denounce white supremacism? We'll report next week if he does.
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Sen. Marco Rubio (R/FL) seems intent on proving beyond any reasonable doubt that he has no idea what's going on in the world of foreign policy.
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Remember when Sen. Rand Paul (R/KY) was praised because he was a "man of principle?" We suppose, if you looked at him through broken, mud-spattered glasses after ingesting the right psychotropic drugs. Now, though he has demonstrated how authentic his principles are, by reversing most of them in hopes of beating Tailgunner Ted for the far-right-fringe vote in the Republican primaries.
Paul on same-sex marriage in October 2014: "I believe in old-fashioned traditional marriage but I don't really think the government needs to be too involved in this and I think the Republican Party can have people on both sides of the issue."
In early March 2015: "“I’m for traditional marriage. I think marriage is between a man and a woman. Ultimately, we could have fixed this a long time ago if we just allowed contracts between adults. We didn’t have to call it marriage, which offends myself and a lot of people.”
In late March 2015: “Don’t always look to Washington to solve anything. In fact, the moral crisis we have in our country, there is a role for us trying to figure out things like marriage, there’s also a moral crisis that allows people to think that there would be some sort of other marriage. We need a revival in the country. We need another Great Awakening with tent revivals of thousands of people saying, ‘reform or see what’s going to happen if we don’t reform.’”
Paul on military spending in October 2010: "I think the issues are more important than the party. I think often we get too distracted by getting too partisan. I don’t see people who are Democrats as always being wrong or Republicans as always being wrong. I think there has to be a compromise on the budget. In order to address the deficit the only compromise that I think we can have is you have to look at the whole budget. We’ve always excluded the military and said we’re not gonna look at the military. Or the Democrats exclude the social and domestic welfare spending. Everything has to be on the table. We have to do this intelligently."
In March 2015, Paul has a different idea. Time reports:
"In an olive branch to defense hawks hell-bent on curtailing his White House ambitions, the libertarian Senator introduced a budget amendment late Wednesday calling for a nearly $190 billion infusion to the defense budget over the next two years—a roughly 16 percent increase
"The move completes a stunning reversal for Paul, who in May 2011, after just five months in office, released his own budget that would have eliminated four agencies—Commerce, Housing and Urban Development, Energy and Education—while slashing the Pentagon, a sacred cow for many Republicans. Under Paul’s original proposal, defense spending would have dropped from $553 billion in the 2011 fiscal year to $542 billion in 2016. War funding would have plummeted from $159 billion to zero. He called it the “draw-down and restructuring of the Department of Defense.” But under Paul’s new plan, the Pentagon will see its budget authority swell by $76.5 billion to $696,776,000,000 in fiscal year 2016."
Paul on ISIS, in June 2014: “Should not the Shiites, the Maliki government, should they not stand up?” And, if they’re ripping their uniforms off and fleeing, if they don’t think Mosul is worth saving, how am I going to convince my son or your son to die for Mosul? Yes, we should prevent them from exporting terror; but, I’m not so sure where the clear-cut, American interest is.”
In August 2014: "“I have mixed feelings about it. I’m not saying I’m completely opposed to helping with arms or maybe even bombing, but I am concerned that ISIS is big and powerful because we protected them in Syria for a year. Do you know who also hates ISIS and who is bombing them? Assad, the Syrian government. So a year ago, the same people who want to bomb ISIS wanted to bomb Syria last year. Syria and ISIS are on opposite sides of the war. We’re now bombing both sides of one war that has spread into another country.”
In September 2014: "The military means to achieve these goals include airstrikes against ISIS targets in Iraq and Syria. Such airstrikes are the best way to suppress ISIS’s operational strength and allow allies such as the Kurds to regain a military advantage.”
And on, and on, and on, and on. Every "shift" in Paul's positions brings him more in line with the central current of Republican voters, and away from the days when he used to praise himself as being his own man. And with each change, he denies that he's changed.
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GQ has a new piece out on "Dr." Ben Carson, relating just how ignorant Carson in with regard to foreign policy, and just about everyone else. The article reminds us how Carson became popular with the far right:
"Since his inadvertent entry into politics two years ago, Carson has defined himself chiefly as a rhetorical bomb-thrower. He's invoked bestiality and pedophilia while arguing against gay marriage, and earlier this month, during an appearance on CNN, he argued that homosexuality is a choice, 'because a lot of people who go into prison go into prison straight, and when they come out, they're gay.' (After an uproar, Carson issued an apology and declared he would no longer talk about gay rights.) With equally provocative flair, he's railed against the forces of government, declaring that Obamacare is 'the worst thing that has happened in this nation since slavery' and, in fact, 'is slavery, in a way.' Similarly outrageous was his contention that 'we live in a Gestapo age' and that America today is 'very much like Nazi Germany.'"
It's funny how the proper sort of ignorance, paired with extreme ideology, goes so far in the conservative world. But not "funny ha-ha."
This Week in Congress
Also in 2016--but not in presidential politics--there will be a major shakeup in Democratic Senate leadership. Minority leader Harry Reid (D/NV) has announced that he won't seek reelection next year, but will retire after a 30-year Senate career.
Former boxer Reid has distinguished himself over the years as a polite, principled, soft-spoken man with a spine of steel and a deep understanding of Senate rules and processes, and a courageous fighter for important policies. Sure, there have been times progressives felt he didn't fight hard enough, and conservatives thought he fought too hard. That's what it means to be minority leader (or majority leader, which he was until early this year). You have to walk a fine line, balancing the interests of both parties, to get legislation passed.
Steve Benen at Maddowblog pointed to a great Harry Reid story from a New Yorker article a few years ago, about Reid's time as chair of the Nevada Gaming Commission:
"In July of 1978, a man named Jack Gordon, who was later married to LaToya Jackson, offered Reid twelve thousand dollars to approve two new, carnival-like gaming devices for casino use. Reid reported the attempted bribe to the F.B.I. and arranged a meeting with Gordon in his office. By agreement, F.B.I. agents burst in to arrest Gordon at the point where Reid asked, 'Is this the money?' Although he was taking part in a sting, Reid was unable to control his temper; the videotape shows him getting up from his chair and saying, 'You son of a bitch, you tried to bribe me!' and attempting to choke Gordon, before startled agents pulled him off. 'I was so angry with him for thinking he could bribe me,' Reid said, explaining his theatrical outburst. Gordon was convicted in federal court in 1979 and sentenced to six months in prison."
Some people think there should be term limits for members of Congress (some think there should be for any elected office). We've always disagreed, and someone like Reid is exactly why. He's hardly a traditional Democrat--he's a devout Mormon whom the New Yorker piece describes as "pro-gun and anti-abortion"--but he has continued to win his seat, term after term, because he is an effective representative of his state and an effective legislator for his country. It takes a long time to develop a thorough understanding of how Congress works, and the institutional memory of someone like Reid is invaluable to keeping it working. Term limits for elected officials ought to be decided by their voters--if they think someone has served too long, they can vote for another candidate.
Reid still has a long time to serve in his current term, but we wish him well on his last months in office and thereafter.
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Speaker of the House John Boehner has had a rocky path during his years at the helm. The House, under him, has hardly passed any legislation of consequence, mostly because whenever anything was the least bit controversial, Boehner buckled to pressure from his farthest right members, thereby ensuring that Democrats wouldn't support whatever came up for a vote.
This week, he did get a major piece of legislation--a long-needed Medicare "doc fix" passed. And he did it in an unusual way, for him: before he brought it to the floor, he reached out to Democratic leader Nancy Pelosi (R/CA) and crafted a deal. Yes, Boehner actually made an effort at bipartisanship, and it paid off. The bill goes to the Senate, and the hope is that bipartisan support there will push it through. President Obama has promised to sign it.
The other hope is that Boehner will remember that this worked--that having the leadership of both parties on board, that writing legislation that compromises the desires of the most extreme members but works for the big bloc closer to the middle, is the route to legislative achievement. The way he was going, he was destined for a spot in the history books as one of the worst, most ineffective Speakers ever. If he learned his lesson here, he has a chance to change that in the years to come.
This Week in Legalized Discrimination
Oh, Indiana. What can we do with you?
This Week in Duck Dynasty
Phil Robertson is a disgusting pig. Just saying. We hear Clint Eastwood is already looking forward to Robertson's prime-time speech at the 2016 Republican convention.
This Week in Bears
Two adorable sun bear cubs at the National Zoo in Washington D.C. were named through input from the general public. Meet Mayni and Muniri.