Affordable Care Act Quotes

It is hard to talk about a middle ground for something that is a fundamental right.

Proximity to power has an unsurprising ability to mutate a politician's spinal cord into bright yellow jelly.

Health is a human necessity; health is a human right

Though nothing Donald did surprised me, the speed and volume with which he started inflicting his worst impulses on the country—from lying about the crowd size at the inauguration and whining about how poorly he was treated to rolling back environmental protections, targeting the Affordable Care Act in order to take affordable health care away from millions of people, and enacting his racist Muslim ban—overwhelmed me.

The Affordable Health Care for Americans Act, passed by the House of Representatives on November 7, 2009, was 1,990 pages long. You could stand on it to paint the ceiling. The entire U.S. Constitution can be printed on eight pages. That's eight pages to run a whole country for 221 years versus four reams of government pig latin if you slam your thumb in a car door.

The thing they're trying to stop is 30-million people getting health insurance. That's the substance.

Calls from the antis to overturn Roe, to repeal the Affordable Care Act, and to defund Planned Parenthood are growing ever louder. Each one of these backward moves will not only restrict women’s access to safe, affordable abortion care, but will diminish women’s access to good health care in general, putting their lives and the lives of their children at risk.

Dissent from liberal orthodoxy is cast as racism, misogyny, bigotry, phobia, and, as we’ve seen, even violence. If you criticize the lack of due process for male college students accused of rape, you are a “rape apologist.” End of conversation. After all, who wants to listen to a rape lover? People who are anti–abortion rights don’t care about the unborn; they are misogynists who want to control women. Those who oppose same-sex marriage don’t have rational, traditional views about marriage that deserve respect or debate; they are bigots and homophobes. When conservatives opposed the Affordable Care Act’s “contraception mandate” it wasn’t due to a differing philosophy about the role of government. No, they were waging a “War on Women.

This is the opposite of the free market.

Affordable Care Act" roll out isn't Obama's fault. It's what happens when you elect a President without any real-world business experience.

Thank God for the American Affordable Care Act. It was passed in a limited form right before the Rising began, despite the opposition of one hell of a lot of people who thought that providing health care to their fellow citizens was somehow, I don’t know, inappropriate. Honestly, it was a miracle the thing passed at all, considering that we’re talking about the era of vaccine denial and homeopathic cures for everything from autism to erectile dysfunction. If the Rising hadn’t come along when it did, most of the United States would probably have died of whooping cough before 2020, leaving the middle part of the continent ripe for Canadian invasion. But

Tolerance is a virtue, but like all virtues, when exaggerated, it transforms itself into a vice. We need to be careful of the ‘tolerance trap’ so that we are not swallowed up in it. The permissiveness afforded by the weakening of the laws of the land to tolerate legalized acts of immorality does not reduce the serious spiritual consequence that is the result of the violation of God’s law of chastity.

It's WW2 and there are wage controls in place. Instead of health care, companies decide to offer employees shoes. Having absorbed those costs, they later lobby for every company to be required to offer shoes. That calls forth regulation and monopolization of the shoe industry. Shoes are heavily subsidized. Every shoe must be approved. Producers must be domestic. They must adhere to a certain quality. They can't discriminate based on foot size or individual need. Prices rise, and some people lack shoes, so the Affordable Shoe Act forces everyone to buy into an official shoe plan or pay a fee. Here we have a perfect plan for making shoes egregiously expensive. The entire country would be consumed with the fear of being shoeless if they lose their job. The left wing calls for a single shoe provider to offer universal shoes and the right wing meekly suggests that shoe makers be permitted to sell across state lines. Meanwhile, libertarians suggest that we just forget the whole thing and let the market make and deliver shoes of every quality to anyone from anyone. Everyone screams that this is an insane and dangerous idea.

Let's run the experiment.

He sold Syria way better than he sold this.

Tolerance is a virtue, but like all virtues, when exaggerated, it transforms itself into a vice. We need to be careful of the “tolerance trap” so that we are not swallowed up in it. The permissiveness afforded by the weakening of the laws of the land to tolerate legalized acts of immorality does not reduce the serious spiritual consequence that is the result of the violation of God’s law of chastity.

That springtime does not last forever and that the fine seasons should have their harvest gathered and stored against harsher times. That you should choose your battles wisely. You cannot fight everything and win. Sometimes the price of losing is beyond what you can afford to pay, but that applies to winning as well.” She narrowed her focus on the girls. “Be very careful and think before you act. Make friends with those who you know will stay true to you and reward them fittingly.

Americans are beginning to wake up to the travesty that a federal government that controls our medical care has become. Everyone is finally realizing that what’s happening in veterans’ hospitals now will happen across our entire medical system under the Affordable Care Act. Many are now saying that what we see going on in our VA medical system—double sets of books, people dying because of delayed or unavailable treatment—is likely to be what’s coming to the American medical industry.

The winds of secession are blowing... Over the past 50 years, the U.S. government has grown too big, too corrupt and too aggressive toward the world, toward its own citizens and toward local democratic institutions. It has abandoned the democratic vision of its founders and eroded Americans’ fundamental freedoms…” The Federal Superstate In the midst of the fight over the Affordable Care Act, known colloquially as Obamacare, Judge Andrew Napolitano interviewed South Carolina Congressman Jim Clyburn, the number three ranking Democrat in Congress, on the Fox News Channel.

When people say they do not care what others think of them, for the most part they deceive themselves. Generally they mean only that no one will know their vulgarities; and at the utmost only that they are willing to act contrary to the opinion of the majority because they are supported by the approval of their neighbours. It is not difficult to be unconventional in the eyes of the world when your unconventionality is but the convention of your set. It affords you then an inordinate amount of self-esteem. You have the self-satisfaction of courage without the inconvenience of danger.

Over a two-year period, the Obama administration delayed the implementation of the Affordable Care Act twenty-eight times, ostensibly to give employers time to comply with the law.9 This was a blatantly unconstitutional power grab by the executive office. Congress alone has the power to legislate, and once a law is passed and signed by the president, the executive branch has a constitutional responsibility to enforce that law. Obama had no legal authority to issue such delays, particularly in regard to employer and individual mandates. These mandates would have been (and are) painful and probably would have resulted in even larger losses for the Democrats in the 2014 election cycle.

In his book Dying of Whiteness, Metzl told of the case of a forty-one-year-old white taxi driver who was suffering from an inflamed liver that threatened the man’s life. Because the Tennessee legislature had neither taken up the Affordable Care Act nor expanded Medicaid coverage, the man was not able to get the expensive, lifesaving treatment that would have been available to him had he lived just across the border in Kentucky. As he approached death, he stood by the conviction that he did not want the government involved. “No way I want my tax dollars paying for Mexicans or welfare queens,” the man told Metzl. “Ain’t no way I would ever support Obamacare or sign up for it. I would rather die.” And sadly, so he would.

The truth is, I don’t really believe that Republicans are ever going to come up with a real replacement for the Affordable Care Act. Because it seems to me that they don’t actually care about making sure that every American has access to quality, affordable health care. What do they care about? They want insurance companies to be able to sell you junk policies. They want drug manufacturers to be able to gouge people who rely on medications to stay healthy. They want to make it harder for people who’ve suffered from medical malpractice to get their day in court. They want rich people to not have to pay for health care for poor people. And, most of all, they want to keep using this issue to rally their base, reward their donors, and punish Democrats. I don’t know what’s going to happen going forward.

Great Britain has cut its teen pregnancy rate—once the highest in Western Europe—in half over the last two decades. The experts say success came from connecting young people to high-quality, nonjudgmental counseling. The United States has also been successful in bringing down teen pregnancy rates. The country is at a historic low for teen pregnancy and a thirty-year low for unintended pregnancy. Progress is due largely to expanded use of contraceptives, which accelerated thanks to two initiatives begun in the prior administration—first, the Teen Pregnancy Prevention Program, which spends $100 million a year to reach low-income teens in communities across the United States; and second, the birth control benefit in the Affordable Care Act, which allows women to get contraceptives without paying for them out of pocket.

While women suffer from our relative lack of power in the world and often resent it, certain dimensions of this powerlessness may seem abstract and remote. We know, for example, that we rarely get to make the laws or direct the major financial institutions. But Wall Street and the U.S. Congress seem very far away. The power a woman feels in herself to heal and sustain, on the other hand--"the power of love"--is, once again, concrete and very near: It is like a field of force emanating from within herself, a great river flowing outward from her very person. Thus, a complex and contradictory female subjectivity is constructed within the relations of caregiving. Here, as elsewhere, women are affirmed in some way and diminished in others, this within the unity of a single act. The woman who provides a man with largely unreciprocated emotional sustenance accords him status and pays him homage; she agrees to the unspoken proposition that his doings are important enough to deserve substantially more attention than her own. But even as the man's supremacy in the relationship is tacitly assumed by both parties to the transaction, the man reveals himself to his caregiver as vulnerable and insecure. And while she may well be ethically and epistemically disempowered by the care she gives, this caregiving affords her a feeling that a mighty power resides within her being. The situation of those men in the hierarchy of gender who avail themselves of female tenderness is not thereby altered: Their superordinate position is neither abandoned, nor their male privilege relinquished. The vulnerability these men exhibit is not a prelude in any way to their loss of male privilege or to an elevation in the status of women. Similarly, the feeling that one's love is a mighty force for the good in the life of the beloved doesn't make it so, as Milena Jesenka found, to her sorrow. The feeling of out-flowing personal power so characteristic of the caregiving woman is quite different from the having of any actual power in the world. There is no doubt that this sense of personal efficacy provides some compensation for the extra-domestic power women are typically denied: If one cannot be a king oneself, being a confidante of kings may be the next best thing. But just as we make a bad bargain in accepting an occasional Valentine in lieu of the sustained attention we deserve, we are ill advised to settle for a mere feeling of power, however heady and intoxicating it may be, in place of the effective power we have every right to exercise in the world.

A brick could be used to show you how to live a richer, fuller, more satisfying life. Don’t you want to have fulfillment and meaning saturating your existence? I can show you how you can achieve this and so much more with just a simple brick. For just $99.99—not even an even hundred bucks, I’ll send you my exclusive life philosophy that’s built around a brick. Man’s used bricks to build houses for centuries. Now let one man, me, show you how a brick can be used to build your life up bigger and stronger than you ever imagined. But act now, because supplies are limited. This amazing offer won’t last forever. You don’t want to wake up in ten years to find yourself divorced, homeless, and missing your testicles because you waited even two hours too long to obtain this information. Become a hero today—save your life. Procrastination is only for the painful things in life. We prolong the boring, but why put off for tomorrow the exciting life you could be living today? If you’re not satisfied with the information I’m providing, I’m willing to offer you a no money back guarantee. That’s right, you read that wrong. If you are not 100% dissatisfied with my product, I’ll give you your money back. For $99.99 I’m offering 99.99%, but you’ve got to be willing to penny up that percentage to 100. Why delay? The life you really want is mine, and I’m willing to give it to you—for a price. That price is a one-time fee of $99.99, which of course everyone can afford—even if they can’t afford it. Homeless people can’t afford it, but they’re the people who need my product the most. Buy my product, or face the fact that in all probability you are going to end up homeless and sexless and unloved and filthy and stinky and probably even disabled, if not physically than certainly mentally. I don’t care if your testicles taste like peanut butter—if you don’t buy my product, even a dog won’t lick your balls you miserable cur. I curse you! God damn it, what are you, slow? Pay me my money so I can show you the path to true wealth. Don’t you want to be rich? Everything takes money—your marriage, your mortgage, and even prostitutes. I can show you the path to prostitution—and it starts by ignoring my pleas to help you. I’m not the bad guy here. I just want to help. You have some serious trust issues, my friend. I have the chance to earn your trust, and all it’s going to cost you is a measly $99.99. Would it help you to trust me if I told you that I trust you? Well, I do. Sure, I trust you. I trust you to make the smart decision for your life and order my product today. Don’t sleep on this decision, because you’ll only wake up in eight hours to find yourself living in a miserable future. And the future indeed looks bleak, my friend. War, famine, children forced to pimp out their parents just to feed the dog. Is this the kind of tomorrow you’d like to live in today? I can show you how to provide enough dog food to feed your grandpa for decades. In the future I’m offering you, your wife isn’t a whore that you sell for a knife swipe of peanut butter because you’re so hungry you actually considered eating your children. Become a hero—and save your kids’ lives. Your wife doesn’t want to spread her legs for strangers. Or maybe she does, and that was a bad example. Still, the principle stands. But you won’t be standing—in the future. Remember, you’ll be confined to a wheelchair. Mushrooms are for pizzas, not clouds, but without me, your life will atom bomb into oblivion. Nobody’s dropping a bomb while I’m around. The only thing I’m dropping is the price. Boom! I just lowered the price for you, just to show you that you are a valued customer. As a VIP, your new price on my product is just $99.96. That’s a savings of over two pennies (three, to be precise). And I’ll even throw in a jar of peanut butter for free. That’s a value of over $.99. But wait, there’s more! If you call within the next ten minutes, I’ll even throw in a blanket free of charge. . .

Dissent from liberal orthodoxy is cast as racism, misogyny, bigotry, phobia, and, as we’ve seen, even violence. If you criticize the lack of due process for male college students accused of rape, you are a “rape apologist.” End of conversation. After all, who wants to listen to a rape lover? People who are anti–abortion rights don’t care about the unborn; they are misogynists who want to control women. Those who oppose same-sex marriage don’t have rational, traditional views about marriage that deserve respect or debate; they are bigots and homophobes. When conservatives opposed the Affordable Care Act’s “contraception mandate” it wasn’t due to a differing philosophy about the role of government. No, they were waging a “War on Women.” With no sense of irony or shame, the illiberal left will engage in racist, sexist, misogynist, and homophobic attacks of their own in an effort to delegitimize people who dissent from the “already decided” worldview. Non-white conservatives are called sellouts and race traitors. Conservative women are treated as dim-witted, self-loathing puppets of the patriarchy, or nefarious gender traitors. Men who express the wrong political or ideological view are demonized as hostile interlopers into the public debate. The illiberal left sees its bullying and squelching of free speech as a righteous act. This

We liberals and progressives need to do a better job at verbalizing what we are for, and not just what we are against. If we want a public option, we must make the case for it. Every time the Republicans start talking about the corruption, waste, and negligence of “Big Government,” we should talk about those same qualities in Big Corporations. If we want to end factory farming, decrease income inequality, and end discrimination in all its insidious forms, we must fight for those things and so much more. It is a subtle but important difference to stand for equality rather than to merely stand against inequality, and I believe that within this positive framework, more transformative arguments can be made.

OBAMA WENT THROUGH STAGES. That first day, I was in multiple meetings where he tried to lift everyone’s spirits. That evening, he interrupted the senior staff meeting in Denis McDonough’s office and gave a version of the speech that I’d now heard three times as we all sat there at the table. He was the only one standing. It was both admirable and heartbreaking watching him take everything in stride, working—still—to lift people’s spirits. When he was done, I spoke first. “It says a lot about you,” I said, “that you’ve spent the whole day trying to buck the rest of us up.” People applauded. Obama looked down. On the Thursday after the election, he had a long, amiable meeting with Trump. It left him somewhat stupefied. Trump had repeatedly steered the conversation back to the size of his rallies, noting that he and Obama could draw big crowds but Hillary couldn’t. He’d expressed openness to Obama’s arguments about healthcare, the Iran deal, immigration. He’d asked for recommendations for staff. He’d praised Obama publicly when the press was there. Afterward, Obama called a few of us up to the Oval Office to recap. “I’m trying to place him,” he said, “in American history.” He told us Trump had been perfectly cordial, but he’d almost taken pride in not being attached to a firm position on anything. “He peddles bullshit. That character has always been a part of the American story,” I said. “You can see it right back to some of the characters in Huckleberry Finn.” Obama chuckled. “Maybe that’s the best we can hope for.” In breaks between meetings in the coming days, he expressed disbelief that the election had been lost. With unemployment at 5 percent. With the economy humming. With the Affordable Care Act working. With graduation rates up. With most of our troops back home. But then again, maybe that’s why Trump could win. People would never have voted for him in a crisis. He kept talking it out, trying on different theories. He chalked it up to multiple car crashes at once. There was the letter from Comey shortly before the election, reopening the investigation into Clinton’s email server. There was the steady release of Podesta emails from Wikileaks through October. There was a rabid right-wing propaganda machine and a mainstream press that gorged on the story of Hillary’s emails, feeding Trump’s narrative of corruption.

Behold, thou art fair, my Beloved." Song of Solomon 1:16 From every point our Well-beloved is most fair. Our various experiences are meant by our heavenly Father to furnish fresh standpoints from which we may view the loveliness of Jesus; how amiable are our trials when they carry us aloft where we may gain clearer views of Jesus than ordinary life could afford us! We have seen him from the top of Amana, from the top of Shenir and Hermon, and he has shone upon us as the sun in his strength; but we have seen him also "from the lions' dens, from the mountains of the leopards," and he has lost none of his loveliness. From the languishing of a sick bed, from the borders of the grave, have we turned our eyes to our soul's spouse, and he has never been otherwise than "all fair." Many of his saints have looked upon him from the gloom of dungeons, and from the red flames of the stake, yet have they never uttered an ill word of him, but have died extolling his surpassing charms. Oh, noble and pleasant employment to be forever gazing at our sweet Lord Jesus! Is it not unspeakably delightful to view the Saviour in all his offices, and to perceive him matchless in each?--to shift the kaleidoscope, as it were, and to find fresh combinations of peerless graces? In the manger and in eternity, on the cross and on his throne, in the garden and in his kingdom, among thieves or in the midst of cherubim, he is everywhere "altogether lovely." Examine carefully every little act of his life, and every trait of his character, and he is as lovely in the minute as in the majestic. Judge him as you will, you cannot censure; weigh him as you please, and he will not be found wanting. Eternity shall not discover the shadow of a spot in our Beloved, but rather, as ages revolve, his hidden glories shall shine forth with yet more inconceivable splendour, and his unutterable loveliness shall more and more ravish all celestial minds.

As Sam came to a panting stop, a jet of orange flame burst from a high window. Several dozen kids were standing, watching. A crowd that struck Sam as very strange, until he realized why it was strange: there were no adults, just kids. “Is anyone in there?” Astrid called out. No one answered. “It could spread,” Sam said. “There’s no 911,” someone pointed out. “If it spreads, it could burn down half the town.” “You see a fireman anywhere?” A helpless shrug. The day care shared a wall with the hardware store, and both were only a narrow alley away from the burning building. Sam figured they had time to get the kids out of the day care if they acted fast, but the hardware store was something they could not afford to lose. There had to be forty kids just standing there gawking. No one seemed about to start doing anything. “Great,” Sam said. He grabbed two kids he sort of knew. “You guys, go to the day care. Tell them to get the littles out of there.” The kids stared at him without moving. “Now. Go. Do it!” he said, and they took off running. Sam pointed at two other kids. “You and you. Go into the hardware store, get the longest hose you can find. Get a spray nozzle, too. I think there’s a spigot in that alley. Start spraying water on the side of the hardware store and up on the roof.” These two also stared blankly. “Dudes: Not tomorrow. Now. Now. Go! Quinn? You better go with them. We want to wet down the hardware—that’s where the wind will take the fire next.” Quinn hesitated. People were not getting this. How could they not see that they had to do something, not just stand around? Sam pushed to the front of the crowd and in a loud voice said, “Hey, listen up, this isn’t the Disney Channel. We can’t just watch this happen. There are no adults. There’s no fire department. We are the fire department.” Edilio was there. He said, “Sam’s right. What do you need, Sam? I’m with you.” “Okay. Quinn? The hoses from the hardware store. Edilio? Let’s get the big hoses from the fire station, hook ’em up to the hydrant.” “They’ll be heavy. I’ll need some strong guys.” “You, you, you, you.” Sam grabbed each person’s shoulder, shaking each one, pushing them into motion. “Come on. You. You. Let’s go!

I glanced across the room at Thaddeus seated at a long table within a group of shop keepers, and I contemplated him strongly. My heart leaped in my chest at the mere sight of him. I felt myself overcome. The acts of kindness and sweet attention and gratifying moments of passion afforded me by this man since the day of our marriage were purely pleasing. To be loved was a desirous affair! It was the aim of every beating heart! I nearly cast aside my concerns and allowed myself to be consumed by these agreeable sentiments except for one thing: I could not forget how stripped of power and dignity I had felt that very morning. Thaddeus had essentially commanded me to sit and stay like a dog. And I had heeded my master without so much as a growl! This was not me. No one stayed me. I watched those at the table grow more intensely involved in the details of a trade agreement I cared nothing about. Such business bartering was always selfishly motivated. When it appeared that my husband’s attention was engrossed on a point of aggressive negotiation, I excused myself from the weaving party and slipped out the back door. I turned down the alleyway and hurried to a crumbling chimney flue that was easy enough to climb. Almost immediately, a fit of anxiety gripped at my chest, and I felt as if a war was being waged in my gut—a battle between my desire to protect what harmony existed in my marriage and the selfish want to reclaim an ounce of the independence I had lost. This painful struggle nearly persuaded me to reconsider my childish act of defiance. Why was I stupidly jeopardizing my marriage? For what purpose? To stand upon a rooftop in sheer rebellion? Was I really that needy? That proud? I could hear my husband’s command echoing in my mind—no kind persuasion, but a strict order to keep my feet on the ground. I understood his cautious reasoning, and I didn’t doubt he was acting out of concern for my safety, but I was not some fragile, incapable, defenseless creature in need of a controlling overseer. What irked me most was how my natural defenses had failed me. And the only way I could see to restore my confidence was to prove I had not lost the courage and ability to make my own choices and carry them out. Perhaps this act of defiance was childish, but it was remedial as well.

Punishment is not care, and poverty is not a crime. We need to create safe, supportive pathways for reentry into the community for all people and especially young people who are left out and act out. Interventions like decriminalizing youthful indiscretions for juvenile offenders and providing foster children and their families with targeted services and support would require significant investment and deliberate collaboration at the community, state, and federal levels, as well as a concerted commitment to dismantling our carceral state. These interventions happen automatically and privately for young offenders who are not poor, whose families can access treatment and hire help, and who have the privilege of living and making mistakes in neighborhoods that are not over-policed. We need to provide, not punish, and to foster belonging and self-sufficiency for our neighbors’ kids. More, funded YMCAs and community centers and summer jobs, for example, would help do this. These kinds of interventions would benefit all the Carloses, Wesleys, Haydens, Franks, and Leons, and would benefit our collective well-being. Only if we consider ourselves bound together can we reimagine our obligation to each other as community. When we consider ourselves bound together in community, the radically civil act of redistributing resources from tables with more to tables with less is not charity, it is responsibility; it is the beginning of reparation. Here is where I tell you that we can change this story, now. If we seek to repair systemic inequalities, we cannot do it with hope and prayers; we have to build beyond the systems and begin not with rehabilitation but prevention. We must reimagine our communities, redistribute our wealth, and give our neighbors access to what they need to live healthy, sustainable lives, too. This means more generous social benefits. This means access to affordable housing, well-resourced public schools, affordable healthcare, jobs, and a higher minimum wage, and, of course, plenty of good food. People ask me what educational policy reform I would suggest investing time and money in, if I had to pick only one. I am tempted to talk about curriculum and literacy, or teacher preparation and salary, to challenge whether police belong in schools, to push back on standardized testing, or maybe debate vocational education and reiterate that educational policy is housing policy and that we cannot consider one without the other. Instead, as a place to start, I say free breakfast and lunch. A singular reform that would benefit all students is the provision of good, free food at school. (Data show that this practice yields positive results; but do we need data to know this?) Imagine what would happen if, across our communities, people had enough to feel fed.

What the research shows is that the charge master and commercial insurance company prices for the same test or treatment will also vary substantially even at neighboring medical facilities where, presumably, basic input costs such as rent and wages do not vary substantially. Colonoscopies in New York City can vary fourfold—between $2,025 and $8,700—depending on the hospital. This variation in price is very hard to justify. Typically, neither patients nor physicians have access to the price, so they cannot shop around for lower prices. Imagine you were shopping for a new shirt but there was no price tag and you could not know until weeks after you bought it whether the shirt cost $25 or $200. This would make shopping a crazy experience.

In other words, path dependence means that the institutions and arrangements created before—often created haphazardly or as an expedient—now constrain and shape the changes that are possible today.

The decision temporarily exempts a Christian college from part of the regulations that provide contraception coverage under the Affordable Care Act.

Today 60% of workers in the private sector receive their insurance through their employer. I believe that by 2025 fewer than 20% of workers at private companies will continue to receive their health insurance through an employer-sponsored program. Nevertheless many will still receive an employer contribution, a so-called defined contribution toward the purchase of health insurance in the exchange. I believe the majority of private-sector workers will get their coverage through the exchanges.

provided in the table below. The requirements for a Medicaid pediatric ACO are contained in Section 2706 of the Affordable Care Act. ACOs established for commercial populations by private payers may differ from these Medicare requirements.

Once-unimpeachable federal agencies now appear as 19th-century tribal fiefdoms. No one much trusts the IRS anymore. Partisan politics seem to determine whether Americans are audited. The Department of Veterans’ Affairs covered up callous — and occasionally lethal — treatment of scores of hospitalized veterans. The National Security Agency lied about monitoring the communications of average Americans. Almost nothing in Obama’s lectures about the new unaffordable Affordable Care Act proved accurate. U.S. Immigration and Customs Enforcement cannot come clean about the nation’s utter lack of border enforcement with Mexico. The once-hallowed Secret Service seems incompetent and scandal-ridden.

of the time, inertia is the most powerful force in government.  Those who seek change have to succeed at dozens of potential veto points.  Those who seek to prevent change usually have to succeed at only one.

This is the way it is with all people, I’ve learned. A person’s strengths almost always have a flip side. Obama’s strengths are prodigious, but he’s not perfect or exempt from blame for some of the disappointments I hear expressed about him ever more frequently these days. The day after the Affordable Care Act passed, a slightly hungover but very happy president walked into my office to reflect on the momentous events of the night before. “Not used to martinis on work nights,” he said with a smile, as he flopped down on the couch across from my desk, still bearing the effects of the late-night celebration he hosted for the staff after the law was passed. “I honestly was more excited last night than I was the night I was elected. Elections are like winning the semifinals. They just give you the opportunity to make a difference. What we did last night? That’s what really matters.” That attitude and approach is what I admire most about Obama, the thing that makes him stand apart. For him, politics and elections are only vehicles, not destinations. They give you the chance to serve. To Obama’s way of thinking, far worse than losing an election is squandering the opportunity to make the biggest possible difference once you get the chance to govern. That’s what allowed him to say “damn the torpedoes” and dive fearlessly into health care reform, despite the obvious political risks. It is why he was able to make many other tough calls when the prevailing political wisdom would have had him punt and wait for another chance with the ball. Yet there is the flip side to that courage and commitment. Obama has limited patience or understanding for officeholders whose concerns are more parochial—which would include most of Congress and many world leaders. “What are they so afraid of?” he asked after addressing the Senate Democrats on health reform, though the answer seemed readily apparent: losing their jobs in the next election! He has aggravated more than one experienced politician by telling them why acting boldly not only was their duty but also served their political needs. Whether it’s John Boehner or Bibi Netanyahu, few practiced politicians appreciate being lectured on where their political self-interest lies. That hint of moral superiority and disdain for politicians who put elections first has hurt Obama as negotiator, and it’s why Biden, a politician’s politician, has often had better luck.

Reagan decried Medicare as the foot in the door for socialized medicine. Medicare and Medicare passed in 1965. Fifty years later, even after the Affordable Care Act passed, and then survived a tsunami of Republican opposition and legal challenges, still no socialized medicine. No socialism. No communism. No jack-booted thugs breaking down the door in the middle of the night to force grandma to sign a DNR. More

But this is why you would save money with the midwifery program. The hospital can save money when a midwife delivers a baby,” Ivey said, but suddenly the problem dawned on her like a pink zebra in the room. Doctors, pressed between onerous HMOs breathing down their backs and struggling hospitals, felt their livelihoods threatened. She’d heard this story before. “You can imagine how well it went over with the doctors on staff. I only have three of them on the L&D floor. It’s hard enough to keep them here. Malpractice insurance costs, rising health care costs, and now the Affordable Health Care Act.” Lillian waved a hand in the air.

The state also spurned the expanded Medicaid coverage for the needy that it was eligible for at no cost under the Affordable Care Act. This show of defiance denied free health care to 500,000 uninsured low-income residents. A study by health experts at Harvard and the City University of New York projected that the legislature’s obstruction of these benefits would cost residents between 455 and 1,145 lives a year.

can assure you that ‘Obamacare’ did not diminish our research efforts in any way,” he said. “However, the sequestration efforts of the right-wing conservatives and their Tea Party colleagues have hampered progress in medical research. The National Institutes of Health is suffering greatly, and it is very difficult for all investigators to obtain funding. You can’t blame the Affordable Care Act, but you certainly can blame the Republicans.

Ellis had a history of creating fake movements in support of unpopular corporations and causes. In the 1990s, he had headed a company called Ramhurst, which documents revealed to be a covert public relations arm of R. J. Reynolds, the giant tobacco company. Under his guidance, Ramhurst organized deceptively homegrown-looking “smokers’ rights” protests against proposed regulations and taxes on tobacco. In 1994 alone, R. J. Reynolds funneled $2.6 million to Ramhurst to deploy operatives who mobilized what they called “partisans” to stage protests against the Clinton health-care proposal, which would have imposed a stiff tax on cigarette sales. Anti-health-care rallies that year echoed with cries of “Go back to Russia!” If the outbursts bore a striking resemblance to those against Obama’s health-care proposal fifteen years later, it may be because the same political operatives were involved in both. Two of Ellis’s former top aides at Ramhurst, Doug Goodyear and Tom Synhorst, went on in 1996 to form DCI Group, the public relations firm that was helping Noble foment Tea Party protests against the Affordable Care Act.

Donald Trump appeared at a moment when evangelicals felt increasingly beleaguered, even persecuted period. From the Affordable Care Act's contraceptive mandate to transgender bathroom laws and the cultural sea change on gay marriage, gender was at the heart of this perceived vulnerability.

the Affordable Care Act and his eleventh hour position reversal on the U.S. citizenship question on the U.S. Census also call into question the use of “The Hammer” for leverage to effect an outcome. “The Whistleblower Tapes” particularly cite Supreme Court Justice John Roberts as being under surveillance by “The Hammer.

Republicans, meanwhile, moved from moderate right to far right, beginning with Barry Goldwater and Ronald Reagan. By the time Newt Gingrich became House Speaker in 1994, the Republican strategy was to deny Democrats successes on any issue. Under Obama, Republican legislators vowed to vote against the Affordable Care Act, sight unseen. Democrats, meanwhile, viewed themselves as the party of government, “the grown-ups in the room,” and were more inclined to compromise in order to keep government functioning. This asymmetry enabled Republicans to roll Democrats, time after time. The tactic reached an apotheosis under Obama, a leader with a personal affinity for compromise, of which Republicans took full advantage. So,

Three million African Americans and four million Latinx secured health insurance through the Affordable Care Act, dropping uninsured rates for both groups to around 11 percent before President Barack Obama left office. But a staggering 28.5 million Americans remained uninsured, a number primed for growth after Congress repealed the individual mandate in 2017.

The Christian right’s religious freedom agenda isn’t just about holiday greetings and clergy endorsement of candidates. Most urgently in 2016, the leaders who met with Trump that day had spent the past eight years fighting some of the signature achievements of Barack Obama’s presidency: the passage of the Affordable Care Act, particularly its regulation requiring that employer-sponsored health care plans include full coverage for contraception, and the rapid and historic expansion of LGBTQ rights.

Yet once he was in office, Trump cold-shouldered the working-class voters who had supported him. He gave lip service to jobs in coal and manufacturing but took no significant step to assist workers, and he made things worse by chipping away at the Affordable Care Act. It was one more scene in a long drama of politicians’ betrayal of America’s working class.

Chief Justice Roberts inexplicably reversed his opposition to The Affordable Care Act, also known as Obamacare, putting Americans’ health care in the hands of government bureaucrats.

In South Carolina, political folks, including my friend Nikki Haley and my old opponent and now governor Henry McMaster, were unwilling to consider measures that literally would have kept white voters alive and kept all of our hospitals running. Medicaid expansion would have added four hundred thousand jobs in South Carolina and billions of dollars of revenue. But they, and virtually all other Republicans, were against it on the basis of their opposition to Obama’s Affordable Care Act. Trump’s win is a clear example of voters voting against their own self-interests.

As I wrote in Still Broken, many factors contributed to the failure of past reform efforts.11 They include that paranoid “political culture” rooted in an “ambivalence toward government and . . . bias toward private solutions to public problems”;12 the absence of a strong labor movement; race, especially during the period prior to the 1960s when Southern Democrats dominated the Congress; and the structure of government, which gives veto power to even small numbers of opponents. The fact is that many different bodies—most important, the two houses of Congress—must agree to pass a major piece of legislation, but it takes only a few determined individuals to kill it.13 But

There had been seventy-five straight months of job growth under President Obama, and incomes for the bottom 80 percent were finally starting to go up. Twenty million more people had health insurance thanks to the Affordable Care Act, the greatest legislative achievement of the outgoing administration. Crime was still at historic lows. Our military remained by far the most powerful in the world. These are knowable, verifiable facts. Trump stood up there in front of the world and said the exact opposite—just as he had throughout the campaign. He didn’t seem to see or value any of the energy and optimism I saw when I traveled around the country. Listening to Trump, it almost felt like there was no such thing as truth anymore. It still feels that way.

Despite the absence of directly racist statements, it is worth noting that the states that rejected the free expansion of Medicare under the Affordable Care Act are mostly former members of the Confederacy.

Netherlands, which has a restrictive immigration policy compared to the United States. Most European nations, including the Netherlands, after all, have universal health insurance coverage, which makes drug treatment and psychiatric treatment more available, and the Dutch government subsidizes more housing. Finally, the Netherlands’ big success was with heroin, which has effective pharmacological substitutes, methadone and Suboxone, not with meth, which lacks anything similar. But there may be fewer obstacles than appear. The Netherlands has a private health-care insurance system similar to that of the United States and covered the people who needed health care in ways similar to Medicaid and the Affordable Care Act, which significantly expanded access to drug treatment, including medically assisted treatment, in the United States.4 San Francisco subsidizes a significant quantity of housing, as we have seen. While California is larger than the Netherlands, the population of Amsterdam (872,000) is nearly identical to San Francisco’s (882,000).5 And while California’s population and geographic area are larger and more difficult to manage than those of the Netherlands, California also has significantly greater wealth and resources, constituting in 2019 the fifth-largest economy in the world.6 And the approach to breaking up open drug scenes, treating addiction, and providing psychiatric care is fundamentally the same whether in five European cities, Philadelphia, New York, or Phoenix.

then–Vice President Joe Biden made national news by not saying but whispering, “This is a big fucking deal!” to President Barack Obama after the passage of the Affordable Care Act,

What American Healthcare Can Learn from Italy: Three Lessons It’s easy. First, learn to live like Italians. Eat their famous Mediterranean diet, drink alcohol regularly but in moderation, use feet instead of cars, stop packing pistols and dropping drugs. Second, flatten out the class structure. Shrink the gap between high and low incomes, raise pensions and minimum wages to subsistence level, fix the tax structure to favor the ninety-nine percent. And why not redistribute lifestyle too? Give working stiffs the same freedom to have kids (maternity leave), convalesce (sick leave), and relax (proper vacations) as the rich. Finally, give everybody access to health care. Not just insurance, but actual doctors, medications, and hospitals. As I write, the future of the Affordable Care Act is uncertain, but surely the country will not fall into the abyss that came before. Once they’ve had a taste of what it’s like not to be one heart attack away from bankruptcy, Americans won’t turn back the clock. Even what is lately being called Medicare for All, considered to be on the fringe left a decade ago and slammed as “socialized medicine,” is now supported by a majority of Americans, according to some polls. In practice, there’s little hope for Italian lessons one and two—the United States is making only baby steps toward improving its lifestyle, and its income inequality is worse every year. But the third lesson is more feasible. Like Italy, we can provide universal access to treatment and medications with minimal point-of-service payments and with prices kept down by government negotiation. Financial arrangements could be single-payer like Medicare or use private insurance companies as intermediaries like Switzerland, without copying the full Italian model of doctors on government salaries. Despite the death by a thousand cuts currently being inflicted on the Affordable Care Act, I am convinced that Americans will no longer stand for leaving vast numbers of the population uninsured, or denying medical coverage to people whose only sin is to be sick. The health care genie can’t be put back in the bottle.

But for now, I will say this: It would be a mistake to downplay the consequences of having Justice Kavanaugh on the Supreme Court. With this lifetime appointment, he will be in a position, along with the conservative majority on the court, to end a woman's right to choose as we know it; to invalidate the Affordable Care Act; to undo the legal basis by which corporations are regulated; to unravel fundamental rights to vote, to marry, and to privacy. I worry about the ways his partisanship and temperament will infect the court, how it will color his decision making, how it will disadvantage so many who seek relief in the courts. I worry about what it will do to the court itself to have a man credibly accused of sexual assault among its justices. I worry about the message that has been sent yet again to Americans and the world: that in our country, today, someone can rage, lash out, resist accountability, and still ascend to a position of extraordinary power over other people's lives.

Five years later, the legacy of Trump’s presidency and his promises can be addressed. There never was an infrastructure bill. Trump’s budgets consistently proposed cuts to the social programs he vowed not to touch. He did little to combat the opioid epidemic he promised to end, with deaths rising by the end of his tenure. The national debt Trump promised to erase has ballooned by almost $7.8 trillion. Trump’s failed effort to repeal the Affordable Care Act and replace it with nothing remains the nadir of his public approval, surpassing even the days following his incitement of an armed attack on the Capitol building in an effort to overturn his 2020 election loss. Trump has the worst jobs record of any president since 1939, with more than three million lost. He is, in fact, the worst jobs president “god ever created,” despite inheriting an economy that had finally begun to boom in the later years of the Obama administration. The promises of better healthcare didn’t materialize, and the job and wage growth from the economy he inherited were crushed by the pandemic he refused to address. Those were not the promises Trump kept.

Keep in mind that doctors are frequently paid thousands of dollars to promote drugs to other doctors and allied health care professionals. The cozy (and lucrative) relationship between the pharmaceutical industry and physicians has become such a problem that the Affordable Care Act mandates public disclosure of these payments.

For this reason alone, Parasite (Korea 2019, Bong Joon-ho) is well worth seeing. What the film avoids is any moralizing idealization of the underdogs in the Frank Capra style. We should oppose here content and form: at the level of content, the upper-class Parks are without any doubt morally superior; they are considerate, sympathetic, and helpful, while the underdogs effectively act like parasites, intruding, manipulating, exploiting . . . However, at the level of form, the Parks are the privileged ones who can afford to be caring and helpful, while the underdogs are pushed by their material circumstances into not very gracious acts. The same holds for the common anti-feminist complaint made by men: “I treat women in a kind, unpatronizing way, but they are so aggressive toward me . . .”—of course they are, since for them this is often the only way to counteract their formal submission. As a rule, it is only those at the top who can afford kindness and sympathy.

Nixon proposed a universal health insurance plan not unlike Obama’s Affordable Care Act,

My Choice Health Insurance is a black-owned health insurance agency in New Orleans that specializes in helping the underserved black community in New Orleans to obtain affordable health insurance through the ACA Marketplace (Affordable Care Act) also known as Obamacare. We are dedicated to empower individual and black families to make sure they are educated, supported, and provided all the resources to help them take advantage of free or low-cost Obamacare health insurance plans.

We had had a few beers, and while we hadn’t touched our tiny stash of azzies, we had smoked a little pot. Stamets dilated on the idea of psilocybin as a chemical messenger sent from Earth, and how we had been elected, by virtue of the gift of consciousness and language, to hear its call and act before it’s too late. “Plants and mushrooms have intelligence, and they want us to take care of the environment, and so they communicate that to us in a way we can understand.” Why us? “We humans are the most populous bipedal organisms walking around, so some plants and fungi are especially interested in enlisting our support. I think they have a consciousness and are constantly trying to direct our evolution by speaking out to us biochemically. We just need to be better listeners.” These were riffs I’d heard Stamets deliver in countless talks and interviews. “Mushrooms have taught me the interconnectedness of all life-forms and the molecular matrix that we share,” he explains in another one. “I no longer feel that I am in this envelope of a human life called Paul Stamets. I am part of the stream of molecules that are flowing through nature. I am given a voice, given consciousness for a time, but I feel that I am part of this continuum of stardust into which I am born and to which I will return at the end of this life.” Stamets sounded very much like the volunteers I met at Hopkins who had had full-blown mystical experiences, people whose sense of themselves as individuals had been subsumed into a larger whole—a form of “unitive consciousness,” which, in Stamets’s case, had folded him into the web of nature, as its not so humble servant. “I think Psilocybes have given me new insights that may allow me to help steer and speed fungal evolution so that we can find solutions to our problems.” Especially in a time of ecological crisis, he suggests, we can’t afford to wait for evolution, unfolding at its normal pace, to put forth these solutions in time. Let the depatterning begin. As

Many abled Black and brown activists I know remain ignorant of the fact that sick and disabled Black and brown people are doing critical organizing and cultural work on issues from protesting the police murders of Black and brown disabled people to not being killed off by eugenics, killer cops, and medical neglect, from fighting the end of the Affordable Care Act, Medicaid, and the Americans with Disabilities Act to claiming the right to exist as we are.

In the days leading up to the passage of Obamacare (the Affordable Care Act of 2010), I listened on the radio to ‘a town hall’. ‘I happen to be an American,’ said a woman in the audience, her voice yodelling and hiccuping with emotion, ‘and I don’t want to live in a country like the Soviet Union!’ Or, she might have said, a country (at last) beginning (at least) to emulate Canada, Australia, and all the constituent states of the EU. But in the US saying ‘like Europe’, or ‘like England’, or ‘like France’, or ‘like Switzerland’, is the rough equivalent of saying ‘like the Soviet Union’ – which disappeared for ever in 1991.

Of course, Adam was still counting days the old way, as Sunday was the first day of the week, so he was misinforming me as to which day his father actually arrived in Spain, seemingly by accident, by mistake. Perhaps it was a mistake that Adam had confused the European calendar with the Israeli calendar from time to time; perhaps it was not a mistake. Ferran actually arrived the following day, Tuesday, according to the Gregorian calendar and not Monday, when we had all been preparing for his arrival with Martina in vain. I had wanted to introduce her to the old man nicely. However, Tuesday, when he was scheduled to arrive, Mario Larese - Mister Twister - showed up, banging the glass of the store-front door, echoing throughout the entire store and upstairs apartment, as if he was about to break the glass if I did not go down to open it. He was knocking on the plain, large glass of the door with either a lighter or with his metal ring; I don't know which, but it was terrible. I knew Ferran could arrive at any moment, so I told Martina it might be best if she went home to Paola and let me take care of the business. I couldn't ignore Mario, who was almost breaking the glass, seemingly because he had seen my scooter parked in front of the store. I opened the door and he started pushing his way inside, saying, “Let's smoke a joint and drink a coffee.” I replied, “Slow down, cowboy. I've got company, I'm expecting more company, and I just woke up. I have no time now; sorry, Mario.” He kept banging the door because he wanted to smoke somewhere early in the morning, and Canale Vuo was still closed. I was so tempted to slap him. Unintentionally, I let slip that I was expecting Ferran, which only increased his refusal to leave. Theatrical. Dramatic. He wasn't going to get out of my store, my way, my day, my life, my struggle, or my schedule. Meanwhile, the same time, Nico was bugging me on the phone to make sure I delivered a box of 1,000 cones for La Silla because they needed it to make pre-rolled joints for their smokers. They sold 2-3,000 pre-rolled joints a week, ordering two boxes weekly, thus making me waste my time for free. I started to think it had all been planned just to make me lose time every week. They sold 3,000 joints a week and yet couldn't afford more than two boxes of cones to purchase to keep up. Tuesday morning was so urgent for La Silla to get those 1,000 brown cones right then. Just for Nico's 5-euro commission and so he wouldn't be embarrassed in front of his friends at La Silla with his sales performance - no problem. I couldn't kick out Mario, and I didn't want to kick out Martina, who apparently didn't want to leave. I asked them to leave, but Mario was leaning on the kitchen table and unable to look up or turn toward me to meet my gaze. Martina was looking at me angrily. So, I told them both, “OK then, stay here; let the old man inside once he arrives. I have to deliver this box of cones to La Silla right away, but I will be right back. 20 minutes tops.” Adam had also failed to inform me that he had copied a set of keys for his dad at one point, and he had somehow sent them to Israel by mail, I guess. Martina did not need to stay in the store to let Ferran in, but I did not know that. Adam was always secretive and brief with his words, as if it cost him money to say words out of his mouth or dictate to Rachel what to write in an email or what he was supposed to tell me on the phone. I thought that Martina had to stay to let Ferran into the store in case he arrived just when I went to La Mesa to do a favor for Nico. I was on my way back to Urgell from La Silla, when Adam suddenly called me from Amsterdam, screaming on the phone.

I think you’re going to get a disproportionate impact on people who supported Donald Trump but maybe don’t realize that his policies may end up hurting them instead of helping them,” Moore claimed. Salon echoed Moore’s assessment: “Donald Trump is about to victimize his own voters.” Meanwhile, a lead editorial in the New York Times announced that “Trumpcare Is Already Hurting Trump Country.”1 Trump didn’t bother denying any of it. During an interview on Fox News in March 2017, Tucker Carlson told the president that “counties that voted for you, middle-class and working-class counties, would do far less well” under the proposed repeal of the Affordable Care Act (ACA). “Yeah. Oh, I know that. It’s very preliminary,” Trump replied.2

A major exception was President Obama, whose Affordable Care Act was a milestone in U.S. social policy. The ACA’s opponents tried to frame it as an identity issue, suggesting sotto voce that the policy was designed by a black president to help his black constituents. But it was in fact a national policy designed to help less well-off Americans, regardless of their race or identity. Many of the law’s beneficiaries include rural whites in the South who have nonetheless been persuaded to vote for Republican politicians vowing to repeal the ACA.

Conversely, there are other services in which Medicare is required to pay whatever it is charged. For instance, Medicare Part B pays oncologists for intravenous cancer chemotherapy drugs administered in the office. The

clearly remembers the Soviet Union collapsing, so when I was a kid, he kept saying that the Affordable Health Care Act, and the way the NSA, DHS, EPA, and TSA were acting, was inching us closer to that system of government. Now, along with the United Nations’ Agenda 21, we’re almost there. I really wish the Conservative Party and Victor Tyson could win the Presidency, because he would ask the U.N. to leave and try to get us back to being a federal republic,

Create Your Love of Life List   How do you know what you like? Well, if someone describes an experience and you get excited or you see something happen that makes you smile, this is a sign that you want to have a similar experience. Write down the signs and your desired experiences. Research how you could make it happen. Keep a journal of all your ideas and mark them off one by one as you do them! Such experiences are food for the soul. Begin to taste the richness of life. Your favorite experiences may be something as simple as taking a walk with your loved ones, playing a board game, listening to old music, and eating together with your family at the dinner table more often than just on holidays. Remember, we all need nourishment of the spirit as much as, if not even more than, we need food. Have you been starving your soul? You can gain access to everything you are searching for and need if you are clear, consistent, and persistent. You may think, “Well, those ideas are nice, Christy, but I could never afford to do this or that.” So I am here to tell you that you are exactly right! Whatever you confirm, you get in your world. Period. This means, if you want something, you have to ask the right questions to get the answer about how to go and get it! These are mind-opening questions like, “What would it cost for me to take a cruise and have my partner with me?” Write down a question about one of the items in your love of life list and then let it go! There are only a couple of tricks in this process. It’s amazing what often unfolds when we follow these three guidelines. Do not put a time limit on when you will experience what you want. It will come once you allow God to work out the right plan to bring it to you. Believe that your desire will come into existence and do not put parameters on how. Move toward your objective by listening carefully to the whispers of God that come your way and acting on them as soon as you can. This is spirit giving you a little help.   Without any further hesitation, I want you to put this book down, grab your journal or a piece of paper and a pen, or a dry erase marker so you can write on your bathroom mirror. Immediately put down your ideas for your love of life list. Keep writing until you feel you have nothing to write anymore. No idea is too silly, too strange, or too expensive to put on your list. Write your list and then pick up this book again later to learn more about loving your life out loud!

groggily

If the federal government really wanted to provide affordable, quality healthcare to as many citizens as possible (including the poor), they would be deregulating the healthcare industry, introducing competition, and encouraging private investment – the exact opposite of what the Affordable Care Act has done.

I can assure you that ‘Obamacare’ did not diminish our research efforts in any way,” he said. “However, the sequestration efforts of the right-wing conservatives and their Tea Party colleagues have hampered progress in medical research. The National Institutes of Health is suffering greatly, and it is very difficult for all investigators to obtain funding. You can’t blame the Affordable Care Act, but you certainly can blame the Republicans.

The day Speaker of the House Paul Ryan announced that he was going to do everything he could to repeal the Affordable Care Act and defund Planned Parenthood, [...] we saw a 900% increase in requests for appointments to get IUDs, a form of birth control that lasts for several years. Women wanted to make sure their birth control would outlast the [new] Administration.

After only eight months in office, Meadows made national headlines by sending an open letter to the Republican leaders of the House demanding they use the “power of the purse” to kill the Affordable Care Act. By then, the law had been upheld by the Supreme Court and affirmed when voters reelected Obama in 2012. But Meadows argued that Republicans should sabotage it by refusing to appropriate any funds for its implementation. And, if they didn’t get their way, they would shut down the government. By fall, Meadows had succeeded in getting more than seventy-nine Republican congressmen to sign on to this plan, forcing Speaker of the House John Boehner, who had opposed the radical measure, to accede to their demands. Meadows later blamed the media for exaggerating his role, but he was hailed by his local Tea Party group as “our poster boy” and by CNN as the “architect” of the 2013 shutdown. The fanfare grew less positive when the radicals in Congress refused to back down, bringing virtually the entire federal government to a halt for sixteen days in October, leaving the country struggling to function without all but the most vital federal services. In Meadows’s district, day-care centers that were reliant on federal aid reportedly turned distraught families away, and nearby national parks were closed, bringing the tourist trade to a sputtering standstill. National polls showed public opinion was overwhelmingly against the shutdown. Even the Washington Post columnist Charles Krauthammer, a conservative, called the renegades “the Suicide Caucus.” But the gerrymandering of 2010 had created what Ryan Lizza of The New Yorker called a “historical oddity.” Political extremists now had no incentive to compromise, even with their own party’s leadership. To the contrary, the only threats faced by Republican members from the new, ultraconservative districts were primary challenges from even more conservative candidates. Statistics showed that the eighty members of the so-called Suicide Caucus were a strikingly unrepresentative minority. They represented only 18 percent of the country’s population and just a third of the overall Republican caucus in the House. Gerrymandering had made their districts far less ethnically diverse and further to the right than the country as a whole. They were anomalies, yet because of radicalization of the party’s donor base they wielded disproportionate power. “In previous eras,” Lizza noted, “ideologically extreme minorities could be controlled by party leadership. What’s new about the current House of Representatives is that party discipline has broken down on the Republican side.” Party bosses no longer ruled. Big outside money had failed to buy the 2012 presidential election, but it had nonetheless succeeded in paralyzing the U.S. government. Meadows of course was not able to engineer the government shutdown by himself. Ted Cruz, the junior senator from Texas, whose 2012 victory had also been fueled by right-wing outside money, orchestrated much of the congressional strategy.

These books and magazines acted as therapy for my working-class single mom who couldn’t afford to sit on someone’s sofa once a week to discuss her problems. She had a daughter to feed and bills to pay. This bookshelf and coffee-table therapy gave birth to two unspoken mantras that shaped our life together: “Take care of business” and “Daughter, heal thyself.