Why Republicans are failing to govern

“Different Republican senators have different ideas, but across the party as a whole, there is no plan. The Republican Party has no policy theory for how to contain the coronavirus, nor for how to drive the economy back to full employment. And there is no plan to come up with a plan, nor anyone with both the interest and authority to do so. The Republican Party is broken as a policymaking institution, and it has been for some time.

“I don’t think you’re missing anything,” said a top Republican Senate staffer. “You have a whole bunch of people in the Senate posturing for 2024 rather than governing for the crisis we’re in.”

“There hasn’t been a coherent GOP policy on anything for almost five years now,” a senior aide to a conservative Senate Republican told me. “Other than judges, I don’t think you can point to any united policy priorities.””

Health providers’ scramble for staff and supplies reveals sharp disparities

“Doctors, nurses and caregivers at smaller and poorer hospitals and medical facilities across the country are still struggling to obtain the protective gear, personnel and resources they need to fight the coronavirus despite President Donald Trump’s repeated assertions that the problems are solved.

Health care workers at all types of facilities scrambled for scarce masks, gloves and other life-protecting gear at the beginning of the pandemic. The White House was letting states wage bidding wars against one another, rather than establish a central national manufacturing, supply and distribution chain.

But now, health care workers say a clear disparity has emerged and persisted. Larger and richer hospitals and practices outbid their smaller peers, sometimes for protective gear, sometimes to fill in staffing gaps. And some of those having the hardest time are precisely where the virus is spreading.”

Covid-19 is pushing red states to finally expand Medicaid

“For the second time this summer, voters in a solidly Republican state have decided now is the moment to expand Medicaid coverage through the Affordable Care Act.
Missouri voters passed a ballot initiative to expand Medicaid during Tuesday’s primary elections; 53 percent of voters supported the measure and 47 percent opposed it. That vote comes about a month after Oklahoma voters also decided to expand Medicaid via ballot referendum by less than 1 percentage point.

Once the expansion takes effect in those two states next year, an estimated 340,000 people who currently have no affordable health insurance option will become eligible for Medicaid. That still leaves nearly 2 million people in 12 states nationwide who are stuck in the Medicaid expansion gap — ineligible for coverage because their state refuses to expand the program but with an income too low to qualify for tax credits to buy private insurance — but it is yet another step toward the universal Medicaid expansion Obamacare authors envisioned. In the last few years, voters in Idaho, Maine, Nebraska, and Utah have also approved Medicaid expansion via ballot initiative.”

How inequality is changing the Republican Party — and breaking American politics

“The most compelling evidence Hacker and Pierson cite for this argument comes from a study conducted by political scientists Margit Tavits and Joshua Potter, which looked at party platforms from 450 parties in 41 countries between 1945 and 2010. Tavits and Potter find that as inequality rises, conservative parties ratchet up their emphasis on religious and racial grievances — particularly in countries with deep racial and religious fractures. The pivot only works, Tavits and Potter say, when there is high “social demand” for ethnonationalist conflict.”

“If you survey the modern Republican Party, the figures most intent on turning it into a vehicle for ethnonationalist resentment are the least committed to the plutocratic agenda. Steve Bannon, Tucker Carlson, Sen. Josh Hawley, and 2016 candidate Donald Trump are all examples of the trend: They are, or were, explicit in their desire to sever the ties that yoke angry nationalism and a desire for a whiter America to Paul Ryan’s budget.
Conversely, the Republican figures most committed to plutocracy — like Ryan or the Koch brothers or the Chamber of Commerce — tend to back immigration reform and recoil from ethnonationalist rhetoric, and in 2016, they opposed Trump in favor of Jeb Bush and Chris Christie and Marco Rubio. They just lost on all those fronts.

Hacker and Pierson emphasize the fact that once in office, Trump abandoned populist pretense and gave the Chamber of Commerce everything it had ever wanted and more. But, as with so much else with Trump, it can be hard to distinguish decision-making from disinterest. Trump outsourced the staffing of his White House to the Koch-soaked Mike Pence and his agenda to congressional Republicans. The question, then, is whether the dissonance of his administration represents an inevitability of Republican Party politics or simply a lag between Trump demonstrating the base’s prioritization of ethnonationalist resentment and a politician who will both win and govern on those terms.”

“At key moments, Fox News tried to support immigration reform and deflate Trump, and it lost those fights and remade itself in Trump’s image. There are lines even conservative media can’t cross.”

“As Hacker and Pierson show, this is a point of true convergence between the identitarians and the plutocrats: Both have lost confidence that they can win elections democratically, so they have sought to rewrite the rules in their favor. What hold on power they retain comes from the way American politics amplifies the power of whiter, more rural, more conservative areas — and that’s given the conservative coalition a closing window in which to rig the system such that they can retain control.

America does not exist in a steady state of tension between majoritarian and minoritarian institutions. Those institutions can be changed, and they are being changed. A party in power can rewrite the rules in its own favor, and the Republican Party, at every level, is trying to do just that — using power won through white identity politics and geographic advantage, but deploying strategies patiently funded by plutocrats. As Hacker and Pierson write:

“Recent GOP moves in North Carolina show what’s possible in a closely balanced state. Republicans first took the statehouse in 2010. They quickly enlisted the leading Republican architect of extreme partisan gerrymanders, Thomas Hofeller. A mostly anonymous figure until his death in 2018, Hofeller liked to describe gerrymandering as “the only legalized form of vote-stealing left in the United States.” He once told an audience of state legislators, “Redistricting is like an election in reverse. It’s a great event. Usually the voters get to pick the politicians. In redistricting, the politicians get to pick the voters.” In 2018, North Carolina Republicans won their “election in reverse,” keeping hold of the statehouse even while losing the statewide popular vote. In North Carolina’s races for the US House, Republicans won half the statewide votes and 77 percent of the seats. A global elections watchdog ranked North Carolina’s “electoral integrity” alongside that of Cuba, Indonesia, and Sierra Leone.””

“History shows that democratic systems thrive amid responsible conservative parties — parties that make their peace with democracy and build agendas that can successfully compete for votes — and they collapse when conservative parties back themselves into defending constituencies and agendas so narrow that their only path to victory is to rig the system in their favor.
This is the cliff on which American democracy now teeters. The threat isn’t that Donald Trump will carve his face onto Mount Rushmore and engrave his name across the White House. It’s that the awkward coalition that nominated and sustains him will entrench itself, not their bumbling standard-bearer, by turning America into a government by the ethnonationalist minority, for the plutocratic minority.”

Performative masculinity is making American men sick

“Poll after poll, most recently a Gallup poll from July 13, has found American men are more likely to not wear masks compared to women. Specifically, the survey found that 34 percent of men compared to 54 percent of women responded they “always” wore a mask when outside their home and that 20 percent of men said they “never” wore a mask outside their home (compared to just 8 percent of women).”

“Glick and Reny echoed a sentiment that health experts I spoke to in July said: To get people to change behavior, masks have to become a socially accepted norm. Once people start accepting masks as normal behavior, like they do wearing seat belts and not smoking indoors, the number of people going against the norm decreases.
Getting to that tipping point is a lot easier said than done.”

America is failing Black moms during the pandemic

“Black women are disproportionately impacted, dying in childbirth at three to four times the rate of white women.”

“Many factors contribute to overall maternal mortality in the US, from underlying conditions like diabetes to a lack of adequate health insurance. All of these disproportionately impact Black women — Black Americans, for example, are 60 percent more likely than whites to be diagnosed with diabetes. And 11.5 percent of Black Americans were uninsured as of 2018, compared with just 7.5 percent of whites.”

“For Black women, “even when we get prenatal care,” Crear-Perry explained, “even when we are normal weight and not obese, even when we have no underlying medical conditions, we are still more likely to die in childbirth than our white counterparts.” In New York City, for example, a 2016 study found that Black patients with a college education were more likely to have pregnancy or childbirth complications than white patients who hadn’t graduated from high school.”

“Part of the issue is that providers treat Black patients differently from white ones. Black women and other women of color often aren’t listened to when they express pain or discomfort, Jamila Taylor, director of health care reform at the Century Foundation, told Vox.
Racist beliefs about people’s bodies and their ability to experience pain are shockingly widespread: Half of the white medical students and residents surveyed in one 2016 study, for example, believed at least one myth about racial differences in pain perception, such as the idea that Black people’s nerve endings are less sensitive than white people’s. The more myths someone believed, the more likely that person was to underestimate a Black patient’s pain.”

“Advocates have long been calling for greater access to non-hospital births, whether at a birthing center or at home, as a way to combat the discrimination Black patients and other patients of color can face in hospital settings. “Other countries that have better outcomes than we do create a system and a network of birth centers and home births that allow for people to make choices based upon their needs,” Crear-Perry said.”