In the wake of the debt-ceiling crisis he helped manufacture last summer, Senate Minority Leader Mitch McConnell boasted it was "a hostage that's worth ransoming" which "also is a new template" for the future. As it turns out, those threats were among the few true words McConnell has uttered. Because while he's promising once again to blackmail the White House over the debt ceiling, the Kentucky Republican claimed it's because "we'd like to do something about the nation's biggest problem, spending and debt, which of course is the reason for this economic malaise." Of course, as the data show, it's the very austerity policies here and in Europe which are costing jobs and hurting growth.

But Mitch McConnell's myth-making hardly ends there. On the economy, taxes, deficits, health care and so much else, virtually all of McConnell's talking points are tried - and untrue.

(Click a link to jump to the details for each below):

• "Obama Made the Economy Worse"
• "No Evidence Whatsoever That the Bush Tax Cuts Actually Diminished Revenue"
• "Punishing Job Creators"
• "We Look a Lot Like Greece Already"
• Public Sector Layoffs Are a "Local" Problem
• 47 Million Uninsured Americans "Don't Go Without Health Care"
• The Public Option "May Cost You Your Life"
• Democrats Are "Sticking It to Seniors with Cuts to Medicare"

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As The New York Times suggested last week, the fate of President Obama's Affordable Care Act in general, and its mandate that Americans obtain health insurance in particular, may hinge on Justice Anthony Kennedy's notion of "liberty." While Solicitor General Donald Verilli posited "a profound connection" between health care and liberty, his opponent Paul Clement argued, "that it's a very funny conception of liberty that forces somebody to purchase an insurance policy whether they want it or not."

Of course, that very conception of liberty has been the law of the land for decades. Today, tens of millions of Americans must purchase health insurance and a pension plan for their golden years. And as it turns out, the Medicare and Social Security mandates for individuals and employers dwarf anything required by the dreaded Obamacare.

As we learned during the recent debate over the extension of the payroll tax cut, 160 million Americans pay taxes to fund the Medicare and Social Security trusts for today and tomorrow's retirees. Since 1935, workers and their employers have each paid into the Social Security trust fund, a figure which next year will return to its 6.2 percent rate on the first $106,000 of income. In addition, employer and employee alike are on the hook for another 1.45 percent for Medicare, the insurance program for the elderly established in 1965.

In comparison, the Affordable Care Act's individual mandate impacts just a small fraction of Americans. For starters, over 80 percent already have health insurance, compared to roughly 17 percent who do not. The Economic Policy Institute estimates that 59 percent of those under age 65 receive employer-sponsored insurance, while another 22 percent are covered by public programs including Medicaid and SCHIP. Of the 50 million people who are currently uninsured, about 20 million (including undocumented immigrants and those with religious objections or claiming economic hardship), are not covered or are otherwise exempt from the health insurance mandate. As a recent Urban Institute analysis concluded:

What may be surprising, however, is that if the ACA were in effect today, 94 percent of the total population (93 percent of the nonelderly population) or 250.3 million people out of 268.8 million nonelderly people would not face a requirement to newly purchase insurance or pay a fine.

As Ryan Grim noted, that's because "98 percent of Americans would either be exempt from the mandate — because of employer coverage, public health insurance or low income — or given subsidies to comply." The Urban Institute estimated that 8.1 million Americans would have their insurance paid for by the expansion of Medicaid to 133 percent of the federal poverty level. Another 10.9 million people would receive subsidies to buy private insurance in the new state exchanges, while only 7.3 million (2 percent of the total U.S. population) would be required to purchase a health plan using their own resources alone. As for those Americans choosing to instead to pay the penalty for failing to obtain insurance at all, the CBO estimated that number at 4 million. (That forecast is almost double the rate in Massachusetts, where only 48,000 in a state of 6.6 million people opted to pay the penalty rather than acquire health insurance under Mitt Romney's version of the individual mandate.)

But if far more Americans pay the Social Security and Medicare mandates, the number of direct beneficiaries of "Obamacare" is much lower.

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When I heard the initial reports on today's Supreme Court arguments, my heart sank. For ill or for good, the individual mandate is an integral part of the machinery that allows health insurance to be affordable for people with pre-existing conditions, who would otherwise be excluded, and the pundits were saying Solicitor General Verrilli had blown it. But then I listened and read the transcript and I came away with an entirely different impression.

The first impression is this: If they kill the Affordable Care Act, that would be the only time we could actually find the political will to get Medicare for All passed, particularly after Justices Ginsburg and Sotomayor elicited agreement from counsel representing the states and the NFIB that Medicare for All would be perfectly constitutional, in their esteemed opinions.

Arguments today ranged from the need for telephones to the requirement that cars have anti-emissions devices, from wheat to milk to marijuana, all related to the commerce powers granted to Congress under the Constitution.

I am not going to try and describe all of the legal arguments. If you want those, I would recommend reading this analyis at SCOTUSblog or Brian Beutler's more optimistic view. I'm also not going to try and figure out which way the Justices are leaning on this. I have no idea, though it's safe to say that Alito and Scalia along with Clarence Thomas are not going to uphold it. Kennedy and Roberts would be the two to watch.

There were, however, some moments that are worth highlighting because they do summarize the conflict so well.

First, this from Solicitor General Verrilli, in response to Justice Roberts' questioning about covering services some people will not use and others will, like maternity or pediatric services:

And the problem here in this market is that for -- you may think you're perfectly healthy and you may think that you're not -- that you're being forced to subsidize somebody else, but this is not a market in which you can say that there is a immutable class of healthy people who are being forced to subsidize the unhealthy. This is a market in which you may be healthy one day and you may be a very unhealthy participant in that market the next day and that is a fundamental difference...

That's a key point, and one that differentiates the health care "market" from others. Later on, Justice Kagan put the exclamation point on it when she asked whether the "subsidizers eventually become the subsidized."

That led to this exchange with Justice Scalia, which drove this listener to despair:

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Credit: Gallup

This week, GOP White House frontrunner Mitt Romney marked the two year anniversary of the Affordable Care Act by declaring the reform law the "national nightmare" he "always predicted." But leaving aside for the moment that Romney repeatedly touted his virtually identical Massachusetts law as a model for the nation, there's a much bigger problem with his call for a "free market, federalist approach" in which "each state should be allowed to pursue its own solution." As Ezra Klein exhaustively documented five years ago, it's almost impossible for even the wealthiest of those state "laboratories of democracy" to achieve universal health care on their own. Worse still, Romney's mythical nightmare future is the horrifying present in the states his party currently represents. As the data show, health care is worst precisely where Republicans poll best.

That point was reinforced last week with the latest Gallup poll on the uninsured in America. With almost 28 percent of respondents uninsured, Texas far and away led the nation as well as the "uninsured belt" that stretches across the solidly red south. Led by Mitt Romney's Massachusetts, 9 of the top 10 performing states voted for Barack Obama in 2008.

But tallying up the ranks of the uninsured understates the magnitude of the unfolding health care horror story in Red State America. Two years ago, the Commonwealth Fund released its 2009 state health care scorecard, which measured performance in providing health care access, prevention and treatment, avoidable hospital use, equity across income levels, and healthy lives for residents. Again, while nine of the top 10 performing states voted for Barack Obama in 2008, four of the bottom five (including Arkansas, Mississippi, Oklahoma and Louisiana) and 14 of the last 20, backed John McCain. (That at least is an improvement from the 2007 data, in which all 10 cellar dwellers had voted for George W. Bush three years earlier.)

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... And What To Replace Them With

We talk about the "Death Tax" and not the "Estate Tax." Two little words—"Death Panels"—were capable of nearly derailing the best thing that's happened to health insurance in this country in decades. Harvard-educated President Obama is universally considered "elite," while Yale-educated George W. Bush is considered "down home."

Many Democrats buy into the old saw that the Democratic party has had a history of "tax and spend" policies that needs to change or be lived down somehow. Until the Occupy movement brought the topic front and center, even most Democrats accepted the notion that businesses were "job creators" and worried more about distracting the opposition from this "fact" than debunking it for the lie it actually is.

Unfortunately, this is because Democrats have failed to speak in a language strong enough to rebut Republicans who have defined who we are and what we want, in a way that doesn't even remotely reflect an iota of the truth, and instantly conjures up the negative in the mind of the listener.

HOW TO TALK LIKE A REPUBLICAN

Professional media strategist Frank Luntz has been providing Republicans with a detailed handbook on exactly what language to use and not to use for decades. He has built up a lexicon that is not only far-reaching and deeply ingrained, but also very, very successful. As Progressive Democratic linguist George Lakoff explains, this "framing" is crucial to how they've managed to win so much of the debate.

Here are some examples from Luntz's handbooks, of how the Republican party has been taught to frame the way they talk:

Don’t say "bonus!"

Luntz advised that if [corporations] give their employees an income boost during the holiday season, they should never refer to it as a "bonus."

"If you give out a bonus at a time of financial hardship, you’re going to make people angry. It’s 'pay for performance.'"

Don't say that the government "taxes the rich."

Instead, tell [people] that the government "takes from the rich."

"If you talk about raising taxes on the rich," the public responds favorably, Luntz cautioned. But "if you talk about government taking the money from hardworking Americans, the public says no."

This sleight-of-tongue has managed to manipulate at least half the country into believing things that simply are not true. And this type of language mash-up has been so successfully drilled into the vernacular, that Democrats have been hard-pressed to come up with a simple and just-as-effective way to expose the lies beneath them.

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The Affordable Care Act is working. 2.5 million more young adults ages 19 to 26 now have health insurance. The shrinking of the Medicare "donut hole" allowed 3.6 million seniors to save $2.1 billion on their prescription drugs last year. And the ban on insurers refusing to cover pre-existing conditions is saving lives (even among those who opposed so-called "Obamacare"). And even though most of its provisions don't go into effect until 2014, the data from Oregon and Massachusetts strongly suggest the 30 million people who will gain coverage will be much healthier and more financially secure.

In Massachusetts, the 2006 health care reform Governor Mitt Romney signed into law lowered the uninsured rate from 10 percent to a national low of two percent. Even with its individual mandate, "Romneycare" is extremely popular, enjoying a 3 to 1 margin of support from Bay State residents. Now, a new study by Charles J. Courtemanche and Daniela Zapata published by the National Bureau of Economic Research (NBR) shows that universal coverage in Massachusetts is indeed making people there healthier. As Ezra Klein of the Washington Post summed up their findings:

The answer, which relies on self-reported health data, suggests they did. The authors document improvements in "physical health, mental health, functional limitations, joint disorders, body mass index, and moderate physical activity." The gains were greatest for "women, minorities, near-elderly adults, and those with incomes low enough to qualify for the law's subsidies."

Importantly, the researchers concluded that "the general strategies for obtaining nearly universal coverage in both the Massachusetts and federal laws involved the same three-pronged approach of non-group insurance market reforms, subsidies, and mandates, suggesting that the health effects should be broadly similar." (Or MIT professor and architect of both laws Jonathan Gruber put it bluntly last year, "they're the same f--king bill.") It's no wonder Mitt Romney used to recommend his Massachusetts reform as a model for the nation.

If the individual mandate is one of the highest profile (if contentious) aspects of the 2010 Patient Protection and Affordable Care Act, the expansion of Medicaid is among the most important in enabling 30 million currently uninsured Americans to get coverage. By extending Medicaid coverage to families earning up to 133 percent of the federal poverty level (FPL) and providing subsidies to those up to four times the FPL, starting in 2014 the Affordable Care Act passed by Democrats in Congress will bring insurance to millions more Americans. A March 2011 analysis by the Commonwealth Fund revealed that when fully implemented, the ACA will bring relief to "nearly all of the 52 million working-age adults who were without health insurance for a time in 2010."

As it turns out, America's future is Oregon's present.

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Credit: Clay Jones - Fredricksburg Free Lance-Star

The right-wing noise machine has attempted to make the contraception argument about who "pays" for birth control, and Rush Limbaugh and commenters on Fox have gone so far as to claim that contraception advocates "want me to pay for them to have sex."

The debate was instigated by concerns at Georgetown University, a Catholic institution that does not provide contraception through their student health insurance program.

It is shocking to discover, then, that undergraduate students pay over $1800 per year for health insurance.

Until we get single payer, taxpayer-funded insurance for all, health insurance will continue to be a product that is bought and sold in the marketplace. Health insurance reform breaks up monopolies in that area and also regulates abuses from the sale of that insurance product. It is not out of line to compare the health insurance product to the car insurance product. (Except for the little inconvenient fact that people without health insurance are not as healthy and are more likely to die due to lack of medical care.) If I buy a car and insurance for it, I'm going to buy collision insurance. I'm not going to buy a policy that doesn't have collision insurance attached to it, and by the way insurance LAW says I can't anyway. I have to have that coverage. Now, because I have a womb and ovaries, the healthcare reform law says I have to have health coverage for those organs, and that insurance companies and employers can't separate them out from the total person and not cover them because any person who uses those organs outside of a specific religious dictum is a "slut." Sorry, boys, "sluts" who pay for their health insurance get covered same as anybody.

Couples of family-bearing age and yes, young women who are FERTILE, use birth control for family planning. Even in an unregulated market, husbands and wives, men and the women who love them, are not going to buy an insurance policy that does not cover that medicine. And now the laws regulating health insurance says that that medicine has to be covered, because NOT covering it is discriminating against women simply because they have reproductive organs that get them pregnant.

Finally, this is a non-issue. Blue Cross covers birth control pills, diaphragms, hormone implants, the whole shebang because it's good business.

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Credit: Commonwealth Fund

A new study last week from the Commonwealth Fund confirmed the shocking gap between lower and higher income Americans when it comes to health insurance coverage. While only 12 percent of families making $89,400 a year (or four times the federal poverty rate for a family of four) was uninsured at some point last year, that figure skyrockets to 57 percent for a family at about $29,700. Mercifully, thanks to the Affordable Care Act (ACA), beginning in 2014 that gap will largely be erased. Unless, that is, Republicans take control of the White House and Congress. If the GOP succeeds at the polls in 2012, the health insurance income gap will get much, much worse.

Last March, a previous Commonwealth Fund study found that since the start of the recession, almost 60% of Americans who lost a job and their health insurance - 9 million people - could not afford to regain coverage. Medical costs pushed four million more into bankruptcy. Its 2010 Biennial Health Insurance Survey of over 3,000 adults ages 19-64 highlighted the devastating toll of the Bush recession which started in December 2007:

Both insured adults--who are facing higher premiums and out-of-pocket costs--and uninsured adults cannot afford adequate health care. Seventy-five million adults did not get needed health care in 2010, skipping doctor visits, prescriptions, specialist care, and recommended tests and treatments because of costs. This represents a 60 percent increase from 2001, when 47 million people reported skipping needed care because of costs. Uninsured adults were the most likely to forgo care because of costs, with 66 percent reporting they did so. However, many insured adults were also less insulated from high health care costs--31 percent of adults who were insured all year went without the health care they needed because of costs, up from 21 percent in 2001.

Likewise, 73 million people reported problems paying their medical bills or were paying off medical debt, up from 58 million in 2005. The survey finds that because of medical bills, an estimated 29 million people spent all of their savings, 17 million incurred credit card debt, 22 million were unable to pay for basic necessities like food, heat, and rent, and 4 million declared bankruptcy.

Now, a new Fund analysis revealed the yawning chasm that constitutes the "Income Divide in Health Care":

The new Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults finds nearly three of five adults in families earning less than 133 percent of the federal poverty level were uninsured for a time in 2011; two of five were uninsured for one or more years. Low- and moderate-income adults who were uninsured during the year were much less likely to have a regular source of health care than people in the same income range who were insured all year.

As Sarah Kliff of the Washington Post explained, "This underscores how central the health reform law's expansion of Medicaid -- in which anyone below 133 percent of the poverty line qualifies for the program -- will be to the law's expanded coverage. Everyone represented by the yellow triangles above becomes eligible for Medicaid in 2014."

But the reach of the Affordable Care Act doesn't end there.

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On Saturday morning Lidiane Carmo woke up in Florida, where she was attending a church conference with her father, mother, and sister. Carmo was the youngest in her family, and they had traveled to Florida with her pastor father, her aunt, uncle and cousins as well as several other other church members.

On Sunday morning, Lidiane woke up in a Florida hospital with broken bones and internal injuries after the van they were traveling in was involved in Sunday's horrendous highway pileup on I-75 near Gainesville, Florida. Her father, mother, sister, uncle, aunt and cousin were killed. She is the sole survivor in her immediate family.

Lidiane's parents came to the United States from Brazil 12 years ago, bringing five-year old Letiticia and three-year old Lidiane with them. They had legal visas which have since expired.

Lidiane is now an orphan. She has no health insurance. She has no legal status to remain in this country. And she has no family beyond those remaining members of her father's church. She is the sole survivor.

If we had a DREAM Act in place, Lidiane could petition for citizenship here since she entered the country legally. But we don't, and because of Republicans' insane need to pander to bigots and racists, we're unlikely to see it without a completely different Congress.

I'm writing about Lidiane because she puts a very human face on what they're doing when they block the DREAM Act. I wonder if any of these crazy Republican candidates could gaze into her frightened, hurting eyes, and tell her she has to go back to a country she doesn't even know. I think they could, and that should concern us all.

Congress forced a clause into the Affordable Care Act which excluded undocumented immigrants from coverage. The exclusion wasn't simply from federal funds for subsidies. They are barred from purchasing insurance on the state-based exchanges and the national exchange. Barred. Even if they pay with their own funds. Barred.

Today a 15-year old child is in a hospital in Florida, suffering from severe injuries, bereft of her family, in Rick Scott's state. What will become of her?

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Fox News has been in full-blown Mitt Romney rehabilitation mode Tuesday. Beginning with Gretchen Carlson through every hour up to this segment on Megyn Kelly's show, they've worked very hard to convince viewers that Mitt Romney's gaffe, "I like to fire people," was taken out of context and unfairly depicts what he said.

We could simply say that what is good for the goose is good for the gander. It's fair game, right? After all, he said those words in that order. Yes, he did, and even in context, he could have said "I like to choose service providers," or something similar. Instead he chose to employ CEO-speak; that is, authoritarian, emperious words that no one likes to think about, much less experience. Being fired sucks. As one who spent a long time in a career as a service provider, I'll vouch for that. Whether it's a client leaving or a boss firing, it's a rotten thing. Still, I believe it's fair to put his remarks in context, and even inside that context, he's wrong. Very wrong, very cynical, and it's actually worse when placed into the context he intended it.

Before I continue, let's stipulate that the very best way to handle health care costs would be single payer. I agree with all of you who say that. But this post is not about that. It is about what we have or are about to have and what Mitt Romney thinks we should have. And firing people.

As the clip at the top shows, Romney was talking about health care, and presumably about how he would change Obamacare after he repealed it, as he has promised to do. Here's the full quote:

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