Tag: ACA

Bernie Sanders: We Need Medicare for All, Not Cutbacks That Will Kill Our Seniors

The 50th anniversary of Medicare is a reminder that this program needs to be stronger to meet today’s challenges.

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Source: AlterNet

Author: Sarah Burris

Emphasis Mine

Vermont Senator Bernie Sanders and Maryland Representative Donna Edwards joined the rally celebrating the 50th anniversary of Medicare in Washington, D.C. this Thursday with several hundred nurses, health care workers, and labor allies.

Senator Sanders touted the success of the Medicare program and the millions of seniors and disabled patients it has helped. “Before Medicare, If you were poor and old or sick, you had no options, you died or you suffered,” he said.

The familiar Sanders crusade to fix financial inequalities is a key reason Sanders says he supports a single-payer system and promised to announce legislation within the next year. “We need to expand Medicare to cover every man, woman, and child,” he told the cheering crowd. “Every year, thousands die just because they can’t afford to go to the doctor. No one should go into the hospital and have to file for bankruptcy when they come out.” The Sanders plan, he said, will provide healthcare through the most “cost effective way, and that is a Medicare for all.”

Recent suggestions from Republican Party presidential candidate Jeb Bush that Medicare should be phased out has lead to linguistic punches from many progressive thinkers including economist Paul Krugman, who wrote this week “It’s the very idea of the government providing a universal safety net that they hate, and they hate it even more when such programs are successful.”

Senator Sanders told The Hill Bush’s comments are an example of how far right the Republican Party has become when their so-called moderate candidate is advocating “phasing out” Medicare.  

“As we celebrate the 50th anniversary of Medicare, it is important that we defend this enormously important program rather than talk about ending it,” Sanders continued. “Medicare provides health care to 51 million American seniors and people with disabilities and has saved the lives of countless Americans. Further, as a result of the Affordable Care Act, the finances of Medicare have been significantly improved and it is now fully funded for the next 15 years through 2030. Our goal as a nation should be to join the rest of the industrialized world and guarantee health care to all Americans, not end a highly-successful program which protects seniors and the disabled.”

Representative Donna Edwards (D-MD) followed Senator Sanders speech with a powerful story about her grandfather who died at an early age forcing her grandmother to scrape together money to cover her healthcare costs.

“My grandmother lived much of her life before Medicare,” Edwards told AlterNet in a statement “I know how much she and our family struggled to pay medical bills. Thanks to Medicare, Americans like my grandmother can see their doctor and not go broke paying medical bills. This is why I continue to fight to protect Medicare and ensure that all Americans can lead healthy and productive lives.”

“After 50 years, we have a lot of experience with Medicare,” National Nurses United co-President Jean Ross, RN, said in a statement. “Enough time to see that it works, has kept tens of millions of Americans out of poverty, and remains enormously popular.”  The coalition of nurses and other health care professionals have organized a day of actions including lobbying legislators in Washington to encourage expanding Medicare for all. Other cities including Boston, Detroit, El Paso, Las Vegas, Los Angeles, Miami, Oakland, Portland, Maine, St. Paul, and Lakewood, Ohio will be holding rallies, town hall meetings, parties, picnics and barbecues where nurses and other health care workers can celebrate the success of Medicare and talk about ways to expand the program to cover more people. The coalition of nurses and other health care professionals have organized a day of actions including lobbying legislators in Washington to encourage expanding Medicare for all. Other cities including Boston, Detroit, El Paso, Las Vegas, Los Angeles, Miami, Oakland, Portland, Maine, St. Paul, and Lakewood, Ohio will be holding rallies, town hall meetings, parties, picnics and barbecues where nurses and other health care workers can celebrate the success of Medicare and talk about ways to expand the program to cover more people.

See: http://www.alternet.org/personal-health/bernie-sanders-draws-line-sand-we-need-medicare-all-not-cutbacks-will-kill-our?akid=13344.123424._gla7O&rd=1&src=newsletter1040172&t=3

Startling Proof that Teen Pregnancies Drop When Birth Control Is Free

If birth control were free, there would be fewer unwanted pregnancies.

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Source: AlterNet

Author:April Short

Emphasis Mine

If birth control were free, there would be fewer unwanted pregnancies. This is the longstanding hypothesis put forth by women’s health advocates (and correspondingly written into the Affordable Care Act). Over the last six years, a private grant fund from the Susan Thompson Buffett Foundation (billionaire investor Warren Buffett’s late wife) has given Colorado a unique opportunity to test this hypothesis. The results are astounding.

When teenagers and poor women in the state were offered free, long-acting contraceptives—i.e. intrauterine devices (IUD) and implants—they overwhelmingly accepted, and the rate of teen pregnancies has plunged. Teen births in Colorado dropped by 40 percent between 2009 and 2013 and the number of abortions in the state decreased by 42 percent, according to the Colorado Department of Public Health and Environment.

The New York Times called the results of the experiment “startling,” in a cover story this week, noting that while teenage births “have been declining nationally, experts say the timing and magnitude of the reductions in Colorado are a strong indication that the state’s program was a major driver.”

The impact of the program has been most noticeable in the poorest parts of the state, where the rates of unplanned teenage pregnancy have historically been highest. As the Times explains,

“In 2009, half of all first births to women in the poorest areas of the state happened before they turned 21. By 2014, half of first births did not occur until the women had turned 24, a difference that advocates say gives young women time to finish their educations and to gain a foothold in an increasingly competitive job market.”

The Times article also notes that the number of women using long-term birth control methods in Colorado is much greater than the use of those methods nationally.

“About 7 percent of American women ages 15 to 44 used long-acting birth control from 2011 to 2013, the most recent period studied, up from 1.5 percent in 2002. The figures include all women, even those who were pregnant or sterilized. The share of long-acting contraception users among just women using birth control is likely to be higher.”

While the Affordable Care Act mandates “free contraception” for many in the US, not all insurance coverage is panning out equal. Some plans include a required payment for birth control, and others only offer a limited selection of birth control methods free of charge. And, as the Times notes:

“Only new plans must provide free contraception, so women on plans that predate the law may not qualify. (In 2014, about a quarter of people covered through their employers were on grandfathered plans, according to the Kaiser Family Foundation.)

Advocates also worry that teenagers — who can get the devices at clinics confidentially — may be less likely to get the devices through their parents’ insurance. Long-acting devices can cost between $800 and $900.”  Meanwhile, Colorado’s program is beginning to run low on funding, but for now continues to save the state money and time. The Colorado Department of Public Health and Environment estimates that the birth control initiative has saved the state’s Medicaid program (which covers more than three-quarters of teenage pregnancies and births) $5.85 for every dollar spent.

See: http://www.alternet.org/gender/startling-proof-teen-pregnancies-drop-when-birth-control-free?akid=13285.123424.ETvjTg&rd=1&src=newsletter1039055&t=1

Obamacare’s Victory Is a Defeat For Fundamentalism

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Source:Patheos

Author: Adam Lee

Emphasis Mine

You know it’s been a big week when the Supreme Court once again upholding Obamacare is only the second biggest story to come out of the court. But I wanted to write about this ruling and what it means.

As you may remember, I exulted in 2012 when the Supreme Court upheld Obamacare the first time, rejecting a claim that the law was unconstitutional. It turns out I spoke too soon, because there was another challenge waiting in the wings: King v. Burwell, a right-wing attack which sought to cripple the law rather than strike it down entirely.

Obamacare, like Romneycare in Massachusetts, is a “three-legged stool“: regulations on insurance companies, so they can’t turn people away or drop them for being sick; an individual mandate requiring everyone to buy insurance; and tax credits to help pay for insurance for people who couldn’t otherwise afford it. Some states have their own exchange websites where people can shop for insurance, but a majority use exchanges set up by the federal government. The King lawsuit focused on an ambiguous and obscure clause which said that the tax credits were available on exchanges “established by the state”, which they used to argue that the credits shouldn’t be available for policies purchased on the federal exchanges (even though the law directs the federal government to set up that exchange in the state’s place if the state declines to).

This was no small matter. Without the credits, Obamacare in these states would have turned into a “death spiral”: poor people drop out, raising the cost of premiums for everyone else, which forces still more people to drop their coverage, which raises premiums still further, and so on. Millions of people would have lost their health insurance. The exchanges could have collapsed entirely. (The hand-picked plaintiff, David King, bragged that he has health insurance through the V.A. and wouldn’t have been affected whatever the outcome.)

With an even minimally rational Congress, a one-line legislative fix could have resolved this. But with a fundamentalist Republican Congress dead-set on destroying Obamacare by any means necessary, there would have been no hope of a fix if the court had ruled badly. Even so, the plaintiffs’ gotcha reading was so absurd and tendentious that few legal scholars took it seriously. But then the Supreme Court agreed to hear the case.

I remember the gut-churning anxiety I felt when I heard that news last year. At the time, it seemed plausible that there were five conservative justices who would seize on any excuse to rule against a Democratic accomplishment. But the ruling, when it came down on Thursday, was an enormous relief: not just a victory, but a solid 6-3 victory. Roberts and Kennedy joined the court’s liberals to draw the commonsensical conclusion that all the parts of the law work together as a unified whole, and Congress clearly didn’t intend to set up an exchange that was intended to fail. As Roberts cleverly pointed out, even the more conservative justices understood this until it became politically convenient for them not to

In retrospect, this wasn’t a surprising outcome. John Roberts upheld Obamacare when he could have killed it the first time; it seemed unlikely that he was going to destroy it on the second go-round. Even so, conservatives were furious, accusing Roberts of betrayal as if he had an obligation to rule the way they wanted. Most hilarious was libertarian wingnut Wayne Root, who speculated that President Obama was blackmailing him.

The cynicism and callousness of the conservatives who backed the King lawsuit is astonishing. Without even a constitutional principle at stake, they were willing to create nationwide chaos and take away millions of people’s access to desperately needed medical care, all out of spiteful desire to destroy President Obama’s greatest accomplishment. But they lost – again – and apart from some residual issues (like the continued tussling over the expansion of Medicaid and the birth control mandate), there’s now a wide-open path for Obamacare to do what it was always designed to do.

Just to be clear, I had no personal stake in either of these rulings. I have health insurance through my day job, and, being straight, I’ve never had to fight for recognition or legitimacy for my marriage. But the lives and happiness of millions of people were hanging on the outcomes of both. Since the good guys won in both cases, I think any person of conscience would feel vicarious joy and relief.

There’s one more point relevant to this blog, which is that both rulings undermine the power of religious fundamentalism. With marriage equality, that’s obvious, as I discussed previously. With health care, the connection is more subtle, but just as real. It’s no coincidence that some of the fiercest opposition to Obamacare has come from the religious right: they want to shred the social safety net, so that people have no option but to turn to churches when they need help. There’s plenty of research to establish that in societies that are prosperous, peaceful and secure, people see less need for religious consolation; and I don’t doubt the religious right knows this as well. Their defeat has weakened their influence and made us a more just and humane society, and that’s very much worth celebrating.

One of the Most Incredible Weeks for the Progressive Movement in Ages

Let’s take a look at what happened this week.

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Source: American Prospect, via AlterNet

Author: Robert Kuttner

Emphasis Mine

What an extraordinary week in the political and spiritual life of this nation.

It was a week in which President Obama found the voice that so many of us hoped we discerned in 2008; a week in which two Justices of the Supreme Court resolved that the legitimacy of the institution and their own legacy as jurists was more important than the narrow partisan agenda that Justices Roberts and Kennedy have so often carried out; a week in which liberals could feel good about ourselves and the haters of the right were thrown seriously off balance.

Yet this is one of those inflection points in American politics that could go either way. It could energize the forces of racial justice and racial healing. It could reconstitute the Supreme Court as a body that takes the Constitution seriously. The week’s events could shame, embarrass and divide the political right.

Or the events of the week — the Court upholding the Affordable Care Act and same-sex marriage; the racist South giving up a cherished symbol of slavery; President Obama explicitly and eloquently embracing the pain of the black experience –– could energize the haters.

Consider Obama first. His eulogy for Rev. Clementa Pinckney was the finest expression of political and moral leadership of his presidency. Obama has spoken this candidly on race only once before as a political leader — when his candidacy was on the line in 2008, in the Reverend Jeremiah Wright affair.

In that speech, Obama managed to thread the needle of candidly explaining the experience and the rhetoric of Reverend Wright’s generation, without either condoning the things Wright had said (“God Damn America”), or quite throwing him under the bus. And in the process, Obama won praise for his skill as a leader and a truth-teller on race, and defused a potentially lethal threat to his candidacy.

For the most part, Obama has been timid about using his rhetorical gifts; timid about fighting for what he believes; reticent about engaging Congress or the nation. The exceptional moment, such as the Charleston eulogy shows what the man is capable of — but allows himself to express only rarely.

It is just possible, now in the last 18 months of his presidency, that Obama, with not much to lose, will embrace the boldness that has eluded him for most his two terms — on race, on gun control, on social justice generally, and on the red-state/blue state divisions that are far more severe now than when he gave the now-famous speech at the 2004 Democratic National Convention that established him as a national contender.

There was also one sour note in Obama’s successes of past week. His victory in the fight to pursue a Pacific trade deal was the wrong battle for the wrong goal. Countless progressives wondered where that fighting spirit was when we needed it on so many battles that he and we lost.

There is a direct connection between the racial equality that was, paradoxically, advanced by the Charleston massacre and the economic inequality that has only worsened on Obama’s watch. The more that the One Percent makes off with the lion’s share of America’s productivity, the more the white working class and the downwardly mobile middle class are inclined to scapegoat people of color and immigrants.

(N.B.: Yes!)

How much stronger a hand Obama would have to call America to be its best self on racial healing, if he had been a fighter all along for economic justice; if working class people of all races felt that they had a champion in him. Instead, the biggest economic battle of his second term was on behalf of a corporate wish list.

That said, there is now momentum on the progressive side. There is movement for the symbolism of taking down the Confederate battle flag to give way to substance. If Southern Republican leaders now recognize the pain that such symbols cause, how about the pain of the denial of the right to vote? How about the pain of denial of health coverage under Medicaid so that Republican leaders can score political points against Obama.

The president was eloquent in his eulogy on the subject of grace.

According to the Christian tradition, grace is not earned. Grace is not merited. It’s not something we deserve. Rather, grace is the free and benevolent favor of God… As a nation, out of this terrible tragedy, God has visited grace upon us, for he has allowed us to see where we’ve been blind. [Applause.] He has given us the chance, where we’ve been lost, to find our best selves.

Well, if we as a nation were to stop with the removal of the Confederate flag from official sites, that would be cheap grace indeed. To shift the metaphor from Christian to Jewish, one thinks of the Passover song, Dayenu, which means, “It would have been enough:” If God had led the Hebrew slaves out of Egypt, that would have been enough; if He had given us the Torah, it would been enough. And so on. But God’s blessings are infinite.

To flip the sentiment, if the Southern elite took down the flag — that would not be enough. And if they restored the right to vote freely, that would not be enough. And if America got serious about police brutality, that would not be enough. And if conservatives stopped trying to overturn affirmative action — that would only be the bare beginning of what we owe the descendants of slavery, segregation and continued acts of racial violence.

Which brings me to the Supreme Court. In the decision upholding the Affordable Care Act, Justice Roberts rose to the occasion with true eloquence and discernment. Justice Kennedy, author of the soaring decision on gay marriage, has displayed growth and compassion on a range of issues. Even in dissent, in the gay marriage decision Justice Roberts acknowledged what a momentous shift the acceptance of same-sex marriage was and is.

Justice Scalia was revealed, even more than before, as a petty, vindictive crank. His cheap, personal put-downs of Kennedy and Roberts in dissent can hardly serve to win them over in future decisions.

Here again, if the Court really wants to atone for past sins, Roberts and Kennedy might revisit the absurd decision throwing out key sections of the Voting Rights Act on the premise that racist denial of the right to vote was no longer a problem; and the equally bizarre decision equating money with speech. They have now had time for penitence — to see the real-world consequences of their handiwork and consider just how wrong they were, not just on the Constitution but on how politics actually operates.

Still to come will be a decision on affirmative action, where past signals have suggested that the Roberts Court is ready to overturn it. After Charleston, and the national conversation that the massacre has opened, this would not be the moment to destroy the society’s ability to very partially remediate past oppression.

All in all, a good week for everything decent in America. But only the bare beginnings of the progress we need to make. President Obama needs to keep following that inner light. The new Supreme Court majority needs to continue aiming higher than narrow partisanship. And the rest of us need to broaden the struggle for economic as well as racial justice.

 

Robert Kuttner is the former co-editor of the American Prospect and a senior fellow at Demos. His latest book is “Obama’s Challenge: America’s Economic Crisis and the Power of a Transformative Presidency.”

See: http://www.alternet.org/culture/one-most-incredible-weeks-progressive-movement-ages?akid=13255.123424.mgnLe2&rd=1&src=newsletter1038583&t=13

Paul Krugman Reveals the Real Reason Conservatives Fear Obamacare

The law’s opponents’ real fear was that it might work. It is.

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Source: AlterNet

Author: Janet Allon

Emphasis Mine

Paul Krugman celebrated the Obamacare victory in the Supreme Court by pointing out the unforeseen success of the law in Friday’s column.

Start with the act’s most basic purpose, to cover the previously uninsured. Opponents of the law insisted that it would actually reduce coverage; in reality, around 15 million Americans have gained insurance.

But isn’t that a very partial success, with millions still uncovered? Well, many of those still uninsured are in that position because their state governments have refused to let the federal government enroll them in Medicaid.

… In states that have implemented the act in full and expanded Medicaid, data from the Urban Institute show the uninsured falling from more than 16 percent to just 7.5 percent — that is, in year two we’re already around 80 percent of the way there. Most of the way with the A.C.A.!

Hmmm, not enough reason to call the law a success? Next, Krugman tackles the issue of the quality of coverage.

The answer: not bad, but not perfect. Cheaper plans have high deductibles, but the long and the short of it is that any plan is better than no plan. Pretty undeniable. “The newly insured have seen a sharp drop in health-related financial distress, and report a high degree of satisfactionwith their coverage,” Krugman writes.

Rate shock did not materialize either. And though premiums may go up next year, the rise will be well below the scare monger’s claims.

Finally, this is a law even supposedly fiscal conservatives can love. Overall health spending is down. Do the opponents do any homework at all?

Did Obamacare kill jobs? Nope. “The U.S. economy has added more than 240,000 jobs a month on average since Obamacare went into effect, its biggest gains since the 1990s,” Krugman says.

Budget deficit down. Check.

There’s your  “interpretive jiggery-pokery,” Scalia.

One conservative fear has truly come to pass. Health reform has apparently succeeded. The government can actually make a positive difference in people’s lives.

The horror.

See:http://www.alternet.org/news-amp-politics/paul-krugman-reveals-real-reason-conservatives-fear-obamacare?akid=13250.123424.aa5-Ay&rd=1&src=newsletter1038451&t=5

Supreme Court to Hear Arguments Over Obamacare

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Source: The Washington Spectator via AlterNet

Author: Lou Dubose

Emphasis Mine

N.B.: The Patient Protection and Affordable Care Act was crafted and passed by the House and Senate, and signed into law by the POTUS.

The amicus briefs filed in the challenge to the Affordable Care Act (ACA) to be argued before the Supreme Court on March 4 illuminate the Great American Political-Cultural divide.

Those who filed briefs in defense of Obama’s legislation are recognizable: theAmerican Cancer Society, the American Academy of Pediatrics, et al. There is a different anthropology among those who filed briefs supporting the plaintiffs who are challenging tax subsidies for low-income buyers of health-care insurance policies.

Texas’s Black Americans for Life considers abortion and contraception “a tool by some who wish to target the African-American community.”

Colorado’s Mountain State Legal Foundation is “dedicated to bringing before the courts those issues vital to the defense and preservation of individual liberties, the right to own and use property, and the free enterprise system.”

The American Civil Rights Union is “dedicated to defending all of our constitutional rights, not just those that might be politically correct.”

Senator John Cornyn of Texas is named on the amicus brief filed by 16 Congressional Republicans, an unlikely choice to lead any health-care pleading.

At 26.8 percent (24.81 percent after ACA enrollment), Texas leads the nation in the percentage of residents lacking health-care coverage. It also leads the nation in the number of eligible residents, 1,046,430, who are shut out of Medicaid. Texas, like 25 other Republican-led states, has rejected the Medicaid expansion provided through the ACA.

A Fight over Five Words

King v. Burwell is a fight over five words in the statute: “Exchanges established by the State.”

The ACA creates insurance-market exchanges through which anyone can purchase private health-insurance policies. In an attempt to subvert the law, most states governed by Republicans refused to establish exchanges. But the law also created a federal exchange, where residents who are denied access to state exchanges can purchase insurance. Currently, state and federal exchanges provide subsidies for low-income purchasers of insurance.

According to the plaintiffs, one phrase in a section of the statute describing the subsidies—“Exchanges set up by the State”—restricts the subsidy program to state insurance exchanges, although other language indicates that Congress intended to extend subsidies to all insurance buyers who meet the law’s income qualification.

This lawsuit isn’t what it claims to be.

Contradictions and hypocrisy underlie the intent of the plaintiffs and the politicians supporting them.

Consider the plaintiffs.

David King and three other residents of Virginia, which has no exchange, qualify for subsidies provided through the federal exchange. They are asking the Court to overturn the subsidies, because, on ideological grounds, they object to the ACA’s mandate requiring individual health-care coverage.

Consider the elected officials.

John Cornyn, for example. Or Florida’s Marco Rubio, or Utah’s Jake Garn, or Tennessee Rep. Marsha Blackburn. All signed the anti-subsidy amicus brief filed with the Court, and all represent states whose Republican governments refused to create exchanges. They are petitioning the Supreme Court to hand down a decision that will strip subsidies from low-income residents in the states they represent.

It requires at least four justices to decide to hear a case. The activist and Republican majority on the Roberts Court has decided to hear the appeal of a lawsuit filed and financed by ideologues determined to destroy the Affordable Care Act.

To decide on behalf of the plaintiffs, the justices will have to ignore principles by which they have decided cases requiring them to interpret the meaning of statutes. Yale Law School Professor Abbe Gluck explains in an article published by Scotusblog.

Republican justices, he writes, in particular Antonin Scalia, are “textualists” who have “repeatedly emphasized that textual interpretation is to be sophisticated, ‘holistic’ and ‘contextual,’ not ‘wooden’ or ‘literal,’ to use Justice Scalia’s words.”

Gluck quotes Scalia’s explaining textualism in an opinion handed down in June 2014, in which the justice describes “the fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme.”

Gluck also quotes four of the five Republican justices who published a joint dissent in the 2012 case that upheld critical provisions of the ACA. They address the very subsidies that are now before the Court: “Congress provided a backup scheme; if a State declines to participate in the operation of an exchange, the Federal Government will step in and operate an exchange in that State. That system collapses if the federal subsidies are invalidated.”

The preceding sentence is critically important. The Republican justices know “the system collapses if the federal subsidies are invalidated.”

Lou Dubose is a former Observer editor and co-author of “The Hammer: Tom DeLay, God, Money and the Rise of the Republican Congress.”

 

See:http://www.alternet.org/news-amp-politics/supreme-court-hear-arguments-over-obamacare?akid=12841.123424.cMyi55&rd=1&src=newsletter1032656&t=19

Health Law Drives Down U.S. Rate Of Uninsured Patients, Survey Finds

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Source: National Memo

Author: Noam Levy

Emphasis Mine 

America’s uninsured rate plummeted last year, with the improvement driven by states that have fully implemented the Affordable Care Act, a new nationwide Gallup survey indicates.

Led by Arkansas and Kentucky, which both saw double-digit declines, seven states saw the percentage of adults without insurance fall by more than 5 percentage points between 2013 and 2014.

All but one of the 11 states with the biggest drops implemented both pillars of the federal health law: expanding Medicaid coverage to low-income adults and setting up a fully or partially functioning state-based marketplace.

“While a majority of Americans continue to disapprove of the Affordable Care Act, it has clearly had an impact in reducing the uninsured rate in the U.S., which declined to its lowest point in seven years in 2014,” Gallup’s Dan Witters wrote in a report outlining the new findings.

While some critics of the health law continue to question its impact on coverage, a growing number of independent surveys show the number of Americans without health insurance fell dramatically last year. The rate had been increasing in the years before the new law went into effect.

Gallup’s poll is among the largest surveys on the issue, with more than 175,000 interviews annually. It found that nationwide the rate of uninsured adults declined from 17.3 percent in 2013 to 13.8 percent last year.

The lowest uninsured rates continue to be primarily in the Northeast and upper Midwest. Massachusetts, whose 2006 coverage expansion became the model for the national law, had the lowest rate at 4.6 percent.

The highest uninsured rates are in the South and West. For the seventh consecutive year, Texas has the worst rate in the country, with nearly a quarter of its adults uncovered.

Gallup’s survey also underscored how the health law may be widening the nation’s health care divide.

States that have fully implemented the law saw a 4.8 percentage point improvement in the share of the adult population with insurance between 2013 and 2014. That was nearly twice the rate of decline in states that have not fully implemented the law.

California, which historically had among the highest uninsured rates, recorded one of the fastest declines. The share of adults without coverage in the state fell from 21.6 percent to 15.3 percent.

Even Connecticut and Maryland, which already had among the highest rates of coverage, saw major declines in the rate of uninsured adults. Connecticut’s rate dropped from 12.3 percent to 6 percent; Maryland’s went from 12.9 percent to 7.8 percent.

All three states have enthusiastically embraced the health law.

By contrast, Texas, where opposition to the health law has been fierce, recorded a decline of less than 3 points, from 27 percent to 24.4 percent.

The Gallup survey results were based on interviews nationwide with 178,072 adults in 2013 and 176,702 adults in 2014. The margin of error is plus or minus 1 or 2 percentage points in most states, though it is closer to 4 percentage points in small states.

================================================================================

See: http://www.nationalmemo.com/health-law-drives-u-s-rate-uninsured-patients-survey-finds/

We Would Miss Obamacare

the arguments you usually hear about the law are remarkably fact-free.

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N.B.: Since the ACA was:

 o crafted by the House and Senate

 o Passed by both the House and Senate

 o Signed into law by the President,

Should we call it HouseSenateCare?

Source: National Memo

Author: EJ Dionne

Emphasis Mine

WASHINGTON — Will it take the repeal of the Affordable Care Act or its evisceration by the Supreme Court for us to appreciate what it’s actually done?

Critics of the ACA are so insistent on pointing to the problems it has encountered — erroneous tax information to 800,000 taxpayers is the latest — that it was especially enlightening on Friday to talk with Sylvia Mathews Burwell, the secretary of Health and Human Services.

You might think of her as a wonk with a heart. She refers to her agency as the “Department of the Kitchen Table” because the issues it deals with, from health care to food safety to the problems facing elderly parents, are the sorts that we discuss at breakfast or dinner.

What does Obamacare mean at many of those kitchen tables? Because of the law, at least 10 million fewer Americans are uninsured — and that’s a conservative number. The drop in the nation’s uninsured rate is the largest since the early 1970s, when Medicaid was still taking hold and both Medicare and Medicaid were expanded to cover people with disabilities.

These aren’t just government numbers. Here is what Gallup said in January: “The uninsured rate has dropped 4.2 percentage points since the Affordable Care Act’s requirement for Americans to have health insurance went into effect one year ago.”

Gallup might have mentioned not just the mandate but also the financial help many Americans have received to buy coverage under the ACA. Some more numbers: 87 percent of the people who signed up on the exchanges qualified for subsidies, and the average assistance to each was $268 per month. Perhaps some out there would rather not have government help people buy health insurance, but this seems to me a good and decent use of our tax money.

True, the administration messed up at the start of the program and will have to rectify this tax problem. Still, in this year’s enrollment period, its target was 9.1 million, and 11.4 million signed up. Again, Burwell doesn’t want to oversell: Some of those signing up will fall by the wayside before they complete the process and pay for insurance. But past experience suggests the final number will still surpass the target.

We don’t talk about it much, but by closing the “doughnut hole” in the Medicare drug program, thus providing more help, the law has saved 8.2 million seniors over $11 billion since 2010. That comes to $1,407 per beneficiary. How many elderly Americans want that to go away? This is something else that “repealing Obamacare” would mean.

Are you a budget hawk? The slowdown in Medicare cost inflation between 2009 and 2012 saved the government $116.4 billion. Burwell is way too careful a wonk to claim that all this was caused by the health care law, but largely good things have happened — including, by the way, to employment — since it passed. Its critics predicted all sorts of catastrophes. They were wrong.

Oh, yes, and between the Medicaid expansion and the children’s health insurance program, 10 million people gained coverage. And that’s with two of the states with the largest number of uninsured, Texas and Florida, staying out of the ACA expansion.

Roughly 3 million young adults have received coverage courtesy of the law’s provision that allows them to stay on their parents’ plans until age 26. And Americans no longer have to worry that they won’t be able to get insurance because of pre-existing conditions.

I am sorry to burden you with all these numbers, but the arguments you usually hear about the law are remarkably fact-free. As Burwell says, they typically focus on a single word — that would be “Obamacare” — not what the law does.

Burwell would love to work with Republicans to make the law better. More could be done, she says, to ensure that people now getting coverage also receive the care they need. Both parties could team up to improve “the quality of the care and the value of the dollar we pay.” And we could ease the income “cliffs,” the points where people become ineligible for government help.

But it’s lots more fun for opponents of Obamacare to scream “socialism” and make scary and groundless predictions.

I hope that when the Supreme Court deals with the frivolous lawsuit concocted to wreck the law, the justices think about all the people they would hurt — badly — if they destroyed it. The Repeal Obamacare crowd might usefully think a little more about them, too.

E.J. Dionne’s email address is ejdionne@washpost.com. Twitter: @EJDionne.

 

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See: http://www.nationalmemo.com/miss-obamacare/

Paul Krugman: 4 Surprising Reasons to be Cheerful at the Close of 2014

Don’t believe the propaganda that good governance can’t deal with big problems

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Source: NY Times via AlterNet

Author: Janet Allon

Emphasis Mine

Paul Krugman is feeling a tad optimistic as the year 2014 winds down. In his Friday column, he writes about “Tidings of Comfort,” if not quite tidings of great joy. The reason? Despite all the miserable messages about a world spinning out of control and a government completely not up to the task of confronting tough problems, “a number of major government policies worked just fine,” he writes. “And the biggest successes involved the most derided policies. You’ll never hear this on Fox News, but 2014 was a year in which the federal government, in particular, showed that it can do some important things very well if it wants to.”

Here are the four areas where Krugman posits the government, and in particular, the Obama administration showed its competency:

1. Ebola

Just a month or so ago we were in a full-blown panic about Ebola coming to this country. And the message of many policiticans was that our public health officials were in no way up to the task of dealing with it using conventional methods.” Instead, they insisted, we needed to ban all travel to and from West Africa,” Krguman writes, “imprison anyone who arrived from the wrong place, and  close the border with Mexico. No, I have no idea why anyone thought that last item made sense.”

This was all wrong. It turned out that the epidemiologists at the Centers for Disease Control and Prevention actually knew what they were doing, despite some early mistakes. Ebola is still killing people in Africa, but there was no outbreak here, despite what the fearmongers projected. 

2. The Economy

Yes, the recovery has been painfully and unneccessarily slow, in particular it has been ” held back by unprecedented cuts in public spending and employment,” Krugman writes.

But the story you hear all the time portrays economic policy as an unmitigated disaster, with President Obama’s alleged hostility to business holding back investment and job creation. So it comes as something of a shock when  you look at the actual record and discover that growth and job creation have been substantially faster during the Obama recovery than they were during the Bush recovery last decade (even ignoring the crisis at the end), and that while housing is still depressed,  business investment has been quite strong.

What’s more, recent data suggest that the economy is gathering strength —  5 percent growth in the last quarter! Oh, and not that it matters very much, but there are some people who like to claim that economic success should be judged by the performance of the stock market. And stock prices, which hit a low point in March 2009,  accompanied by declarations from prominent Republican economists that Mr. Obama was killing the market economy,  have tripled since then. Maybe economic management hasn’t been that bad, after all.

Whether the gains in the economy help poor Americans still struggling with low wages, staggering inequality and brutal rises in the cost of living, remains to be seen. But at least by some conservative standards, Obama’s stewardship has been on track. Not that you’ll ever see that acknowledged on Fox or by Republicans.

3. Obamacare Krugman cites one of his favorite topics, “the hidden-in-plain-sight triumph of Obamacare,” at the end of its first full year.  Krugman says he is asked, even by liberal friends, whether the program can be made to work. Apparently, they have not gotten the memo. It is working. 

In fact, Year 1 surpassed expectations on every front. Remember claims that more people would lose insurance than gained it? Well, the number of Americans without insurance  fell by around 10 million; members of the elite who have never been uninsured have no idea just how much positive difference that makes to people’s lives. Remember claims that reform would break the budget? In reality,  premiums were far less than predicted, overall health spending is moderating, and  specific cost-control measures are doing very well. And all indications suggest that year two will be marked by further success.

4. Foreign policy This one will be controversial, but Krugman writes that Obama’s foreign policy of containing threats like Putin’s Russia and Islamic State. rather than waging all-out war on them, is “looking pretty good.” The message is that, despite all the right-wing propaganda to the contrary, 2014 shows that the government can be part of the solution, which is not to say that problems have disappeared from the world. Or that Fox News and their flunkies will admit it. 

See: http://www.alternet.org/economy/paul-krugman-4-surprising-reasons-be-cheerful-close-2014?akid=12617.123424.-2lbsH&rd=1&src=newsletter1029336&t=7

Republicans deliver another self-inflicted wound

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Source: Washington Post

Author: Dan Balz

Republicans may yet win the elections in November. They may end up in control of both houses of Congress come January. But in the final week before a lengthy August recess, they have shown a remarkable capacity to complicate their path to victory.

The latest blow came Thursday in what has become predictable fashion: chaos in the House. Amid fractious infighting, House leaders abruptly pulled their alternative to President Obama’s bill to deal with the influx of Central American children crossing the border. What was said to be a national crisis turned into one more problem facing deferral.

But there was more over the week that could contribute to the deteriorated brand called the Republican Party. On Wednesday, the House voted to sue Obama, an action that may cheer the party’s conservative wing but that also may appear to other voters to be a distraction at a time of major domestic and international problems.

In the background this week was talk of impeachment. Republicans rightly suggest that the White House and Democrats are doing all they can to stoke discussion of the topic as a way to raise money and motivate their base. But it is a subject that has bubbled up from the conservative grass roots of the GOP and that now bedevils Republican leaders.

Fundamentals in this election year continue to favor the Republicans. Obama’s approval rating is low and stagnant. Not much on the immediate horizon is likely to change that, given the state of the world. The economy is getting better, but many voters aren’t convinced of that. The Senate map favors Republicans, who need a net of six seats to gain control of the chamber.

This isn’t 2010 all over again by any means: The unrest is more muted. But looking toward November, it’s better to be in the Republicans’ position now than the Democrats’. Standing in the GOP’s path to victory, however, are perceptions of the party itself, nationally and in some of the states. How much self-inflicted damage is too much?

The tea party movement gives the Republicans energy, but it continues to push the party further to the right than some strategists believe is safe ground. In a number of states, strategists for the GOP say tea party positions are outside the mainstream, even the conservative mainstream.

Republicans are asking for the right to govern, to control the legislative machinery starting in 2015. But they continue to struggle with that very responsibility in the one chamber they control. How many times have Speaker John A. Boehner (R-Ohio) and his top lieutenants suffered similar embarrassments as support for leadership measures suddenly eroded in the face of a conservative revolt?

Republicans have been repeatedly criticized for not offering a governing agenda if they take power. What happened Thursday underscores why that has been so difficult. Getting the party’s factions on the same page has proved more than difficult. In some states where Republicans control the governorship and the legislature, there has been a backlash to their governing agenda. Kansas and North Carolina are two prime examples.

In Congress, Republicans have spent four years attacking the Affordable Care Act with a series of votes to repeal or defund it. But is there a Republican alternative they are collectively promoting this fall? No. Rep. Paul Ryan (Wis.) told reporters at a breakfast held by the Christian Science Monitor on Thursday that he is working on one — but that it is just one of several GOP ideas on health care.

House Republican leaders say Democrats are hypocritical to blame them for the gridlock and chaos. They point to a series of bills approved with Democratic support that are parked in the Senate with no action. They say Senate Majority Leader Harry M. Reid (D-Nev.) should let senators vote on them. But by their own high-voltage missteps, they draw attention away from that and to themselves. They reinforce a narrative that remains not in their favor.

The immigration issue offered a fresh example of the conundrum for Republicans. The border crisis presented Obama with a serious problem — substantively and politically. He offered his own plan for $3.7 billion in spending, which was too high-priced for the GOP. Their alternative called for $659 million in spending.

 But at the center was an issue of power. Republicans view Obama as an out-of-control executive who has exceeded his constitutional authority and they want to take him to court (although ironically for doing something with the Affordable Care Act, delaying the employer mandate, a move they favor).

The issue of executive power extends to immigration. With comprehensive immigration reform locked down in the House and heading nowhere this year, Obama’s administration is exploring what he can do through his executive powers to accomplish some of what immigration reform legislation would do, including possibly allowing some of the adults here illegally not to face deportation.

Many House Republicans want to stop him. Some also wanted to force him to roll back what he did in 2012, when he allowed children who came into the United States illegally with their parents to stay without an immediate threat of deportation. All of that contributed to the collapse of the border bill.

It also prompted a call from at least one powerful Republican for Obama to act on his own.

“I think this will put a lot more pressure on the president to act,” House Appropriations Committee Chairman Harold Rogers (R-Ky.) told reporters on Capitol Hill. “In many ways, it was his actions and inactions that caused the crisis on the border, and we attempted in this bill to help remedy this crisis. He has the authority and power to solve the problem forthwith.”

Obama ridiculed the House for wanting to sue him. “They’re mad because I’m doing my job,” he told an audience in Kansas City, Mo., on Wednesday.

That’s a large overstatement by the president, but Republicans have handed him the argument to make through their actions and inactions.

Republicans will have five weeks outside of Washington to let things settle after Thursday’s breakdown. They will have time  to regroup and try to put this moment behind them. Obama and the Democrats are still on the defensive in the battle for control in these midterm elections. But Republicans would do better if they found a way to stop hurting themselves.

Emphasis Mine

See: http://www.washingtonpost.com/politics/republicans-deliver-another-self-inflicted-wound/2014/07/31/d78f131a-18e5-11e4-9e3b-7f2f110c6265_story.html?wpisrc=nl_politics&wpmm=1