“Ebola And The 41 Million Uninsured Americans”: Political Failure’s That Have Left Americans More Vulnerable To Deadly Diseases
With the first diagnosed case of the deadly Ebola virus in the United States located in Dallas, Texans are understandably alarmed. The patient just died. Gov. Rick Perry has established a taskforce to address the Ebola threat.
Not a bad idea but still a feeble response coming from a governor who refused to expand Medicaid in his state, leaving millions of his people outside the health care system. About 6 million Texans are now walking around without health insurance. That’s almost 1 in 4 residents — the highest rate of uninsured in the country.
Of course, those without health coverage are least likely to have a relationship with a health care professional, someone they could contact about worrisome symptoms. And because vomiting and other signs of Ebola could indicate something far less serious, these mostly low-income people might put off going to a hospital until it’s too late.
But Perry was among the large group of so-called conservative governors deeming it was more important to stick it to President Obama than to broaden health coverage in their states. Not surprisingly, the sharpest drops in the rates of the uninsured are in states that went along with the expansion. The rates remain nearly unchanged in the 23 nonparticipating states.
There was always a humanitarian reason for supporting the Affordable Care Act. Now we are seeing the self-interested reasons, which have been missing in most of the Obamacare debate. Covering all is essential to public health. Even the rich don’t enjoy divine protection from deadly infectious diseases. That the federal government is covering nearly the entire cost of the Medicaid expansion makes the excuses for not joining the program especially ugly.
And this is not just about Ebola. The flu is a communicable disease that typically kills 30,000 Americans a year, mainly the very old, the very young and the frail. Universal coverage can help contain that, as well.
The Ebola scare has overshadowed another frightening virus that has been diagnosed in hundreds of children since August — and that has just claimed the life of a 4-year-old in New Jersey. Enterovirus-68 has been found in 48 states, with significant numbers reported in Colorado, Illinois and Missouri. This respiratory illness, which has been associated with partial paralysis, spreads the same way colds do, through saliva and other bodily fluids.
Controlling these diseases requires early quarantine of those infected, and how are you going to find people who would test positive if they don’t go to a medical facility? Politicians who irresponsibly passed up an opportunity to bring such health services to their people are currently grasping at useless proposals.
Louisiana Gov. Bobby Jindal thinks the answer is to “stop accepting flights from countries that are Ebola stricken.” But what about the two nurses in Madrid who tested positive for the virus after treating a Spanish priest? The priest and one of the nurses have already died of the disease.
Do we stop accepting flights from Spain, which has a pretty good health care system, of course covering everyone? Not unexpectedly, the Texas governor opposes the flight ban idea.
Jindal was inexplicably proud to decline $6 billion in federal money to expand Medicaid coverage in his state. Nearly 900,000 Louisianans currently lack health insurance.
“Expansion would result in 41 percent of Louisiana’s population being enrolled in Medicaid,” Jindal explained at the time. “We should measure success by reducing the number of people on public assistance.”
There are many ways of measuring success in a society, widespread health coverage being one. Instead, we see a political failure that has left Americans more vulnerable to a deadly disease than they had to be. It’s really something.
By: Froma Harrop, The National Memo, October 9, 2014
When it comes to healthcare, Southwest Virginia is a desperate place. Many of the state’s poorest and sickest live in that pocket of coal country between US Route 19 and the Kentucky and Tennessee borders, where it’s so hard to see a doctor that a free mobile health clinic held each July at a county fairground draws hundreds. “Southwest Virginia is one of the worst places we go to,” said Stan Brock, the founder and president of Remote Area Medical, which runs that clinic and others throughout the country.
That corner of Virginia also encompasses the district of Phillip Puckett, who served as a Democratic state senator until Monday, when he suddenly resigned. His decision to step down appears to have been the result of a bribe offered by Republican colleagues bent on stopping the expansion of Medicaid. Puckett’s resignation gave Republicans the one seat they needed to take control of the Senate; it also put him in the running for a paid post on a state tobacco commission that is controlled by some of the very same Republicans. And it cleared the way for the chamber to appoint his daughter to a state judgeship.
By stepping down, Puckett effectively ended a months-long battle over the fate of the 400,000 Virginians who are too poor to buy insurance but don’t meet the state’s restrictive eligibility requirements for Medicaid. The state Senate had been on course to vote to expand the program under the Affordable Care Act, setting up a budget showdown with the Republican-controlled House. But with the GOP now in control of the Senate, both chambers are expected to pass a spending plan on Thursday that does not include the expansion.
The advocacy group ProgressVA called for an investigation of allegations of a quid pro quo between Puckett and Republicans, who deny they made any sort of deal. Puckett cited “recent issues that have developed in our family” as grounds for his resignation, and said he would withdraw his name from consideration for the job on the tobacco commission. Virginia Attorney General Mark R. Herring announced that he does not see an “investigative role” for his office.
The question of what prompted Puckett’s mid-term resignation is tantalizing, and potentially important, but it’s also beside the point. The true scandal is that hundreds of thousands of Virginians—including more than 20,000 of Puckett’s own constituents—will be denied health insurance.
The Medicaid showdown in Virginia was particularly heated because the legislature was so closely split. But Republicans all across the country have gone to insane lengths to keep millions uninsured, or to justify doing so. In Louisiana, for example, the state sued MoveOn.org for a billboard criticizing Governor Bobby Jindal’s opposition to the Medicaid expansion. Republicans in Utah are trying to embed work requirements into a private alternative to the expansion, a stipulation that would likely make the plan unworkable. In Arkansas, Republicans tried to roll back the Medicaid alternative that passed last year by refusing to reauthorize its funding. Although the program was finally re-approved, conservative lawmakers—who are steadily gaining ground in the Arkansas legislature—indicated that they’ll attack it again next year.
For years now Republicans have trotted out the same reasonable-sounding lies to fight the expansion, namely the myth that states can’t afford it. The real callousness that undergirds their ideological campaign was made clear this year, however, by a handful of state senators in Missouri, who gathered on the Senate floor to make it clear that there would be “no path” forward for the expansion. “Why is this somehow our problem?” one lawmaker asked. “It’s not happening,” said another. “Go find something else to do.”
There simply isn’t anything else that the millions of Americans who fall into the coverage gap can do to afford healthcare. Expanding Medicaid won’t fix all of the health problems in Southwest Virginia; a shortage of providers serving rural and low-income patients also challenges the region. But that’s no reason to deny insurance to people, particularly when the costs of doing so will be born almost entirely by the federal government, not the state. The persistence of myriad other issues to be dealt with is simply an indicator that people would be better served if lawmakers spent less time devising elaborate schemes to keep the poor uninsured and found something else to do, themselves.
By: Zoe Carpenter, The Nation, June 10, 2014
“A Sordid Approach To The Uninsured”: Republican’s Increasingly Appear Eager To Punish The Poor Because They’re Poor
Even if the Affordable Care Act is implemented perfectly, and the system works exactly as planned, millions of Americans will go without access to affordable health care. Is it due to a flaw in the law? Not exactly.
The problem is Republican opposition to Medicaid expansion at the state level. If your income is between 100% and 138% of the poverty line, you can qualify for Medicaid and get covered – unless you live in a “red” state where GOP officials have rejected Medicaid expansion. If so, you can (a) move; (b) figure out a way to make more money; or (c) go without.
Just in recent days, we’ve seen reports reinforcing how inexplicable these states’ policies really are. Refusing Medicaid expansion will not only cost states billions, but it will also severely undermine state hospitals, all while hurting struggling families.
Kevin Drum today called it “one of the most sordid acts in recent American history.”
The cost to the states is tiny, and the help it would bring to the poor is immense. It’s paid for by taxes that residents of these states are going to pay regardless of whether they receive any of the benefits. And yet, merely because it has Obama’s name attached to it, they’ve decided that immiserating millions of poor people is worth it. It is hard to imagine a decision more depraved.
Alternatively, Republicans in Congress could agree to fix this problem and allow people without access to Medicaid to qualify for exchange subsidies. But of course they won’t do that either for the same reason.
Conservatives hate it when you accuse them of simply not caring about the poor. Sometimes they have a point. This is not one of those times.
I strongly agree, though I’d just add that it’s amazing to hear Republican governors who reject Medicaid expansion try to present their approach as sensible.
Wyoming Gov. Matt Mead (R) recently said he refused the policy because he doesn’t like exchange marketplaces, which doesn’t make any sense. Alaska Gov. Sean Parnell (R) justified his opposition by saying the health care law is a “mess,” which is shallow even by GOP standards. Wisconsin Gov. Scott Walker (R) appeared on MSNBC and said he rejected Medicaid expansion because, someday, federal officials may “renege on their promise” to reimburse states.
Has that ever happened? No. Is there any reason to believe it might happen? No. Could Wisconsin bring coverage to struggling families in the meantime, and then drop the policy in the event Washington refused to meet its obligations? Yes, but Walker doesn’t want to.
The larger takeaway here is that Republican officials increasingly appear eager to punish the poor because they’re poor. Indeed, it’s become a common theme in GOP policymaking just in recent weeks: no extension of unemployment benefits, no extension of the status quo on food stamps, no increase in the minimum wage, and wherever possible, no Medicaid expansion, either.
Republicans better hope low-income Americans vote in low numbers in the near future.
By: Steve Benen, The Maddow Blog, December 9, 2013
The latest polls on Obamacare are bleak. A Kaiser Family Foundation survey found that almost half of those questioned last week had an unfavorable opinion of the law. Just a third had a favorable opinion, even less than the 40 percent support for the law in the Nov. 14 Gallup poll.
But those poll numbers will change as more people like Bob Freukes of St. Louis and Donna Smith of Denver are finally able to shop for coverage on the new health insurance websites — and find coverage that is surprisingly affordable.
Considering all the negative stories about the malfunctioning HealthCare.gov website and policy cancellations folks have been receiving, the steep decline in support for Obamacare shouldn’t surprise anyone.
But in the very week that poll numbers reached an all-time low, people who had tried for more than a month to enroll online in a health plan were finally able to do so.
Just minutes after the administration’s tech surge team said 90 percent of applicants were now able to enroll online, I started getting emails from people eager to share their success stories.
“My wife and I are both self-employed small sole proprietors,” wrote Freukes, a photographer. “This will be the first time in our married lives we will have health insurance.”
Freukes said that over the course of the past year, he and his wife — married 30 years and are now in their fifties — rarely went to the doctor because of the expense.
“We paid for doctor visits, prescriptions, eye glasses and everything else out of [our] own pockets, always knowing we were one major illness away from bankruptcy.
“We tried to find an affordable policy, but the going rate for my wife and me was roughly $900-$1,400 dollars a month with deductibles in the $5,000 range.” Considering that their combined annual income is often no more than $25,000, health insurance was out of the question.
Not only will they finally have coverage starting January 1, it will cost the Freukes less than they had expected because of the federal tax credits available to low- and middle-income individuals who buy coverage on the state exchanges. In fact, with the tax credits, the Freukes will not have to pay monthly premiums at all.
“I sat rubbing my eyes in amazement as the website did the math. Our portion of the premium for both plans was ZERO. No cost to us at all. I was stunned.”
Donna Smith wasn’t that fortunate, but she at long last will be able to get a comprehensive policy that she can afford.
Like Bob Freukes, it took Smith weeks of effort before she was finally able to enroll in a plan. Her delay, though, was caused by a different, though no less frustrating quirk in the system. Colorado is one of 13 states and the District of Columbia operating their own exchanges, which generally have experienced fewer problems than the federal website, where residents of most states have been sent. Several thousand people were able to begin the application process in Colorado but they had to wait — and wait and wait — while state officials checked to see if the applicants were eligible for Medicaid.
Smith knew her income was too high to qualify for Medicaid, but she nevertheless had to fill out an extensive questionnaire and was put in what she described as a “bureaucratic black hole” for 37 days. It was an agonizing wait for Smith, a cancer survivor who — along with husband Larry — had to file for bankruptcy several years ago because of medical debt. If her name sounds familiar, by the way, it might be because you’ve seen her in the movies. When she wrote filmmaker Michael Moore about her plight, he included her in the 2007 documentary, SiCKO. Since then she has been an active supporter of health care reform.
After she finally got the Medicaid denial she was expecting, Smith called Connect for Health Colorado — the name of the state exchange — and worked with an employee to complete her application.
“If people can get through the Medicaid process, I think they’ll be pleasantly surprised,” said Smith, who has been paying $875 a month for an individual policy. Beginning next year, she will be covered in a better plan, but it will cost her only $450 a month after factoring in a $72 federal tax credit.
As happy as she was to discover she will soon have affordable coverage —and that it can’t be canceled if her cancer returns, thanks to Obamacare — she still believes a single-payer, Medicare-for-all type system would be better.
She has a point. The Affordable Care Act is far from perfect. But in the coming months and years, millions of us who have been unable to find affordable coverage will at long last be insured. Poll numbers will eventually reflect that.
By: Wendell Potter, The Center for Public Integrity, November 25, 2013
“A Sobering Reminder”: The Number Of Uninsured Americans Increased By 7.9 Million Under George W. Bush
The week President Obama took office, initial jobless claims, the statistic that immediately gauges layoffs, hit a 26-year high with 637,000 applying for unemployment insurance in one week. It was clear that the president was inheriting a record deficit, a cratering economy and two floundering wars. But buried in all those crises was an unspoken slow-motion disaster that people rarely mentioned: the steady crumbling of our health care system.
“When [former president Bill] Clinton left office, the number of uninsured Americans stood at 38.4 million,” Ron Brownstein wrote in 2009. “By the time [former president George W.] Bush left office that number had grown to just over 46.3 million, an increase of nearly 8 million or 20.6 percent.”
The numbers were just as bad when you looked at the share of the uninsured.
When Clinton left office, 13.7 percent of the population was uninsured. Bush left with 15.4 percent lacking coverage. And the only health reform the last Republican to occupy the White House enacted in his eight years was to add an unfunded prescription drug benefit that guaranteed cuts would need to be made at some point.
So the 15.4 percent of Americans Bush left uninsured in 2008 continued to rise in 2009 to 16.1 percent, then peaked at 16.3 percent in 2010. In 2011, it dipped to 15.7 percent, the biggest drop since 1999. The last census report showed that 48.6 million Americans were uninsured – that’s 15.4 percent. Exactly where it was in 2008.
It would be easy to credit the recovering economy for the rise of insured Americans — initial jobless claims last week were half of what they were when Obama took office. But the percentage of the uninsured is now lower than it was in 2006, before the Great Recession hit.
The New York Times‘ Paul Krugman calls the Affordable Care Act’s role in bringing health-cost growth to its lowest rate on record the law’s “secret success.” But the other secret success is how Obamacare is helping to reverse the growth of the uninsured population. This began in 2011 with children and young adults being able to stay on their parents’ plans until age 26, covering more than three million. And it continues this year with millions of Americans being added to the Medicaid rolls and millions likely to sign up for private plans, if the law’s health care exchanges begin working well enough.
Still Republicans are playing up the estimated 5 million cancellations of plans due to Obamacare the same way they played up the deficit and faltering economy President Obama inherited as if it had been his fault.
We won’t know how many of these people end up in new plans until next year, but we do know that nearly all of them will pay the same or less with a new plan that cannot deny them coverage or charge them more if they get sick.
“To sum up, lots of people losing coverage are losing policies they never liked much, that they would have dropped soon anyway, and that would have left them facing potential financial ruin if they got sick,” The New Republic‘s Jonathan Cohn wrote. “Even those with truly good policies had no guarantees that in one year, let alone two or three, they’d still be able to pay for them.”
Now, millions of Americans are being offered affordable health insurance possibly for the first time in their lives, promising to cut the ranks of the uninsured by millions in just a few years.
While Republicans are mourning cancellations of the exact kinds of plans that left massive holes in our health care system, the question is: Where were those crocodile tears when almost 8 million Americans became uninsured under George W. Bush… and Republicans did nothing to stop it?
By: Jason Sattler, The National Memo, November 29, 2013