Representative Renee Ellmers (R-NC) introduced a bill on Tuesday that returns sequester-cut funding to physicians to provide chemotherapy drugs to patients. The Cancer Patient Protection Act of 2013, H.R. 1416, restores sequester cuts made to Medicare Part B in order to provide cancer treatment and reimburse physicians for the costs of cuts already made.
Ellmers, who voted in favor of the Budget Control Act of 2011, called these cuts to cancer treatment “unintended consequences.” However, the cutback in funding wasn’t accidental, as Ellmers suggests—the Budget Control Act explicitly orders a sweeping two-percent cut to Medicare.
Despite her efforts to reverse its inevitable effects, Ellmers still defends the sequester. “I do believe it will start a very important process that will help our economy to start to grow,” she said. “The debt that we have at the federal level is our biggest threat for our country.”
Representative Blake Farenthold (R-TX) joins Rep. Ellmers in opposing elements of sequestration despite having voted for it. Farenthold, among others, was disturbed to hear of the closing of 149 air traffic control towers—especially those in Texas. The congressman sent a letter to FAA Deputy Administrator Michael Huerta, stating, “I am deeply troubled for your public statements and proposed actions regarding the effect of the sequester on smaller, local airports. These airports have long played a vital role in economies across the country.”
Congressman Rodney Frelinghuysen (R-NJ) was among the 269 representatives who voted in favor of the Budget Control Act, yet he too did not hesitate to criticize its effects. In Frelinghuysen’s district, children in Washington Township may be unable to enroll in Head Start programs due to lack of funding. Frelinghuysen said, “I view potential budget cuts to such an important program as another reason why sequestration is a bad idea.”
To date, sequestration has had significant effects on many Americans, and is expected to cause upward of $85 billion in cuts to communities across the country. The elderly have lost vital programs like Meals on Wheels; veterans may face difficulty accessing mental health, substance abuse, and job counseling services; and funding can be cut for medical research of illnesses like Alzheimer’s Disease.
The effects of sequestration are tangible; millions across the country have faced cuts across a range of industries. Rather than criticizing the effects of the sequester and introducing legislation to obtain certain exemptions from these imminent cuts, perhaps members of Congress like Ellmers, Farenthold and Frelinghuysen should have weighed the consequences before even voting for the measure.
By: Allison Brito, The National Memo, April 11, 2013
When Governor Scott Walker faces Wisconsin voters in 2014, he’ll be running on a record of confronting public worker unions, turning down Medicaid expansion that would have covered 181,000 Wisconsinites and creating far fewer than the 250,000 new jobs he promised.
And if that isn’t enough, he can run on the Wisconsin Omnibus Tort Reform Act of 2011.
One of the first bills Walker signed into law, these reforms were taken almost entirely from the Koch-funded legislative warehouse of the Billionaire Rights Movement, the American Legislative Exchange Council (ALEC).
The legislation prevents state health investigation records from being admitted as evidence in any civil or criminal cases against long-term care providers, including nursing homes and hospices.
Sarah Karon of the Wisconsin Center for Investigative Journalism looked into the impact of the reform and found that the families of patients who often cannot testify on their own behalf are powerless to redress abuse and neglect.
In one case, Joshua Wahl — a paraplegic patient with spina bifida and brain damage — had a bedsore left to fester for months before he was finally hospitalized, according to a state investigator.
“It scares me for those who put their trust in a facility,” said Karen Nichols-Palmerton, Wahl’s mother. “It scares me to think of things that could be brushed aside. I don’t rest so easy anymore.”
Nichols-Palmerton is suing the facility, but the investigator’s report will not be heard in court, thanks to the Wisconsin Omnibus Tort Reform Act of 2011.
Why did Walker and Wisconsin’s Republicans decide records documenting such abuse shouldn’t be admissible in court?
It isn’t good for business.
“Each of these (proposals) is aimed at one thing — jobs,” said Brian Hagedorn, Walker’s chief legal counsel, during a hearing for the bill. “These changes send a symbolic and substantive message that Wisconsin is open for business.”
State investigators’ reports are published online. But a Department of Justice spokeswoman told Karon that the law makes it difficult to prosecute abuse and neglect cases at early stages, when severe injuries or death can be prevented.
Nursing homes that accept Medicaid or Medicare must be investigated every 15 months. Non-federally certified facilities are investigated by the states every two years. Wisconsin has cut its staff of nursing home surveyors by more than 30 percent, even as complaints about such facilities have risen by more than 100 percent since the year 2000.
Walker’s record of opening Wisconsin “for business” and turning away from its grand tradition of progressivism hasn’t had such a great effect on job creation. And the cost, especially for those forced to rely on long-term care, is falling squarely on the most vulnerable.
By: Jason Sattler, The National Memo, February 22, 2013
Gov. Romney and Rep. Ryan have been adamant that their Medicare proposals won’t affect people over 55. That may be true. But their Medicaid proposals sure will. A lot of health care for the elderly comes from Medicaid. We call those people “dual-eligibles”, because they qualify for both Medicare and Medicaid. Some dual-eligible are younger disabled people, but about two-thirds are 65 or older. The Kaiser Family Foundation reports:
Dual eligibles as a share of total Medicaid enrollees ranged from a low of 10 percent in Arizona and Utah to a high of 26 percent in Maine, due to demographic differences and policy preferences across the states. Similarly, spending on dual eligibles as a percentage of total Medicaid spending ranged from a low of 18 percent in Arizona to a high of 59 percent in North Dakota.
Lots of Medicaid money goes to the elderly. Cut Medicaid, and you likely cut some of that. Here’s more:
One quarter (25%) of Medicaid spending for dual eligibles went toward Medicare premiums and cost-sharing for Medicare services in 2008. Five percent of spending for duals was for acute care services not covered by Medicare (e.g., dental, vision, and hearing services). Another 1 percent of Medicaid dual eligible spending was for prescription drugs, a percentage that has fallen significantly since coverage for nearly all prescribed drugs for duals was shifted from Medicaid to Medicare Part D in 2006. The remaining 69% of Medicaid spending was for long-term care services, which are generally not covered by Medicare or private insurance.
That Medicaid money is going to Medicare premiums! It’s also going to actual care. Cut Medicaid, and you likely cut some of that.
It’s about time someone pointed that out. The health care proposals of Gov. Romney and Rep. Ryan will absolutely impact some elderly people way earlier than a decade. Unless they’ve changed their minds again.
By: Aaron Carroll, Washington Monthly Political Animal, September 7, 2012
The key passage in today’s opinion striking down part of the Affordable Care Act appears on page 113, where the two judge majority explains how they will determine whether this law is constitutional:
In answering whether the federal government may exercise this asserted power to issue a mandate for Americans to purchase health insurance from private companies, we next examine a number of issues: (1) the unprecedented nature of the individual mandate; (2) whether Congress’s exercise of its commerce authority affords sufficient and meaningful limiting principles; and (3) the far-reaching implications for our federalist structure.
This is one way to evaluate whether a law is constitutional, but a better way is to ask whether the law can be squared with text of the Constitution. The Constitution provides that Congress may “regulate Commerce…among the several states,” and the very first Supreme Court decision interpreting this language made clear that this power is “plenary,” meaning that Congress may choose whatever means it wishes to regulate interstate marketplaces such as the national health care market, so long as it does not violate another textual provision of the Constitution.
A law requiring most Americans to either carry insurance or pay slightly more taxes clearly regulates the national market for health care. It determines how people will finance health care purchases. It lowers the cost of health insurance. And it protects that market from something known as an “adverse selection death spiral.” So that should have been the end of the case. The Court cites no provision of the Constitution limiting Congress’ authority to pass this law because no such provision exists.
Instead, it imposes two extra-textual limits on national leaders’ ability to solve national problems. If the law is somehow “unprecedented,” and if a decision upholding the law lacks vague and undetermined “meaningful limit[s]” on Congress’ authority that somehow upset the balance between federal and state power, then the law must be struck down even if the Constitution’s text says otherwise.
Yet even if these two novel limits are taken seriously, the court’s analysis still makes no sense. For one thing, the law is only “unprecedented” in the sense that it preferred a market-driven solution to the problem of widespread uninsurance over more government driven solutions such as Medicare. The truth is that Congress already requires nearly all Americans to purchase health insurance — and they have done so for many years. Every year the federal government collects taxes which are in no way optional. A portion of these taxes are then spent to buy health insurance for the elderly (Medicare) for the poor (Medicaid) and for children (SCHIP).
So the only real question in this case is whether the government is required to first take your money and then buy health coverage for you, or whether the Constitution allows Congress to cut out the middle man.
The Court is also simply wrong to claim that a decision upholding the ACA would necessarily mean that there are no limits on federal power. The Constitution does not simply allow Congress to regulate commercial markets. It establishes that, in Justice Scalia’s words, “where Congress has the authority to enact a regulation of interstate commerce, it possesses every power needed to make that regulation effective.”
Scalia’s rule is important because the ACA doesn’t just require people to carry insurance, it also eliminates one of the insurance industry’s most abusive practices — denying coverage to patients with pre-existing conditions. This ban cannot function if patients are free to enter and exit the insurance market at will. If patients can wait until they get sick to buy insurance, they will drain all the money out of an insurance plan that they have not previously paid into, leaving nothing left for the rest of the plan’s consumers.
Because the ACA’s regulation of the national insurance market cannot function without a requirement that nearly every American carry insurance. this requirement is clearly constitutional under Justice Scalia’s statement that Congress possess “every power needed” to make it’s economic regulations effective. Moreover, upholding the Affordable Care Act under Justice Scalia’s rule would require a court to do nothing more than hold that the Affordable Care Act is constitutional. There is no federal law which depends upon mandatory broccoli purchases, for example, in order to function properly in the same way that the ACA’s preexisting conditions provision can only function properly in the presence of an insurance coverage requirement. Accordingly, the court’s concern that upholding the law would destroy any limits on federal power is unwarranted.
As a final note, it is likely that conservatives will tout the fact that Judge Hull was appointed by President Clinton in the same way that progressives touted Bush-appointed Judge Sutton’s decision rejecting an ACA challenge. The two judges are not comparable, however. Judge Sutton is a former Scalia clerk who stood on the vanguard of the conservative legal movement for many years. Judge Hull, by contrast, is a compromise nominee Clinton selected in order to overcome obstruction from the Republican-controlled Senate.
Hull has a long record of conservative criminal and individual rights decisions. We now know that she is also very far to the right questions of federal power. That is unfortunate, but it also places her well to the right of some of the Supreme Court’s most conservative members.
By: Ian Millhiser, U. S. News and World Report, August 12, 2011
If you’re a woman from Texas—or indeed, any woman—there’s a lot to dislike about Gov. Rick Perry.
Perry reminds me of the scene in Thelma and Louise in which Thelma (Geena Davis) says of her n’er-do-well husband, “He kind of prides himself on being infantile.” Louise (Susan Sarandon) responds, “He’s got a lot to be proud of.”
So as we all prepare for the media barrage surrounding Perry’s presidential announcement on Saturday, and in tradition of my idol Molly Ivins, I’m going to start a new group, Texas Women Enraged by Rick Perry—TWERP for short.
As TWERP’s organizer, I feel obliged to point out that on a practical level, Rick Perry has made it pretty lousy for women in Texas, especially for women at the bottom of the economic ladder. He’s also made it pretty lousy for anybody who doesn’t look like him. As Eileen Smith wrote in the Texas Observer, “In just one session, Republicans managed to screw children, women, gays, immigrants, teachers, the elderly, Hispanics, the unemployed and the uninsured. The only people who got off easy were white guys. Can’t imagine why.”
The numbers tell the tale. Texas is dead last in the number of non-elderly women without health insurance, and 6th nationally in the percentage of women in poverty, according to the Texas Legislative Study Group. One in five Texas children lack health insurance, the highest rate in the nation. And if that weren’t bad enough, Perry tried to opt out of Medicaid, which provides healthcare to the most vulnerable Texas populations, including pregnant women and children.
When it comes to reproductive healthcare, the state budget guts family planning, leaving 284,000 Texas women without birth control or access to basic reproductive healthcare. This will also likely increase the abortion rate, sonograms or no sonograms. And of course there’s the standard right wing assault on Planned Parenthood. Women needing prenatal care fare no better.
As reported in the Texas Tribune, “Texas has the worst rate of pregnant women receiving prenatal care in the first trimester, according to the report commissioned by the Legislative Study Group…And though Texas has the highest percent of its population without health insurance, the state is 49th in per capita spending on Medicaid, and dead last in per capita spending on mental health, according to the report.”
So if you’re a working class Texas woman, Rick Perry doesn’t want you to have access to birth control or reproductive healthcare to prevent unintended pregnancy, but once you’re pregnant the state mandates a sonogram and a lecture to convince you of the error of your ways. After that sonogram and lecture, if you need prenatal care, you’re SOL. And once the baby is born, Texas is 47th in monthly benefit payments under the Women, Infants, & Children program, which provides nutrition assistance.
This is Rick Perry’s vision for women in the United States. Limited healthcare, little birth control, low income women and kids left to fend for themselves, a bunch of bureaucrats telling you what to do—and the very real human suffering that goes along with it. TWERP might be an understatement.
By: Laura Chapin, U. S. News and World Report, August 11, 2011