“Muddied Waters And Smokescreens”: These Six States Want To Allow Health Insurers To Deny Coverage To Sick People
Officials in Texas and five other GOP-led states are refusing to oversee even Obamacare’s most basic — and popular — consumer protections and insurance market reforms. That includes the law’s ban on denying coverage or charging more because of a pre-existing condition and discriminating against women on the basis of gender. The decision could present major hurdles to Americans who buy health insurance through federally-run marketplaces in the Lone Star State, Arizona, Alabama, Missouri, Oklahoma, and Wyoming.
A majority of states haven’t set up their own insurance marketplaces, opting to let the federal government set one up for them. But every one of those states (other than the six in question) have at least said they will police the insurers that sell plans on their federally-run marketplaces to make sure that they aren’t giving consumers short shrift. The Centers for Medicare and Medicaid Services (CMS) will instead be responsible for enforcing Obamacare’s insurance industry reforms and reviewing consumer complaints in the states refusing to do so on their own.
That could be confusing for Americans who are buying insurance for the first time through the marketplaces. For example, imagine you’re a relatively poor person with diabetes. Your income isn’t low enough to get you on Medicaid — but your employer doesn’t offer health benefits, and you’ve never qualified for insurance on the individual market because of your medical condition. On October 1st, you can go buy insurance with government subsidies for the first time on an Obamacare marketplace. But the plan you choose charges you a suspiciously high premium relative to your income. You suspect it’s because of your medical problem, which is clearly illegal under the reform law. But who do you complain to?
Usually the answer is your state’s insurance department. But the answer is CMS if you live in one of the six states that won’t enforce the consumer protections. Unfortunately, if you don’t know that, you could spend months oscillating between the state and federal government, trying to figure out if you’re getting hoodwinked by your insurance company. And in the meantime, the bills are piling up.
Those kinds of scenarios are the reason that health policy experts say insurance complaints are best handled by state agencies. Officials with the Texas Department of Insurance argue that they legally can’t enforce the regulations because they’ve ceded authority over the marketplace to the federal government, and Texas doesn’t have corresponding state laws holding insurers to the same standards as Obamacare. But Stacy Pogue of the Center for Public Policy Priorities tells the Texas Tribune that’s likely a smokescreen, since Texas has enforced plenty of other federal laws on a statewide level in the past.
Officials in the Lone Star State certainly haven’t been shy about their opposition to the health law. Gov. Rick Perry (R) dug in his heels against reform in 2012, saying he wouldn’t “be a part of expanding [the] socializing of our medicine.” More recently, Perry denied basic health benefits to 1.5 million of his state’s poorest residents by forgoing Obamacare’s Medicaid expansion. Evidently, that wasn’t going far enough.
National Republicans have also been stepping up their efforts to to undermine Obamacare. Reps. Tim Huelskamp (R-KS) and Jason Chaffetz (R-UT) are refusing to help their own constituents if they have questions about the health law, and the Tea Party-affiliated advocacy group FreedomWorks has been telling young Americans to forgo signing up for health coverage under Obamacare entirely.
By: Sy Mukhergee, Think Progress, August , 2013
“GOP National Tour Of Shame”: The Republicans’ Desperate Plan To Hide Its Clowns
Reince Priebus, the head of the Republican National Committee, has told NBC and CNN that they will not be allowed to have any Republican presidential debates in 2016 if they go ahead and air planned films about Hillary Clinton, who will likely be the front-runner for the Democratic presidential nomination. That is the reason he gave them, at least, but it is not the actual reason Priebus wants to not have any debates on those two channels. The real reason, everyone knows and sort of acknowledges, is that debates were a disaster for the party in 2012, an endless circus made up entirely of clowns on a national tour of shame.
These debates were on TV, people watched (and mocked) them, and the real candidates, the ones the money people were counting on to win the stupid race, were forced to say unacceptable things to appeal to raging loons. Furthermore, the serious candidates looked less serious simply by sharing a stage with Newt Gingrich and Herman Cain. So: Fewer debates, next time, is the plan, and these Hillary movies are a convenient reason to cancel on two of the big networks. (Do you know how I know that the Hillary Clinton movies aren’t the real reason? Media Matters’ David Brock would also like the networks to cancel these movies, because, let’s be honest, they probably won’t be entirely flattering.)
The entire Republican primary system is broken, and embarrassing debates really number among the least of their problems, but it is easier for Priebus to preemptively cancel embarrassing debates than it is for him to fundamentally alter the makeup of the Republican primary electorate, a small and largely angry group who demand ideological fealty to a political philosophy that most Americans abhor. Unfortunately for Priebus, threatening to cancel debates is going to be much easier than actually preventing them from happening.
Maybe one of the Republican Party’s primary malfunctions these days is that the interests of the party as a whole are frequently in opposition to the interests of individual Republican politicians. Preibus wants there to be fewer debates, because the debates are hugely embarrassing to the party and damaging to the eventual nominee. The candidates, though, need the debates, because there is nothing so precious as free airtime, and saying stupid things on television and then losing elections is a surprisingly lucrative career move these days. The debate problem is like the Ted Cruz problem: He acts against the long-term best interests of his party because in the shorter term, being an ultra-conservative is likely to make him rich and beloved. When 2015 rolls around a half-dozen would-be presidents and tryouts for the conservative speaking circuit are going to want free airtime, and the networks will happily provide it. The only question is whether the eventual “serious” nominee, if that’s Jeb Bush or Chris Christie, is going to join them or not.
Cruz may well be among those jokers, along with Marco Rubio, Rand Paul, Scott Walker, Peter King, Rick Perry and various other figures adored by “the base” but sort of terrifying and confusing to everyone else. These guys are going to go on television if they are given the opportunity to go on television. You either finish your presidential campaign as the president or as a person who isn’t the president but who is much more famous than before, and conservative movement fame means well-compensated positions at nonprofits or think tanks, speeches, maybe even television or radio jobs. Mike Huckabee is doing so well for himself he couldn’t be bothered to run in 2012, and he would’ve probably beaten Mitt if he had.
So boycotting NBC and CNN isn’t going to prevent another string of embarrassing debates from happening. But it may still be useful. Priebus wants to avoid those two channels in part because they’re hostile to conservatives, and the moderators they select will likely actively seek to embarrass the candidates. Republicans are still mad that in 2007, NBC allowed Chris Matthews to co-moderate a Republican debate. They sort of have a point — he’s a shouty Democrat, and likely had no respect for the people onstage — but the problem isn’t liberal bias, it’s “nonpartisan” journalist idiocy. Nonpartisan television news personalities are generally ill-informed about policy and hostile to politics in general. Bob Schieffer was utterly useless as a debate moderator. Partisan journalists are, by and large, more engaged with the issues and much more likely to ask interesting questions. There’s really no reason why conservative journalists shouldn’t be moderating, or at least co-moderating, Republican debates. Byron York and Rich Lowry would do a fine job.
If there are going to be another hundred primary debates, and there probably will be, the party would most likely prefer most of them to be on Fox. And that’d be fine: The candidates will be trying to appeal to Fox’s audience for votes, after all. And liberals ought to be fine with it too, because the candidates will be just as likely, or maybe even more likely, to say dumb and embarrassing things on Fox as they would be on CNN or NBC. So boycott away, Reince Priebus.
By: Alex Pareene, Salon, August 7, 2013
“A Pattern For The Court”: SCOTUS’s Meaningless Death Penalty Rules
Monday evening, the state of Florida executed John Errol Ferguson. This was not an act of injustice because Ferguson was innocent—he brutally killed eight people. It was an act of injustice because Ferguson was mentally ill. The Eighth Amendment forbids his execution.
In 2008, the Supreme Court held that a person cannot be executed if he or she is insane at the time of his or her execution. To the extent that the term has meaning, it’s hard to imagine that it doesn’t apply to Ferguson, who experts have testified has a “genuine belief” that he is the “prince of God” and has the power to control the sun. Stephanie Mencimer of Mother Jones details Ferguson’s history of mental illness:
Ferguson’s story, and long-documented record of mental illness, starts back in 1965, when records show Ferguson was suffering from hallucinations. In 1971, he was committed to a state mental hospital after being diagnosed as a paranoid schizophrenic. For the next several years, court-appointed doctors repeatedly reported that Ferguson was psychotic and in need of long-term hospitalization.
In 1975, a court-appointed psychiatrist reported that Ferguson was “suffering from a major mental disorder and is extremely dangerous to himself and others. He is dangerous to the point where he is considered homicidal … He should be in a maximum security ward … He should not be released under any circumstances.”
As Mencimer goes on to explain, Ferguson was nonetheless released from custody, a decision and failure of judgment that cost eight people their lives. Yet Florida continues to deny the obvious about Ferguson’s paranoid schizophrenia. Despite its earlier command, the Supreme Court allowed him to be executed without comment.
This kind of outcome is becoming a pattern for the Court, as we saw earlier this year with respect to its formal holding that executing someone with a severe mental handicap violates the Eighth Amendment. The Supreme Court’s prohibition on executing the mentally handicapped or severely ill have become more of a Potemkin village façade of fairness than the real thing because of its refusal to define or enforce any kind of substantive standard to determine whom the rule applies to. The Court’s deference to state determinations—no matter how implausible they are—means that the only states that won’t execute those with severe mental incapacities are those already committed not to doing so. Any state that lacks that commitment can proceed as before.
This is illustrative of the larger problem with the death penalty: The American criminal-justice system does not appear capable of rationally designating only those most clearly culpable of heinous crimes for execution. It remains true, in the memorable phrase of Justice Potter Stewart, that capital punishment as applied by the states is “cruel and unusual in the same way that being struck by lightning is cruel and unusual.” Some people are executed while others found guilty of more horrible crimes in the same state are not, and some people who are executed are probably not guilty of anything. The Supreme Court’s occasional gestures towards making the death penalty less arbitrary have done almost nothing to alter this fact.
And yet, as Sarah Muller of MSNBC points out, not only is Florida refraining from tightening its procedures, it’s actively seeking to speed up executions with its “Timely Justice Act.” It’s become increasingly hard to imagine that the Supreme Court will stand in the state’s way, which will have the effect of making an already unjust and error-prone process for killing people even more so.
By: Scott Lemieux, The American Prospect, August 7, 2013
“It’s Not Just About Burger Flippers”: A Preview And A Parable, McDonald’s And The Fate Of The Middle Class
In recent weeks fast-food workers have staged dramatic one-day strikes in cities across the country, demanding a $15 starting wage, instead of about $8 on average at places like McDonald’s. The strikes have prompted much debate about fast food and the cost of a Big Mac. But this moment isn’t just about burger-flippers—it’s about the realization that the American middle class has been hollowed out to the point of decimation. Today, one in four jobs is low-wage, and at current pace it will be one in two jobs by 2024—which means that what fast-food companies pay people today will affect us all.
Companies like McDonald’s may protest that their margins are too thin, their workforces too transient to justify a $15 minimum wage. Yet in other countries the company pays exactly that wage and manages to make profits while charging only a few cents more for burgers. In this sense, fast-food workers are like water drops on a hot griddle: once they’re vaporized, everyone else is about to get cooked. And as these strikers are now showing, more and more low-wage workers in America, even ones that aren’t unionized, are tired of being vaporized.
A $15 minimum wage is the key building block to “middle-out economics” (a concept I’ve helped shape, along with my co-author Nick Hanauer). Middle-out economics, as opposed to trickle-down, says that the best job creator is a healthy middle class with the purchasing power to generate and sustain demand. It says – as Henry Ford figured out a long time ago – that workers aren’t costs to be cut; they are customers to be cultivated. Investing in that middle class makes more sense than expanding tax breaks for the wealthy.
A middle-out policy agenda includes a more progressive tax system, but also focuses on high-skill education and fostering more entrepreneurs. And it crosses left-right lines: after all, the rock-bottom wages of a “free enterprise” like Wal-Mart leads to more “big government” spending on food stamps and Medicaid. A $15 minimum wage would take tens of millions off the dole and turn them into more robust consumers and less dependent citizens.
The fast-food strikes have framed the issue and are a sign of a reorganization of labor itself. Because traditional unions now cover only a tiny slice of the private workforce, new forms of organized, joint action are emerging to pressure employers for a better deal, such as coalitions of domestic workers in various states, or advocacy centers for oft-abused guest workers.
Too many American think that the plight of the low-wage worker has nothing to do with them. In fact it is both a preview and a parable. The fate of the middle class rests, in part, on whether more Americans learn to see the fate of fry cooks as their own.
By: Eric Liu, Time Magazine, August 7, 2013
“On The Receiving End Of Right-Wing Ire”: The GOP Struggles To Contain The Monster They Created
When it comes to Republican threats to shut down the government over funding for the federal health care system, Sen. Marco Rubio (R-Fla.) has adopted a you’re-either-with-us-or-you’re-against-us attitude: “All I’m saying is that you cannot say you are against Obamacare if you are willing to vote for a law that funds it. If you’re willing to fund this thing, you can’t possibly say you’re against it.”
It’s a sentiment the GOP base has embraced with great enthusiasm. Watch on YouTube
In this clip, we see Rep. Robert Pittenger (R-N.C.) pressed by a constituent at a town-hall meeting on whether the congressman will go along with the far-right scheme to shut down the government in the hopes of defunding the Affordable Care Act. “Do you want the thoughtful answer?” Pittenger asked. The voter replied, “I want yes or no.”
The answer, of course, was “no.” The North Carolina Republican considers himself a fierce opponent of “Obamacare,” but nevertheless sees the shutdown threat as unrealistic. Indeed, Pittenger tried to explain why the tactic would fail in light of the Democratic White House and Democratic majority in the Senate, but the angry activists didn’t care.
“It doesn’t matter,” one voter is heard saying. “We need to show the American people we stand for conservative values,” said another.
The clip was posted to a Tea Party website called “Constitutional War.”
Keep in mind, Pittenger is not exactly a Rockefeller Republican from New England. As Greg Sargent reported yesterday, the congressman is a red-state conservative who’s not only voted to repeal the Affordable Care Act, but has co-sponsored a dozen or so bills to destroy all or part of the current federal health care system.
But as far as some Tea Partiers are concerned, Pittenger and other conservative Republicans who see the shutdown strategy as folly are suddenly the enemy.
It appears that Republican officials have created a monster, and like Frankenstein, they aren’t altogether pleased with the results.
For the last few years, GOP lawmakers have said, repeatedly, that the base should rally behind Republicans as they valiantly try to tear down the federal health care system and take access to basic care away from millions. And by and large, Tea Partiers and other elements of the party’s base cheered them on.
The scheme was, for the most part, a rather cruel con — Republicans almost certainly realized that their last chance to repeal “Obamacare” was the 2012 presidential election, which they lost badly. But they kept fanning the flames anyway, telling right-wing activists to keep fighting — and more importantly, keep writing checks.
Party leaders may have winked and nodded to one another, realizing that they’d never be able to fulfill their dream of heath care destruction, but therein lies the problem: conservative activists thought the party was serious, and saw neither the winks nor the nods.
The result, as Robert Pittenger noticed in North Carolina, isn’t pretty. The GOP base seems to be waking up and saying, “What do you mean you’re not willing to shut down the government over Obamacare funding? If Rubio, Cruz, and Lee have a plan, why are you betraying us by rejecting their idea?”
Republicans had an opportunity after the 2012 elections to shift gears. Party leaders could have subtly and understandably made clear that the repeal crusade had fallen short, and the GOP would have to begin focusing on other fights.
But the party did the opposite, telling easily fooled donor supporters that this was a fight Republicans could win. Now the GOP finds itself stuck in a hole they dug for themselves. Republicans were gleeful when the August recess meant Democrats getting yelled at over health care; they may be less pleased when they’re on the receiving end of right-wing ire.
By: Steve Benen, The Maddow Blog, August 7, 2013
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