By: Jay Inslee, Steve Beshear and Dannel P. Malloy, Opinion Pages, The Washington Post, Published: November 17, 2013: Jay Inslee, a Democrat, is governor of Washington. Steve Beshear, a Democrat, is governor of Kentucky. Dannel P. Malloy, a Democrat, is governor of Connecticut.
“Less Than American”: It Is In The Public Interest To Have People Assimilated And Participating Stakeholders In Our Democracy
Not so long ago, it seemed the debate over immigration reform was all about borders. Politicians competed to offer the most draconian solutions — higher fences, longer fences, electrified fences, armies of guards, fleets of drones, moats and crocodiles. Never mind that the Border Patrol had already more than doubled in a decade. Never mind that many of those here illegally never hopped a fence but simply overstayed a student or tourist visa. The nativist mythology has us under siege from relentless hordes striding toward Arizona on, in the fevered imagination of Tea Party Congressman Steve King, “calves the size of cantaloupes because they’re hauling 75 pounds of marijuana across the desert.” To pacify the border neurotics, authors of the bill that passed the Senate last summer included $46.3 billion to militarize our southern flank.
Now, with the bill stranded in the House, it seems the immigration debate is all about citizenship. To opponents, the idea of offering 11-plus million undocumented immigrants a pathway to citizenship — even a 13-year slog like the one envisioned by the Senate bill — is anathema, so politically toxic that the measure’s most prominent Republican sponsor, Senator Marco Rubio, pulled back as if he’d put his hand on a lit stove. To proponents of comprehensive reform, or at least to activists on the issue, citizenship is the prize, and nonnegotiable.
It’s beginning to look as if advocates of fixing our broken immigration system will face an unpleasant choice: no bill at all, or a bill that legalizes the foreigners who are already here but does not offer most of them a chance to become citizens. On Capitol Hill several lawmakers are quietly drafting compromises that give the undocumented millions little hope of full membership in America.
The first thing to note is that this is progress. The Republican mainstream view has moved in the last year or so, from Mitt Romney’s “self-deportation” to something considerably less callous. Most Republicans in Congress now say they can live with legalizing the undocumented as long as (a) we don’t call it amnesty and (b) we don’t reward lawbreakers by bestowing the precious gift of citizenship.
The second point that needs making — and my Times colleague Julia Preston made it last week — is that while citizenship is the priority for pro-immigration activists, to immigrants living here as a fearful underclass the aim is not so clear cut. For many of them, the priority is to be made legal, to come out of hiding and live their lives without the threat of deportation, without the risk of exploitation by unscrupulous employers, without wondering whether your spouse will make it home at night.
“The entire narrative behind comprehensive immigration reform has elevated the path to citizenship as this must-have component of an acceptable bill,” said Oscar Chacon, executive director of the National Alliance of Latin American and Caribbean Communities, a network of immigrant organizations that includes many foreigners here without visas. “What you hear from the undocumented is: ‘We like the idea of citizenship, but what really hurts us is that we are vulnerable, that I can’t easily get a job to feed my family, that I can’t drive a car without being at risk, that I want to be able to visit relatives back home and come back safely.”
Just to be clear, I believe (and so does Oscar Chacon) that deliberately creating a class of disenfranchised residents goes against the American grain. There are few precedents for consigning whole categories of people to a sub-citizen limbo, and they are not proud moments in our history. (See the Fugitive Slave Act of 1793 and the Chinese Exclusion Act of 1882.) It is clearly in the public interest to have people become assimilated, taxpaying, participating stakeholders in our democracy. Most Americans polled, including a majority of Republicans, agree that those now in the country illegally should be allowed to eventually apply for citizenship.
If House Speaker John Boehner is willing to brave the fury of his extreme flank and put the matter to a vote, a path to citizenship stands a decent chance of passing the House with a majority of Democrats and a minority of Republicans. You might even think Republicans would want to get immigration settled and off the table so they could begin wooing Hispanic voters on more favorable ground — social issues, taxes, education. But among the people most immersed in this issue, I can’t find many who expect Boehner to suddenly become a statesman and defy his fanatics. In part, let’s be honest, that’s because the Republican stance is, “We protect America from Obama.” It is also in part because they fear newly enfranchised Hispanics will become Democrats — which the Republicans, by opposing citizenship, make a self-fulfilling prophecy.
So it may well be that supporters of immigration reform have to choose between half a loaf and none at all. Half a loaf might include a prospect of citizenship for some undocumented immigrants — the so-called Dreamers, who entered the country as children, and those in the military — but not the majority. If that’s the option, should Democrats swallow hard and take it?
Yes, and here’s why.
First, even without a prospect of citizenship, legalization would make the undocumented much safer from the family-wrecking heartbreak of deportation, which has continued at record numbers under President Obama. It would free them to press for better education for their children, to approach the police when they are victims of crime, to challenge abusive employers, to seek medical care without fear of exposure. Some advocates of citizenship-or-nothing suggest that the president should simply use his prosecutorial discretion to stop deportations altogether, as he has done for the Dreamers and undocumented soldiers. But the public would view that as a grievous abuse of power, and Congress might very well take away his authority. An executive order is no substitute for a protection enshrined in the law.
Second, the legislation has other good things going for it. It puts a little sense into our archaic legal immigration system, and establishes some meaningful protection against future illegal immigration (like holding employers rigorously accountable for assuring their workers have legal status, much more important than fortifying the border.)
Third, this is not the end of the story. We elect a new Congress in 2014, and another in 2016, and so on, and the electoral clout of Hispanics will continue to grow. “I’m a firm believer in the notion of incremental change,” Chacon told me. “The best public policies — look at gay rights — have evolved, they didn’t happen all at once.”
And fourth, even if many undocumented workers never make it to citizenship, the injustice will last for just one generation. Their children are citizens by birth. Young Latinos are reaching voting age at the rate of about 50,000 per month. I suspect many in that rising generation will remember, and punish, the politicians who decided their parents should remain less than American.
By: Bill Keller, Op-Ed Columnist, The New York Times, November 24, 2013
“Prudence Or Cruelty?”: Slashing Food Stamps Is A Mark Of Shortsighted Cruelty
When members of Congress debate whether to slash the food stamp program, they should ask if they really want more small children arriving at school having skipped breakfast.
As it is, in the last few days of the month before food stamps are distributed, some children often eat less and have trouble focusing, says Kisha Hill, a teacher in a high-poverty prekindergarten school in North Tulsa, Okla.
“Kids can’t focus on studying when their stomachs are grumbling,” Hill told me.
Some 47 million Americans receive food stamps, including some who would otherwise go hungry — or hungrier. A recent government study found that about 5 percent of American households have “very low food security,” which means that food can run out before the end of the month. In almost a third of those households, an adult reported not eating for an entire day because there wasn’t money for food.
Meanwhile, 14 percent of American toddlers suffer iron deficiency. Malnutrition isn’t the only cause, but it’s an important one — and these children may suffer impaired brain development as a result. This kind of malnutrition in America is tough to measure, because some children are simultaneously malnourished and overweight, but experts agree it’s a problem. We expect to find malnourished or anemic children in Africa and Asia, but it’s dispiriting to see this in a country as wealthy as our own.
Let me take that back. It’s not just dispiriting. It’s also infuriating.
“The cutback in food stamps represents a clear threat to the nutritional status and health of America’s children,” says Dr. Irwin Redlener, the president of the Children’s Health Fund and a professor of pediatrics at Columbia University. Dr. Redlener said that one result of cutbacks will be more kids with anemia and educational difficulties.
Food stamp recipients already took a cut in benefits this month, and they may face more. The Senate Democratic version of the farm bill would cut food stamps by $4 billion over 10 years, while the House Republican version would slash them by $40 billion.
More than 90 percent of benefits go to families living below the poverty line, according to federal government data, and nearly two-thirds of the recipients are children, elderly or disabled.
Let’s remember that the government already subsidizes lots of food. When wealthy executives dine at fancy French restaurants, part of the bill is likely to be deducted from taxes, which amounts to a subsidy from taxpayers. How is it that food subsidies to anemic children are more controversial than food subsidies to executives enjoying coq au vin?
Meanwhile, the same farm bill that is hotly debated because of food stamps includes agricultural subsidies that don’t go just to struggling farmers but also, in recent years, to 50 billionaires or companies they are involved in, according to the Environmental Working Group, a Washington research group.
Among the undeserving people receiving farm subsidies has been a New York Times columnist. Yes, I have been paid $588 a year not to grow crops on wooded land I own in Oregon (I then forward the money to a maternity hospital in Somaliland). When our country pays a New York journalist not to grow crops in an Oregon forest, there’s a problem with the farm bill — but it’s not food stamps.
Granted, safety-net spending is more about treating symptoms of poverty than causes, and we may get more bang for the buck when we chip away at long-term poverty through early education, home visitation for infants, job training and helping teenagers avoid unwanted pregnancies.
That said, food stamps do work in important ways. For starters, they effectively reduce the number of children living in extreme poverty by half, according to the Center on Budget and Policy Priorities in Washington.
By improving nutrition of young children, food stamps also improve long-term outcomes. In recent years, mounting scholarship has found that malnutrition in utero or in small children has lasting consequences. One reason seems to be that when a fetus or small child is undernourished, it is programmed to anticipate food shortages for the remainder of its life. If food later becomes plentiful, the metabolic mismatch can lead to diabetes, obesity and heart disease.
An excellent study last year from the National Bureau of Economic Research followed up on the rollout of food stamps, county by county, between 1961 and 1975. It found that those who began receiving food stamps by the age of 5 had better health as adults. Women who as small children had benefited from food stamps were more likely to go farther in school, earn more money and stay off welfare.
So slashing food stamp benefits — overwhelmingly for children, the disabled and the elderly — wouldn’t be a sign of prudent fiscal management by Congress. It would be a mark of shortsighted cruelty.
By: Nicholas D. Kristof, Op-Ed Columnist, The New York Times, November 16, 2013
“How We Got Obamacare To Work”: We Urge Congress To Get Out Of The Way And Support Efforts To Make Health-Care Reform Work
In our states — Washington, Kentucky and Connecticut — the Affordable Care Act, or “Obamacare,” is working. Tens of thousands of our residents have enrolled in affordable health-care coverage. Many of them could not get insurance before the law was enacted.
People keep asking us why our states have been successful. Here’s a hint: It’s not about our Web sites.
Sure, having functioning Web sites for our health-care exchanges makes the job of meeting the enormous demand for affordable coverage much easier, but each of our state Web sites has had its share of technical glitches. As we have demonstrated on a near-daily basis, Web sites can continually be improved to meet consumers’ needs.
The Affordable Care Act has been successful in our states because our political and community leaders grasped the importance of expanding health-care coverage and have avoided the temptation to use health-care reform as a political football.
In Washington, the legislature authorized Medicaid expansion with overwhelmingly bipartisan votes in the House and Senate this summer because legislators understood that it could help create more than 10,000 jobs, save more than $300 million for the state in the first 18 months, and, most important, provide several hundred thousand uninsured Washingtonians with health coverage.
In Kentucky, two independent studies showed that the Bluegrass State couldn’t afford not to expand Medicaid. Expansion offered huge savings in the state budget and is expected to create 17,000 jobs.
In Connecticut, more than 50 percent of enrollment in the state exchange, Access Health CT, is for private health insurance. The Connecticut exchange has a customer satisfaction level of 96.5 percent, according to a survey of users in October, with more than 82 percent of enrollees either “extremely likely” or “very likely” to recommend the exchange to a colleague or friend.
In our states, elected leaders have decided to put people, not politics, first.
President Obama announced an administrative change last week that would allow insurance companies to continue offering existing plans to those who want to keep them. It is up to state insurance commissioners to determine how and whether this option works for their states, and individual states will come to different conclusions.
What we all agree with completely, though, is the president’s insistence that our country cannot go back to the dark days before health-care reform, when people were regularly dropped from coverage, and those with “bare bones” plans ended up in medical bankruptcy when serious illness struck, many times because their insurance didn’t cover much of anything.
Thanks to health-care reform and the robust exchanges in our states, people are getting better coverage at a better price.
One such person is Brad Camp, a small-business owner in Kingston, Wash., who received a cancellation notice in September from his insurance carrier. He went to the state exchange, the Washington Healthplanfinder, and for close to the same premium his family was paying before got upfront coverage for doctor’s office visits and prescription drug , vision and dental coverage. His family was able to keep the same insurance carrier and doctors and qualified for tax credits to help cover the cost.
Since Howard Stovall opened his sign and graphics business in Lexington, Ky., in 1998, he has paid half the cost of health insurance for his eight employees. With the help of Stovall’s longtime insurance agent and Kentucky’s health exchange, Kynect, Stovall’s employees are saving 5 percent to 40 percent each on new health insurance plans with better benefits. Stovall can afford to provide additional employee benefits, including full disability coverage and part of the cost of vision and dental plans, while still saving the business 50 percent compared with the old plans.
In Connecticut, Anne Masterson was able to reduce her monthly premiums from $965 to $313 for similar coverage, including a $145 tax credit. Masterson is able to use her annual premium savings of $8,000 to pay bills or save for retirement.
These sorts of stories could be happening in every state if politicians would quit rooting for failure and directly undermining implementation of the Affordable Care Act — and, instead, put their constituents first. Health reform is working for the people of Washington, Kentucky and Connecticut because elected leaders on both sides of the aisle came together to do what is right for their residents.
We urge Congress to get out of the way and to support efforts to make health-care reform work for everyone. We urge our fellow governors, most especially those in states that refused to expand Medicaid, to make health-care reform work for their people too.
“Don’t Bother Us With Governing”: With Caucus-Wide Sentiment, House GOP Pushes Distractions Over Policy
At the start of every Congress, the leadership of both chambers generally set aside bill numbers as a way of designating their biggest priorities. The House Republican majority, for example, will set aside H.R. 1 through H.R. 10 for their top 10 most important bills – the ones they’re most eager to pass.
And in this Congress, H.R. 1 has nothing to do with immigration, health care, energy, or security. Rather, it’s tax reform.
For the last several months, House Ways and Means Committee Chairman Dave Camp (R-Mich.) has been quietly meeting with Senate Finance Committee Chairman Max Baucus (D-Mont.) on a major overhaul of the federal tax code – the first in a generation. It’s no easy task, and Camp has made clear he considers this the most important project of his political career.
The general proposition is pretty straightforward: if Congress eliminates unnecessary deductions, closes loopholes, and scraps superfluous tax giveaways, the result will be a simpler, streamlined tax code that produces more revenue. The benefit would mean more deficit reduction, lower rates overall, or both. The trouble, of course, is that those deductions, loopholes, and giveaways have their champions and they’re hard to get rid of, compounded by the fact that Democrats and Republicans disagree on what to do with the new revenue.
But that’s not the only trouble. Brian Faler had a report this morning on an angle I hadn’t considered.
[Some of Ways and Means Committee Chairman Dave Camp’s] fellow Republicans now don’t want him to release his long-awaited tax reform bill for fear it will allow Democrats to change the subject. They want the public’s focus on people who have lost their health insurance and those having trouble signing up at healthcare.gov, and not on what will surely be a controversial tax-reform bill.
It’s a cruel bit of timing for Camp, who’s spent three years, almost since the day Republicans took control of the House, trying to build support for the first tax overhaul in a generation. He’s repeatedly promised his panel would take up legislation this year, and if it doesn’t soon, Camp – who faces term-limit restrictions on his chairmanship – may never get the chance.
Got that? Camp believes he’s finally made progress on H.R. 1 – ostensibly the one thing House Republicans actually want to pass in this Congress – and he’s eager to move forward. Camp, however, is effectively hearing from his own allies, “Don’t bother us with that now; we’re too busy raising a fuss about health care.”
Indeed, the Politico report added that lobbyists involved with the process believe House GOP leaders will “pressure Camp to pull the plug” on his tax-reform measure.
This reminds me a bit of a story from March, when Rep. Mike Kelly (R-Pa.) said he wanted to tackle legislation regarding loan guarantees to clean-energy companies, but he dropped the legislation because “he chose to focus more” on Benghazi and Fast and Furious.
In other words, the congressman had a policy priority, but it was abandoned – a partisan crusade got in the way.
Seven months later, it seems Camp is running into a similar issue. He wants to follow through on years of work on tax reform – for the record, I have a hunch I won’t care for his plan – but his effort is getting in the way of Republicans’ anti-healthcare fun.
And since it’s a post-policy party, the conflict between governing and gamesmanship isn’t much of a contest, at least with the House GOP majority.
Don’t forget, just last week Rep. Pete Sessions (R-Texas) boasted that the House Republicans’ top priority should be “messaging,” not problem solving. As Dave Camp is apparently realizing, this is a caucus-wide sentiment.
By: Steve Benen, The Maddow Blog, November 13, 2013
“What Congress Didn’t Say”: Obamacare Outlaws Policies That Are Essentially Worthless
As I watched Health and Human Services Secretary Kathleen Sebelius being grilled by members of the House Energy and Commerce Committee last week, it was immediately clear to me just how many of them are in the pockets of the industry I used to work for.
Former colleagues of mine undoubtedly had a hand in writing the members’ comments and questions. Their behavior showed just how much more willing they are to protect the profits of health insurers than protect the health and financial well- being of their constituents.
I got the same treatment from many of those committee members when I provided testimony in March — or tried to. I had been invited to talk about the business practices of insurers — practices that have contributed to the rising number of uninsured and underinsured Americans. Among them: refusing to sell policies to millions of us because of preexisting conditions and charging exorbitant premiums for skimpy coverage to others.
When I tried to tell the tale of a Florida woman who died of cancer last year because she was priced out of the market and was unable to buy coverage at any price, Rep. Marsha Blackburn, a Republican from my home state of Tennessee, cut me off. She clearly had no interest in hearing about Leslie Elder or anything else I had to say. Instead, Blackburn held forth for more than five minutes and gave me all of 20 seconds to respond.
Throughout that hearing, a former co-worker from my Humana days, who later worked for the industry’s big lobbying group and then the Bush administration, stood a few feet behind Blackburn. That former co-worker now serves as senior policy adviser to the committee. So I was not the least bit surprised that Blackburn was determined to give me as little time to talk as possible.
During the Sebelius hearing, Blackburn and other GOP members talked about letters constituents have received informing them that their policies will not be available next year. How could that be, they asked, when the president assured us four years ago that, “If you like your health care plan, you can keep your health care plan.” Blackburn, et al accused the president of being dishonest.
Obama should not have used those exact words. That’s because one reason for the Affordable Care Act in the first place was to protect us from insurers all too willing to lure us into inadequate policies with slick marketing materials. Insurers have made billions in profits from selling such junk insurance, and people like Blackburn clearly want to get rid of the law that makes junk insurance illegal.
As I wrote in Deadly Spin, a years-long industry strategy has been to shift more and more medical expenses to patients. As part of that strategy, big insurance firms bought smaller companies that specialize in limited-benefit plans, which often provide such skimpy coverage that some insurance brokers have refused to sell them.
Cigna, for example, marketed a limited-benefit plan to narrowly targeted prospective customers: mid-sized employers with high employee turnover, such as chain restaurants. The underwriting criteria was specific. The average age of an employer’s workers couldn’t be higher than 40 and no more than 65 percent of the workers could be female. (Insurers have long charged women more than men because in their eyes being born female is a pre-existing condition.) In addition, employers had to have a 70 percent or higher annual employee-turnover rate, meaning that most employees wouldn’t stay on the job long enough to use their benefits. Employees also could not get coverage for care related to any pre-existing condition during their first six months of enrollment.
Limited-benefit plans like that one, blessedly, will not be available next year, and that’s because of the Affordable Care Act. Neither will plans with sky-high deductibles. Another way insurers have shifted costs to patients in order to enhance profits: luring or forcing them into plans with such high deductibles they join the ranks of the underinsured the moment they enroll. When people in these plans get seriously sick or injured, they are on the hook for thousands of dollars in medical bills they’ll have to pay out of their own pockets.
Millions of Americans — including my son, Alex — got letters from their insurers in the years before the ACA was enacted informing them that their plans were being discontinued. Why? To fulfill the industry strategy of moving people out of plans with affordable co-payments and co-insurance obligations and into high-deductible or limited-benefit plans. Such plans are far more profitable.
Keep this in mind the next time you hear a politician railing against Obamacare because people are getting letters from their insurers. The truth these politicians want to obscure is that Obamacare is protecting their constituents from buying coverage that provides little to no shield against financial ruin. And that protection is something the insurance industry wants to get rid of.
By: Wendell Potter, The Center for Public Integrity, November 4, 2013
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