By: Eugene Robinson, Opinion Writer, The Washington Post, February 9, 2012
There’s More To Women’s Health Than Contraception
If you have been listening to the contraception debate in Washington (sort of hard to avoid, isn’t it?), you may be under the impression that preventive health for women equals contraception. Or contraception equals women’s preventive health. (We’re putting aside, for the purpose of this post, the debate about religion, conscience and the role of government).
The Senate has defeated one bid to overturn the administration rule requiring employers to provide an insurance plan with first-dollar coverage of birth control, and it’s not clear what the House will do. But the issue is likely to percolate in Washington, state legislatures and the courts for some time to come.
The health reform law, and the regulations being developed to implement it, has a far more expansive definition of prevention and what it means for women’s health. Here are more details on the new regulations and a tutorial from Kaiser.edu. According to the new women’s preventive health rule, new health plans must cover, without cost-sharing, a lot more than the pill:
- well-woman visits;
- screening for gestational diabetes;
- human papillomavirus (HPV) DNA testing for women 30 years and older;
- sexually-transmitted infection counseling;
- human immunodeficiency virus (HIV) screening and counseling;
- FDA-approved contraception methods and contraceptive counseling;
- breastfeeding support, supplies, and counseling; and
- domestic violence screening and counseling.
These requirements will go into effect in August (with another year allowed to finalize how the religious exemptions will work). Grandfathered plans won’t have to follow the new rule, while they maintain their “grandfather” status. Over time, many health plans will go through changes that will mean that they will no longer be “grandfathered.” Then they too will have to follow the new regulations.
Of course, more women will get these benefits, simply because more women will be insured. Approximately one in five women of reproductive age is currently uninsured. Most of them will get coverage, including preventive services, starting in 2014 whether through Medicaid, through subsidized coverage in the exchanges or by buying coverage. Right now, coverage of maternity benefits is spotty on the individual insurance market, but the plans in the health exchanges will cover it.
The law also requires many other preventive services – some free – for men, women and children. They have not gotten much attention in the polarized birth control debate.
The conversation (and press coverage) about the contraceptive rules have included lots of misinformation about abortion. Politicians who misstate policy don’t help, but reporters need to know what the law does and does not do.
The health law does not mandate abortion coverage and this preventive health rule does not change that. In fact, states under health reform have the explicit ability to limit abortion coverage in policies sold in state exchanges and several have already taken action to do precisely that. Plans that do cover abortion in the exchange will have to wall that off in a way to keep it apart from the federal subsidies.
A few more stray but relevant facts:
According to the Kaiser.edu materials, about two-thirds of women aged 15 to 44 use contraception – and do so for about 30 years.
Most employer-based insurance plans do cover contraception, though there are often co-pays. Among large employers, more than 80 percent cover contraception.
Federal Medicaid dollars do not cover abortion under the Hyde Amendment (except for rape, incest or when the life of the mother is in danger) – although some states use their own money to cover abortion in some circumstances. But Medicaid does cover contraception. In fact, Medicaid pays for more than 70 percent of publicly financed family planning services.
And Title X funds family planning clinics (created in 1970 under the Nixon presidency). According to HHS, about 5 million women and men get family planning services through more than 4,500 community-based clinics. Someone with religious objections to providing contraceptives for employees is indirectly paying for Medicaid birth control coverage – and indirectly for the tax subsidies of employer-sponsored insurance – just as we all pay taxes that fund some things we agree with and some we don’t.
By: Joanne Kenen, Association of Health Care Journalists, March 1, 2012
Consistency Is An Over-Rated Virture: What “Left” And “Right” Really Mean
Perhaps my biggest frustration with the U.S. news media (and yes, I am a card-carrying member) is that we permit the two parties to decide what is “left” and what is “right.” The way it works, roughly, is that anything Democrats support becomes “left,” and everything Republicans support becomes “right.” But that makes “left” and “right” descriptions of where the two parties stand at any given moment rather than descriptions of the philosophies, ideologies or ideas that animate, or should animate, political debates.
There is a good reason why we do it this way. It isn’t the media’s job to police political ideologies, and it wouldn’t be a good idea for us to try. But that leaves ordinary voters in a bit of a tough spot.
The reality is that most Americans aren’t policy wonks. They don’t sit down with think-tank papers or economic studies and puzzle over whether it’s better to address the free-rider problem in health care through automatic enrollment or the individual mandate. Instead, they outsource those questions to the political actors — both elected and unelected — they trust.
Unfortunately, those political actors aren’t worthy of their trust. They’re trying to win elections, not points for intellectual consistency. So the voters who trust them get taken for a ride.
Consider the partywide flips and flops of just the past few years:
— Supporting a temporary, deficit-financed payroll-tax cut as a stimulus measure in 2009, as Republican Sen. John McCain and every one of his colleagues did, put you on the right. Supporting a temporary, deficit-financed payroll tax-cut in late 2011 put you on the left. Supporting it in early 2012 could have put you on either side.
— Supporting an individual mandate as a way to solve the health-care system’s free-rider problem between 1991 and 2007 put you on the right. Doing so after 2010 put you on the left.
— Supporting a system in which total carbon emissions would be capped and permits traded as a way of moving toward clean energy using the power of market pricing could have put you on either the left or right between 2000 and 2008. After 2009, it put you squarely on the left.
— Caring about short-term deficits between 2001 and 2008 put you on the left. Caring about them between 2008 and 2012 put you on the right.
— Favoring an expansive view of executive authority between 2001 and 2008 put you on the right. Doing so since 2009 has, in most cases, put you on the left.
— Supporting large cuts to Medicare in the context of universal health-care reform puts you on the left, as every Democrat who voted for the Affordable Care Act found out during the 2010 election. Supporting large cuts to Medicare in the context of deficit reduction puts you on the right, as Republicans found out in the 1990s, and then again after voting for Representative Paul Ryan’s proposed budget in 2011.
— Decrying the filibuster and considering drastic changes to the Senate rulebook to curb it between 2001 and 2008 put you on the right, particularly if you were exercised over judicial nominations. Since 2009, decrying the filibuster and considering reforms to curb it has put you on the left.
— Favoring a negative tax rate for the poorest Americans between 2001 and 2008 could have put you on the right or the left. In recent years, it has put you on the left.
I don’t particularly mind flip-flops. Consistency is an overrated virtue. But honesty isn’t. In many of these cases, the parties changed policy when it was politically convenient to do so, not when conditions changed and new information came to light.
There are exceptions, of course. It’s reasonable to worry about short-term deficits during an economic expansion and consider them necessary during a recession. That’s Economics 101.
But nothing happened to explain the change from 2006, when the individual mandate was a Republican policy in good standing, to 2010, when every Senate Republican, including those who still had their names on bills that included individual mandates, agreed it was an unconstitutional assault on liberty. Nothing, that is, but the Democrats’ adopting the policy in their health-care reform bill.
Flips and flops like these make the labels “left” and “right” meaningless as a descriptor of anything save partisanship over any extended period of time. I could tell you about a politician who supported deficit-financed stimulus policies and cap-and-trade, and I could be describing McCain. Or Newt Gingrich. And I could tell you about another politician who opposed an individual mandate, and who fought deficits, expansive views of executive authority and efforts to reform the filibuster, and be describing Sen. Barack Obama.
Parties — particularly when they’re in the minority — care more about power than policy. Perhaps there’s nothing much to be done about this. And as I said, it isn’t clear that the media, or anyone else, should try. But it puts the lie to the narrative that America is really riven by grand ideological disagreements. America is deeply divided on the question of which party should be in power at any given moment. Much of the polarization over policy is driven by that question, not the other way around.
But the voters who trust the parties don’t know that, and they tend to take on faith the idea that their representatives are fighting for some relatively consistent agenda. They’re wrong.
By: Ezra Klein, The Washington Post, February 24, 2012
“Pathological Dishonesty”: On The Campaign Trail With Mitt Romney
Paul Krugman argued today that Mitt Romney “is running a campaign of almost pathological dishonesty.” That need not be considered hyperbole.
Indeed, Greg Sargent added this morning that Romney’s “falsehoods and all around dissembling” may be designed to “simply wear reporters and commentators down by trafficking in them so heavily that they throw up their hands and give up on trying to track or debunk them.”
But I remain undeterred. A couple of months ago, I launched a Friday afternoon feature, highlighting the most offensive Mitt Romney falsehoods of the week. It moved to Maddow Blog a few weeks ago, so let’s keep this going with another installment.
1. Romney told an audience in Arizona this week, in reference to President Obama, “He said he’d cut the deficit in half. He’s doubled it. He’s doubled it.”
For an alleged numbers guy, Romney is either lying or he’s bad at arithmetic. When Obama took office, the deficit was about $1.3 trillion. Last year, it was $1.29 trillion. This year, it’s on track to be about $1.1 trillion. Does Romney not know what “double” means?
2. On health care, Romney argued, “Our bill [Romneycare] was 70 pages; his bill [Obamacare] is 2,700 pages.”
This not just a dumb argument, it’s also not true.
3. On foreign policy, Romney said, “[T]his president should have put in place crippling sanctions against Iran, he did not.”
Actually, he did.
4. Romney claimed that Syria is Iran’s “route to the sea.”
Iran has 1,520 miles of its own coastline — and doesn’t share a border with Syria.
5. Romney boasted, “I also served in the Olympics, balanced a budget there.”
Well, that’s not entirely right. He hired lobbyists to get a taxpayer bailout for the Olympics and then balanced the budget.
6. Romney claimed, “You can’t be, I don’t believe, anything but a fiscal conservative and run a business, because if you don’t balance your budget, you go out of business.”
That’s both untrue and ridiculous. Businesses operate in the red all the time, and take out loans for capital improvements, expansions, acquisitions, etc. If Romney’s background is in the private sector, how could he not know this?
7. On contraception access, Romney argued, “I don’t think we’ve seen in the history of this country the kind of attack on religious conscience, religious freedom, religious tolerance that we’ve seen under Barack Obama.”
That’s so ridiculous, even Romney couldn’t actually mean that.
8. Also on contraception access, Romney said, “[The Obama administration is] requiring the Catholic Church to provide for its employees and its various enterprises health care insurance that would include birth control, sterilization and the morning-after pill. Unbelievable.”
Yes, it’s literally unbelievable, because he’s lying: churches are exempt. (He’s also contradicting his own previous position.)
9. On the Affordable Care Act, Romney said, “I will repeal Obamacare for a lot of reasons. One, I don’t want to spend another trillion dollars… Number two, I don’t believe the federal government should cut Medicare by some $500 billion.”
One, the ACA saves money and reduces the deficit. Number two, the Medicare claim continues to be wildly misleading.
10. On Pentagon spending, Romney claimed, “This is a president who is … cutting our military budget by roughly a trillion dollars.”
That’s not even close to being true.
11. On international affairs, Romney argued about the president, “He decided to give Russia their number one foreign policy objective — removal of our missile defense sites from Eastern Europe — and got nothing in return.”
That’s just not what happened.
12. Romney’s new attack ad says Rick Santorum voted to confirm Supreme Court Justice Sonia Sotomayor.
Santorum left the Senate in 2006 — three years before Sotomayor’s confirmation. [Update: It looks like the Romney camp played fast and loose on this one, showing Sotomayor with President Obama in 2009 when she was nominated for the Supreme Court, but counting Santorum’s vote when Sotomayor was a lower-court nominee. The implication for viewers is that Santorum backed Sotomayor for the high court, which is not true, when he and other Republicans did support her confirmation to a lower court.]
Foreign Policy columnist Michael Cohen noted yesterday that he understands that “politicians mislead and occasionally fib,” but added, “[H]onestly, I’ve never seen anyone do it as brazenly as Mitt Romney.”
With each passing week, I find it harder to disagree with such a sentiment.
By: Steve Benen, The Maddow Blog, February 24, 2012
“No Policy Or Vision”: The Hole In Mitt Romney’s Campaign
Criticism of Mitt Romney for lacking a coherent message is grossly unfair. He has been forthright, consistent and even eloquent in pressing home his campaign’s central theme: Mitt Romney desperately wants to be president.
Everything else seems mushy or negotiable. Romney is passionate about the need, as he sees it, to defeat President Obama — but vague or self-contradictory as to why. The lyrics of “America the Beautiful,” which Romney has recited as part of his standard campaign speech, don’t solve the mystery; Obama, too, is on record as supporting spacious skies and fruited plains.
Beyond personal ambition, what does Romney stand for? Obviously, judging by Rick Santorum’s clean sweep Tuesday, I’m not the only one asking the question. I suspect an honest answer would be something like “situational competence” — Romney boasts of having rescued the 2002 Olympics, served as the Republican governor of one of the nation’s most Democratic states and made profitable choices about where to invest his money. But with the economy improving and the stock market soaring, Romney’s president-as-CEO argument loses whatever relevance it might have had.
To conservative groups, Romney can sound like a true believer who never met a tax or a labor union he could abide — and not at all like a “Massachusetts moderate,” which is what Newt Gingrich claims Romney really is.
But Romney will never be able to match Gingrich’s record, for better or worse, as one of the key figures in the development of the modern conservative movement. And Romney — who once was pro-choice — will never be able to get to the right of Santorum on social issues.
The intended centerpiece of the Romney campaign — his 160-page economic plan — is really just a list of proposed measures with no discernible ideological framework holding them together. “Any American living through this economic crisis will immediately recognize the severity of the break that Mitt Romney proposes from our current course,” the candidate promises on his Web site. But much of what he pledges to do on “Day One” has already been accomplished, or is promised, by Obama.
Romney wants to cut the corporate tax rate; Obama has said he wants to lower rates while also closing loopholes.
Romney wants to forge new trade agreements; Obama signed into law free-trade pacts with South Korea, Colombia and Panama.
Romney wants to weed out burdensome regulations; Obama has such a project underway.
Romney wants to survey and safely exploit U.S. energy reserves; Obama says essentially the same thing.
To be sure, some other initiatives Romney promises on Day One would take us in precisely the wrong direction. He would ask Congress for a gratuitous $20 million budget cut that would fail to make a scratch, let alone a dent, in the deficit. He would propose ending the federal role in job training, thus abdicating presidential responsibility for meeting one of the central challenges facing our economy. He would sanction China for manipulating its currency — and, perhaps, launch a needless trade war. He would seek to discourage the use of union labor on government projects, purely as a sop to the conservative GOP base.
And, of course, Romney wants to repeal the Patient Protection and Affordable Care Act, whose centerpiece, the individual insurance mandate, was pioneered in Massachusetts. By Romney. Who continues to defend the mandate as a good idea — too good, apparently, for the rest of the country.
My point is that even Romney’s sharp disagreements with Obama’s policies don’t add up to a philosophy or a vision. They’re more like what stuck after a bunch of random tough-sounding positions were thrown at the wall.
On foreign affairs, Romney offers a lot of blah blah blah about “restoring the sinews of American power” and the like, but nothing as distinctive as, say, Santorum’s extreme hawkishness on Iran or Ron Paul’s isolationist call to bring the troops home from just about everywhere. It’s hard to find any substantive differences between what Romney would do and what Obama is already doing.
Romney does accuse Obama of “appeasement,” and perhaps the charge would have some credibility if Obama hadn’t ordered the raid that killed Osama bin Laden, or used unmanned missile-firing drones to decimate the international jihadist leadership, or helped eliminate dictator Moammar Gaddafi, or demonstrated in countless other ways that whatever else he might be, no one can call him some kind of flower-power peacenik.
One distinction — and, really, this may be the most original position that Romney takes on anything — is that he has ruled out negotiations with the Taliban and apparently wants to extend the U.S. troop commitment in Afghanistan indefinitely.
Wish him luck with that on the campaign trail. He’ll need it.
Staples Co-Founder: Allowing Women To Breastfeed At Work Will Cost Jobs
Staples co-founder Tom Stemberg is speaking out against a serious threat to economic recovery and job creation: breastfeeding moms.
Stemberg, a longtime supporter of Republican policies and candidates like Mitt Romney, complained recently that President Obama’s health care reform law hurts businesses by requiring them to provide what he dubbed “lactation chambers” for new moms who need to breastfeed at work:
Tom Stemberg, co-founder of mega-office supply chain Staples is questioning an Obamacare provision that discourages job creation by dictating employers funnel their capital into lactation chambers.
“Do you want [farming retailer] Tractor Supply to open stores or would you rather they take their capital and do what Obamacare and its 2,700 pages dictates – which is to open a lactation chamber at every single store that they have?” he asked.
“I’m big on breastfeeding; my wife breastfed,” Stenberg added. “I’m all for that. I don’t think every retail store in America should have to go to lactation chambers, which is what Obamacare foresees.
Stemberg was presumably referring to provisions in the Affordable Care Act that require employers to give lactating mothers “reasonable break time” to nurse their child, as well as “a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public…” The place they provide for new moms does not have to be a dedicated room as long as it’s private and can be called into use when female employees need it.
Stemberg, who has contributed tens of thousands of dollars to Romney’s campaign and SuperPAC, added that repealing the health care law should be at the top of the next president’s “to-do” list.
As of early January, the Labor Department had already cited 23 companies, including Starbucks and McDonald’s stores, for violating the new protections for breastfeeding employees.
By: Marie Diamond, Think Progress, February 7, 2012
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