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“Unexpanded Medicaid”: Millions Of Women Could Remain Uninsured If States “Opt Out”

It can seem like just a mirage created by the summer heat: only a few weeks ago the Supreme Court actually handed down a decision that progressives could celebrate. It held that the Affordable Care Act is constitutional, including the individual mandate, meaning that implementation can roll on full steam ahead. I was one of the first to celebrate, in particular for all the ways that the law will help women who need healthcare (which is all of us). As Katha Pollitt recently wrote here, women will benefit dramatically from the ACA. The law bars practices like charging women more just for being women, dropping women’s coverage if they become pregnant or sick, and denying coverage due to “pre-existing conditions” like having had breast cancer or being a victim of domestic violence. It adds new benefits like birth control coverage at no cost to the patient, expanded coverage of preventative services like prenatal care, mammograms, pap smears, and bone-density screenings through Medicare, and requiring insurance companies to cover maternity care.

But one aspect of the Supreme Court’s decision could have some very bad results for women: the ruling that states can opt out of the Medicaid expansion. While this could end up harming men and women, women in particular stand to suffer if states refuse to participate in the program.

The Medicaid expansion is a crucial component of the law’s overall goal of extending coverage to over 30 million uninsured Americans by 2019, covering almost half of the total number of people the bill promised to insure. Originally, the law included a provision that the federal government could take away all of a state’s Medicaid funding if it refused to go along with the expansion, which all but ensured participation. But the Court ruled that such a maneuver was unconstitutional. Just a few days after the decision was announced, seven Republican governors said they would flat out reject the money to expand Medicaid rolls, with at least eight more looking to follow suit. More have said no since then.

This could create a no-man’s land for those who earn less than 100 percent of the Federal Poverty Line, making them ineligible for tax subsidies to help them buy insurance, but don’t qualify for their state’s (unexpanded) Medicaid program. These Americans are surely struggling to get by, but not quite enough to get health coverage promised to those above and below them.

And women are likely to fall into this chasm. Remember that unexpanded Medicaid does not cover most childless adults. Currently, a woman must meet both categorical and income criteria to qualify for Medicaid: she must be pregnant, a mother of a child under age 18, a senior citizen, or have a disability, and each category has income criteria, which differ state by state. Given that women are more likely to be pregnant (duh) but also to fall into the other categories, they are already the majority of enrollees in the program. However, given that many women don’t meet categorical criteria, many don’t qualify no matter how poor they are. Over 17 million women lived in poverty last year, compared to 12.6 million men.

By 2016, 13.5 million women were expected to get coverage under the Medicaid expansion. That figure is now in danger. As the Kaiser Family Foundation reported before the Supreme Court decision, “Medicaid will be the foundation of health coverage expansions to very low-income women.” But not if some Republican governors get their way.

Many of the states already rejecting the expansion are home to the greatest number of women who would benefit. Texas and Florida top the list for the most uninsured women in their states: about 2.4 million and 1.5 million, respectively, and both states plan to refuse the expansion. (Some of these women were supposed to get coverage through the Medicaid expansion, but some will still qualify for the subsidies and be able to buy insurance in the state exchanges.)

Using Kaiser’s predictions, I calculate that there are over 4.2 million women who would be eligible for the Medicaid expansion by 2014 in the states either refusing or indicating they will refuse to participate. That’s a huge chunk of the 10 million women that were expected to be covered by that time through Medicaid.

Those are the immediate impacts on low-income, uninsured women. The ruling may have other far-reaching impacts on women’s lives, however. As Jessica Mason Pieklo writes at RH Reality Check, the idea that the federal government can’t withdraw all Medicaid funds from states that don’t follow federal requirements might have other consequences. The first may be states that are trying to prevent Medicaid from contracting with providers that also offer abortions (i.e., in many cases, Planned Parenthood). Such a case is going on in Indiana right now. As Pieklo writes,

Thanks to the majority in NFIB v. Sebelius, conservative states looking to enact state-wide funding bans may have the framing necessary to pin the federal government. That’s because the language of Roberts’ opinion as to the Medicaid expansion is vague enough to argue that the federal government can’t coerce a state into funding Planned Parenthood by threatening to withhold all of that state’s federal Medicaid money, especially, since conservative states argue, they believe cutting Medicaid funds is the only way to guarantee state dollars do not fund abortion services.

Planned Parenthood and its affiliate centers provide services to 3 million people annually, including 4 million tests for sexually transmitted infections, 770,000 Pap tests, and 750,000 breast exams. Banning Medicaid from contracting with Planned Parenthood will hurt the low-income women who need these services—but states may now have a legal leg to stand on if they try to do just that.

Perhaps the worst thing of all? The excuse that Republican governors are using to get out of the Medicaid expansion may not even hold up. They claim to be worried that even though the federal government will pick up the whole tab for the first few years, the portion they’ll have to pay after that (10 percent) is too burdensome on their budgets. Yet there is evidence that expanding Medicaid could actually help their finances. Rejecting the Medicaid expansion may not even make fiscal sense, but no matter what it doesn’t make moral sense. It could leave millions of women exposed, unable to afford health insurance but not able to participate in Medicaid.


By: Bryce Covert, The Nation, July 17, 2012

July 18, 2012 Posted by | Women's Health | , , , , , , , , | Leave a comment

“Lying Through His Teeth”: The Anatomy Of Mitt “The Jokester”

Today, let’s do a favor for Mitt Romney.

Not on your to-do list?

Indulge me.

You have undoubtedly heard the story about a bullying episode during Romney’s high school years. The Washington Post quoted former classmates who said that Mitt had led an attack on a kid who had bleached blond hair that he wore over one eye. While the others held the boy down, Romney cut off the offending tresses.

Let me say right off the bat that stuff politicians did when they were in high school shouldn’t count. And while this appears to be a particularly mean, and possibly homophobic, incident, it is really a good idea to stick to that rule. Otherwise, we would have to go back to the question of whether Barack Obama ate dog meat in Indonesia and we will never move on to health care reform.

But about the hair-cutting story. When Mitt was asked about it, he said he did not “recall the incident.”

This puts a whole new spin on things. The idea that Romney could have absolutely no recollection of this event is way more shocking than the incident itself. Did he engage in this sort of behavior so often that things just sort of ran together?

I don’t believe he’s that lacking in feeling. So I propose that we give him the benefit of the doubt and agree that he is lying through his teeth.

Yes! And, honestly, it’s a good bet. We have seen far less evidence of Romney as a guy with a mean streak than of Romney as a robotic campaigner who finds it impossible to speak in an open, unprogrammed manner — particularly about any incident that makes him look bad.

He probably looks back at what he did and feels terrible. Then he represses that genuine emotion and tells Fox News that it’s all a blank to him, but that, if anyone was offended by the thing he doesn’t even recall happening, he is very, very sorry.

He is incapable, really, of admitting past errors. Perhaps you may remember that Romney once drove to Canada with the family Irish setter stuck in a cage on the station wagon roof. When he was originally asked about it, he claimed the dog “loves fresh air.”

This was more than four years ago. What would have happened if Romney had just said: “Boy, in retrospect that really does sound like a bad idea. But you have to remember that we had five boys under the age of 14. It was like living in a vortex; we did all kinds of stupid stuff.”

Do you think the nation — particularly the part that has ever tried to drive long distances with a car full of children — would have been understanding? I personally would never have mentioned the incident at all.

But since we haven’t gotten that sort of input, I kind of feel free to bring it up now and then.

Romney supporters have made a vague attempt to lump the hair-cutting incident in with Mitt’s long history of pranksterism. “You know, you hold the scissors close to his ear and you make a lot of snipping sounds, and you may traumatize the guy a little or scare the guy a little, but no harm, no foul,” Gregg Dearth, another Romney classmate, told ABC News.

It certainly is true that Mitt has a longstanding affinity for practical jokes. Let’s revisit a few:

• Invited to the wedding in which his wife was one of the bridesmaids, Romney livened up the afternoon by snitching the groom’s shoes and using nail polish to write H-E-L-P on the soles so all the guests could see it when the happy couple knelt down to take their marital vows.

• On his first visit to the White House during the Clinton administration, Romney protested when he was handed a red visitors’ badge with the letter A. “I’m not the one that cheated on my wife. He should be wearing the scarlet A, not me,” Mitt said, repeatedly, to the fun-loving White House security staff.

• During his stint in France, Romney entertained a homesick and undoubtedly edgy fellow young missionary by coming to his door wearing a sheet and impersonating a French terrorist/bandit.

• A teacher who students enjoyed making fun of for his poor eyesight was walking with Romney and some of his classmates when they came to two sets of glass doors. Mitt opened the first for his professor, swept his hand forward to indicate the second set was open as well, and then laughed hysterically when the teacher smacked into the closed door.

That last one was in high school, so we’re not counting it. Except as part of a lifelong pattern of fun.


By: Gail Collins, Op-Ed Columnist, The New York Times, May 11, 2012


May 12, 2012 Posted by | Election 2012 | , , , , | Leave a comment

“Sunspot Technical Malfunctions”: Romney Proves He’s As Anti-Gay As You Thought

Mitt Romney, so incredibly comfortable in his skin he apparently couldn’t give a damn what anyone except his radical right wing overlords think, last night in a show of true homophobic independence announced he didn’t really mean to say he is “OK” with gay couples adopting children, and he’s very sorry you misunderstood his real positions on the matter. Wait, what time is it?

“And if two people of the same gender want to live together, want to have a loving relationship, or even to adopt a child — in my state individuals of the same sex were able to adopt children,” Romney had told reporters on Thursday. “In my view, that’s something that people have a right to do. But to call that marriage is something that in my view is a departure from the real meaning of that word.”

That, as we said, was Thursday, and apparently there were… sunspots that caused a technical malfunction… or something.

Because today, in flip flop number 412, Mitt told reporters what he meant for them to have heard on Thursday is that, according to CBS News, “he simply ‘acknowledges’ the legality of such adoptions in many states.”

In other news, the Romney campaign acknowledged the legality of skeet shooting.

CBS News adds:

But then on Friday, he was asked, in an interview with CBS’ WBTV in Charlotte, N.C., how his opposition to same-sex marriage “squared” with his support for gay adoptions. Romney told anchor Paul Cameron, “Well actually I think all states but one allow gay adoption, so that’s a position which has been decided by most of the state legislators, including the one in my state some time ago. So I simply acknowledge the fact that gay adoption is legal in all states but one.”

Romney did remain consistent on one point: He said he does not intend to use President Obama’s flip flop of same-sex marriage against him in the campaign.

Of course, Romney hadn’t checked in with his radical right wing overlords, who have already decided they, er, Romney will be campaigning on President Obama’s affirmation of the right of same-sex couples to marry.

Meanwhile, gay kids continue to commit suicide, largely due to anti-gay bullying fueled and supported by the environment Republican politicians create — from Mitt Romney to Reince Priebus to Michele Bachmann to Rick Santorum, and all the way down to this school board member and this school board member.


By: David Badash, The New Civil Rights Movement, May 12, 2012

May 12, 2012 Posted by | Election 2012 | , , , , , , , , | Leave a comment

“Atta Girl”: Mitt Romney Was A High School Gay-Bashing Bully

Mitt Romney, the presumptive GOP presidential nominee, was a gay-bashing high school bully who said, “Atta girl,” to effeminate boys and shockingly had a days-long emotional attack that culminated with him pinning down a gay classmate and cutting off his bleached-blond long hair. Governor Romney claims he has no memory of any of these incidents that date back to 1965, according to a lengthy and heart-wrenching exposé in today’s Washington Post. An excerpt:

John Lauber, a soft-spoken new student one year behind Romney, was perpetually teased for his nonconformity and presumed homosexuality. Now he was walking around the all-boys school with bleached-blond hair that draped over one eye, and Romney wasn’t having it.

“He can’t look like that. That’s wrong. Just look at him!” an incensed Romney told Matthew Friedemann, his close friend in the Stevens Hall dorm, according to Friedemann’s recollection. Mitt, the teenaged son of Michigan Gov. George Romney, kept complaining about Lauber’s look, Friedemann recalled.

A few days later, Friedemann entered Stevens Hall off the school’s collegiate quad to find Romney marching out of his own room ahead of a prep school posse shouting about their plan to cut Lauber’s hair. Friedemann followed them to a nearby room where they came upon Lauber, tackled him and pinned him to the ground. As Lauber, his eyes filling with tears, screamed for help, Romney repeatedly clipped his hair with a pair of scissors.

The incident was recalled similarly by five students, who gave their accounts independently of one another. Four of them — Friedemann, now a dentist; Phillip Maxwell, a lawyer; Thomas Buford, a retired prosecutor; and David Seed, a retired principal — spoke on the record. Another former student who witnessed the incident asked not to be named. The men have differing political affiliations, although they mostly lean Democratic. Buford volunteered for Barack Obama’s campaign in 2008. Seed, a registered independent, has served as a Republican county chairman in Michigan. All of them said that politics in no way colored their recollections.

“It happened very quickly, and to this day it troubles me,” said Buford, the school’s wrestling champion, who said he joined Romney in restraining Lauber. Buford subsequently apologized to Lauber, who was “terrified,” he said. “What a senseless, stupid, idiotic thing to do.”

“It was a hack job,” recalled Maxwell, a childhood friend of Romney who was in the dorm room when the incident occurred. “It was vicious.”

The Post article concludes with an emotional note about John Lauber:

He came out as gay to his family and close friends and led a vagabond life, taking dressage lessons in England and touring with the Royal Lipizzaner Stallion riders.

His hair thinned as he aged, and in the winter of 2004 he returned to Seattle, the closest thing he had to a base. He died there of liver cancer that December.

He kept his hair blond until he died, said his sister Chris. “He never stopped bleaching it.”

But Lauber was not the only target for the gay-bashing Mitt Romney.

In an English class, Gary Hummel, who was a closeted gay student at the time, recalled that his efforts to speak out in class were punctuated with Romney shouting, “Atta girl!” In the culture of that time and place, that was not entirely out of the norm. Hummel recalled some teachers using similar language.

Saul, Romney’s campaign spokeswoman, said the candidate has no recollection of the incident.

Yes, it was 1965, a different time, when these acts of anti-gay bullying were not just ignored or accepted, but often condoned.

But the handful of Mitt Romney’s classmates who either participated or didn’t stop it, not only remember his gay-bashing, they feel terrible about it. For Romney to not remember, and thus not be affected by his own gay-bashing, speaks volumes about his character.

The Romney campaign, and others, no doubt would say it was 1965. It doesn’t matter. But Mitt Romney married his wife Ann in 1969, just four years later, and that certainly matters in his campaign.

And they have on their campaign website a video that shows Mitt’s life, beginning with 1968, with the note:

“I think there’s one word that would be high on my list of a few words you would describe Mitt with. It would be trust. I think the qualities Mitt would bring to the Oval Office would be integrity, intelligence, an ability to see a problem and see a solution and make people recognize that he has those leadership qualities that would unite many people.” – Ann Romney

At what point do your actions matter?

By: David Badash, The New Civil Rights Movement, May 10, 2012

May 10, 2012 Posted by | Civil Rights | , , , , , , , , | Leave a comment

“We Will Not Be Denied”: Giving Women Maternity Care Is Illegal. Really?

We all know that the health care law signed by President Obama in 2010 has its detractors. It’s a shame. The law goes a long way to expanding access to health care for women. It’s not perfect, but the law does some really important things, like ending gender discrimination in health care and making sure insurance coverage includes services women need like maternity care. But, a majority of Missouri State Representatives do not agree with me. In fact, they loathe this law so much that the House of Representatives recently passed a bill that would make it illegal to implement the health care law. The bill states, “Any official, agent, or employee of the United States government who undertakes any act within the borders of this state that enforces or attempts to enforce any aspect of the federal Patient Protection and Affordable Care Act is guilty of a class A misdemeanor.”

Wow, a class A Misdemeanor for implementing the health care law? This is serious stuff. And it’s pretty unfortunate because Missouri could stand to improve health care access for women.

Here is what’s not working in Missouri: 100% of health plans in the individual market in Missouri charge women more for the same health coverage than if they were men and no health plans in the individual market provide maternity services for women.

These policies should be illegal, and under the health care law, they will be.

The health care law is already helping women and families in Missouri. Health plans must now cover preventive services such as mammograms, flu shots, and colon cancer screenings at no additional out of pocket costs such as co-payments. Over 408,000 women in Missouri are receiving preventive services without a co-payment. The law also allows young adults to remain on their parents’ health insurance until age 26. Nearly 40,000 young people in Missouri have gained coverage thanks to the law. And this is just the beginning. Women will experience even more benefits as the law is fully implemented in 2014.

Despite these advances, legislators in Missouri want to make it illegal to implement the law. It’s illegal to make sure women have maternity coverage? It’s illegal to insist women should not have to pay more for the same health coverage as men?

Don’t let the opponents have their way. We will not be denied.


By: Anna Benyo, Senior Health Policy Analyst for Health and Reproductive Services, National Womens Law Center, NWLC Blog, April 23, 2012

April 25, 2012 Posted by | Women's Health | , , , , , , , | Leave a comment

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