Arizona’s “20th Century Boss” In 2012: Using Birth Control? You’re Fired!
First, a bill that gives immunity to doctors who lie to couples about the results of their prenatal tests in order to prevent them from getting an abortion. Now, a bill that would give your boss the green light to fire you for using birth control. You think I am kidding? I wish. For a decade now, Arizona insurance companies have been required to provide coverage for contraception just like other prescriptions. But, because they saw an opening to score some political points, some politicians there are suddenly moving to take that coverage away from women and their families.
And we aren’t talking here just about exemptions for religiously affiliated employers like Catholic hospitals and universities. We are talking about authorizing secular, for-profit employers to deny a woman coverage for birth control if the employer doesn’t believe that she and her partner should be allowed to have sex without getting pregnant. Yup, that’s right. If the owner of the Taco Bell where you work opposes birth control, Arizona legislators want to give him a legal right to deny you insurance coverage for your pills.
Sadly, that isn’t even the half of it. You may want to sit down for this one. Arizona legislators know that whether or not her insurance covers it, a woman may get the prescription she needs to prevent an unintended pregnancy. They want to give her boss the right to control that too. The bill they are pushing would not only allow employers to take the insurance coverage away, but it would also make it easier for an employer who finds out that his employee uses birth control to fire her. You heard me right . . . to fire her. And I thought Rush Limbaugh’s comments were as low as you could go on this one.
The Arizona bill has, incredibly, already passed one house, but we can still stop it. We’ve seen what can happen if we make our voices heard. So, if you’ve had enough; if you think the decision about whether to have a child is one for you and your partner, not your boss and your senator, I urge you to speak up now. Tell the legislators in Arizona to stop playing politics with women’s health and put personal and private decisions back in the hands of a woman and her family.
By: Jennifer Dalven, Reproductive Freedom Project, ACLU Blog, March 12, 2012
“Irrational Actors”: Republican State Legislators Shoot Selves In Foot, Help Citizens
One of the main features of the Affordable Care Act is the creation of 50 state-based health-insurance exchanges, online marketplaces where people and small businesses will be able to easily compare competing plans and select the one they prefer. If you’re buying insurance on the individual market after the beginning of 2014 (but not if you get your insurance through your employer like most people), your state’s exchange is where you’ll go. While the federal government establishes a baseline of requirements for what plans offered through the exchange must contain, each state will determine exactly how theirs will work.
But after the ACA was passed, and especially after the 2010 election where Republicans won huge gains at the state level, a lot of states run by Republicans refused to take any action to create their exchanges. Like a Catholic bishop looking at a package of birth-control pills, they retched and turned away, not wanting to sully their hands at all with involvement in President Obama’s freedom-destroying health-care plan. But the law also provides that if a state doesn’t get around to creating its exchange, then the federal government will just do it for them.
Which is why I’ve always found the actions of Republicans on this issue puzzling. They all say they hate the federal government, and states can do things better. But in this case, they’re letting the federal government take over. Which is probably a good thing.
Let’s say you live in Arkansas. Who would you trust to create an exchange that works well and empowers consumers: a state government run by Republicans who think any government involvement in health care is vile, or the Obama administration’s Department of Health and Human Services, which has a huge reputational stake in making the Affordable Care Act work as well as possible? Well, you’re in luck, because Arkansas has explicitly refused to create an exchange. Plenty of other states with Republican-controlled legislatures have simply dragged their feet in the hopes that either the Supreme Court will strike down the ACA when it hears the case later this year, or that a Republican will win the White House in November and successfully repeal the law (this is a list of where exchanges stand in each state, if you’re curious).
Conservative health-care wonks seem to be divided on the issue. Here’s one (h/t Sarah Kliff) making exactly the case that I made—if Republicans just ignore this, it’ll be turned over to an administration they hate (I just happen to think that’s a good thing, while he doesn’t). But here’s another testifying before the New Hampshire Legislature, telling them not to do anything and hope it just goes away.
This offers a reminder, in case you needed one, that elected officials are not always rational actors. They’ll even do things that undermine the principles they hold, for reasons of emotion or pique or false hope. In this case, that means a lot of people living in Republican-dominated states will probably have access to an exchange that works substantially better than whatever their state would have set up. So it’ll be a happy ending!
By: Paul Waldman, Contributing Editor, The American Prospect, March 14, 2012
“Good Job Mitt”: Romneycare Is Making Massachusetts Healthier
In newly released research, Charles Courtemanche and Daniela Zapata ask perhaps the most important question about the Massachusetts health-care reforms: Did they improve health outcomes in Massachusetts?
The answer, which relies on self-reported health data, suggests they did. The authors document improvements in “physical health, mental health, functional limitations, joint disorders, body mass index, and moderate physical activity.” The gains were greatest for “women, minorities, near-elderly adults, and those with incomes low enough to qualify for the law’s subsidies.”
Some of those results are a bit odd. Although it’s possible to tell yourself a story about how the Massachusetts health reforms affected the body mass indexes of the newly insured, you have to stretch a bit.
But most of them make perfect sense. The reforms led to more people having insurance, which is to say more people having more opportunities to see a doctor and get early and/or regular treatment for ailments. That led to improvements in health. If that hadn’t led to improvements in health, it would be the worth of going to the doctor and getting timely medical care that would be called into question. And if going to the doctor and getting timely medical care isn’t worth doing, the Massachusetts reforms are pretty far down the list of practices and policies we need to rethink.
The researchers end by asking whether the Massachusetts reforms provide a good guide to what will happen under the Affordable Care Act. “The general strategies for obtaining nearly universal coverage in both the Massachusetts and federal laws involved the same three-pronged approach of non-group insurance market reforms, subsidies, and mandates, suggesting that the health effects should be broadly similar,” they write. “However, the federal legislation included additional costcutting measures such as Medicare cuts that could potentially mitigate the gains in health from the coverage expansions. On the other hand, baseline uninsured rates were unusually low in Massachusetts, so the coverage expansions — and corresponding health improvements — from the Affordable Care Act could potentially be greater.”
I’d add one point to their discussion: The national reforms, unlike the Massachusetts reforms, included major investments in comparative-effectiveness research, electronic health records, accountable care organizations and pay-for-quality pilots. If any or all of those initiatives pay off, they could dramatically improve our understanding of which treatments work and force the health-care system to integrate that new knowledge into everyday treatment decisions very quickly.
If that happens, medical care could become substantially more effective than it is now, which should also improve health outcomes. Quality improvements like that could, for the already insured, be the largest payoff from the Affordable Care Act.
By: Ezra Klein, The Washington Post, March 12, 2012
“Picking And Choosing”: The Church, Taxes, And Health Insurance
The other day Tim Noah used the occasion of the Senate’s vote on allowing any employer to prevent their employees’ insurance from covering anything and everything the employer doesn’t like (which every Republican senator except Olympia Snowe voted for) to argue that this is yet more evidence that employers ought to get out of the business of providing health coverage, and we ought to just have the government do it. In a single-payer system, these kinds of decisions can be made by our democratic process, and not by every employer individually.
There’s just one note I want to make about this. Conservatives have been talking a lot about the importance of preserving the “conscience” of the Catholic Church, their right not to participate in anything that violates their beliefs. That, of course, is a privilege that the rest of us, being citizens of a democracy, don’t enjoy. We pay taxes, which go to a lot of things we dislike. I don’t like the fact that our government spends as much on the military as every other nation on earth combined. I also don’t like the money we spend on tax subsidies for oil companies. My conservative friends don’t like the fact that the government gives food stamps to poor people, and pays the EPA to make sure our air and water are clean. But we all pay taxes, because that’s how it works—we don’t get to pick and choose each line item we want to pay for and which ones we don’t.
The Catholic Church, on the other hand, like all religious institutions, doesn’t pay taxes. Nor do their affiliated organizations like hospitals and universities, because they are nonprofit organizations. So if we had a single-payer system, the Church wouldn’t be involved in anybody’s insurance. The only way they could influence the law would be the way they do on other issues now: not by demanding that the law give them yet more special treatment, but through their moral persuasion on how they think the rest of us should act. And you can imagine how much force that would have.
By: Paul Waldman, The American Prospect, March 5, 2012
Why The Catholic Contraception Controversy Is A Phony Battle
Public health and women’s autonomy collided with religion last week. Elders in the Catholic Church were incensed as the regulations implementing the federal healthcare law would have required institutions affiliated with the Church (but not the Church itself) to provide health plans covering contraception. The rules (part of the normal regulation-writing process that comes after a sweeping law is enacted) would not have forced the Church or its clergymen to hand out birth control; they only would have required Catholic-affiliated schools, hospitals, and universities to play by the rules everyone else has to follow, and provide for full healthcare coverage for women.
The Obama administration, under fire as the health issue turned into a political issue, offered a compromise: health insurance companies would have to provide the free birth control to the female employees (some of whom are not even Catholic), but the religious-affiliated institutions would not have to pay for it.
It was a dodge of sorts, to be sure, but it gave the bishops the cover they needed to maintain the Catholic Church standard opposing contraception. Still, it was a generous compromise. And now the bishops are suggesting it is not enough, citing “serious moral concerns” about the compromise, particularly as it might apply to entities that self-insure.
That, on its own, is a bit of a stretch. The Church, after all, has given marriage annulments to politically-connected people who had not only been married for years, but have had children. If that’s not an inartful dodge around the Church rule forbidding divorce, nothing is. And while it’s probably not helpful to resurrect the painful episode of the decades of child sexual abuse by priests and the failure of the Church to stop them, it’s also true that the institution of the Church is still rebuilding its “moral” brand.
Picking a fight with the Obama administration does nothing to advance that goal. Nor does it improve the Church’s power over its own flock—98 percent of whom have used birth control. Government should indeed protect religious freedom, which is why no one’s asking priests to marry same-sex couples or forcing Catholic hospitals to perform abortions. But what the Church is dangerously close to doing is an equally invasive reverse: asking the government to try to enforce a rule the Church has been wildly unsuccessful in imposing on its own members.
There’s one clear reason why both the Church and the GOP presidential candidates have been raising the tired old accusations of the a war on Catholicism (an allegation that is extremely insulting to Catholics, to whom faith in God is sincere and unshakeable—certainly not threatened by a coworker getting free birth control pills). It’s an election year, so it’s prime time for making hyperbolic and incendiary accusations that have little basis in fact. Social issues have been largely absent from the campaign so far, and for a reason: the economy has been so bad that it was enough of an issue for GOP candidates to run on. But now that the unemployment rate is creeping slowly down and the stock market is stabilizing, the economy may retreat somewhat as an issue. And that leads candidates to insert wedge issues like the contraception debate.
Remarkably, opponents of the Obama administration rule, along with self-described liberal pundits, are convinced that the “Catholic vote” will rise up against Obama in the fall. That analysis assumes that all Catholics vote according to their Church’s dictates, which is absurd, especially in this case. If nearly all Catholics use birth control, why on earth would they vote against a president who tried to make access to birth control easier? Those who are that upset about contraception weren’t planning to vote for this president, anyway.
There will be more social issues raised during this election year, especially after the GOP nomination is sealed. But the contraception debate is a phony one.
By: Susan Milligan, U. S. News and World Report, February 13, 2012
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