“Terrifying Implications”: Texas Says “No Thanks” To Women’s Health Care
If you haven’t been worn down reading about Todd Akin’s bizarre and ignorant views about the female reproductive system, now turn to Texas, where women’s uteruses may soon have to move out of state to find health care. Late Tuesday night, a federal court of appeals ruled that Texas can exclude Planned Parenthood from the Women’s Health Program, which provides basic preventative care—like birth control and cancer screenings—for low-income women. The decision has terrifying implications in a state where women’s access to health care is already poor.
One in four women in Texas is uninsured, and the state also has the third-highest rate of cervical cancer in the country. In Texas, women’s health-care clinics serving low-income populations rely on two sources of funding: the Women’s Health Program and general state family-planning dollars. Lawmakers have attacked both streams.
In 2011, the state legislature slashed state funding for family planning—you know, the thing that prevents abortions—by two-thirds. A recent report from the Texas Observer revealed that 60 family planning facilities have already closed as a result of the cuts. While a full picture of the effect is still emerging, the Legislative Budget Board, a bipartisan committee, had estimated that when all was said and done, the cuts would lead to 20,000 additional births (which Medicaid would have to pay for). Projections show that around 180,000 women would lose health services.
Then there’s the damage to the state Women’s Health Program (WHP), a separate program that serves 130,000 low-income women. Created in 2005, the WHP is a crucial state service that provides preventative health care and family-planning services. It’s run through Medicaid, so the feds paid for 90 percent of the $40 million program. While it only serves women who are not pregnant, it saved around $75.2 million in 2009 by preventing a projected 6,700 births. The program seemed like a win-win; it decreased unplanned pregnancies and abortions, while increasing access to health care.
But the WHP may soon not exist, or at least not in a recognizable way. Lawmakers added new rules in 2011 that excluded Planned Parenthood from receiving funding. The trouble is, Planned Parenthood provided services to nearly half the women covered under the program and received about 25 percent of the program’s total funding last year. Barring the organization leaves many wondering whether those clinics left would meet demand.
Furthermore, the state violated federal policy by slashing Planned Parenthood funding, which means Medicaid can no longer foot the bill for the Women’s Health Program. Texas supposedly has a plan to transition to a state-run program by November 1; that plan will continue to exclude Planned Parenthood. The influential organization is fighting the state’s decision, and in October, the two parties begin court proceedings on whether Texas can permanently exclude the main provider of women’s health from its Women’s Health Program.
Yesterday’s decision means that between now and the court case, Texas can halt funding to Planned Parenthood clinics. It’s only a few months, but the clinics are already reeling from the family-planning cuts. The loss of WHP funding is a double whammy. Twelve Planned Parenthood clinics have already shut down, alongside the many clinics with no relation to the organization. Meanwhile, if the courts ultimately decide Texas cannot exclude Planned Parenthood from the WHP, the state may opt to shut down the program entirely.
Many, including the attorney general and Governor Rick Perry, celebrated the decision, and the state Health and Human Services Commission announced it would immediately halt funding to the group. Meanwhile, for the hundreds of thousands of low-income women in the state, there are fewer and fewer health-care options.
By: Abby Rapoport, The American Prospect, August 22, 2012
“Mitt’s 13% Tax”: Romney’s Embodiment Of The Principle Of Equal Sacrifice
Mitt Romney says “every year I’ve paid at least 13 percent [of my income in taxes] and if you add in addition the amount that goes to charity, why the number gets well above 20 percent.”
This is supposed to be in defense of not releasing his tax returns.
Assume, for the sake of the argument, he’s telling the truth. Since when are charitable contributions added to income taxes when judging whether someone has paid his fair share?
More to the point, Romney admits to an income of over $20 million a year for the last several decades. Which makes his 13 percent — or even 20 percent — violate the principle of equal sacrifice that lies at the core of our notion of tax fairness.
Even Adam Smith, the 18th century guru of free-market conservatives, saw the wisdom of a graduated tax embodying the principle of equal sacrifice. “The rich should contribute to the public expense,” he wrote, “not only in proportion to their revenue, but something more in proportion.”
Equal sacrifice means that in paying taxes people ought to feel about the same degree of pain regardless of whether they’re wealthy or poor. Logically, this means someone earning $20 million a year should pay a much larger proportion of his income in taxes than someone earning $200,000, who in turn should pay a larger proportion than someone earning $50,000.
But Romney’s alleged 13 percent tax rate is lower than that of most middle class Americans who earn a tiny fraction of what he earns.
At a time when poverty is increasing, when public parks and public libraries are being closed and when public schools are shrinking their offerings and their hours, when the nation’s debt is immense, and when the 400 richest Americans have more wealth than the bottom 150 million of us put together — Romney’s 13 percent is shameful.
By: Robert Reich, Robert Reich Blog, August 17, 2012
“Ryan’s America”: Here’s How Much It Would Hurt To Be Poor Under Paul Ryan’s Budget
There are many different ways to talk about Paul Ryan’s Roadmap, but maybe the most useful is to imagine how his budget affects your budget.
How much more money would you keep under his broad tax plan? How much more would you have to save to pay for health care?
And for the low-income, whom—as we’ll see—bear the brunt of Ryan’s cuts: How alone would they be in Ryan’s America?
But let’s start with a bit of basic arithmetic.
There are two ways that the government’s budget can affect yours. Clearly, one is taxes. More than 80 percent of government revenues comes from individuals’ wages and income. (The rest comes from corporate taxes and things like excise taxes on gasoline, which also affects our budgets, but less directly.)
Two is spending. Although most of us might think of government as providing public goods like airports and security, $3 out of every $5 Washington spends is basically insurance—a transfer to those who are old, sick, and poor. Social Security writes checks equal to 20% of government outlays. Medicare, Medicaid and CHIP account for another 20%. Safety net programs and benefits for veterans and federal retirees account for another 20%.
So, a full accounting of how Ryan’s budget would affect your budget must consider how much he would cut our taxes and how much he would cut our transfers.
TAXES. Ryan cuts income tax rates and abolishes investment taxes to reduce government revenues by about $450 billion* per year over the next ten years. (That’s after he makes permanent the Bush/Obama tax cuts.)
We don’t know exactly how Ryan’s tax cuts would break down by family income level, but the Tax Policy Center has published an estimate based on the Ryan-inspired budget passed by the House of Representatives this year. The upshot is that the federal income tax code—the one highly-progressive part of our tax system—would become significantly less progressive. Taxes would barely change (or even rise) on the low-income Americans, and the top 1% would see a windfall from the elimination of taxes on most of their investment income.
“Those making $1 million or more would enjoy an average tax cut of $265,000 and see their after-tax income increase by 12.5 percent,” TPC found. “By contrast, half of those making between $20,000 and $30,000 would get no tax cut at all.”**
SPENDING. Ryan is most famous for his Medicare plan, but if his budget became law at midnight tomorrow, the most dramatic changes over the next ten years would be everything but Medicare. That’s because Ryan’s long-term plan to move Medicare from a defined-benefit fee-for-service system (where government is your insurance) to a defined-contribution system (where government writes you a check to help you pay somebody else for insurance) is truly a long-term plan. It wouldn’t begin to take effect until the early 2020s. The typical family might prepare for a more modest Medicare by putting more money away. They might leave more of their salaries in a savings account. They might invest in the stock market, with the understanding that any gains wouldn’t be taxed. They might use their modest income gains to buy a house, with the intention to sell at a tax-free gain later.
Ryan slashes deeply, but he spares defense and Social Security, which, together, account for 40% of the budget. That means his $4 trillion in cuts come mostly out of health care spending, income security spending, and basic government duties. By 2023, Ryan would spend 16 percent less than Obama on income security programs like unemployment benefits and food stamps. He would spend a quarter less on transportation, and 13 percent less per veteran, according to Brad Plumer.
Medicaid spending would be shaved by about a third, and the Urban Institute calculated that a similar proposal would force the states to drop between 14 million and 27 million people from Medicaid by 2021 (note: that’s an extreme prediction). It’s not clear exactly what programs would be cut, or by exactly how much. What is clear is that everything within the bundle of government responsibility—from subsidizing science research to subsidizing education to keeping up national parks and law enforcement—would come under pressure for cuts to make room for the massive and regressive cuts to taxes.
What does that budget mean for your budget? It rather depends where you fall on the income ladder. Romney is relieving the richest Americans from some of their duties to pay for the risk-protection of the poor, and he is asking some of the poorest Americans to accept less help from the government in exchange for … well, the virtue of independence from government. It is stark, but broadly accurate, to say that the less you benefit from Ryan’s tax cuts, the more you would potentially suffer from Ryan spending cuts. It is possible—and, in Ryan’s vision, duly hope for—that devolving responsibilities from the federal government to the states and the private sector will drive efficiencies. But, as the GOP likes to point out about the president, “hope is not a policy,” and it is definitely not an inevitability.
Remember when Romney said he’s “not concerned about the very poor” because there’s a safety net for them? Well, there wouldn’t be the same safety net after Ryan’s plan took root. Romney doesn’t have to embrace every detail of Ryan’s plan, and he won’t. But he has embraced the philosophy of Ryan’s vision: That true freedom means freedom from government dependency, and that the poor are somehow richer, in spirit or in literalness, if they take less money from the government. Ryan believes that his budget could unlock spectacular growth and increase lower-income wages. And it might! But most of what we know about the impact of technology, emerging markets, and off-shoring suggests that gaping income inequality is a side-effect of global capitalism more than an outcome of progressive government.
This budget would have a very predictable outcome: It would make poor families poorer, and more exposed to the risks of medical or financial calamity, all under the banner of “Responsibility And Freedom.” Ryan is free to march under his banner. But don’t ask me to call it responsible.
By: Derek Thompson, The Atlantic, August 14, 2012
“Decimation Of Health Care For The Poor And Uninsured”: Mitt Romney Puts Women’s Lives At Risk
If you want to see what women’s health care in America will be like if Mitt Romney becomes president, just look at Texas and Arizona.
Both states are in the news these past few weeks for trying to prevent women from getting health care at Planned Parenthood. It’s wrong, and it will have devastating consequences for women for years to come—and Mitt Romney wants to do it in all 50 states.
Romney said in November that he wants to eliminate the nation’s family-planning program, which was signed into law by President Richard Nixon in 1970 and provides essential preventive health services to more than 5 million people a year, the vast majority of whom are poor and uninsured.
Beyond the millions of people who are helped by this health-care program, investing in family planning saves the government money—for every dollar spent on family planning, experts say taxpayers save around $4.
Romney said in March that, if elected president, he would “get rid of” Planned Parenthood. He clarified his remarks to say he would end federal funding for Planned Parenthood. Either way, he would seek to dismantle a nationwide network of community-based health centers that one in five American women rely on for care at some point in their lives.
This isn’t about abortion. These health-care programs provide blood pressure and cholesterol monitoring, flu shots, breast-cancer screenings, Pap tests, and birth control. Planned Parenthood is the only medical care many women receive all year.
Michele Azzaro knows what Mitt Romney’s America would look like—because she’s already experiencing it in Texas.
Azzaro has been a Planned Parenthood patient in Dallas for more than 20 years. Planned Parenthood was there when she had a breast-cancer scare, and her local health center has been there when she needs her yearly cholesterol test.
Last year, Texas drastically cut its family-planning funding, the same way Mitt Romney says he would cut federal funding. Michele lost access to annual breast screenings and the birth-control pills she needs to manage her painful uterine fibroids.
She isn’t alone.
An estimated 160,000 women lost their health care when Texas slashed its family-planning program last year. Now, the state is trying to throw more women off health care by taking Planned Parenthood out of the state’s Women’s Health Program. Planned Parenthood health centers provide care to 52,000 women in the program.
Texas’s program provides low-income working women in Texas with lifesaving cancer screenings, well-woman exams, contraception, screenings for diabetes and high blood pressure, and testing for sexually transmitted infections. The program was sponsored and implemented by Republicans less than a decade ago—an indication of how far to the right some in the party have gone in just a few years.
Planned Parenthood sued the state in federal court in order to continue providing these critical health services to women, and last week a federal appeals court blocked the state’s effort to deny women the health care they rely on at Planned Parenthood while the lawsuit proceeds.
Meanwhile, Arizona Gov. Jan Brewer recently signed legislation that cuts state funding for Planned Parenthood’s preventive care. The new law could cut 4,000 women off from the health care they need.
What’s happening in Texas and Arizona isn’t about Planned Parenthood. It’s about Michele Azzaro—and the 3 million people a year who rely on us for cancer screenings, birth control, and well-woman exams.
Our patients aren’t making a political statement when they come to Planned Parenthood. But they’re not afraid to make a political statement to keep the health care they rely on when they vote in November.
“Larger Deficits, More Inequality”: The House Republicans’ Head Scratching Economics
Whether you worry about the sluggish recovery, budget deficits, or widening inequality, you should be scratching your head at what the House of Representatives is up to this week.
On the one hand, the House will likely pass the small business tax cut sponsored by House Majority Leader Eric Cantor, which adds $46 billion to the deficit, largely benefits very high-income taxpayers, and has little potential for creating jobs. On the other hand, the House Agriculture Committee has approved a proposal, as part of its deficit reduction mandate, to cut $36 billion from the Supplemental Nutrition Assistance Program—formerly food stamps—a program that goes mainly to low-income households and is one of the best policies we have for creating jobs in a weak economy.
In Tuesday’s post on the New York Times Economix blog, Bruce Bartlett, who held senior policy roles in the Reagan and George H.W. Bush administrations and served on the staffs of Reps. Jack Kemp and Ron Paul, asks the question, “Do small businesses create jobs?” He appropriately cites the research showing that politicians’ worship of small businesses as jobs creators is misguided, and that it is start-up firms, not small firms per se, that are the job creators. Moreover, many of those who would benefit from the tax cut are affluent doctors, lawyers, and stockbrokers—hardly the local mom and pop store that most people imagine when they hear the phrase “small business.”
Bartlett is scathing on the Cantor bill:
There may be policies that would increase the number of business start-ups and aid employment this way. But an across-the-board tax cut for every small business, defined only in terms of employment, is nothing but …[a] giveaway unlikely to create any jobs whatsoever.
Bartlett’s indictment is backed up by standard “multiplier” or “bang-for-the-buck” analyses from the Congressional Budget Office and private analysts like Mark Zandi, chief economist of Moody’s Analytics. In contrast to an increase in SNAP benefits, which they find to be among the most cost-effective measures for stimulating economic growth and job creation in a weak economy, both the Congressional Budget Office and Zandi find business tax cuts similar to the Cantor bill to be among the least effective. The economic growth and job creation impact per dollar of nutritional assistance spending is six to eight times larger than that of an across-the-board tax cut.
Here is what the House is doing with these two measures: It is adding $46 billion of tax cuts, nearly half of which will go to those making more than $1 million, to the budget deficit. According to the official Joint Committee on Taxation estimate, about $45 billion of it will be received in 2012-13, when the economy could in fact use a boost to jobs. At the same time, any stimulus from the tax cut will be wiped out by the $8 billion of the $36 billion SNAP cut that also would occur in 2012-13.
The bottom line on these actions is that they produce larger budget deficits, more inequality, and no net new jobs. So when I see the House moving in exactly the opposite direction of what is fair and makes economic sense, I’m inclined to ask: “Is it really more politically appealing to cut taxes for millionaires and increase the budget deficit than to maintain food benefits for the poor that also give an extra boost to the economic recovery?”
By: Chad Stone, Chief Economist at the Center on Budget and Policy Priorities, Washington Whispers, U. S. News and World Report, April 19, 2012
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