“Practicing Without A License”: Iowa Governor Must Personally Decide Whether Each Poor Woman On Medicaid Deserves Abortion Coverage
Iowa Gov. Terry Branstad (R) has approved a measure to expand his state’s Medicaid program under Obamacare, which will extend health coverage to tens of thousands of his poor residents. But there’s a catch buried in the Medicaid expansion legislation that the governor signed last week. Now, when low-income women on Medicaid seek insurance coverage for medically-necessary abortions, they’ll have to get approval from Branstad himself.
State-level Medicaid programs often exclude abortion from the health services they will cover for low-income beneficiaries. Just like the Hyde Amendment prevents federal money from directly funding abortion care, over 35 states have decided they don’t want state dollars to pay for abortion, either. Just 17 states allow low-income women on Medicaid to receive insurance coverage for most abortion services — the others, like Iowa, will only permit those women to be reimbursed for the cost of their abortion in cases of rape, incest, and life endangerment.
But now Iowa is going a step further. If a woman who gets her health care through Medicaid has an abortion that falls under one of the exceptions in the state’s abortion coverage ban — if she has been a victim of rape or incest, if her fetus has fatal abnormalities that won’t allow it to survive outside the womb, or if her life will be put in danger unless she ends the pregnancy — she’ll need to have her case approved by the governor’s office. Presumably, Branstad will choose whether to approve or deny each woman’s request for insurance coverage for her abortion. It’s the first law of its kind in any state.
“This bill — now law — is outrageous on many different levels,” Ilyse Hogue, the president of NARAL Pro-Choice America, said in a recent statement. “Women in Iowa already face so many barriers in trying to get safe, legal abortion care. Now their governor will be deciding personally on a case-by-case basis, whether a woman’s doctor will be paid for providing a legal, medically appropriate, and constitutionally guaranteed procedure.”
Under Iowa’s current policy, a state agency already reviews claims for Medicaid funding of abortion services to make sure the billing is adhering to the law and doesn’t fall outside of the approved exceptions. As the Des Moines Register reports, that process will likely continue under the new law. But there’s a notable difference: “instead of the final call being rendered by the Medicaid medical director, the democratically elected and politically accountable governor will decide.”
Low-income women are unlikely to be able to afford bills for abortion care, which can exceed $1,000 dollars. If the governor decides that Medicaid won’t cover the cost of an abortion procedure, the medical providers will likely be forced to absorb the cost.
Ultimately, denying low-income women access to affordable abortion services simply exacerbates the economic divides that lead some desperate women to seek out illegal abortion providers. By passing a mounting number of state laws that prevent women from using their insurance coverage to pay for reproductive care — as well as by forcing abortion clinics out of business and driving up the cost of the abortion pill — lawmakers are essentially making abortion too expensive for low-income women to access at all.
By: Tara Culp-Ressler, Think Progress, June 25, 2013
“The Eric Cantor Story”: Waste, Fraud, And Abuse
The farm bill was defeated in part because they got fewer yea votes out of Democrats than they were hoping for. This happened, according to moderate Democrat Collin Peterson of Minnesota, because of a last-second amendment from Eric Cantor that sought to impose sterner work requirements on recipients of food stamps. Democratic whip Steny Hoyer says it took a bipartisan bill and turned it into a partisan bill.
This was just a cat-piss mean amendment that you have to think was almost designed to push Democrats away. Fraud in the food-stamp program (known by the acronym SNAP) is a frightening 1 percent, according to Think Progress. And existing work requirements are pretty stringent already. If you live in Cantor’s Virginia and want food stamps, here’s what you have to do, according to the state’s web site:
If you are age 18 to 50 and able to work, you may be subject to a work requirement in order to receive SNAP. This requirement would limit the number of months for which you could receive SNAP to three months in a 36 month period. After you receive SNAP for three months, you may be able to receive three additional months if you complete certain work related requirements. You may be exempt from this work requirement if you are currently working or participating in an approved work program; responsible for the care of a child; pregnant; medically certified as unable to work; meet one of several work registration exemption reasons; or live in an exempt locality.
I can’t find what these “certain work requirements” are, but it seems to me that having to re-meet them every three months provides a pretty constant check on people and meets a high standard of being responsible with the taxpayers’ money.
It’s just amazing to me the way they keep finding new ways to kick poor people. One, deregulate everything so that banks can start placing bets against their own securities. Two, destroy the economy, so that millions more people lose their jobs and have to go on food stamps in the first place. Three, decide that poor people have to pay the penalty for all this financial hanky-panky, and cut the federal programs they depend on to the bone. Four, cut food stamps even more, and make the recipients work more.
“Waste, fraud, and abuse” describe Eric Cantor’s contribution to this nation, his character, and his attitude toward people who aren’t rich.
By: Michael Tomasky, The Daily Beast, June 21, 2013
“The Sequester Will Help The Economy”: Another Right-Wing Fairy Tale Debunks Itself
Remember all those fearless predictions by the usual grinning idiots on the right about how the sequester was going to work miracles for the economy? Well guess what? That never happened.
I know, I know. I’m trying to recover from the shock.
The sequester took effect on March 1, so we now have three months’ worth of jobs data that have been released in its aftermath. The results have been underwhelming, to say the least. As Brad DeLong observed this week, we are still in a depressed economy. And as Ed noted yesterday, the latest monthly jobs report was thoroughly mediocre.
I particularly wanted to highlight the point the New York Times’ Annie Lowrey made: that the report shows that the sequester is already, specifically beginning to have a negative impact on employment. Yesterday’s report shows that the federal workforce, which has suffered cutbacks due to the sequester, is shrinking at a dramatically accelerated rate:
Federal employment had been on a downward trend since the start of 2011, with the government shedding about 3,000 or 4,000 positions a month through February. Then sequestration hit on March 1. And in the last three months, the federal work force has shrunk by about 45,000 positions, including 14,000 in May alone.
Those newly unemployed federal workers, of course, now have less money to spend, which will also slow down the economy. In addition, the sequester is also causing cuts in programs like unemployment benefits and benefits to low-income people such as aid for Women, Infants, and Children (WIC) and the Low Income Home Energy Assistance Program (LIHEAP). Benefits to the unemployed and low-income folks act not only as a social safety net, but also as stimulus, since poor people and the jobless are likely to spend every penny they’ve got. Now, less of that money will be going into the pockets of those people and thus into the economy at large. That will also hurt the economic recovery, such as it is.
So, for those of you keeping score at home? The right wing/free market fundamentalists/austerity caucus? They are wrong. Again. And once again, they are continuing to drive the economy, and the country, into the ground.
By: Kathleen Geier, Washington Monthly Political Animal, June 8, 2013
“The Spite Club”: Driving Home The Fact Of Just How Little The GOP Cares About Your Well-Being
House Republicans have voted 37 times to repeal ObamaRomneyCare — the Affordable Care Act, which creates a national health insurance system similar to the one Massachusetts has had since 2006. Nonetheless, almost all of the act will go fully into effect at the beginning of next year.
There is, however, one form of obstruction still available to the G.O.P. Last year’s Supreme Court decision upholding the law’s constitutionality also gave states the right to opt out of one piece of the plan, a federally financed expansion of Medicaid. Sure enough, a number of Republican-dominated states seem set to reject Medicaid expansion, at least at first.
And why would they do this? They won’t save money. On the contrary, they will hurt their own budgets and damage their own economies. Nor will Medicaid rejectionism serve any clear political purpose. As I’ll explain later, it will probably hurt Republicans for years to come.
No, the only way to understand the refusal to expand Medicaid is as an act of sheer spite. And the cost of that spite won’t just come in the form of lost dollars; it will also come in the form of gratuitous hardship for some of our most vulnerable citizens.
Some background: Obamacare rests on three pillars. First, insurers must offer the same coverage to everyone regardless of medical history. Second, everyone must purchase coverage — the famous “mandate” — so that the young and healthy don’t opt out until they get older and/or sicker. Third, premiums will be subsidized, so as to make insurance affordable for everyone. And this system is going into effect next year, whether Republicans like it or not.
Under this system, by the way, a few people — basically young, healthy individuals who don’t already get insurance from their employers, and whose incomes are high enough that they won’t benefit from subsidies — will end up paying more for insurance than they do now. Right-wingers are hyping this observation as if it were some kind of shocking surprise, when it was, in fact, well-known to everyone from the beginning of the debate. And, as far as anyone can tell, we’re talking about a small number of people who are, by definition, relatively well off.
Back to the Medicaid expansion. Obamacare, as I’ve just explained, relies on subsidies to make insurance affordable for lower-income Americans. But we already have a program, Medicaid, providing health coverage to very-low-income Americans, at a cost private insurers can’t match. So the Affordable Care Act, sensibly, relies on an expansion of Medicaid rather than the mandate-plus-subsidy arrangement to guarantee care to the poor and near-poor.
But Medicaid is a joint federal-state program, and the Supreme Court made it possible for states to opt out of the expansion. And it appears that a number of states will take advantage of that “opportunity.” What will that mean?
A new study from the RAND Corporation, a nonpartisan research institution, examines the consequences if 14 states whose governors have declared their opposition to Medicaid expansion do, in fact, reject the expansion. The result, the study concluded, would be a huge financial hit: the rejectionist states would lose more than $8 billion a year in federal aid, and would also find themselves on the hook for roughly $1 billion more to cover the losses hospitals incur when treating the uninsured.
Meanwhile, Medicaid rejectionism will deny health coverage to roughly 3.6 million Americans, with essentially all of the victims living near or below the poverty line. And since past experience shows that Medicaid expansion is associated with significant declines in mortality, this would mean a lot of avoidable deaths: about 19,000 a year, the study estimated.
Just think about this for a minute. It’s one thing when politicians refuse to spend money helping the poor and vulnerable; that’s just business as usual. But here we have a case in which politicians are, in effect, spending large sums, in the form of rejected aid, not to help the poor but to hurt them.
And as I said, it doesn’t even make sense as cynical politics. If Obamacare works (which it will), millions of middle-income voters — the kind of people who might support either party in future elections — will see major benefits, even in rejectionist states. So rejectionism won’t discredit health reform. What it might do, however, is drive home to lower-income voters — many of them nonwhite — just how little the G.O.P. cares about their well-being, and reinforce the already strong Democratic advantage among Latinos, in particular.
Rationally, in other words, Republicans should accept defeat on health care, at least for now, and move on. Instead, however, their spitefulness appears to override all other considerations. And millions of Americans will pay the price.
By: Paul Krugman, Op-Ed Columnist, The New York Times, June 6, 2013
“From The Mouths Of Babes”: The Ugly, Immoral, Destructive War Against Food Stamps
Like many observers, I usually read reports about political goings-on with a sort of weary cynicism. Every once in a while, however, politicians do something so wrong, substantively and morally, that cynicism just won’t cut it; it’s time to get really angry instead. So it is with the ugly, destructive war against food stamps.
The food stamp program — which these days actually uses debit cards, and is officially known as the Supplemental Nutrition Assistance Program — tries to provide modest but crucial aid to families in need. And the evidence is crystal clear both that the overwhelming majority of food stamp recipients really need the help, and that the program is highly successful at reducing “food insecurity,” in which families go hungry at least some of the time.
Food stamps have played an especially useful — indeed, almost heroic — role in recent years. In fact, they have done triple duty.
First, as millions of workers lost their jobs through no fault of their own, many families turned to food stamps to help them get by — and while food aid is no substitute for a good job, it did significantly mitigate their misery. Food stamps were especially helpful to children who would otherwise be living in extreme poverty, defined as an income less than half the official poverty line.
But there’s more. Why is our economy depressed? Because many players in the economy slashed spending at the same time, while relatively few players were willing to spend more. And because the economy is not like an individual household — your spending is my income, my spending is your income — the result was a general fall in incomes and plunge in employment. We desperately needed (and still need) public policies to promote higher spending on a temporary basis — and the expansion of food stamps, which helps families living on the edge and let them spend more on other necessities, is just such a policy.
Indeed, estimates from the consulting firm Moody’s Analytics suggest that each dollar spent on food stamps in a depressed economy raises G.D.P. by about $1.70 — which means, by the way, that much of the money laid out to help families in need actually comes right back to the government in the form of higher revenue.
Wait, we’re not done yet. Food stamps greatly reduce food insecurity among low-income children, which, in turn, greatly enhances their chances of doing well in school and growing up to be successful, productive adults. So food stamps are in a very real sense an investment in the nation’s future — an investment that in the long run almost surely reduces the budget deficit, because tomorrow’s adults will also be tomorrow’s taxpayers.
So what do Republicans want to do with this paragon of programs? First, shrink it; then, effectively kill it.
The shrinking part comes from the latest farm bill released by the House Agriculture Committee (for historical reasons, the food stamp program is administered by the Agriculture Department). That bill would push about two million people off the program. You should bear in mind, by the way, that one effect of the sequester has been to pose a serious threat to a different but related program that provides nutritional aid to millions of pregnant mothers, infants, and children. Ensuring that the next generation grows up nutritionally deprived — now that’s what I call forward thinking.
And why must food stamps be cut? We can’t afford it, say politicians like Representative Stephen Fincher, a Republican of Tennessee, who backed his position with biblical quotations — and who also, it turns out, has personally received millions in farm subsidies over the years.
These cuts are, however, just the beginning of the assault on food stamps. Remember, Representative Paul Ryan’s budget is still the official G.O.P. position on fiscal policy, and that budget calls for converting food stamps into a block grant program with sharply reduced spending. If this proposal had been in effect when the Great Recession struck, the food stamp program could not have expanded the way it did, which would have meant vastly more hardship, including a lot of outright hunger, for millions of Americans, and for children in particular.
Look, I understand the supposed rationale: We’re becoming a nation of takers, and doing stuff like feeding poor children and giving them adequate health care are just creating a culture of dependency — and that culture of dependency, not runaway bankers, somehow caused our economic crisis.
But I wonder whether even Republicans really believe that story — or at least are confident enough in their diagnosis to justify policies that more or less literally take food from the mouths of hungry children. As I said, there are times when cynicism just doesn’t cut it; this is a time to get really, really angry.
By: Paul Krugman, Op-Ed Columnist, The New York Times, May 30, 2013
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 