mykeystrokes.com

"Do or Do not. There is no try."

“When The Worm Turns”: Republican Fallacies On Obamacare, The Greatest Hits

Before the holiday spirit makes Republican-bashing a little unseemly, it’s time to get in a last ornery blast at the party’s Obamacare stance. Republicans have enjoyed themselves immensely during the Affordable Care Act’s bungled rollout, but most of the claims they’re making are preposterous and phony. Since anyone able to take a longer view knows we’ll one day be well past Obamacare’s self-inflicted wounds, I’d like as a public service to catalog the GOP’s shabbiest arguments, so we’ll all have a handy reference once the worm fully turns.

The selective “humanitarian crisis.” Conservatives have warned of the “humanitarian disaster” that will ensue if several million people with cancelled policies are unable to secure new coverage before January 1. But this theoretical woe (which will almost certainly be avoided thanks to Web site fixes and policy extensions) pales next to the much larger humanitarian disaster of America’s nearly 50 million uninsured — a crisis that’s persisted for decades without conservatives caring a whit. I can’t be the only one who finds the right’s sudden concern for a small subset of the uninsured a bit rich.

The bogus oppression of the young and healthy. Another confused conservative trope bemoans the enslavement of younger or healthier Americans, who’ve supposedly been conscripted to subsidize their older, sicker countrymen. “Liberals justify these coercive cross-subsidies as necessary to finance coverage for the uninsured and those with pre-existing conditions,” the Wall Street Journal editorialized last Saturday. “But government usually helps the less fortunate honestly by raising taxes to fund programs.” Actually, the Journal has the American way of health subsidy exactly wrong. Most people aged 19 to 34 who have health coverage get it from their employer. And, as I’ve noted before, at nearly every firm, young people pay the same premiums as employees who are older and get more expensively sick. In other words, Obama’s scheme to rob Peter to fund health care for Paul already exists, at vastly larger scale, in corporate America. And while Obamacare is only hoping to sign up 2 million or so young people, 20 million Americans aged 19 to 34 get their coverage on the job. Where’s the Wall Street Journal’s rant against corporate America’s “coercive cross-subsidies”? And while we’re at it, when will we stop making all those people whose houses don’t burn down subsidize those whose do?

The “men and 55 year old women don’t need maternity care” fallacy. Well, yes, and people whose genes don’t predispose them to cancer (which tests will reveal soon enough) don’t need cancer coverage. As Bob Kocher, a doctor and former senior Obama health care advisor, explained, if one of our goals is to not charge women higher premiums than men, all plans have to cover maternity. Among younger women, moreover, maternity is the biggest driver of costs — so if you allow optional coverage, the plans young people buy would be super-expensive. “For insurance to work, you can’t allow people to opt into benefits like maternity right before they get pregnant,” Kocher adds. “When spread across the population, it’s not expensive.” Sounds like Insurance 101. Which in the social insurance context, conservatives can’t abide.

Insurance “bailout” baloney. Sen. Marco Rubio talks opportunistically (but I repeat myself) of Obama’s pledge to “bail out” health plans if the folks they sign up end up being unduly costly to treat. Once again, conservatives eat their own. Such “risk adjustment” — after-the-fact payments to reflect the actual vs. expected risk experience of health plans — has been a sensible staple of conservative insurance market reforms since George H.W. Bush proposed it in 1992. Little known but true: Before Romneycare begat Obamacare, Bushcare begat Romneycare. Rubio was only 21 then. He must not know. Or care.

The “Obama is taking over one-sixth of the economy” ruse. In the Fox News cocoon, this truth is self-evident. But it makes as much sense as crying that Ben Bernanke is “remaking 6/6ths of the economy” every time the Fed touches interest rates. The fact that health-care spending is 18 percent of GDP doesn’t mean Obama is “remaking” or “taking over” anything. He’s tweaking a dysfunctional corner of the market where 5 percent of us get our health coverage. He’s also testing ideas that health gurus in both parties have long suggested might help reign in future costs.

Worse than these GOP fallacies is the party’s smug sanctimony. It’s as if conservatives have decided to parody the moral preening they loathe in liberals, except that the right is serious. As one pundit lectured, “the administration didn’t care enough to make sure the people of their country were protected. In the middle of a second age of anxiety they decided to make America more anxious.”

Yes, the rollout was botched. But what is this person talking about? Finally assuring that illness in the United States can’t be the cause of financial ruin is the very essence of “protection.” How galling that conservatives can make such hollow charges while putting forward no plan of their own to “protect” anyone from anything!

Or take the pundit who wrote that “extending enrollment periods does nothing but provide Americans more time to contemplate their miserable choices.” Only someone with no empathy — someone who has never tried and failed to get coverage in the individual market — could possibly say such a thing.

I’ve spent a lot of time over the years arguing that we can solve big problems such as providing insurance coverage in ways that honor both liberal and conservative values. It’s entirely doable — John Rawls and Milton Friedman can be reconciled, trust me. Apart from being sound policy, I’ve assumed such approaches would also be necessary, because with power closely divided in the United States, we’d need to strike big cross-party deals to make progress. The breathtaking intellectual and moral dishonesty of those driving the Obamacare debate in the GOP today makes me feel foolish for having tried.

 

By: Matt Miller, Opinion Writer, The Washington Post, December 4, 2013

December 5, 2013 Posted by | Affordable Care Act, Obamacare, Republicans | , , , , , , | Leave a comment

“What’s The Matter With Motherhood?”: Hey Conservatives, Health Coverage Including Maternity Care Is A Right-To-Life Issue

If you’re a conservative strongly opposed to abortion, shouldn’t you want to give all the help you can to women who want to bring their children into the world? In particular, wouldn’t you hope they’d get the proper medical attention during and after their pregnancy?

This would seem a safe assumption, which is why it ought to be astonishing that conservatives are positively obsessed with trashing the Affordable Care Act’s regulation requiring insurance policies to include maternity coverage.

Never mind that we who are lucky enough to have health insurance end up paying to cover conditions we may never suffer ourselves. We all want to avoid cancer, but we don’t begrudge those who do get it when the premiums we pay into our shared insurance pools help them receive care.

Yet critics of Obamacare apparently think there is something particularly odious when a person who might not have a baby pays premiums to assist someone who does. It’s true that men cannot have babies, although it is worth mentioning that they do play a rather important role in their creation. In any event, it is hardly very radical to argue that society is better off when kids are born healthy to healthy moms.

Yet the conservatives’ ire over this issue knows no bounds.

“And so what if a health policy lacks maternity care?” wrote Deroy Murdoch on National Review’s Web site , the italics on that impatient “so what” being his. “Not all women want to bear more children — or any children at all. . . . And how about lesbians who do not want kids, and are highly unlikely to become pregnant accidentally?” It’s touching, actually, to see such concern for lesbians in a conservative publication. Behold the miracles Obamacare already has called forth.

On “Fox News Sunday” this month, host Chris Wallace was very worked up as he pressed Zeke Emanuel, a former health-care adviser to President Obama, over how unfair it is that a single woman with a 24-year-old son would be forced to pay for such coverage. “She’s not going to have any more children,” Wallace said with great certainty. “She’s not going to need maternity services.”

Writing on the FreedomWorks Web site, Julie Borowski declared, unhappily: “Maternity coverage will be mandatory — even for men. . . . Adding coverage for things that some people do not want will only increase insurance costs for everyone .”

Well, not exactly. But you get the drift. Who knew that supporting motherhood was suddenly controversial?

All of which ought to present members of the right-to-life movement with a challenge. In the name of consistency, they need to break with their conservative allies and insist that maternity coverage be included in all health-care plans. Shouldn’t those who want to prevent abortion be in the forefront of making the case that a woman will be far more likely to choose to have her baby if she knows that both she and her child will get regular medical attention?

For too many politicians on the right, what they say about abortion is at odds with what they say about so many other issues. They speak with great concern and compassion for the unborn, and I respect that. You don’t have to support making abortion illegal to think that there are too many of them in the United States.

To their great credit, some right-to-lifers really do follow the logic of their position and support expanded health coverage, food stamps, the Women, Infants and Children feeding program and other measures that help parents after their kids are born. This reflects a consistent ethic.

But many other conservatives would make abortion illegal and leave it at that. Thus we have the spectacle in Texas of right-wing politicians trying to make it as difficult as possible for a woman to obtain an abortion while proudly blocking the state’s participation in the expansion of Medicaid to cover the near-poor. Does it serve the cause of life to keep more than 1.8 million Texans from getting health insurance?

President Obama apologized last week after all the criticisms of what’s happening in the individual insurance market. But where is the outrage over governors and legislators flatly cutting off so many lower-income Americans from access to Medicaid? The Urban Institute estimates that 6 million to 7 million people will be deprived of coverage in states that are refusing to accept the expansion.

If health coverage — yes, including maternity care — isn’t a right-to-life issue, I don’t know what is.

 

By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, November 10, 2013

November 12, 2013 Posted by | War On Women, Women's Health | , , , , , , , | 1 Comment

“Old Time Crackpot Patriarchy”: Behind The Right’s Crazy Crusade To Make Women Pay More For Health Insurance

In a sane world, when Rep. Renee Ellmers asked rhetorically last week “Has a man ever delivered a baby?” she would have been arguing not against, but for the Affordable Care Act’s requirement that men and women pay the same insurance premiums. After all, the special physical burdens borne solely by women to ensure the life and health of the next generation obviously benefit both genders, right? Healthy men today can thank their mothers for eating well and getting good prenatal care; likewise fathers are grateful to the mothers of their children for the same. (Michael Hiltzik runs down the case for sharing those costs publicly here.)

But no, Ellmers asked that question of Health and Human Services Secretary Kathleen Sebelius in order to rail against the ACA’s equal premium requirement. She thought it was a clever “gotcha” moment, designed to show the craziness of requiring all insurance policies to cover maternity care and contraception without a co-pay. (The doofuses at Breitbart agreed, declaring “Ellmers brings her A game.”) Amazingly, Ellmers chairs the House GOP’s “women’s policy committee” – so how could she be so tone-deaf in attacking the way the ACA helps that increasingly elusive GOP constituency, female voters?

Because the right-wing base of the modern Republican Party is dedicated to restoring men as the head of the household, and the nuclear, husband-headed family as the principle social unit. From Rick Santorum railing against contraception and preaching the nuclear family as the answer to poverty in last year’s GOP presidential primary, to Rafael Cruz Sr. telling an audience that “God commands us men to teach your wife, to teach your children—to be the spiritual leader of your family,” today’s right-wing Republicans are increasingly comfortable with open displays of old-time crackpot patriarchy. This week Sen. Ted Cruz Jr. courts the right-wing preachers of the South Carolina Renewal Project, which is thought to be a key stop on his way to the GOP nomination in that early-primary state.

Let’s face it: The only way charging women more for health insurance and healthcare makes sense is if they have a partner who either shares that burden or shoulders it entirely. As in … a husband. Then it’s clear that the male of the species is doing his part to keep the species healthy and reproducing itself. A woman who doesn’t have a husband to play that role? Well, there shouldn’t be women like that – and certainly if there are, they shouldn’t be having children anyway, or even having sex, so they don’t need maternity care or contraception.

That’s the only way I can explain the GOP’s willingness to openly endorse an enormous transfer of wealth from women back to men by not only advocating the repeal of the ACA but specifically railing against its equal-premium provisions. But don’t worry, gals: You’ll get that wealth back once you get yourself a man!

I got a glimpse of this mind-set from an otherwise open-minded Republican, former RNC chair Michael Steele, last year, when he argued against the ACA’s contraception without a co-pay provision on “Hardball.” As Steele told me:

The problem is that you have effectively absolved the male of any responsibility in the relationship with this woman, whether it’s a sexual nature or beyond that. It’s not just about giving women access to contraception. It’s about the responsible behavior that goes with that access. It’s nice for Barack Obama to tell women, ‘I got your back. Here, have a pill.’ Men have a responsibility here … It’s this other piece that doesn’t get talked about in terms of the responsibility of fathers, or potential fathers, in this relationship.

I tried to reassure Steele that men could continue to be responsible to the women in their lives, even if they got contraception without a co-pay, but he wasn’t having it. I saw the uneasiness with female autonomy that’s at the heart of modern Republicanism, even if Steele himself handles that anxiety better than folks on the far right.

The father of the man who led the crusade to shut down the government over Obamacare, Rafael Cruz Sr., is quite clear about his belief that women must be subservient to men. As David Corn revealed in Mother Jones, Cruz told an Irving, Texas, mega-church last year:

As God commands us men to teach your wife, to teach your children—to be the spiritual leader of your family—you’re acting as a priest. Now, unfortunately, unfortunately, in too many Christian homes, the role of the priest is assumed by the wife. Why? Because the man had abdicated his responsibility as priest to his family…So the wife has taken up that banner, but that’s not her responsibility. And if I’m stepping on toes, just say, ‘Ouch.’

Ouch. I’m waiting for mainstream reporters to ask Cruz whether he shares his father’s beliefs – including his claim that President Obama should “go back to Kenya.” Rafael Cruz is a leading surrogate for his son, and has played a core role in his political rise. I don’t think it’s unfair to ask how much their views overlap, especially as Cruz courts the extremists in the South Carolina Renewal Project.

Right now those extremists matter more to key GOP leaders than ordinary women do. But if Ken Cuccinelli loses the Virginia governor’s race to Democrat Terry McAuliffe, as polls indicate is likely, he’ll do so because of the women’s vote. Republicans can’t win women because they’re still fighting a culture war to restore men to their “rightful” place as the head of the family and society. They’re profoundly uncomfortable with women’s autonomy – and that makes women voters increasingly uncomfortable voting Republican. Making Renee Ellmers the face of the backlash won’t help.

But I don’t expect a Cuccinelli loss to sober up the GOP either. Already right-wingers are telling reporters that McAuliffe is winning because the stridently antiabortion lieutenant governor didn’t campaign hard enough on culture-war issues. Antiabortion activist Marjorie Dannenfelser, who leads the Susan B. Anthony List, told Politico that Cuccinelli bowed to a GOP establishment-mandated “jobs, economy, that’s all that matters script.” Dannenfelser says “that script didn’t work in the presidential with [Mitt] Romney, who is not viewed as conservative as Ken is, and it has been problematic in this gubernatorial race. Sometimes, when it gets to social policy, everyone gets in the fetal position on the Republican side.”

Democrats have to hope the GOP listens to Dannenfelser heading into the 2014 midterms.

 

By: Joan Walsh, Editor at Large, Salon, November 5, 2013

November 6, 2013 Posted by | GOP, War On Women, Women's Health | , , , , , , | 1 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

Health Reform’s Gifts For Mom: Celebrating Mother’s Day With Healthier Mothers, Mothers-To-Be, And Grandmothers

Mothers care for their children, spouses, and aging parents around the clock. Many moms work full-time jobs on top of caregiving. But who cares for Mom?

This Mother’s Day, moms can celebrate health care reform’s new provisions that help moms, moms-to-be, grandmothers, and their families to get healthy and stay healthy. Here are some of health care reform’s “gifts” that moms can already enjoy, as well as a sneak peek of gifts to come.

Moms

One of the biggest worries for moms is their kids. Kids get sick, get hurt, and were denied health insurance prior to health care reform. But thanks to reform, moms have support whether they have a young child with a preexisting condition or a college graduate whose employer doesn’t cover them. Insurance companies can no longer deny insurance to children with preexisting conditions, and children up to age 26 can stay on their parent’s plan if their employer doesn’t offer coverage.

But reform looks out for Mom, too. The Affordable Care Act provides free screenings of many of women’s biggest health concerns: breast cancer, cervical cancer, blood pressure, cholesterol, and obesity.

Paired with improvements in primary care, we know this preventive approach will drastically improve the health of moms and their families. We know, for instance, that regular pap smears increase the likelihood of detecting cervical cancer early and subsequently increasing survival rates.

The bottom line? Free screenings allow doctors and their patients to address health problems earlier and help prevent Mom from getting sick.

And if Mom still gets sick, health care reform provides support there, too. Provisions now prohibit annual and lifetime caps, meaning that a person who is severely or continually ill will not “run out” of insurance.

Moms-to-be

Moms-to-be can look forward to the guarantee that all health plans will cover maternity care for the first time. This is especially exciting since prior to health care reform, 22 states offered no coverage of pregnancy-related costs under any health care. Further, in a study conducted by the National Women’s Law Center, only 13 percent of studied health plans in the individual market provided maternity care.

Maternity coverage will also include preventive and prenatal services. For instance, women considering pregnancy can receive free folic acid supplements while pregnant women can receive free, routine screening for anemia. Taking folic acid previous to getting pregnant and during the first trimester of pregnancy helps prevent birth defects and is essential to the development of the fetal nervous system. Further, pregnant women with iron-deficient anemia are at increased risk of preterm deliveries, delivering babies with a low birth weight, and even fetal death.

Finally, new moms will see additional postnatal benefits. Mothers will receive breastfeeding support such as prenatal and postnatal breastfeeding education and evaluation from trained caregivers. This has proven health benefits for both mothers and their children. Additionally, moms who go back to work will benefit from a private space to breastfeed because employers are now required to provide one.

Grandmothers

Grandmothers can stay stronger for longer with free annual checkups covered by Medicare. The physicals are available to every Medicare beneficiary and they don’t cost a thing.

In addition, other health plans will allow grandmothers to receive preventive care without copays or deductibles. All new plans must include free osteoporosis screeninga disease affecting mainly older women that causes the bones to weaken and severely increases the likelihood of fractures and breaks—for women over 65 and for women at higher risk over age 60.

Finally, provisions in health care reform are working to close the “doughnut hole” in which people enrolled in Medicare’s prescription drug program, often women, are forced to pay a greater share out of pocket for prescription drugs due to a gap in coverage. In the last year Medicare beneficiaries received a $250 rebate. In coming years there will be discounts on brand-name and generic prescription drugs, and provisions will work to make it so by 2020 the doughnut hole will be closed.

Future gifts

While many of these “gifts” to mothers are already in place, more gifts will arrive in the next two-and-a-half years.

For starters, because of new and expanded programs, more moms will have health insurance. These new programs will make it so insurance plans include even more mom and family-friendly services that build on the aforementioned maternity, preventive, and Medicare benefits.

Finally, for the first time, women—mothers included—will pay the same rate for health insurance as men. Forty-two states currently allow gender rating (charging women more than men for the same health plan), with some charging up to 84 percent more. This is a huge, long-awaited gift to women and moms everywhere.

Health care reform acknowledges moms’ 24/7 care. That’s why the law works to serve moms every day and not just Mother’s Day.

By: Sandra Bogar, Center for American Progress, May 5, 2011

May 5, 2011 Posted by | Affordable Care Act, Health Care, Health Reform, Insurance Companies, Medicare, Uninsured, Women, Women's Health, Womens Rights | , , , , , , , , , , , , , | Leave a comment

   

%d bloggers like this: