“Victory For The Middle Class”: On Obamacare’s Third Birthday, There Are Already Reasons To Be Grateful
On March 23, 2010, Obamacare — formally known as the Patient Protection and Affordable Care Act — was signed into law by President Obama.
Three years later, the bulk of the first serious attempt at near-universal health care has not yet taken effect. Health marketplaces are still being formed, states are still deciding if they’ll take Medicaid expansion and the subsidies that will help tens of millions of Americans afford health care won’t roll out until January 1, 2014.
Implementing Obamacare won’t be easy, as even some of the biggest fans of the program admit. Expanding Medicare to cover all Americans would have to be an even simpler solution but a complete political impossibility — given that Joe Lieberman (I-CT), whose vote was necessary to pass the law, single-handedly vetoed a provision that would allow 55- to 64-year-olds to buy into Medicare. It’s a compromise solution that uses unpopular provisions — like the individual mandate — to achieve extremely popular results — ending lifetime limits and banning insurance companies from dropping patients once they become sick.
There will be plenty of time to debate the efficacy of Obamacare — especially with insurance companies enjoying record profits threatening to raise rates in order to justify changes to the law.
But right now we should celebrate the greatest victory for the middle class since Medicare and Medicaid. At its heart, Obamacare is a program that asks the rich and corporations to pay a little more to help working Americans get insurance they can count on, thus lowering the cost of health care for everyone. We already pay for each other’s health coverage, but just in the dumbest possible way — emergency rooms.
Here are five reasons to be grateful for Obamacare, which is already making life better for the middle class.
Obamacare Frees Workers And Entrepreneurs
One of the most popular aspects of Obamacare is that beginning in 2014, insurance companies will no longer be able to deny people coverage because of pre-existing conditions. Because insurance companies had been able to do this, many people avoided going to the doctor for fear of being diagnosed with a disease or condition that would brand them for the rest of their lives. Some stayed in jobs they didn’t want and others didn’t take the leap to start a new business for fear of not being able to get coverage. These changes especially free women — who by federal law can no longer be charged more for care because of their gender — to pursue new opportunities.
Insurance Companies Pay You Back
Insurance companies are required for the first time to prove that they’re spending between 80 and 85 percent of premiums, depending on the size of the company, on actual health care. If companies don’t spend that amount on coverage, they have to return that money to their customers — $1.2 billion was returned in 2012 to self-employed Americans whose insurers didn’t hit the proper ratio.
Millions Of Young People Already Covered
An estimated six million college students are already taking advantage of Obamacare’s provision that lets them stay on their parents’ insurance until the age of 26. This has led to a record drop in uninsured young people, allowing them to go back to school or pursue graduate degrees without taking on as much student loan debt.
Seniors Spend Less On Drugs
One of the most immediate benefits of Obamacare was the closing of the Medicare D prescription drug “donut hole,” which requires seniors to pay for the coverage gap between their deductible and yearly limit, at which point the plan covers all medication — $6.1 billion in drug coverage has already been distributed to seniors, which leads to the irony that Republicans ran and won in 2010 on saying that Obamacare cuts Medicare when, in fact, benefits for seniors have only increased. All the savings come from reforming the way providers are paid.
The Red States Get To Pay The Blue States Back
When the Supreme Court ruled that the mandate in Obamacare was Constitutional, it also gave states the chance to opt out of the Medicaid expansion that will provide free public health care for those not already on Medicaid, but who earn up to 133 percent of the poverty level. The states that are turning down the expansion, unfortunately, are some of those that need it the most. All of the states that have rejected the federal extra funding — which begins at 100 percent of the cost of the expansion and goes down to 90 percent — are states that generally vote Republican.
You probably know that most red states take in more federal money than they contribute, as Republican policies encourage growth of programs like food stamps. Though Republican governors can reject the benefits of Medicaid expansion, their richest citizens and corporations will still have to pay the taxes. As a result, they won’t be such “takers.”
Unfortunately, the working poor of red states — who earn too much to be on basic Medicaid — will suffer without the health insurance they need. Those on Medicare and Medicaid will likely see fewer doctors who want to accept clients from these programs, as Medicaid expansion was supposed to make up for the cut in reimbursement rates that begins in 2014. And all residents will not enjoy the slowdown in the growth of health care costs that will come from shrinking the number of the uninsured.
For red state governors, it’s a chance to fulfill the prophecies of doom Republicans made when Obamacare passed. But for residents of blue states, it’s a chance to make America’s health care system more equitable, with red states finally paying closer to their fair share.
By: Jason Sattler, The National Memo, March 22, 2013; Photo: The Advisory Board Company
“Just Another GOP Liability”: Biting The Hand That Feeds Them
Paul Krugman noted on ABC’s This Week yesterday that the GOP’s problem is that their “base is old white people.”
This is largely true. Exit polls show that Mitt Romney won all voters 65 and older by 12 percentage points, and white older voters by 22 points. Barack Obama won all voters under thirty by 23 points, and nonwhite young voters by 36 points.
Such numbers are a big problem for the GOP amid fast changing demographics, as we’ve heard often in recent months.
But here’s an interesting question raised by the same data: If the GOP leans so heavily on older white voters, then why is it leading the charge to cuts entitlements for seniors?
Politics is supposed to be about who gets what, but things often don’t work that way. In 2011, the New York Times ran a fascinating chart about the percentage of personal income that comes from government benefits in different states. It showed that hardcore Republican states—where a lot of those older white coservative voters live—relied most heavily on benefits, with Social Security the largest form of assistance. In a previous post, I looked at John McCain’s margin of victory in 2008 in those states with the highest reliance on government benefits:
West Virginia: 28 percent of all personal income in this state come from government programs. McCain won the state by 13 points.
Mississippi: 26.2 percent of personal income from government benefits; McCain margin: 13 points.
Kentucky: 24.8 percent income from benefits; McCain margin: 17 points.
Arkansas: 24.5 percent income from benefits; McCain margin: 20 points.
South Carolina: 23.4 percent income from benefits; McCain margin: 9 points.
Alabama: 23.4 percent income from benefits; McCain margin: 22 points.
These numbers make you wonder: Do older GOP voters really understand that the conservative assault on government “handouts” may end up reducing their standard of living? And, if they do get better clued into that fact, will the GOP face pushback against entitlement cuts from their own base?
Entitlements aren’t the only area where Republicans aren’t doing a good job of serving the narrow financial interests of their base. As I have noted often, the U.S. tax system disprortionately raises revenue from affluent people in coastal blue states and keeps taxes low on Americans of more modest means in the red states. You’d think heartland Republicans would be okay with this arrangement; instead they have relentlessly fought proposals that would shift even more of the tax burden to residents of Manhattan and Malibu.
Likewise, one big feature of the reviled Affordable Care Act is that the law taxes rich people—which just started happening this month with the Medicare payroll surtax—and subsidizes health insurance for low-income people. The states I mentioned above, with high concentrations of poor rural residents, will benefit from this arrangement. Connecticut will not.
So amid all the talk of the GOP’s grim long-term prospects, let’s add another liability to the list: Congressional Republicans aren’t attuned to one of the most basic responsibilities of elected leaders—putting more money in the pockets of their constituents and getting somebody else’s constituents to pick up the tab.
By: David Callahan, The American Prospect, February 4, 2013
“The Opposite Of Patriotism”: Republican Resistance To Hurricane Relief Is A Stink Of Hypocrisy, And Worse
Provoked by opposition to Hurricane Sandy relief among House Republicans – and the delay in voting the first tranche of aid by Speaker John Boehner – both New Jersey governor Chris Christie and representative Peter King (R-NY) denounced the irresponsibility and cruelty of those betrayals. Even when that first bill passed, 67 Republicans voted no, in contrast with only 11 who voted no when Congress provided emergency funding for Hurricane Katrina (far more quickly, too) in 2005.
The Tea Party Republicans in Congress would offer various excuses for their hostility to Sandy relief, from budgetary constraints to far-right ideology. But those who voted no hail from states that have benefited from all kinds of federal relief over the past two decades, financed by Northeastern taxpayers who send a wildly disproportionate sum in levies to Washington every year.
Moving down the alphabet from Hurricane Andrew onward over the past two decades, it is not hard to trace tens of billions of dollars for storm relief alone that have flowed from New York and Connecticut to the South, the Gulf Coast, the Midwest and other regions over the years, with never a word of demurral over costs, “pork,” or “offsets” from other federal spending.
Then consider the many other forms of federal aid that have benefited the regions where “conservative” fiscal stringency supposedly prevails, and a disturbing habit quickly emerges: Republican members of Congress tend to support aid packages that benefit their own states or districts, while opposing help for other Americans. This doesn’t hold true for all Republicans or conservatives, of course, but it is nevertheless a detectable pattern.
The most obvious example in recent years is the rescue of the auto industry, a decision of national importance supported by both presidents George W. Bush and Barack Obama, which nearly all Republicans rejected – except those from Michigan and auto-plant districts in several surrounding states. Those in favor included Paul Ryan, the House Budget Committee chair from Wisconsin, who voted for the bailout and then, while running for vice president on the GOP ticket, pretended to have opposed it. But he couldn’t bring himself to vote for Sandy relief.
The Republicans in Kansas, whose entire four-member delegation voted against Sandy relief, never voiced any opposition to the massive aid provided by the federal government in 2007 when the city of Greensburg was devastated by a Force 5 tornado – or for that matter all the other instances of disaster assistance accepted by that benighted state over the decades. Nor did the Republicans in places like Missouri or Georgia or any of the other states severely damaged by flooding in recent years suddenly stop their routine pleading for federal aid, which they duly received.
The biggest frauds are naturally to be found in Texas, one of the drought-stricken states where the Federal Emergency Management Agency, the Department of Agriculture, and sundry federal agencies have been spending vast sums to help farmers, ranchers, and other suffering residents. Rep. Randy Neugebauer, a right-wing Texas Republican whose district includes bone-dry Lubbock, praised those federal bureaucrats just last summer for spending funds to help farmers and ranchers in his Lubbock district “mitigate damage caused by wildfires and drought.” Quoted in a local newspaper, Neugebauer said, “I hope that FEMA will quickly follow suit and declare a major disaster declaration for affected Texas counties.” But this week, Neugebauer was one of seven Texas Republicans who voted against Sandy relief, along with fellow wingnuts from drought-afflicted districts across the South and West.
All this represents something worse than cheap hypocrisy, which often crosses political and ideological lines. The behavior of these Republicans is rooted in their selfish ideology and regional chauvinism – and their rejection of a generous spirit that has united this country for more than a hundred years. It is the opposite of patriotism.
By: Joe Conason, The National Memo, January 5, 2013
“It’s All Or Nothing”: The Obama Administration Plays Hardball On Medicaid
When the Supreme Court upheld the Affordable Care Act, it also gave Republican states a gift by saying they could opt out of what may be the ACA’s most important part, the dramatic expansion of Medicaid that will give insurance to millions of people who don’t now have it. While right now each state decides on eligibility rules—meaning that if you live in a state governed by Republicans, if you make enough to have a roof over your head and give your kids one or two meals a day, you’re probably considered too rich for Medicaid and are ineligible—starting in 2014 anyone at up to 133 percent of the federal poverty level will be eligible. That means an individual earning up to $14,856 or a family of four earning up to $30,657 could get Medicaid.
Republican governors and legislatures don’t like the Medicaid expansion, which is why nine states—South Dakota, plus the Southern states running from South Carolina through Texas—have said they’ll refuse to expand Medicaid (many other states have not yet said whether they’ll do it). But some states asked the Obama administration whether they could expand Medicaid a bit—maybe not cover everyone up to 133 percent like the law says, but add a few people to the rolls. And yesterday, the administration said no. It’s all or nothing: either you expand Medicaid up to 133 percent, or you get none of the new money. Was that the right thing to do? Well first, let’s talk about that money.
These Republican states offer worries about cost as their reason for rejecting the Medicaid expansion. But in truth, it’s an incredibly sweet deal for them. Right now, the federal government generally pays half of the cost of Medicaid, with the state picking up the other half. But the federal government will pay 100 percent of the cost of new Medicaid recipients signed up because of the expansion between 2014 and 2016. After that the federal contribution will step down to 90 percent by 2020, where it will stay forever more. So the state gets to insure a whole bunch of its citizens for nothing at first, and eventually for only 10 cents on the dollar. And in return they get reduced costs for uncompensated care, and a healthier, more productive citizenry with more money to spend. Some studies have projected that states will more than make up for their 10 percent contribution with health care savings they’ll get from an insured population; that’s likely to be particularly true among those states whose Medicaid eligibility standards are currently the stingiest, who not coincidentally have the highest rates of uninsured citizens (and, also not coincidentally, are precisely those states where the Republican leadership is refusing to accept the expansion).
And yet, the most conservative among them won’t take the deal. The federal government is saying to the states, Here is a bunch of free money for you to give health insurance to your uninsured poor citizens. And these states are saying, No way! Their justification of budget worries is so unpersuasive that it’s impossible to avoid the conclusion that they would rather see people have no insurance, and thus be poorer, sicker, and die sooner, than get Medicaid via Obamacare. It’s truly a moral abomination.
By playing a little bit of hardball and not letting states get away with a partial expansion, the administration is betting that before long the states will find all this free money to insure their citizens irresistible. And they may be right. That’s what happened when Medicaid was established in 1965; few states signed up at first, but before long they all did. Right now these governments are being pressured by some powerful interests to take the expansion, particularly the hospitals who have to deal with patients with no way to pay their bills. If they expanded Medicaid a little but not fully, that pressure wouldn’t be as intense and they could claim they expanded coverage. This way they won’t be able to hide behind a partial expansion and claim they did the right thing. Let’s hope the administration is right, because millions of Americans’ futures depend on it.
By: Paul Waldman, Contributing Editor, The American Prospect, December 11, 2012
“The Real Moochers”: Obama Supporters Subsidize Romney Supporters With Their Taxes
In a video posted yesterday, Mitt Romney slammed the people who support President Obama, saying they are most likely “dependent on government.” Romney’s comments were recorded as he spoke at to an exclusive group of donors at a private meeting. Obama’s fans think of themselves as “victims,” he said. They believe they are “entitled to healthcare, to food, to housing, to you name it.” He added, “My job is not to worry about those people. I’ll never convince them that they should take personal responsibility and care for their lives.”
Many on both left and right have criticized Romney for his lack of empathy and rejection of the social contract. However, it’s easy to understand why Romney might view America this way. After all, Republicans supposedly represent those with more money, and Democrats supposedly represent those with less—sometimes much less. It’s plausible that Romney’s supporters would pick up the tab (through their taxes) for social programs that benefit Obama’s supporters. For the same reason, it’s plausible that Red states would subsidize Blue states, and Red counties would subsidize Blue counties where the poor people live.
But, although it’s plausible, it’s completely wrong. When Romney says his job isn’t to care about those who depend on government for healthcare, food, and housing, he’s talking about his base. Across America, Obama’s supporters actually subsidize Romney’s supporters.
Blue States Subsidize Red States
Studies show that states that elect Democrats contribute the most in federal taxes relative to what they consume in government services. Conversely, many states that elect Republicans contribute the least in taxes relative to the services they consume. This is true even though many Democratic states contain large, poor, urban populations of color.
Here’s the evidence: The 10 “Tax Producing States” listed below, left, contribute the most in tax revenues relative to the services they consume. They usually vote Democratic. The ten “Tax Dependent States” listed below consume the most in government services relative to the taxes they pay. And they usually vote Republican. (Each state’s name is shown in blue if voters there lean toward Obama, and red if they lean toward Romney, as per Nate Silver’s 538 blog.)
More detailed analysis confirms this pattern. Even the libertarians at the journal Reason acknowledge this so-called “Red/Blue Paradox.”
Blue Counties Subsidize Red Counties
The same imbalance prevails within states, at the county level. The Blue counties contribute the most state taxes relative to the services they consume. The Red counties consume the most services relative to the taxes they pay. For example, a recent study documented the pattern in Washington state. King County, the solidly-Democratic county that surrounds Seattle, provides “nearly 42% of the state’s tax revenues, yet receives only 25% of the money spend from Washington’s general fund.” Conversely, five counties that require the most in services relative to the taxes they pay are largely Republican.
California shows a similar pattern. Republican Modoc and Tulare Counties consume the most in taxpayer-funded services from the state on a per-capita basis. Says San Francisco Chronicle writer Kevin Fagan: “The prevailing attitude among the right-wing ranchers and modern hippies who define Modoc County is of fierce self-reliance—but more people here than just about anywhere else depend on welfare checks of some kind to get by.” In contrast, famously liberal San Francisco and Marin Counties generate the most tax revenues for the state on a per capita basis.
Why Red States Need Blue State’s Tax Dollars
Why do people in Red states and counties resent government spending so passionately even as they need so much of it? The central problem is poverty. Many of the residents of these counties are poor. They are ill-prepared to make a decent living no matter how hard they tug on their own bootstraps. For example, in California’s conservative Modoc county only 12 percent of adults over 25 have a bachelor’s degree. Nearly 20 percent live below the poverty line. Many Modoc residents can’t afford to send their children to college. They need government programs to survive, let alone improve their financial outlook.
Without government support it’s hard to see a way to break the cycle of poverty and dependence. At least so far, the formula of small government, limited services, low investment, and low taxes that conservative states have implemented for themselves hasn’t helped their economies much. (See my earlier column.)
This situation would be funny if it weren’t so tragic. When a tax protester yelled “Keep your goddamn government hands off my Medicare” many scoffed at that one person’s ignorance. But most Americans who rail against taxes and the size of government are profoundly unaware that taxes they hate fund the programs they want and need. And they are unaware that the states and counties inhabited by “welfare queens” and “freeloading illegals” are actually sending them the money that keeps them fed, cared for, and educated.
Put It to a Vote
Let’s put the question of a tax rates to a national referendum and see what Americans really want. Allow voters in each county to decide whether to keep their state and federal taxes at their current level or to lower them. The catch is this: If you vote to lower your taxes then your county or state can’t take out any more money than it puts in. Perhaps this would make everyone happy. Red counties would get the lower taxes and vastly reduced services they want. And people in Blue counties (once they stop trying to give their money to people who don’t want to receive it) would keep more of their hard-earned cash, and enjoy vastly better-funded local services. Let’s give it a try.
By: David Brodwin, U. S. News and World Report, September 18, 2012
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 