“The Fight Is History, Done, Finito”: The Affordable Care Act Is Here To Stay
Now that the fight over Obamacare is history, perhaps everyone can finally focus on making the program work the way it was designed. Or, preferably, better.
The fight is history, you realize. Done. Finito. Yesterday’s news.
Any existential threat to the Affordable Care Act (ACA) ended with the popping of champagne corks as the new year arrived. That was when an estimated 6 million uninsured Americans received coverage through expanded Medicaid eligibility or the federal and state health insurance exchanges. Obamacare is now a fait accompli; nobody is going to take this coverage away.
There may be more huffing, puffing and symbolic attempts at repeal by Republicans in Congress. There may be continued resistance and sabotage by Republican governors and GOP-controlled state legislatures. But the whole context has changed.
Now, officials in states that refused to participate in Medicaid expansion will have to explain why so many of their constituents — about 5 million nationwide — remain uninsured when they could have qualified for coverage. More than 1 million of these needlessly uninsured Americans live in Texas, which is targeted by Democrats as ripe for inroads because of its rapidly changing demographics. Will Gov. Rick Perry (R) be forced to reconsider his Obamacare rejectionism? Or will he ultimately be remembered for speeding the state’s transition from red to blue?
Performance of the federal insurance exchange Web site, HealthCare.gov, will continue to improve, if only because the initial flood of applicants is bound to subside. Meanwhile, insurance costs and benefits in states that refused to set up their own exchanges will be compared with those in states that did. There will be questions about how the new law is performing — but no one will be able to pretend it does not exist.
And we will surely hear more stories about individuals taking advantage of the law’s consumer benefits, especially the fact that preexisting conditions can no longer be used to deny coverage. This is life-changing for insurance seekers who suffer from chronic illnesses such as diabetes or who have survived cancer.
Opponents of the law can hardly advocate going back to a system in which those who really need insurance can’t get it. What they can do, and surely will, is make lots of noise by pretending that any problem with anyone’s health insurance is due to the Affordable Care Act. Before Obamacare, millions of Americans had their policies canceled by the insurance companies every year. Millions more had their premiums raised, their coverage reduced or both. Now when these things happen, critics will try to blame the new law.
Increasingly, though, the GOP will sound foolish and irrelevant if it continues to put all of its eggs in the “repeal and replace” basket. The problem is that the Affordable Care Act is a set of free-market reforms based on ideas developed in conservative think tanks. Republicans who want to repeal Obamacare would have to replace it with something suspiciously similar.
If Republicans in Congress would work with the administration to make technical corrections to the Affordable Care Act, they could claim a victory of sorts: Obama gave you this mess and we cleaned it up. But after demonizing the program — and the president — for so long, the party has painted itself into a corner.
Note to the GOP: “We refuse, under any circumstances, to make the law work better for the citizens we represent” is perhaps not the ideal campaign slogan for the midterm election.
The real problem with the ACA, and let’s be honest, is that it doesn’t go far enough. The decision to work within the existing framework of private, for-profit insurance companies meant building a tremendously complicated new system that still doesn’t quite get the job done: Even if all the states were fully participating, only about 30 million of the 48 million uninsured would be covered.
But Obamacare does establish the principle that health care is a right, not a privilege — and that this is true not just for children, the elderly and the poor but for all Americans.
Throughout the nation’s history, it has taken long, hard work to win universal recognition of what we consider our basic rights. Perhaps future legislation will expand and streamline the ACA reforms until everyone is covered. Or perhaps we’ll move toward a single-payer system, possibly by expanding Medicare and Medicaid until they meet in the middle.
I don’t know how we’ll get there, but we’re now on the road to universal health care. There’s no turning back.
By: Eugene Robinson, Opinion Writer, The Washington Post, January 3, 2014
“The ‘Wingnut Hole’ Measured”: 5 Million Without Insurance Thanks To GOP Refusal
Because of the decision on Obamacare by the Supreme Court, which left the decision to expand Medicaid (a key part of Obamacare) up to the individual states, most Republican-controlled states refused said expansion, leaving substantial portions of the citizenry in the lurch.
Ed Kilgore has been calling this the “wingnut hole,” and many have been speculating about its size. How many Americans will go without health insurance simply because the GOP dislikes the president? Well, happy 2014, dear readers: initial estimates are in, and we have 5 million lucky winners!
About 5 million people will be without health care next year that they would have gotten simply if they lived somewhere else in America. . . . The court effectively left it up to states to decide whether to open Medicaid, the federal-state program for the poor and disabled, to more people, primarily poor working adults without children. . . .
Twenty-five states declined. That leaves 4.8 million people in those states without the health care coverage that their peers elsewhere are getting through the expansion of Medicaid, according to a Kaiser Family Foundation estimate. More than one-fifth of them live in Texas alone, Kaiser’s analysis found.
That’s approximately the combined population of Delaware, Vermont, the District of Columbia, North Dakota, South Dakota, Wyoming and Alaska. Or alternatively, either Alabama, South Carolina, Colorado or the whole of Norway alone.
The Supreme Court decision was doubly unfortunate, because Republican states tend to be poorer than average and contain a disproportionate number of potential beneficiaries who are losing out. Obamacare, by virtue of distributing benefits downward, was aimed at those very people; it never occurred to the law’s architects that the vagaries of politics and law might give states a way out, and so they didn’t design a backup coverage mechanism.
Some refusenik states, like Iowa, might go forward with an Obamacare-instead-of-Medicaid expansion, but most probably will do nothing. Prospects are bad enough that health-care industry groups have basically given up trying to push through the expansion by lobbying and are just biding their time until conditions are more favorable.
It’s worth remembering that the federal government will pay 100 percent of the cost of the Medicaid expansion through 2016 and 90 percent of the cost afterward. It could very well work out that refusenik states will not even save money because of additional spending on the uninsured in emergency rooms and elsewhere.
But regardless of the pitiful sums involved, make no mistake: This action is utterly gratuitous. Combined with the probable coming Republican refusal to extend unemployment benefits that George wrote about this morning, this is a particularly stiff kick in the teeth to the United States’ most vulnerable citizens to usher in the new year.
By: Ryan Cooper, The Plum Line, The Washington Post, December 31, 2013
“Affluenza”: The Latest Criminal Defense For The Spoiled Rich
There’s a tired and persistent canard that criminals end up going without punishment for their violations because they convince lawyers and judges that they were so victimized as children by poverty or abuse that they can’t possibly be held accountable for their own behavior. This is hardly the case; in fact, the opposite is true. Indigent defendants have little recourse if they are assigned substandard public representation, and juries hardly identify with a poor kid or a black kid thought to be up to no good. That was represented pretty clearly in the acquittal of George Zimmerman (“George,” one juror referred to the defendant after that trial, as though he were a pal and neighbor). Zimmerman had shot and killed an unarmed African-American teenager, but the jury appeared to identify with the shooter more.
And one look at the appalling result of mandatory-minimum laws shows that drug offenders, in particular, are being subject to absurdly long prison sentences. A first-time offender found with 5 grams of crack can be subject to a minimum five-year sentence; add on some trumped up “conspiracy” as part of the continuum of drug sales, and the incarceration could jump to a mandatory minimum of 20 years. Jack Carpenter sold medical marijuana to dispensaries in California (where it is legal), but was still sentenced to 10 years behind bars by a federal judge.
Forget about avoiding prison because you had it tough as a kid. And don’t even try the “Twinkie defense,” the contention that you were so amped up on sugar you couldn’t control yourself. A Texas teen has taken miscarriage of justice one further, avoiding punishment for killing four people because of what his lawyer called “affluenza.” In other words, the 16-year-old Ethan Couch is such a spoiled brat because his rich parents never bothered to put any limits on him. Therefore, it was argued, even though his blood alcohol was three times the legal limit when he drove his truck 70 mph in a 40-mph zone – killing four people and seriously injuring two more – how could we possibly expect him to have done otherwise? He was never properly parented by his wealthy family, and so how could he be expected to know right from wrong?
The argument sounds like something out of a TV legal drama, added in to display the occasional absurdities of the legal system, especially in cases where the defense attorney is desperate and has absolutely nothing else to argue. But horrifyingly, in this case, it worked.
Couch was sentenced to probation. So much for a 24-year old woman whose car had broken down on the side of the road, along with the mother and daughter who came to help. And so much, too, for the pastor who also stopped to help the stranded motorist. They’re all dead. And two of Couch’s passengers are seriously injured; one of them, also a teen, is now paralyzed. Couch earlier this month pleaded guilty to four counts of intoxication manslaughter and two counts of intoxication assault causing serious bodily injury.
Before sentencing, a defense-provided psychologist, G. Dick Miller, said Couch would not benefit from jail, but rather from therapy. “This kid has been in a system that’s sick. If he goes to jail, that’s just another sick system.”
There’s a sickness to the system here. And it won’t be solved by the $450,000-a-year rehab center Couch will be attending, courtesy of his parents. And he’s learned his lesson anyway – that the rich don’t live like you and me. They aren’t held to the same standards of personal accountability, either.
By: Susan Milligan, U. S. News and World Report, December 16, 2013
“Republican America”: Voter Suppression Is The New GOP Strategy
Better bring some identification — and not just any identification, official though it may be — if you plan to vote in Republican-controlled states. However, if you contribute tens of millions of dollars to sway an election on Republicans’ behalf, the party will fight to keep your identity a secret.
Consider, for instance, what happened to some attempting to participate in this month’s elections in Texas. The New York Times reported that “Judge Sandra Watts was stopped while trying to vote because the name on her photo ID, the same one she had used for voter registration and identification of 52 years, did not exactly match her name in the official voter rolls.” Both Democratic state Sen. Wendy Davis and Republican Attorney General Greg Abbott — the front-runners in next year’s gubernatorial contest — encountered the same obstacle. As did Jim Wright, the 90-year-old former speaker of the U.S. House. Wright, who represented his Fort Worth district in Congress for 34 years, told the local paper that he had voted in every election since 1944 and that he had realized shortly before Election Day that his identification — a driver’s license that expired in 2010 and a university faculty ID — would not suffice under the state’s 2011 voter ID law. Indeed, officials required Wright to produce a certified copy of his birth certificate to procure a personal identification card that would allow him to vote.
Fortunately, no issues of cosmic importance appeared on this year’s Texas ballots. Next year, however, congressional seats and control of the statehouse will be up for grabs, and voter turnout probably will be much higher. The purpose of these and other vote-deterring measures, adopted in Texas and a slew of other GOP-controlled states, is to make sure turnout is not too much higher by reducing voter participation, particularly among the young (student IDs often don’t suffice), the poor (no driver’s license? Sorry.) and racial minorities. That is, groups that tend to vote Democratic.
Voter suppression has become the linchpin of Republican strategy. After Mitt Romney’s defeat in 2012, the GOP was briefly abuzz with talk of expanding the party’s appeal to young and Latino voters. Instead, the party doubled down on its opposition to immigration reform and its support for cultural conservatism — positions tantamount to electoral suicide unless the youth and minority vote can be suppressed.
Republicans have justified this crackdown as a way to keep non- citizens from infiltrating the electorate, not that there’s evidence such a thing is happening. But if a non-citizen wants to contribute millions of dollars to one of those “social welfare organizations” that spends gobs of money on an election campaign, Republicans fight to shield his or her identity. Recently released tax documents showed that one such organization — Crossroads GPS, the group headed by Karl Rove that spent $189 million in last year’s elections opposing President Obama and Senate Democrats — received 53 contributions of $1 million or more. The three largest were for $22.5 million, $18 million and $10 million.
Who did they come from? Because Crossroads GPS is classified as a 501(c)4 “social welfare” group, which is not legally required to list its donors, we’ll never know. Could such contributions come from a non-citizen? With donors’ identities shielded by law, there is no way of knowing.
Some states require donors to such campaign groups in state and local elections to be identified. But other states don’t, which allows for the kind of interstate shell games that wealthy right-wing donors played during the 2012 election. In one instance, an anonymous $11 million contribution to a California campaign opposing a ballot measure that raised taxes on the rich and supporting a measure to curtail unions’ political activities was tracked by state election officials to a 501(c)4 organization in Arizona that had gotten its funding from another such group in Virginia. The investigation revealed that a California GOP consultant had raised money for the ballot measure campaigns by promising his donors the anonymity that this shell game provided.
A pre-election tally by the Sunlight Foundation of “dark money” contributions to federal races as of Nov. 1, 2012, showed nearly $175 million going to GOP candidates and roughly $35 million to Democrats. A bill backed by Senate Democrats that would have required such groups to report the identity of donors who give more than $10,000 for electoral campaigns was killed last year by GOP opposition to a cloture motion, even though it was backed by a majority of senators.
So: If you want to vote in the Republicans’ America, remember to bring your birth certificate. But if you want to buy an election and stay under wraps, your secret is safe with them.
By: Harold Meyerson, Opinion Writer, The Washington Post, November 21, 2013
“The Texas Abortion Emergency”: This Isn’t Complicated, Women Are Paying An Unconstitutional Price
Outside the chambers of federal appellate judges Priscilla Owen, Jennifer Elrod, and Catharina Haynes, virtually everyone understands that H.B. 2, the new Texas law that places various restrictions on a woman’s ability to obtain an abortion, is not about protecting women’s health — it’s about stopping abortion.
And yet on Friday, those three judges, who sit on the U.S. Court of Appeals for the Fifth Circuit in New Orleans, ruled that the law could go into effect, since it was “not designed to strike at the right itself,” and wasn’t invalid simply because it “has the incidental effect of making it more difficult or more expensive to procure an abortion.”
That ruling led to the immediate closure of one-third of clinics in Texas where abortions are performed — several in rural areas that serve women without the means to travel hundreds of miles to another clinic.
On Monday morning, Supreme Court Justice Antonin Scalia allowed the charade to continue for at least another week when he declined to grant an emergency request by the law’s challengers to stay the appeals court’s ruling, and ordered the state to file a response by Nov. 12. (Justice Scalia hears all emergency-stay applications out of the Fifth Circuit.)
The law requires, among other things, a doctor to have admitting privileges at a hospital no more than 30 miles from where he or she performs abortions. On Oct. 28, U.S. District judge Lee Yeakel ruled that this provision was “without a rational basis and places a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus.”
The state appealed immediately, and on Friday, the Fifth Circuit panel issued its stay of Judge Yeakel’s ruling.
But no matter what the panel says, the law is intended precisely to “strike at the right itself” — only dishonest politicians pretend otherwise. Making it harder for women to get an abortion is not an “incidental effect” of the law; it is its primary goal.
Consider the words of Texas solicitor general Jonathan Mitchell, who claimed during the trial before Judge Yeakel that the state has a vested interest in “protecting the life of the unborn child,” and thus may impose “inconveniences on women seeking abortion in hopes that it may lead women considering abortion to consider childbirth instead.”
Like similar laws popping up all over the country, H.B. 2 is cloaked in the guise of protecting women’s health only because anti-abortion activists know it’s their best shot of surviving judicial scrutiny.
This shouldn’t be complicated. On one side is a law of dubious constitutionality passed by legislators who openly admit their desire to end all abortions. On the other side are real women whose constitutional right to have an abortion is being effectively blocked.
The arguments of all sides have been on the table for months, which is why Texas was able to file its appeal within hours of the district court’s ruling. Now the state has at least another week, while Texas women pay the price.
By: Jess Wegman, The Opinion Pages, The New York Times November 4, 2013
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