“24 Health-Care Scandals”: Legislators Who Block Medicaid Expansion Are Stiffing Veterans Out Of Health Care, And Stiffing Workers Out Of Jobs
The scandal over long wait times for veterans in the Department of Veterans Affairs health system has grabbed a lot of headlines and elicited a lot of righteous anger — as it should. America’s veterans deserve so much better.
But as Ezra Klein pointed out in a piece in Vox, there’s another health care scandal that also deserves its share of righteous anger, and it also has a big impact on veterans with health care needs: the self-destructive refusal of lawmakers in 20-plus states to accept federal funds to expand their Medicaid programs.
Klein cataloged “24 health-care scandals that critics of the VA should also be furious about” (that is, the 24 states that have rejected the Medicaid expansion). Thanks to lawmakers’ knee-jerk opposition to expanding health coverage in those states, there are huge numbers of uninsured veterans who should be eligible for coverage, but aren’t: 41,200 veterans in Florida, 24,900 in Georgia, 48,900 in Texas… and the list goes on.
All in all, about 250,000 uninsured veterans are getting stiffed out of eligibility for health coverage by lawmakers who have blocked Medicaid expansion, according to Pew’s Stateline. As it turns out, those lawmakers are also stiffing their own states out of economy-boosting jobs — health care jobs that are overwhelmingly good-paying jobs. Medicaid expansion would create thousands more of these jobs.
Virginia, where Medicaid expansion still hangs in limbo, is a perfect example. According to a report from Chmura Economics & Analytics, Medicaid expansion would create an average of over 30,000 jobs annually in Virginia, including more than 15,000 jobs in the state’s health care sector. An analysis of data on projected job openings and wage levels underscores that these will be good-paying, economy-boosting jobs.
For a single adult in Virginia, less than half of all projected job openings statewide pay above a living wage ($18.59/hour, according to the 2013 Virginia Job Gap Study). However, three out of five health care job openings and close to nine out of 10 health practitioner and technical job openings do.
For a household with two working adults and two children, while less than two out of five projected job openings in Virginia pay median wages above a living wage ($21.99/hour per worker), half of health care job openings and more than seven out of 10 health practitioner and technical job openings do.
Or look at Maine, where Gov. Paul LePage vetoed a bipartisan Medicaid expansion plan passed by the Maine Legislature earlier this year, and too few Republican legislators were willing to break ranks with the Governor to override his veto. There, Medicaid expansion would create over 4,000 jobs by 2016, including more than 2,000 jobs in Maine’s health care sector. As with Virginia, health care jobs beat statewide wage levels in Maine by wide margins.
For a single adult, less than half of all projected job openings in Maine pay above a living wage ($15.18/hour, according to the 2013 Maine Job Gap Study). But two-thirds of health care job openings and almost nine out of 10 health practitioner and technical job openings do. For a household with two working adults and two children, while barely one-third of projected job openings in Maine pay above a living wage ($18.87/hour per worker), almost three-fifths of health care job openings and more than four out of five health practitioner and technical job openings do.
Health care jobs are also overwhelmingly higher-wage jobs in states like Montana and Idaho. But all these states, along with 20 others, have been missing out on these economy-boosting jobs because their legislatures or governors have rejected Medicaid expansion.
State lawmakers who continue to block Medicaid expansion do so at their own peril — both morally and electorally. Because you can only stiff your own constituents — including low-income, uninsured veterans — out of both access to health care and good-paying, economy-boosting jobs for so long before it catches up with you.
Want to really do something to help veterans get access to the health care they need and create good-paying jobs for your constituents at the same time? Two words: expand Medicaid.
By: LeeAnn Hall, Executive Director, The Alliance For A Just Society; The Huffington Post Blog, August 6, 2014
“What Occurred Here Is Unacceptable”: Attempting To Forge Relationships With Republican Is An Exercise In Futility
When reader G.S. emailed me yesterday to tell me Republican lawmakers in Virginia had broken into Gov. Terry McAuliffe’s (D) office, I assumed this was some kind of joke. But as the Richmond Times-Dispatch reported, that’s kind of what happened on Fathers’ Day weekend.
At the urging of House Speaker William J. Howell, the clerk’s office of the House of Delegates enlisted the help of the Capitol Police to enter Gov. Terry McAuliffe’s unoccupied, secure suite of offices on a Sunday afternoon to deliver the state budget.
The highly unusual entry on June 15 took place without the permission of administration officials or the knowledge of the Virginia State Police, which is in charge of protecting the governor. McAuliffe was not in the building.
Let’s back up and review the larger context. GOP lawmakers in the commonwealth recently hatched an ugly scheme, arguably bribing a Democratic state senator – who has since lawyered up – in order to allow GOP control of the chamber. Once the scheme worked and Republicans seized control of the state Senate, GOP lawmakers passed a conservative budget that, among other things, tried to kill Medicaid expansion, denying medical coverage to 400,000 low-income Virginians.
McAuliffe eventually signed the budget bill, but not before using his line-item veto on Medicaid-related provisions. The Democratic governor said at the time that he would have preferred to veto the entire budget, but with state finances expiring on July 1, he didn’t have time – a veto likely would have shut down the state government.
And that’s where the GOP plan to enter McAuliffe’s office without his permission becomes important.
Once Republicans completed work on their version of the budget, the next step was to deliver the document to the governor’s office. GOP lawmakers, however, wanted to give McAuliffe as little time as possible, increasing the pressure that he’d have to sign it to prevent a shutdown.
As the Richmond paper explained, “Once the clerk’s office enrolls a budget and delivers it to the governor, the statutory clock starts ticking. The governor has seven days to take action on the spending plan.”
In this case, however, Republicans decided to start the clock when they knew the governor and his staff weren’t in their offices. Indeed, GOP lawmakers waited until they knew the offices were empty, ignored security protocols, and delivered the budget knowing no one would be there to receive it.
They then sent an email, 15 minutes later, stating for the record that the document had been dropped off (and the clock was ticking).
To put it mildly, the governor’s office was not pleased that lawmakers had entered their workspace, uninvited, knowing no one was there. McAuliffe’s chief of staff, Paul Reagan, wrote an angry letter to Col. Anthony S. Pike, chief of the Virginia Capitol Police, cc’ing GOP leaders and the superintendent of the Virginia State Police, which is responsible for the governor’s security.
“This letter is to inform you that under no circumstances are you or any of your officers authorized to allow employees of the General Assembly to enter the secure areas of the governor’s office without my express permission, or the express permission of Suzette Denslow, the governor’s deputy chief of staff,” Reagan wrote in the letter to Pike, dated June 18.
“What occurred here Sunday is unacceptable,” the letter continues. “Two employees of the speaker of the House of Delegates were given access to an area of the governor’s office where sensitive files and materials are kept.”
I’m reminded of some reports out of Virginia a few months ago. McAuliffe put his “celebrated talents for sociability and salesmanship” to work, trying to forge relationships with Republican lawmakers, inviting them to social events, and throwing open the doors to the Executive Mansion.
So much for that idea.
As Robert Schlesinger explained at the time: “[A]nyone who thinks that back-slapping joviality is the key to ending Washington gridlock need look no further than Richmond for its limits.”
By: Steve Benen, The Maddow Blog, June 26, 2014
“The Banana Republicans”: Appalling Content Of Policies Aside, When Not Torturing, They Lie, They Cheat, They Steal
If they can’t offer policies that a majority of voters will support without relentless brainwashing, they free up the billionaire beneficiaries of the policies they actually offer to help them buy elections.
If buying elections won’t give them a majority, they rig the districting so they can hold a minority of seats with a minority of votes.
If they can’t win even in gerrymandered districts, they try to keep Democrats from voting.
If they still lose, they resort to outright bribery.
In the latest case, they offered a Democratic state senator in Virginia – whose vote resulted in a tied chamber, giving the Lieutenant Governor the deciding vote – a cushy job for himself and a judgeship for his daughter if he’d resign, giving the GOP 20-19 majority.
Similar deals have been done recently in New York and Washington State, though in those cases the bribes were legislative leadership positions rather than external jobs.
I can confidently predict that a not a single elected Republican, and few if any Red-team pundits, will speak out against this grossly corrupt deal. If the state AG or the U.S. Attorney decide that it’s a prosecutable quid pro quo, Fox News and the National Review will howl about the “criminalization of policy differences.”
“Puckett” deserves to enter the language alongside “Quisling.”
The appalling content of its policies aside – the latest dirty trick is part of an effort to deny medical coverage to the working poor – the modern Republican Party is a threat to the principles of republican government. Even when they’re not torturing, they lie, they cheat, and they steal.
Footnote And note the way the Washington Post uses the morally neutral “outmaneuver” to cover the payment and acceptance of a bribe. Did the Communists “outmaneuver” Jan Masaryk? Did the House of Guise “outmaneuver” the Huguenots on St. Bartholomew’s Day?
By: Mark Kleiman, Professor of Public Policy at The University of California Los Angeles: Washington Monthly, Ten Miles Square; Cross-posted at The Reality-Based Community]; June 12, 2014
“The Same Reasonable-Sounding Lies”: What Won’t The GOP Do To Keep The Poor Uninsured?
When it comes to healthcare, Southwest Virginia is a desperate place. Many of the state’s poorest and sickest live in that pocket of coal country between US Route 19 and the Kentucky and Tennessee borders, where it’s so hard to see a doctor that a free mobile health clinic held each July at a county fairground draws hundreds. “Southwest Virginia is one of the worst places we go to,” said Stan Brock, the founder and president of Remote Area Medical, which runs that clinic and others throughout the country.
That corner of Virginia also encompasses the district of Phillip Puckett, who served as a Democratic state senator until Monday, when he suddenly resigned. His decision to step down appears to have been the result of a bribe offered by Republican colleagues bent on stopping the expansion of Medicaid. Puckett’s resignation gave Republicans the one seat they needed to take control of the Senate; it also put him in the running for a paid post on a state tobacco commission that is controlled by some of the very same Republicans. And it cleared the way for the chamber to appoint his daughter to a state judgeship.
By stepping down, Puckett effectively ended a months-long battle over the fate of the 400,000 Virginians who are too poor to buy insurance but don’t meet the state’s restrictive eligibility requirements for Medicaid. The state Senate had been on course to vote to expand the program under the Affordable Care Act, setting up a budget showdown with the Republican-controlled House. But with the GOP now in control of the Senate, both chambers are expected to pass a spending plan on Thursday that does not include the expansion.
The advocacy group ProgressVA called for an investigation of allegations of a quid pro quo between Puckett and Republicans, who deny they made any sort of deal. Puckett cited “recent issues that have developed in our family” as grounds for his resignation, and said he would withdraw his name from consideration for the job on the tobacco commission. Virginia Attorney General Mark R. Herring announced that he does not see an “investigative role” for his office.
The question of what prompted Puckett’s mid-term resignation is tantalizing, and potentially important, but it’s also beside the point. The true scandal is that hundreds of thousands of Virginians—including more than 20,000 of Puckett’s own constituents—will be denied health insurance.
The Medicaid showdown in Virginia was particularly heated because the legislature was so closely split. But Republicans all across the country have gone to insane lengths to keep millions uninsured, or to justify doing so. In Louisiana, for example, the state sued MoveOn.org for a billboard criticizing Governor Bobby Jindal’s opposition to the Medicaid expansion. Republicans in Utah are trying to embed work requirements into a private alternative to the expansion, a stipulation that would likely make the plan unworkable. In Arkansas, Republicans tried to roll back the Medicaid alternative that passed last year by refusing to reauthorize its funding. Although the program was finally re-approved, conservative lawmakers—who are steadily gaining ground in the Arkansas legislature—indicated that they’ll attack it again next year.
For years now Republicans have trotted out the same reasonable-sounding lies to fight the expansion, namely the myth that states can’t afford it. The real callousness that undergirds their ideological campaign was made clear this year, however, by a handful of state senators in Missouri, who gathered on the Senate floor to make it clear that there would be “no path” forward for the expansion. “Why is this somehow our problem?” one lawmaker asked. “It’s not happening,” said another. “Go find something else to do.”
There simply isn’t anything else that the millions of Americans who fall into the coverage gap can do to afford healthcare. Expanding Medicaid won’t fix all of the health problems in Southwest Virginia; a shortage of providers serving rural and low-income patients also challenges the region. But that’s no reason to deny insurance to people, particularly when the costs of doing so will be born almost entirely by the federal government, not the state. The persistence of myriad other issues to be dealt with is simply an indicator that people would be better served if lawmakers spent less time devising elaborate schemes to keep the poor uninsured and found something else to do, themselves.
By: Zoe Carpenter, The Nation, June 10, 2014
“Feeling A Bit Of Anxiety”: Cantor’s Cause For Concern In The Commonwealth
The idea that House Majority Leader Eric Cantor (R-Va.) would worry at all about his re-election seems hard to believe. The conservative Republican has fared quite well in all of his campaigns; he’s already quite powerful by Capitol Hill standards; and in the not-too-distant future, Cantor might even be well positioned to be Speaker of the House.
And yet, the Majority Leader appears to be feeling quite a bit of anxiety about his future.
House Majority Leader Eric Cantor is boasting in a new campaign mailer of shutting down a plan to give “amnesty” to “illegal aliens,” a strongly worded statement from a Republican leader who’s spoken favorably about acting on immigration.
The flier sent by his re-election campaign comes as Cantor is under pressure ahead of his June 10 GOP primary in Virginia – and as the narrow window for action on immigration legislation in the House is closing fast. Cantor’s flier underscores how vexing the issue is for the GOP.
In the larger context, it’s not helpful for Republicans when the Majority Leader brags about killing a bill that gives “amnesty” to “illegal aliens,” while his party tries to maintain a half-hearted pretense that blames President Obama for the demise of immigration reform.
But at this point, Cantor doesn’t appear to care too much about the larger context or message coherence. He’s worried about losing – the rest can be worked out later.
In fact, the degree of Cantor’s anxiety is pretty remarkable. The Majority Leader is up against David Brat, a conservative economist at Randolph-Macon College, who’s eagerly telling primary voters that Cantor isn’t right-wing enough. What was once seen as token opposition, however, has clearly gotten the incumbent’s attention.
Cantor was concerned enough last month to launch a television attack ad, which was followed by Cantor’s anti-immigrant mailing, which culminated in yet another television attack ad that the congressman’s campaign unveiled yesterday.
These are not the actions of a confident incumbent.
As best as I can tell, there are no publicly available polls out of this Virginia district (though it’s safe to say Cantor has invested in some surveys of his own). With that in mind, it’s hard to say with any confidence whether the Majority Leader is overreacting to a pesky annoyance or a credible challenger.
But Jenna Portnoy and Robert Costa reported recently that it’s probably the former, not the latter.
Most Republicans continue to believe Cantor is safe; he won a primary challenge two years ago with nearly 80 percent of the vote. But the prospect of a competitive and bruising challenge to the second-ranking Republican in Congress is embarrassing to Cantor – and is rattling GOP leaders at a time when the party is trying to unify its divided ranks.
We’ll know soon enough just how serious the threat is – the primary is in 13 days – but as the election draws closer, let’s not forget that Cantor was booed and heckled by Republican activists in his own district just two weeks ago.
No wonder he seems so nervous.
By: Steve Benen, The Maddow Blog, May 28, 2014
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