Since November, the last abortion clinics in East Texas and the Rio Grande Valley, some of the poorest and most remote parts of the state, have been hanging on by their fingernails. The two clinics, both outposts of a network of abortion providers called Whole Woman’s Health, stayed open with slimmed-down staffs while their owner, Amy Hagstrom Miller, struggled to comply with the first chunk of HB2—the voluminous anti-choice law passed by the Texas legislature last summer—which requires abortion doctors to obtain admitting privileges at a local hospital. Today, after weeks of failed negotiations with nearby hospitals, Hagstrom Miller announced that both clinics are closing their doors.
What interests me for the moment aren't homicides, but accidental shootings. How do they compare to other causes of accidental death and injury? We all know that vivid individual cases, no matter how vivid, don't necessarily give an accurate impression what's happening overall. So let's delve into the statistics, shall we?
Even a broken clock is right twice a day. Heeding calls from gay-rights supporters, business groups, and Republicans like John McCain and former presidential candidate Mitt Romney, on Wednesday Arizona governor Jan Brewer vetoed a "religious liberty" bill that would have allowed for-profit businesses to refuse service to gays and lesbians so long as they were motivated by "sincerely held religious belief.” A nearly identical law failed to advance in Kansas last week. Now, in light of the blowback, anti-gay discrimination bills in conservative legislatures—including Mississippi, Georgia, and Oklahoma—have stalled, and even lawmakers who voted for such measures are stepping back their support.
You haven't heard much about healthcare.gov lately, and that's because it's working pretty well. So this is a good moment to think back on both what went wrong and how it got fixed, which we get in a timely article from Steven Brill. The fixing story is an interesting one, but before it's too late, I want to do a little more blame-placing.
It goes without saying that much of the responsibility lies with the contractors who did such a terrible job of creating the site. Another way to think about the problems is that there was a missing middle: you had people who understood the technology but didn't grasp the politics, and people whose job was politics who didn't understand the technological challenges. That's intuitively appealing, but I think it lets the political people off the hook. Their screw-up wasn't a result of their unfamiliarity with technology. It was a political failure, full stop.
Earlier this month, a bill advanced in the Arizona state legislature that would ban the use of midwives in the state during births where the mother has had previous caesarean sections, is delivering multiples or might face breech birth. How best to give birth is, needless to say, a topic of perennial interest. What follows is a conversation between two Prospect staffers who stand on different sides of the midwife debate.
As more people sign up for insurance under the Affordable Care Act, the next few months will usher in a fundamental change in mental health care. Under the ACA, insurers are for the first time required to cover mental health and substance abuse treatment as one of ten “essential benefits.” This is good news for the millions of Americans who suffer from some form of mental illness but don’t seek treatment. The question now is whether the country’s mental health infrastructure is equipped to deal with an avalanche of new patients. The answer? Probably not.
On Tuesday, the Arkansas state legislature failed to renew a bill authorizing its expanded-Medicaid plan, an innovative approach to Obamacare that allowed the state to use federal funds to purchase private insurance for the state's low-income residents. Arkansas's unique plan was a compromise between the state's Democratic governor, Mike Beebe, and the Republican-led legislature, and made the state one of the few ultra-conservative ones to bother expanding Medicaid. In the 25 states that didn't expand, many of the poor are still doing without insurance, because the federal subsidies weren't designed to kick in until people made above a certain threshold. If Arkansas doesn't renew its Medicaid program, 85,000 people who've gotten insurance this year will suddenly lose it again.
For the first few years Liz Evans worked at the Portland Hotel Society, a network of homeless shelters in central Vancouver, she would arrive at her job already exhausted. On her morning walk through Downtown Eastside—a neighborhood infamous as the poorest zip code in Canada—she stepped over drug addicts passed out in doorways and sidled around alleys where people would cook dope and shoot up in broad daylight. It was 1993, and Vancouver was in the throes of an HIV epidemic. Tens of thousands of impoverished injection drug users were crammed into a fifteen-block radius. The Portland Hotel Society was one of the few housing projects in the city that welcomed drug addicts, and working there felt like triage. Evans, a nurse, trained her staff to intervene when the residents overdosed. “It was such a painful time,” Evans says. “These weren’t people who were partying or using drugs to have fun. They were poor and sick and dying.”
Last week, a small drug company called Sprout Pharmaceuticals announced that its version of “female Viagra”—a medication designed to enhance women’s libidos—was going back for yet another battery of tests. The Food and Drug Administration (FDA) wants more data on how Sprout’s drug, the whimsically named “flibanserin,” affects driving ability.
Do you believe everything your boss tells you? The answer probably depends—if he tells you the Cubs are going to win next year's World Series then maybe not, but if he tells you your benefits are being cut and explains the reason why, you'll probably take him at his word. After all, he's in charge of the business, so he should know.
Since I wrote about postal banking this morning, I've decided to continue the day's shameless, lowest-common-denominator clickbaiting by talking about a new Congressional Budget Office report and the Affordable Care Act. Hang on to your hats.
With all the hype of a new Beyonce album, the CBO dropped its latest report on government finances and other related topics, which includes the news that the deficit has dropped to its lowest level since Barack Obama took office. This may prove inconvenient for Republicans still invested in fomenting deficit panic, but they'll be helped by the fact that most Americans actually believe the deficit has gone up in the Obama years. According to a new poll from the Huffington Post, not only do 54 percent of people think so, but 85 percent (!) of Republicans think so.
In any case, the part of the CBO's report that's getting more attention is their projection that as a result of the ACA, the labor force will be reduced by 2 million in 2017, rising to 2.5 million in 2024.
On Monday, the Guttmacher Institute released a study that seemed, at first blush, to vindicate the anti-choice movement’s increasingly feverish attempts to end abortion through state-level restrictions on women and providers. Using survey data from 2011, the research organization—which leans pro-choice—found that abortion rates have plummeted to a 30-year low. Since 2008, the number of abortions performed in the U.S. fell 13 percent.
On the Affordable Care Act front today, there's very good practical news, and not-so-good political news. That gives us an excellent opportunity to remind ourselves to keep in mind what's really important when we talk about health care.
It was a strange State of the Union Address—mixing emotional tugs on the heartstrings with anodyne rhetoric that made it seem like everyone from Barack Obama to the angriest Tea Party Republican was bored with the annual exercise. The speech had no over-arching theme save (yawn) America’s enduring greatness. There were hard-hitting sentences and paragraphs, but no dramatic policy proposals nor even bold, if unattainable, dreams. The State of the Union address was unlikely to anger anyone whether it was financial titans fearing economic Kristallnach or Bashar al-Assad.
In one of the better lines in last night's State of the Union address, President Obama chided House Republicans for their endless series of votes to repeal the Affordable Care Act: "[L]et's not have another 40-something votes to repeal a law that's already helping millions of Americans ... The first 40 were plenty." He followed up by observing that "we all owe it to the American people to say what we're for, not just what we're against." As it happens, last week three Republican senators outlined a plan that can be fairly described as a Republican plan to replace Obamacare. (The basic features of the plan are clearly described by Sarah Kliff of Wonkblog here.) Because most of the Republican Party convinced themselves in 2009 that a tax penalty for people who don't carry health insurance was a grave threat to the American constitutional order, the plan does not include an individual mandate. But otherwise, in its general priorities the plan strongly resembles the Heritage Plan of the late 1980s. That is, it's radically different than the ACA, and it's horrible, immoral public policy.