Health Care

How Low Can Part-Timers' Hours Go?

AP Images/Adam Richard
flick/ Carol Green S ay you’re an employer with an employee who works 30 hours a week. If you have 50 employees or more come next year, you’ll be required either to provide her with health-care coverage, which the Affordable Care Act will by then mandate for all employees who work at least 30 hours a week, or you’ll have to pay a $2,000 penalty for failing to cover her. Or, you could just cut her weekly hours to 29. That way, you won’t have to pay a dime, in either insurance costs or penalties. This thought, not surprisingly, has crossed the minds of quite a number of employers. Right now, the average number of hours an employee in a retail establishment works each week is 31.4 . And a whole lot of Americans work in retail—just slightly over 15 million, according to the latest employment report , out Friday, from the Bureau of Labor Statistics (BLS). Not all of them work hours that hover just over 30, of course, but the UC Berkeley Labor Center has calculated that 10.6 percent of...

Why the Fight over Obamacare May Never End

Since the Affordable Care Act was passed in early 2010, I've held more than one opinion on just how the American public will feel about it as time goes by. Initially, perhaps influenced by the momentousness of the Act's passage, I wrote that once it was implemented, it would be much harder for Republicans to attack. They would no longer be able to frighten people with phantoms of death panels, and instead would have to talk about reality. Since people would have their own experience with the law to judge from as opposed to some hypothetical future, the attacks would lose their potency, Republicans would back off, and the law would rise or fall in public esteem on its own merits. Then I began to have second thoughts. One of the biggest problems, which I wrote about a few months later, is that Obamacare isn't a single program like Medicare that people can come to love. It's a whole bunch of pilot programs and new regulations, many of which involve private insurance or existing programs...

The Unending War on Obamacare

Flickr/Fibonacci Blue
I'm not a historian, so maybe there's something I don't know, but it seems to me that there may never have been a piece of legislation that has inspired such partisan venom as the Affordable Care Act. Sure, Republicans hated Medicare. And yes, their rhetoric at the time, particularly Ronald Reagan's famous warning that if it passed, "We are going to spend our sunset years telling our children and our children's children, what it once was like in America when men were free," was very similar to what they now say about Obamacare. But once it passed, their attempts to undermine it ran more to the occasional raid than the ongoing siege. I bring this up because Kevin Drum makes an unsettling point today about the future of Obamacare: No, my biggest concern is what happens after 2014. No big law is ever perfect. But what normally happens is that it gets tweaked over time. Sometimes this is done via agency rules, other times via minor amendments in Congress. It's routine. But Obamacare has...

Obamacare's Delicious Ironies

We don't have health insurance, suckers! (Flickr/Elvert Barnes)
As the various "gangs" in the House and Senate were writing their immigration proposals, it became clear that to win the support of Republicans, the provisional legal status undocumented immigrants were going to get had to be punitive. No coddling those law-breakers; if they're going to get on a path to citizenship, it had better be an unpleasant path. It had to last for a long time—ten years, in the end. And there had to be a requirement that during that time, you couldn't get any federal benefits like food stamps or welfare. But this has produced a rather amusing irony. Republicans insist that one of the benefits those with provisional status must be barred from receiving is the subsidies that people of moderate incomes will get through Obamacare to buy insurance. As you'll recall, Republicans also believe that Obamacare's individual mandate is the most oppressive, liberty-destroying policy in the history of the republic; for instance, Wisconsin senator and Ayn Rand acoloyte Ron...

The Gosnell Case and the Two Kinds of Media Criticism

Fox is on it.
As you might have heard, conservatives are up in arms that the trial of Kermit Gosnell, the Philadelphia abortion doctor charged with multiple murder counts, hasn't gotten more coverage. They claim that the media have ignored the story because of their pro-choice bias. You should read Scott Lemieux's five lessons of the case, but a lot of liberals have been shaking their heads over conservatives' complaints, because the right's argument about the case is wrong in almost every one of its particulars. The truth is that though there hasn't been a lot of coverage in the mainstream media until now, many feminist writers have written about the case at length. And what allowed this horror to happen is exactly what conservatives want more of: a system where there are few (or no) legitimate abortion providers, sending poor women with few options to the back alleys, where they can be preyed upon by people like Gosnell. But I want to talk about the media angle to all this. As Kevin Drum points...

Five Lessons from the Gosnell Abortion-Clinic Controversy

WikiMedia Commons
The hot conservative story of late last week, starting with a USA Today op-ed by Kristen Powers, was the failure of the mainstream media to cover the horrifying case of Kermit Gosnell, a Philadelphia doctor accused of committing infanticide, and maiming and, in some cases, killing his patients (most of them poor women) in an unsanitary abortion clinic. Perhaps the story does deserve more coverage than it has received, but the lessons to be drawn from it are different from the conclusions conservatives are making. Here are five points currently being overlooked in the coverage of the controversy. Feminists Were on It Whether the mainstream national media has given adequate attention to the Gosnell case is a matter of judgment, although claims that it's been entirely ignored are incorrect. (Consider, for example, Sabrina Tavernise's lengthy New York Times story from 2011.) But it should be remembered who hasn't been ignoring the story: feminist writers . Many prominent feminists, for...

The President's Morning After

Getty Images/Joe Raedle
Getty Images/Joe Raedle L ast Friday, Judge Edward Korman ruled that the federal government must abide by U.S. Food and Drug Administration (FDA) recommendations and make emergency contraception available over the counter without age restrictions. Cue the freak-out about girls having unprotected orgies followed by Plan B snorting parties. Emergency contraception, often referred to as “the morning-after pill,” or by its brand name, Plan B, is designed to be taken in, well, emergencies—the condom breaks, you got carried away in the moment and didn’t ever quite get to the birth control, or in cases of sexual assault or coercion in which the victim doesn’t have much choice about contraception. Plan B was first approved by the FDA for prescription use in 1999. But the prescription requirement is onerous for several reasons, not the least of which is that the later emergency contraception is taken, the less effective it is; it loses any reasonable odds of working after about three days...

On Abortion, the GOP Tacks Right

Flickr/Paul Weaver
In March of 2012, Virginia governor Bob McDonnell was in trouble. The Republican-dominated state legislature had passed a measure that would require women seeking abortions in the early stages of pregnancy to have a transvaginal sonogram—a procedure in which a wand is inserted into the vagina. Pro-choice activists jumped on the bill, calling it “state-sanctioned rape.” The outrage went national, and the conservative governor with aspirations to higher office backed off. A version of the sonogram bill did make it into law, but it does not specifically require transvaginal sonograms, just the better-known “jelly on the belly” type. The debacle was only the beginning of Republicans’ problem with women voters. Two Senate candidates—most famously Todd Akin of Missouri—aired shockingly unscientific views about how pregnancy worked, generating a strong backlash from voters. Elsewhere, cuts defunding Planned Parenthood and women’s health programs only made the perception that Republicans are...

Prospects for Legal Marijuana? Higher and Higher

Flickr/Torben Bjørn Hansen
Anyone who still saw the marijuana-reform movement as a hopeless collection of hippies and slackers got a reality check last November, when advocates successfully passed three major initiatives. Massachusetts became the 18th state to allow for medical marijuana and, most notably, Washington and Colorado became the first two states in the country to legalize recreational use of the drug. Now, less than five months later, a slew of pro-marijuana measures has been introduced in legislatures across the country. At least six have a good chance of passing. Seventeen states have bills to allow medical marijuana. Nine others would make the punishment for possession a fine rather than jail time. Eight states' bills would create a taxing and regulatory system for the drug. And those are just the measures that have already been introduced; others are yet to come. Traditionally, most major progressive changes to drug laws have occurred through ballot initiatives rather than the legislative...

When Public Is Better

Flickr/Mirsasha
L ong before we thought of founding The American Prospect in 1989, I came to know Paul Starr through a prescient article titled “Passive Intervention.” The piece was published in 1979, in a now-defunct journal, Working Papers for a New Society . As Paul and his co-author, Gøsta Esping-Andersen, observed, the American welfare state is built on terrible, even disabling compromises. Progressives often lack the votes to pass legislation to deliver public benefits directly. So they either create tax incentives or bribe the private sector to do the job, thus inflating a bloated system. “The problem is not too much government activism,” they wrote, “but too much passivity.” Their two emblematic examples were housing and health care. In housing, tax advantages became an inflation hedge for the affluent and drove up prices. Low-income homeownership programs, run through the private sector, had huge default rates. In health care, the political compromises necessary to enact Medicare excluded...

How to Survive a Miracle

A World AIDS Day display in Mississippi on Dec. 1, 2009. (AP Photo/MSU, Kenny Billings)
This week, a baby from Mississippi was “functionally cured” of HIV after doctors treated her aggressively from the time of her birth with anti-retroviral medications. It's the first time a patient’s system has been cleared of the disease with a regular HIV treatment regimen designed to disrupt the ability of the virus to replicate itself. It opens the door for new research that could, theoretically, lead to a cure for AIDS. But while the breakthrough illustrates how far we’ve come in treating the virus since it was first identified three decades ago, it's also a stark reminder of how little progress we’ve made in fighting the spread of the disease. In the dark days of the 1980s, AIDS patients often found themselves turned away from emergency rooms by fearful hospital administrators, and politicians debated putting HIV-positive people into permanent quarantine. The Oscar-nominated documentary “ How to Survive a Plague ,” which has recently been optioned by ABC for a mini-series, shows...

The Once and Future Gov

AP Photo/Eric Risberg
AP Photo/Eric Risberg A merica’s most futuristic governor seems borne back ceaselessly into the past these days. As he shows me around his office on a crisp winter morning, California Governor Jerry Brown points out not just the desk that his father, Edmund “Pat” Brown, used during his own term as governor from 1959 to 1967 but also photos of his grandparents and his great-grandfather, who came to California in the gold rush years. “He knew John Sutter,” Brown says. The only two governors in the past half-century who were native Californians, he points out, were he and his father. At 74, Brown has lost little of the intensity that impressed and occasionally discomfited voters during his first tenure as governor nearly 40 years ago. His outfit—an open-collar shirt under a white pullover sweater, blue jeans—may be West Coast casual, his shaved head may call to mind the Zen monks with whom he’s studied, but Brown’s emotional repertoire does not include laid-back, except when he’s talking...

The Sequester: A Mental-Health Crisis

Flickr/ranchocanyon
Flickr/ranchocanyon I f you've been reading The New York Times , The Washington Post and hearing statements by Republicans denouncing the sequester "hype," you may have been lulled into thinking that it won't be so bad after all. The country has apparently reacted with a "collective yawn" to the $85 billion across-the-board cuts that began last Friday, the Associated Press proclaims. "The sword of Damocles turns out to be made of Styrofoam," the Times reports. But the sword feels much sharper for families, advocates, and local officials who rely on government funding to treat and care for those with mental illness. Starting April 1 , cuts to the Mental Health Block Grant program alone will deprive over 373,000 seriously mentally ill and seriously emotional disturbed children of services, according to a White House fact sheet . Experts also say that nearly 9,000 homeless people with serious mental illness won't receive the outreach and social-work assistance offered by PATH , a vital...

Republican Rationality on Medicaid

Rick Scott, who surprised everyone and did the right thing. (Flickr/Gage Skidmore)
Florida governor Rick Scott, with his skeletal frame, shiny bald pate, nine-figure fortune possibly obtained at least partially through Medicare fraud, and love of humiliating poor people, resembles nothing so much as a comic-book villain. So it was something of a surprise when he announced yesterday that he is reversing his previous position and will allow poor Floridians to receive Medicaid coverage as provided for in the Affordable Care Act. It isn't hard to explain why: the federal government is paying 100 percent of the cost of new enrollees in the first few years, and nearly all the cost thereafter, meaning for a small investment on the state's part it gets a healthier, happier, more productive citizenry. Only a truly despicable politician would turn it down, preferring to see their constituents go without health insurance than get it from the government, as I've argued (OK, "raged" is more like it) before. After the Supreme Court said it its Obamacare decision that states could...

Guns—Not the Mentally Ill—Kill People

Flickr/JenXer
Flickr/JenXer A fter a year of violent tragedies that culminated with the elementary school shooting in Newtown, Connecticut, America is finally having a conversation about gun control. For the many who want to decrease access to firearms in the wake of several mass shootings, new laws being proposed around the country to limit and regulate guns and ammunition represent a momentous first step. But running through the gun-control debate is a more delicate conversation: how to handle mental-health treatment in America. Among both Democrats and Republicans, in both the pro-gun and anti-gun lobbies, there’s a widespread belief that mental-health treatment and monitoring is key to decreasing gun violence. Shining more light on the needs and struggles of the mentally ill would normally be a positive change; mental-health programs and services have been cut year after year in the name of austerity. But in the context of gun violence, those with mental illness have become easy scapegoats...

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