Health Care

How District Lines Just Kept 400,000 Poor and Middle Class Virginians From Getting Health Coverage

Flickr/Taber Andrew Baln
Yesterday, the Virginia legislature passed a budget that once again rejected Governor Terry McAuliffe's call to expand Medicaid under the Affordable Care Act, which would have given health insurance to 400,000 Virginians who are currently uninsured. We don't have to go over all the specious arguments made by expansion's opponents, or delve into the details of the billions of federal dollars and economic benefits that the state is giving up. The question I want to address at the moment is, in a state that everyone acknowledges is trending blue, how does this happen? Particularly when even many strongly conservative states are coming around to expanding Medicaid? At one level, the answer is that Virginia's elected Republicans are a particularly cruel bunch, who like Republicans elsewhere would happily see a poor family go without coverage if it means they can give the finger to Barack Obama. But the more structural answer lies in the way district lines have been drawn there. First, let'...

Want to Fix the Jobs Crisis? Build a Federally Funded Worker Education Infrastructure

Critics are wrong when they say that, as one solution to underemployment, job training is a failure. Successful programs are plentiful, but they are small and scattered.

Photo: Paraprofessional Healthcare Institute (PHI)
Photo: Paraprofessional Healthcare Institute (PHI) Job training in cooperation with the NewCourtland Network in Pennsylvania. W ith unemployment still high, and millions discouraged from even looking for work, there is considerable interest in ways to connect people to jobs. Certainly stimulating the economy is essential to creating more opportunity. But what can we do to help people make the connections to employers who are looking for workers? Job training programs would seem to be a logical answer, a key step in moving someone from unemployment, or underemployment due to obsolete skills, into well-paying work. But there is much skepticism that training programs perform well. Reports of scandals surrounding proprietary schools with low placement and high debt feed this doubt. But focusing on these failures misses the larger point. Best-practice models exist, and are slowly diffusing. The challenge lies not in ignorance about what works, but how to reach scale in delivering quality...

Can Republicans Be Convinced to Help Improve the Affordable Care Act?

Eventually, they may find their way to ignoring this guy. (Flicir/Fibonacci Blue)
When the Affordable Care Act was passed in early 2010, people made lots of predictions about how its implementation would proceed, in both practical and political terms. While the law's opponents all agreed that it would be a disaster from start to finish, the law's supporters were slightly less unanimous, if nevertheless optimistic. Most figured that though there would probably be problems here and there, by and large the law would work as it was intended, enabling millions of uninsured Americans to get coverage and providing all of us a level of health security we hadn't known before. And that's what has happened. But there was one other assumption among the supporters that's worth examining anew, now that most of us agree the law isn't going to be repealed. Like every large and complex piece of social legislation, it was said, the ACA would have to be tweaked and adjusted over time. For instance, when it was passed in 1935, Social Security excluded agricultural and domestic workers...

What Happens When the Person Taking Care of Your Mom Can’t Earn a Living Wage?

When the Supreme Court ruled that unions could not collect dues from the home-care workers they represent, the justices set workers and their clients on a course that could harm them both.

(AP Photo/Seth Perlman)
(AP Photo/Seth Perlman) Tanya Melin of Chicago, right, Service Employees International Union members, home care consumers, workers, and allies rally in support of home care funding at the Illinois State Capitol Tuesday, Feb. 28, 2012 in Springfield, Illinois. O n June 30, the Supreme Court ruled that a key strategy used by unions to raise the earnings and professionalism of home-care workers was illegal. Since the 1990s, the labor movement has worked with states and countries to get laws or executive orders to allow home-care workers to be treated as employees of public authorities rather than as individual contractors. The result has been to allow these workers to form unions and to bargain collectively with government for better wages and working standards. In the Harris v. Quinn case, however, the Court held that workers could still unionize, but that they were not true public employees. Unions thus could not collect dues from workers who choose to remain outside the bargaining...

Still Nader After All These Years

(AP Photo/George Ruhe, File)
(AP Photo/George Ruhe, File) In this April 27, 2008, file photo, Ralph Nader speaks to supporters as he campaigns for his 2008 independent presidential bid in Waterbury, Connecticut. F or many Democrats who came of age after 2000, Ralph Nader is a crank who cost Al Gore the presidency. But Nader deserves a more honored place in the progressive pantheon. Over the years, Nader has understood the stranglehold of corporate power on democracy as well as anyone, and throughout his career he has creatively organized counterweights. In the heyday of postwar reform, the 1960s and 1970s, Nader-inspired groups prodded and energized Congressional allies to enact one piece of pro-consumer legislation after another. As both a journalist and senior Senate staffer in that era, I can attest that nobody did it better than Nader. Since then, Nader has been a prophet, often without honor in his own coalition. I should add that I go back a long way with Ralph Nader. When I was in Washington, D.C., in the...

Jindal's Assault on Abortion Rights the Latest Round in the War on Women

The Louisiana governor and 2016 presidential hopeful has signed into law a measure that would shut at least three of the state's five abortion clinics.

(AP Photo/Molly Riley)
(AP Photo/Molly Riley) Louisiana Gov. Bobby Jindal delivers the keynote address during Faith and Freedom Coalition's Road to Majority event in Washington, Saturday, June 21, 2014. UPDATE (September 1, 2014): A ruling issued on Sunday by a U.S. federal court has put on hold enforcement of the Louisiana law discussed in this commentary, which requires doctors who perform abortions to obtain admitting privileges to a hospital within 30 miles of the clinic at which they practice. Under the ruling, doctors are allowed to continue performing abortions while they seek the required privileges. I n 1973, abortion became a constitutionally protected right in the United States. But, judging from the repeated full-fledged attacks on Roe v. Wade and all the protections it provides, it's as if the anti-choice movement has been plugging their ears and singing, “La la la, I can’t hear you!” for the last forty-one years. Unfortunately, its members have proven themselves to be good at multitasking,...

Enough With 'Raising Awareness' Already

Awareness: raised. (Flickr/charlie)
And now, for your morning dose of curmudgeonly griping, I ask: Can we do away with "raising awareness" already? I suppose because I don't spend as much time on Facebook as many people, I just found out today about the "ice bucket challenge," wherein you challenge people to either pour a bucket of ice over their heads or donate to charity. It apparently started among people looking to raise awareness about ALS, and of course money. Here's a bit of explanation from Think Progress : The rules are simple: Players have 24 hours to either to pour a bucket of ice cold water over their head on camera or contribute money to the charity of their choice. After they’ve made their decision, they appoint three more people to do the same. The “ice bucket challenge” has taken social media by storm and shed light on amyotrophic lateral sclerosis (ALS), a genetic disorder also known as Lou Gehrig’s disease. Martha Stewart, Lance Bass, Matt Lauer and other notable stars have taken part in the challenge...

How the GOP's Medicaid Politics Are Hurting Rural Southerners: An Index of Harm

Republican governors, empowered by the Supreme Court, have refused federal funds for the expansion of the program that provides health care to low-income people and the poor. Here's the human cost.

©Jenny Warburg
©Jenny Warburg A protester at a 2013 Moral Monday action in North Carolina. The state's General Assembly rejected federal funds to expand Medicaid—funds that would have given coverage to 500,000 state residents without insurance. This index was originally published by Facing South , a website of the Institute for Southern Studies. Date on which Adam O'Neal, the Republican mayor of Belhaven, North Carolina, arrived in Washington, DC after walking 273 miles from his hometown to draw attention to the recent closure of his community's only hospital and to call for Medicaid expansion under the Affordable Care Act to prevent more such closures: 7/28/2014 Date on which Belhaven's hospital, Vidant Pungo, closed after a failed effort by the town to take it over: 7/1/2014 Number of days after the closure that a local resident died when she suffered a heart attack and had to wait an hour for a helicopter to take her to the nearest hospital: 4 Amount in unpaid care Vidant Pungo had provided since...

Will Electioneering From the Pulpit Be the Next Big Battle Over ‘Religious Liberty’?

Most at stake isn’t the freedom to worship or speak out, but eligibility for tax subsidies that are estimated to cost the government over $80 billion in revenues every year.

AP Photo/David J. Phillip
(AP Photo/David J. Phillip) Participants pray at The Response, a prayer rally that took place on Saturday, August 6, 2011, in Houston. Texas Gov. Rick Perry, then about to launch a presidential bid, addressed the daylong event despite criticism that the it inappropriately mixed religion and politics. This article originally appeared on BillMoyers.com , the website of the Moyers & Company television program. O n July 17, the Freedom From Religion Foundation (FFRF) settled a longstanding suit against the IRS for failing to enforce restrictions on political activities by tax-exempt churches and religious organizations. Since 1954, tax-exempt religious organizations have been barred from endorsing parties or candidates. FFRF filed its 2012 complaint in response to conservative preachers openly defying those restrictions. Since 2008, a growing number of clerics have participated in “Pulpit Freedom Sunday,” offering partisan endorsements during services. As ABC News reported in 2010, “...

How Republicans Are Heightening the Contradictions

Republican inspiration Vladimir Lenin. (Wikimedia Commons)
C ongress is going on recess at the end of this week, and they'll be doing it without a bill to address the large number of Central American children showing up at the southern border—John Boehner couldn't even come up with a bill that would pass his house after Ted Cruz convinced House conservatives to oppose it. On that issue, on the Affordable Care Act, and on other issues as well, we may be seeing the rise of a particular strategy on the right—sometimes gripping part of the GOP, and sometimes all of it—that can be traced back to that noted conservative Vladimir Lenin. I speak of "heightening the contradictions," the idea that you have to intentionally make conditions even more miserable than they are, so the people rise up and cast off the illegitimate rulers and replace them with you and your allies. Then the work of building a paradise can begin. In the end, the House GOP leadership wanted a bill that contained a small amount of money to actually address the problem, made a...

Today's Conservative Obamacare Baloney Debunked

AP Photo/Pablo Martinez Monsivais, File
If you were perusing the conservative twitter-sphere this morning, you would have witnessed a kind of collective orgasm, as it was discovered that back in 2012, MIT economist Jonathan Gruber gave a talk to a small group in which he seemed to support the analysis of the two judges on the D.C. Circuit who ruled this week in Halbig v. Burwell that the subsidies for buying health insurance under the Affordable Care Act should go only to people who live in states that set up their own insurance exchanges. Since Gruber advised Mitt Romney on the creation of Massachusetts' health reform (which became the model for the ACA) and then advised the White House and Congress during the preparation of the ACA reform, conservatives are now convinced they have their smoking gun: The law, they contend, was always designed to deprive millions of Americans of subsidies, and was in fact never meant to achieve that "universal coverage" that everyone involved said was its goal. Up to the point where the...

Health Insurance for Millions Threatened; Republicans Celebrate

If this woman looks familiar, your insurance coverage might be at risk.
When news broke this morning of the decision by a three-judge panel from the D.C. Circuit Court of Appeals in Halbig v. Burwell , which states that because of a part of one sentence in the Affordable Care Act that was basically a typo, millions of Americans should lose the federal subsidies that allowed them to buy health insurance, I'm pretty sure a similar scene played out all around Washington. As word spread through the offices of conservative think-tanks, advocacy groups, and members of Congress, people gathered around TVs or computer screens, quickly taking in the decision. And there were smiles, laughter, maybe even a few high-fives and fist-pumps. Not long after, a second appeals court handed down an opposite ruling on the same question. (If you feel like you don't understand the issue, the rulings, and the implications, I'd recommend Ian Millhiser's explanation .) We won't know for some time whether the Supreme Court will hear these cases and. if it does, it's hard to predict...

Good Obamacare News and the Republican Dilemma

Today the Commonwealth Fund released a new survey on the performance of the Affordable Care Act, and it adds yet more data to the tide of good news on the Affordable Care Act. As a number of people have noted, the law's evident success is making it increasingly hard for Republicans to sustain their argument that Obamacare is a disaster and must be immediately repealed. But it's actually a little more complicated than that, and the ways different Republicans are changing—or not changing—their rhetoric on health care is a microcosm of the GOP's fundamental dilemma. But before we get to that, let's look at what the survey showed: The uninsured rate for people ages 19 to 64 declined from 20 percent in the July-to-September 2013 period to 15 percent in the April-to-June 2014 period. An estimated 9.5 million fewer adults were uninsured. Young men and women drove a large part of the decline: the uninsured rate for 19-to-34-year-olds declined from 28 percent to 18 percent, with an estimated 5...

Justice Samuel Alito's Deep Roots in the American Right

He's the most pro-corporate jurist on the Supreme Court. So decisions that grant companies religious rights or take aim at labor unions come quite naturally to him.

AP Photo/Manuel Balce Ceneta
AP Photo/Manuel Balce Ceneta) U.S. Supreme Court Associate Justice Samuel Alito Jr., delivers his remarks during a Federalist Society dinner gathering, Thursday, Nov. 16, 2006, in Washington. This article originally appeared at The Huffington Post . S upreme Court Justice Samuel Alito ended this Supreme Court session with a bang, writing the majority opinion in two cases that gave for-profit corporations the right to make religious liberty claims to evade government regulation, and set the stage for the fulfillment of a central goal of the right-wing political movement: the destruction of public employee unions. Neither of the decisions was particularly surprising. Samuel Alito is the single most pro-corporate Justice on the most pro-business Court since the New Deal. Still, Alito's one-two punch was another extraordinary milestone for the strategists who have been working for the past 40 years to put business firmly in the driver's seat of American politics. Many would suggest that...

Health Insurance Is Not a Favor Your Boss Does For You

Flickr/Dani Armengol Garreta
The debate over the Hobby Lobby case has been plagued by many problematic presumptions, but there's one that even many people who disliked the decision seem to sign on to without thinking about it. It's the idea that the health insurance you get through your employer is something that they do for you—not just administratively, but in a complete sense. But this is utterly wrong. You work, and in exchange for that labor you are given a compensation package that includes salary and certain benefits like a retirement account and health coverage. Like the other forms of compensation, the details of that insurance are subject to negotiation between you and your employer, and the government's involvement is to set some minimums—just as it mandates a minimum wage, it mandates certain components health insurance must include. Those who support Hobby Lobby are now talking as though mandating that insurance include preventive care is tantamount to them forcing you to make a contribution to your...

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